INTERNATIONAL HEALTH FORUM HELD AT MUMBAI

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Title: INTERNATIONAL HEALTH FORUM HELD AT MUMBAI
extracted text: RF_COM_H_79_SUDHA

MUMBAI DECLARATION
Of the People’s Health Movement
Released on the 25th Anniversary of Alma Ata
At the III International Forum for the Defense of the People’s Health
Mumbai, India
14-15 January 2004
PREAMBLE: We, the 700 persons from 50 countries, gathered at the III International
Forum for the Defense of the People’s Health, hereby affirm the People’s Health Charter.
We celebrate and are inspired by testimonies we have heard in this forum. In the spirit of
Health as a Human Right and Comprehensive Primary Health Care, participants have
spoken about their actions to confront and change the tragic health reality threatening our
lives and the future of our world. As signaled by the Million Signature Campaign, we
demand Health for All, NOW.

ANALYSIS of Current Threats and Gains: We, the representatives of the People’s Health
Movement gathered for the III International Flealth Forum for the Defense of the
People’s Health, insist upon recognition of the social and political determinants of health,
specifically:
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Health is a basic, fundamental human right. We welcome the pronouncement of the
WHO to return to its original constitution and its commitment to the Alma Ata
Declaration on Primary Health Care;
The forces of corporate-led globalisation are violating our human right to health. The
impositions on countries of the International Monetary Fund, the World Bank and the
World Trade Organisation (through trade agreements such as the Trade Related
aspects of Intellectual Property Rights, TRIPS and the General Agreement on Trade
in Services, GATS) have contributed significantly to the current global health crisis.
Privatization of basic needs and resources, from water to electricity to education,
including healthcare through so-called Health Sector Reform, is having a highly
negative impact on health;
Poverty is a form of structural violence and is a public health issue;
Poverty exists in developed countries (including Germany and the USA) as well as
developing countries and is a major cause of poor health;
Malnutrition remains a major killer throughout the developing world, and a problem
within marginalized populations of the developed world;
Poverty reduction strategies, such as those set forth in policy papers such as WHO’s
“PRSPs” fail to address corruption, gender-bias, and the rise of non-communicable
diseases;
Small farmers, fisherfolk and indigenous peoples are among those who suffer the
most from corporate-led globalisation policies;
War, occupation and militarism are devastating to health;
Anti-war actions (against the occupation of Iraq and Palestine, against the Wall in
Palestine, etc.) are pro-health;

Currently the WTO often determines global health priorities through trade
agreements, while the WHO has historically refrained from involving itself in traderelated health issues;
The Doha Agreement of the WTO expressed the will of the world’s countries to be
able to put the health of their people as a higher priority than trade agreements.
However, soon after its inception, the Doha agreement began to suffer multiple
ongoing efforts to weaken health as a priority. The Doha Agreement has yet to be
implemented;
Tobacco kills, and yet transnational tobacco companies continue to directly target
youth and marginalized in their tobacco marketing strategies, especially in the
developing world and the inner-cities of the developed world;
Liberation Medicine is the conscious, conscientious use of health to promote social
justice and human dignity. Paradoxically, doctors and other health professionals often
obstruct efforts toward comprehensive primary health care. Optimal health promotion
emphasizes child-happiness and inclusive respect for elders and traditions;
Public-private partnerships represent an insidious form of privatization that removes
responsibility for health from the public sector, while treating health as a commodity
rather than a human right. The WHO’s initiatives on public-private partnerships lack
transparency and public accountability;
The Basic Human Needs Approach, as practiced in Iran through Health Houses and
“Well-Being Promoters,” represents an exemplary form of comprehensive primary
care;
Selective and vertical health programs have corrupted and weakened the concept of
comprehensive primary health care as defined in the Alma Ata Declaration. They do
not take into account the expressed needs and priorities of the community;
Structural Adjustment Programs, SAPS, have adversely affected public sector
services, especially health;
Multi-disciplinary Health Teams are very effective in the practice of comprehensive
primary health care;
Community Health Workers, chosen by their own communities and given adequate
training, back-up and referral mechanisms, have proven to be excellent at providing
comprehensive primary health care;
Health professionals educated in the developing world and migrating to the developed
world represent a transfer of billions of dollars South to North, due to the investment
in training. Their departure further burdens health systems already suffering from a
precarious lack of human resources. This so called “brain drain” is not only from
developing countries to developed countries, but also exists within developing
countries from the public to the private sector;
There is gross inadequacy of medical education on subjects such as gender, ethics,
comprehensive primary health care, and the realities of poor and marginalized;
Traditional and Alternative Systems of Medicine are a vibrant part of Comprehensive
Primary Health Care.
Traditional birth attendants form the first and often the only access to reproductive
health in many areas of the world. They and their knowledge and traditions should be
validated and their skills reinforced with continuing education, including women’s

rights and prenatal care. They should also be provided with materials to do their jobs
and given adequate back-up for difficult and emergency cases.
H1V/AIDS is spreading along the routes of migration and linked to the influx of
capital related to globalization. HIV/AIDS is Africa’s major health emergency.
HIV/AIDS has been associated with the resurgence of other communicable diseases,
such as tuberculosis. Millions of children, especially in Africa, have been orphaned
by HIV/AIDS, representing a major public health problem. Women are the most
affected culturally, socially and economically by the HIV/AIDS epidemic;
HIV/AIDS in Latin America and the Caribbean, in an ambiance of machismo
attitudes toward women’s rights and taboo around speaking of same-sex coupling, is
a ticking bomb. The window of opportunity for education and enlightened policy to
prevent a major Latin American epidemic is closing if not already shut;
Shaming of the pharmaceutical companies into dropping legal action against the
South African government around anti-retroviral medications is a victory for Health
as a Human Right.
The WHO has made an official commitment to pursue its 3 X 5 (three million persons
with AIDS receiving ARV treatment by the year 2005) through comprehensive
primary health care. However, providing access to ARV’s remains a complex and
very difficult process requiring a stepwise approach. We are concerned that the 3 by
5 initiative address the following challenges:
A focus on treatment alone, can ignore the complexity of the epidemic
High costs and long-term dependency on donors
Inadequate involvement of NGOs and the patients themselves in planning and
implementation
- Failure to address the need for improved infrastructure to provide drugs and
general health services.
We emphasise that ARVs must be delivered through a comprehensive primary heath
care model. Programs to address the HIV/AIDS epidemic require contextual
solutions emphasising availability and effectiveness of drugs, and availability,
effectiveness and efficiency of basic services, especially in areas where people
continue to die of malaria and tuberculosis;
Violence against women is a major public health issue;
Past population policies have involved such reprehensible practices as forced
sterilization of women. Population control policies including the use of disincentives
violate human rights. Newer contraceptives and reproductive technologies often
ignore women’s health hazards, and ethical and moral issues, in their practice;
Many women around the world lack access to basic health care, endangering them
and their families. Women’s right to health, including sexual and reproductive
health, is violated not only by current socio-economic and political structures but also
by religious and cultural fundamentalism;
Trafficking of women and girls is a major public health problem, little addressed by
governments where the trafficking is most rampant;
Technology is misused to discriminate women as seen in sex selective abortion;
Rights of sexual minorities, sex-workers and the mentally challenged and their access
to health care are not being addressed adequately;

The caste system and its vestiges in India have brought an atrocious health and human
rights reality for the Dalit;
Indigenous peoples around the world, including those who live within developed
countries, suffer terribly poor health indices, often double or more those of the
general population of the country in which they reside. Further, they are loosing their
traditional knowledge and traditional systems of medicine. They are forced to follow
the hegemonic cultural system;
The health and other human rights of persons with disabilities are currently ignored or
inadequately addressed throughout the world. Yet we are encouraged by the example
of Palestine, where many persons with disabilities have organized to defend and
promote their own health and human rights;
Migrant workers around the world, including those living and working within the
developed world, suffer poorer health indices than the general population. Migrants
are deprived of their rights in both countries of origin and destination as they lack
access to basic services such as health, education, etc. and suffer other violations of
their human rights;
Discrimination against children in difficult circumstances, such as the street children,
increases with the rising poverty associated with globalization;
Children in difficult circumstances dream of being self-reliant and of having
livelihoods in the future;
The health of all children and youth should be guarded carefully, with strategies
emphasizing their happiness, celebrating their cultural traditions and including the
prevention of disease;
Privatisation of social sector services which should have continued under state
responsibility also leads to uncontrolled accumulation of private wealth at the
expense of people’s health. Privatisation of health care services leads to weakening
of health systems and resurgence of diseases. User fees further decrease people’s
access to health care services;
Monitoring efficiency of health systems has become the essence of health sector
reforms without considering issues of efficacy, effectiveness and equity;
Mental health problems often result in stigma. The links between mental health
problems, poverty, gender and human rights issues are not being properly addressed;
Environment, livelihood, and people’s health are interconnected;
Environmental degradation and loss of livelihoods have a highly negative impact on
health;
Rivers around the world, like the Abra in the Philippines, like the Narmada in India,
are in danger of being destroyed, as are lives and health of those persons and
communities who depend on these rivers;
Toxins, in the form of pesticides, fertilizers, defoliants (such as Agent Orange and
those used in the Amazon as part of the so-called “Anti-Drug” war of Plan
Colombia), waste from US Military Bases (such as those in the Philippines), dust
from exploded depleted uranium ordinance (such as that used in Iraq and Vieques,
Puerto Rico) and medical and nuclear waste as well as mining run-off and
exploitation for petroleum are poisoning our environment and represent a critical
hazard to the health of our lives and communities throughout the world;

CHALLENGES: We, representatives of the People’s Health Movement gathered for the III

International Health Forum for the Defense of the People’s Health, call on:
Civil society to:
• Build solidarity to fight globalisation;
• Establish peace initiatives at various levels based on justice and equality;
• Take the anti-war forward with innovative actions such as:
- The global campaign on “No to War, No to WTO, Fight for People’s Health;
Setting up a global “Occupation Watch” to monitor the impact of war, occupation,
militarization and conflicts;
“Boycott Bush” campaign targeting multinationals which benefited from the Iraq
invasion, industries (i.e. pharmaceutical and food companies) that enrich
themselves while contributing to ill-health;
• Support and promote campaigns on women’s access to health care;
• Address the negative impact on women of current practices of polygamy;
• Campaign on No To Intellectual Property Rights (IPR), including medicines and
seeds, which are our life and our future;
• Include Liberation Medicine in health professional education (emphasizing a value
based. holistic and multi-disciplinary approach) and practice (liberating ourselves
from oppressive concepts and accompanying others in their own liberation);
• Doctors and other health professionals must be encouraged to be part of, rather than
to obstruct, the struggle for health and social justice;
• Work towards Health for All Now, joining the Million Signature Campaign for
Health as a Human Right;.
• Stop tobacco companies from targeting youth and minorities;
• Struggle to strengthen the concept that the health of the people is a higher priority
than trade agreements;
• Pressure the World Bank and the International Monetary Fund to acknowledge their
culpability in the current health care crisis, especially the damage caused by
Structural Adjustment Programs (SAPs);
• Incorporate Comprehensive Primary Health Care promotion into the curriculum of all
health professionals;
• Preserve health-related traditions, while preventing the patent-right robbery of healthrelated traditional medicines by pharmaceutical corporations;
• Demand for representation of people’s organisations in policy-making processes such
as the FCTC;
• Resist the efforts of the WTO and transnational corporations to own and trade in our
traditional systems of medicine and to own and patent our seeds;
• Develop and strengthen efforts by communities to collect data on:
Processes of organizing and mobilizing media campaigns, advocacy for legal
avenues and pressure for policy reforms
Monitoring environmental damages caused by local and transnational industries,
such as pesticides, toxic waste products from military bases, etc.;

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Hold corporations and governments accountable for the damage they have done to the
environment.
Develop a comprehensive approach to address the HIV/AIDS epidemic by having a
range of interventions, including:
- promote peer education
- decrease the stigma against people living with HIV/AIDS
increase access to basic services by people living with HIV/AIDS
make ARV drugs available now
- rebuild the lives of those affected by the epidemic by strengthening and
empowering them;
Pressure media to play a more positive role in the promotion of good health;
Promote access to essential drugs in various ways, including public pressure on
individual governments as well as inter-governmental bodies such as the UN and the
WTO.

Governments to:
• Incorporate and ensure women’s access to health care in national health policies and
programmes;
• Address health needs and rights of women who are victims of trafficking, especially
in destination countries;
• Include sex-ratio at birth, infant mortality rate and gender differential as basic
indicators of development;
• Have a national policy on traditional medical systems and include them in national
health programmes;
• Regulate the corporate sector in the social services such as health, education,
transportation, etc.;
• Involve the marginalised sectors in decision making regarding policies affecting
them;
• Respect the people’s right to ownership of natural resources;
• Strengthen health care systems to respond to health care needs
-no to cost recovery
-no to privatization
-yes to solutions addressing the intemal/external brain drain of health professionals
and health care workers
-yes to having a national policy on traditional medical systems and including them in
national health programs;
• Include sexual and reproductive rights into all Primary Health Care Initiatives;
• Sign, ratify and implement the Framework Convention on Tobacco Control (FCTC);
• Desist if present coercive, women’s-rights-unfriendly policies for population control
• Strengthen and expand community-based primary care programs.

The People’s Health Movement to:
• Recognise and include in the People’s Health Charter challenges and new
developments;
• Include the following issues in the People’s Health Charter:

Ecological/environmental health
Traditional medicines
Rights of the disabled and of marginalized groups
Tobacco control
> Expose, shame and stop government officials, academic institutions, and civil
society organisations from accepting money from the tobacco industry
> Be vigilant over the tobacco industry’s tactics to undermine public interest
initiatives internationally and nationally
> Regulate the tobacco product and the tobacco industry
> Demand from governments to allocate resources for tobacco control
> Include tobacco control in Primary Elealth Care programs
> Demand for governments to ratify and implement the Framework Convention
on Tobacco Control (FCTC)
> Demand for active participation of people’s organisations, health workers,
farmers in the implementation of the FCTC
Address gender inequities in all advocacy efforts for Health for All;
Analyse the disease burden related to industrialisation;
Resist “TRIPS-plus” through bilateral or regional agreements driven by the United
States government;
Link with other civil society organisations working on environmental justice at the
grassroots, national and international levels. Join them in their struggles and invite
them to join in our struggle for the People’s Health;
Consciously incorporate marginalized populations, the “unheard and unseen” groups,
into the People’s Health Movement and build a strong network with them facilitating
their access to mainstream discourse.

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CONCLUSION: Another World, which includes Health for All, is Possible. We must all
join in the struggle to make that world of Health for All a reality, Now.

PROGRAMME
Date/ Time/
Session
DAY ONE(IHF)
14th January 2004
9.00-11.00

Inaugural Plenary
Part I

Programme
Overview on Confronting the Challenge of Globalisation through Health Work:
Perspective, Struggles and Strategies

Chair: Zafrullah Chowdhury (Bangladesh)
Moderator: Sarojini (India)
1) Opening with Campaign Songs (10 mins)

2) Welcome and Introduction - Amit Sengupta (India) (15 mins)
3) Two Keynote Presentations (60 mins)
a) Globalization - A Macro Perspective - Walden Bello (Philippines)
b) Linkages between Globalization and Health - David Legge (Australia)
4)

Brief Overview of People’s Health Movement and the Main Challenges before it
in Response to the Threat of Globalization - Ravi Narayan (India) (15 mins)

5)

Interactions from the floor

11.00-11.30

14th January 2004
11.30-13.30

Break
Chair: N. H. Antia, PHM (India)
Moderator: Maria H. Zuniga, PHM /IPHC (Nicaragua)
1)

Inaugural Plenary
Part II

Panel: Regional Challenges, Struggles and Role of PHM (75 mins)
a) Asia - Edelina De La Paz (Phillipines)
b) Africa - Mwajuma Masaiganah (Tanzania)
c) Americas- Arturo Quizhpe (Ecuador)
d) Europe - Pamela Margaret Zinkin (UK)
e) India - Abhay Shukla (India)

2) Some brief Country Case Studies (30 mins)
a. PHM Italy
b. PHM Bangladesh
c. Others

3) Interactions from the floor
13.30-14.30
14.30-16.30

14th January 2004
14.30-16.30

Lunch
Parallel Plenaries
A) Globalisation, Health Policies and Health Sector Reforms

Chair:
Moderator: Sundararaman (India)
1)

Testimonies:
a) Privatisation and Healthcare - Evelyne Hong (Malaysia)
b) Poverty and Health in USA -Tara Colon/ Jen Cox, KWRU (USA)
c) Privatisation of Electricity: Impact on the Health of the Poor in Industrialised
Countries - Fran Baum (Australia)

2)

Keynote a) "A World without World Bank and IMF - The Cuban experience of Health
for All" - Aleida Guevara March (Cuba)

Parallel
Plenary 1A

b)

3)

Globalisation and Health - Issues and Alternatives - Antonio Tujan
(Philippines)

Round Table - Globalisation and Health
Imrana Qadeer (India)
David Sanders ( South Africa)
Tissa Vitarana (Sri Lanka)
Julie Ancian, MDM - GATS and access to health

4) Interactions from the floor

14th January
2004
14.30-16.30

B) Health under War, Occupation and Militarization

Chair: Babu Matthew, NLSIU / NAPM (India)
Moderators: Unnikrishnan (India) / Ghassan Hamdan (Palestine)
1) Welcome, Introduction

2) Key note address:
Edgar Isch Lopez (Ecuador)

Parallel
Plenary 1B

3) Voices from the field:
a) Palestine - Jihad Mashal
b) Gujarat - Renu Khanna (India)
c) Vietnam: Impact of agent Orange
d) Iraq - Hanna Edwards
e) Iraq - Clara Kim (South Korea)
f) Afghanistan
g) Mindanao - Reginald Pamugas (Philippines)
h) Africa - MalachLOpule Orondo (Kenya)
i) The Cambodian experience - Chiv Bunthy, CHC (Cambodia)
4) Interactions from the floor

16.30-17.00
17.00-19.00

14th January 2004
17.00-19.00

Break
Parallel Workshops
Globalisation and Health Policy

Chair:
Moderator: Anant Phadke (India)
Parallel
Workshop 1

14th January 2004
17.00-19.00

1)

Testimonies
a. Gleevec campaign against Novartis - Clara Kim (South Korea)
b. National Trust fund for Health and Community Mobilisation for Health For All
- Jagdish Goburdhan / Ita Sohan (Mauritius)
c. Trade Union campaign on Right to Health Care - Nicola Delussu (Italy)

2)

Panelists:
a. Securing the Right to Health - Julio Monsalvo (Argentina)
b. WHO or WTO - who determines global health priorities?- Armando de Negri
Filho (Brazil)
c. TRIPS and Access to Essential Medicines- Olivier Brouant, MSF (India/
Belgium)
d. Global Equity Gauge Alliance - Alexandra Bambas (GEGA)

3)

Interactions from the floor

Promoting Synergy: Towards joint Anti - war action

Chair:

Moderators: Unnikrishnan (India) / Ghassan Hamdan (Palestine)

Parallel
Workshop 2

1) Keynote: Bert Beider (Belgium)

2) Voices from the field:
a) Stop the War Coalition UK
b) Resistance in Palestine
c) Anti War effort in South Asia - Sandeep Pandey (India)
d) No money for War: Boycott Bush campaign - Pol d’ Huyvetter, Mother Earth
(Belgium)
e) Sri Lanka Peace Initiative -Vinya Ariyaratne (Sarvodaya, Sri Lanka)
f) Global SOS from a coalition of San Fransisco Bay Area Anti-War Groups Jeff Conant (USA)
3) International Resistance and Local Actions - ILPS, Philippines
4) Interactions from the floor

14th January 2004
17.00-19.00

Learning from the Global Tobacco Control Campaign - including FCTC
Chair: Surendra Shastri (India)
Moderators: Carmelita C. Camla (Philippines) & Shoba John (India)

Parallel
Workshop 3

1) Testimonies:
a) Community in Health Promotion - Sehra Sajjadi (Iran)
b) Youth in Tobacco Control Campaign - Bobby Ramakant (India)
c) Fighting Transnational Tobacco Companies - Olufemi Akinbode (Nigeria)
d) The Canadian Way to Innovative Tobacco Control Policies - Atul Kapur
(Canada)

2)

Round Table (FCA / PATH Canada / PHM and AFTC):
a) Relevance of Tobacco Control within the context of Social Development Prakash Gupta (India)
b) FCTC - An international and legal perspective - Patricia Lambert (South
Africa)
c) FCTC -Entitlements and Lessons - Shoba John (India)
d) People’s Health Charter & Tobacco Control - Carmelita C. Canila
(Philippines)

3) Interactions from the floor
4) Suggestions for the People's Health Charter

14th January 2004
17.00-19.00

Parallel
Workshop 4

14th January 2004
17.00-19.00

Liberation Medicine - Bringing together experiences of the conscious,
conscientious use of health to promote social justice and human dignity
Chair: Fr. John Vattamattom
Moderator: Lanny Smith
1)

Panelists include:
Sayeh Dashti (Iran), Roland Bani (Albania), Chris Fritsch (US) and Medico
Friends Circle (India)

2)

Interactions from the floor

Globalisation and Health Sector Reforms
Chair: Tej Walia, WHO SEARO
Moderators: Ravi Duggal (India)

1)

Testimonies:
a) Privatisation and Health - Eleanor A. Jara (Philippines)
b) A grassroots perspective - GK Health Worker (Bangladesh)
c) Insurance and Healthcare - Santanu Bhattacharjee and team, BRWS (India)

2)

Panelists:
a) Barriers to accessing health care in Africa - Harry Jeene (Kenya)
b) Public Private Interactions and Implications - Jose Utrera (Netherlands)
c) The SACHS report: Increasing the size of the crumbs from the rich man's
table - Allison Katz (PHM Geneva) by Maria Zuniga (Nicaragua)
d) Health Policy Reform for "Health for All”- Basic Human Needs Approach
(Iran) - Md. Ali Barzgar

3)

Interactions from the floor

Parallel
Workshop 5

14th January 2004
17.00-19.00
Parallel
Workshop 6

14th January 2004
17.00-19.00

Health Teams for ‘Health for All’ (including CHWs)

Chair: Qasem Chowdhury, Gono Biswbidyalay, Bangladesh
Moderator: Prem John, ACHAN (India)
1)

Testimonies:
a) CHW’s in Albania - Roland Ban! (Albania)
b) Nurses and Migration - Edelina P. de la Paz (Philippines)
c) The Great Brain Robbery - Vikram Patel (India)
d) CHW experience in Palestine (Palestine)

2)

Panelists:
a) CHWs an overview - Shyam Ashtekar (India)
b) Health teams for HFA - R.K. Boodhun (Mauritius)
c) Engendering Medical Education - Mira Shiva (India)
d) Health teams for HFA- Fran Baum (Australia)

3)

Interactions from the floor

Traditional / Alternative Systems of Medicine and Primary Health Care
Chair: Zafrullah Chowdhury, PHM (Bangladesh)
Moderator: Vijayan, GK (Bangladesh)

Parallel
Workshop 7

19.00-19.15

1)

Testimonies:
a)
Perspective of a TBA from Rajasthan - CHETNA (India)
b)
Parinchay Health Worker, FRCH (India)

2)

Panelists:
a) Integrating ASMs for Primary Health Care - The GK experience - Vijayan,
GK (Bangladesh)
b) Revitalisation of local health traditions - Darshan Shankar, FRLHT(lndia)
c) Training ofTBAs-Smita Bajpai, CHETNA (India)
d) Integrated health policy including TSM - D. Bauhadoor (Mauritius)
e) Promoting herbal medicines and ASMs - Fr. Sebastian, CHAI (India)
f) Integrating ASMs: The GBB course - Vinod, GK (Bangladesh)

3)

Responses from other countries - Niranjan Udumalagala (Sri Lanka), Hugo leu
Peren (Guatemala) and others

4)

Interactions from the floor

5)

Suggestions for the People’s Health Charter
Break

19.15-20.15

Cultural Programme

15th January 2004

DAY TWO

8.00-9.00

Interaction/ Fellowship

15m January 2004
09.00- 11.00

HIV/AIDS: Confronting the Crisis
Chair: Olle Nordberg (Sweden)
Moderators: Thelma Narayan (India)
1)

Testimonies and Regional Reflections
a) Ida Makuka (Zambia)
b) Chiranuch Premchaipon (Thailand)
c) Oblesh (India)
d) Richard Stern, Agua Buena Human Rights Association (Costa Rica)

2)

Panelists
a) HIV/ AIDS: Africa’s Health Emergency- Malach Orondo (Kenya)
b) HIV/ AIDS and Access to Drugs - Lawan Sarovat - MSF (Thailand)
c) Health Systems approach to the AIDS challenge - David Sanders,
EQUINET/IPHC (South Africa)
d) HIV/ AIDS & resurgence of communicable disease- T. Sundararaman, JSA
(India)
e) WHO: Evolving Strategy and Overview of 3 X 5 Initiative- Craig McClure /
Ian Grubb (WHO)

3)

Interactions from the floor

Plenary 2

11.00-11.30
15th January 2004
11.30-13.30

Break

Women, Population policies and Violence

Chair: Mwajuma S. Masiagana (Tanzania)
Moderator: Mira Shiva (India)
1)

Testimonies
a) Population Policies of M.P. - SAMA (India)
b) Population Policies of Rajasthan - Narendra Gupta - (India)

2)

Keynote Presentations
a) Population Policies: Mohan Rao (India)
b) Violence against women as a Public Health issue - Manisha Gupte.(India)

3)

Round Table
1) Farida Akhtar (Bangladesh)
2) Nadia (Netherlands)
3) Other country representatives

Parallel
Plenary 3 A

4) Interactions from the floor

15th January
2004
11.30 -13.30

Health Care and the Marginalised

Parallel
Plenary 3 B

1)

Testimonies
a) Adivasis and Health - C. R. Bijoy (India)

2)

Panelists:
a) Dalit issues and Health - Ruth Manorama (India)

(Access)

Chair: Medha Patkar, NAPM (India)
Moderator: Enrieo-PupulinrAIFO7~PHM~(ltaly)

b)
c)
d)
e)

3)

Health of indigenous people- Hugo leu Peren (Guatemala)
Health and people with disabilities -Anita Ghai (India)
Health care of indigenous people - Fran Baum (Australia)
Health care of migrant workers - Sajida Ally (Asian Migrants
Organisation)

Interactions from the Floor

13.30-14.30:
15th January 2004
14.30-16.30

Lunch
Key Issues in Women’s Health
Chair: Farida Akhtar (Bangladesh)
Moderator: Jaya Velankar (India)
1)

Testimonies
a) Mary Sandasi (Zimbabwe)
b) Elvire Beleoken (Cameroon)

2)

Panelists
a) Women's Access to Health Care - Nadia (Netherlands)
b) Reproductive Technologies: Mayhem on women’s bodies-Sarojini /
Manjeer, SAMA (India)
c) Trafficking, migration & labour rights - Ishrat Shamim (Bangladesh)
d) Sex Selective Abortion - Pavalam and others, CASSA, T N. (India)

3)

Interactions from the floor

4)

Suggestions for the People’s Health Charter

Parallel
Workshop 8

15th January 2004
14.30-16.30

Voices of the Unheard - Children, adolescents and people with disability
Chair: Pam Zinkin (UK)
Moderator: Vandana-Pr-asad-(-lndia)-- H

Parallel
Workshop 9

1)

f

Testimonies
a) Children's dreams through paintings and testimonies by Radio - Child to
child Arturo Peralta Quizhpe (Ecuador)
b) Mama Huaca- Dibujos Animados ( Latin America) - Video
,<&) Disability Movement in Palestine - (Palestine)

2) Panelists:
v4?a) eBR-Drsabilityan’d“Primary-Health“6are—Enr-ieoPupulin-(4taly)
b) Youth and Healthy Living - Ghassan Issa (Palestine)
3)

15th January 2004
14.30-16.30

Interactions from the floor

HIV/AIDS and the Resurgence of Communicable Diseases
Chair: David Sanders, IPHC, PHM (South Africa)
Moderator: Andreas Wulf, Medico International (Germany)

Parallel
Workshop 10

1) Testimonies:
a) HIV/ AIDS and Orphans - Jennifer Atieno (Kenya)
b) PerspectivesofPLWA-CHIN (India)
2) HIV/ AIDS in Latin America and the Caribbean - Rebeca Zuniga (Central
America)

3)

Panelists:
a) HIV/AIDS: Confronting the Crisis - WHO Team
b) Access to ARVs - Some issues - Vivek Diwan, HIV / AIDS Unit, Lawyers

Collective (India)
c) Lessons for HIV / AIDS from MCH, TB and Malaria programmes Rajarathnam Abel, CHIN (India)
4)

15th January 2004
14.30-16.30

Interactions from the floor particularly focused on civil society feedback on the
WHO proposed initiatives

Globalisation, Poverty, Hunqer and Health

Chair: Thomas Kocherry, World Forum of Fisherpeople, (India)
Moderator: Abhay Shukla, (India)
Parallel
Workshop 11

15th January 2004
14.30-17.00
Parallel
Workshop 12

1)

Testimonies:
a) Poverty in Germany: Gopal Dabade, BUKO Pharma - Kampagne
b) Tackling Malnutrition: Arogya lyakkam - Shanti, JSA Tamil Nadu (India)

2)

Panelists:
a) Veena Shatrugna (India)
b) P. Sainath (India)
c) Eugenio Villar (Peru) / Alaka Singh (WHO)
d) PRSP and Health - Atiur Rehman (Bangladesh)

3)

Interactions from the floor

New Economics and its Impact on Medical Practice in India
Chair: Sunil Pandya (India) Co-Chair: R. K. Anand (India)
Moderator: Sanjay Nagral (India)
1)

Testimony:
a) Lessons from my crusade - P.C. Singhi (India)

2)

Panelists:
a) Collapse of Public Health and rise of private medicine-B. Ekbal (India)
b) New players in the medical market - Ravi Duggal (India)
c) Struggle for regulation of private sector -Arun Bal (India)
d) Market, medicine, negligence and ethics - Sanjay Nagral (India)

3)

Responses from around the world - Pakistan, Bangladesh, Philippines, Iran,
UK, Germany, Egypt, South Africa and others

4) Interactions from the floor

15lh January 2004
14.30-16.30
Parallel
Workshop 13

Social determinants of Mental Health and PHM
“Exploring Poverty, Gender, Stigma, Globalisation and Human Rights issues in
Mental Health - Linking them to the People’s Charter for Health"

Chair:
Moderators: Vikram Patel (India) & Bhargavi Daver (India)
1) Panelists:
a)
Mani Kalliath - Basic Needs (India)
b) Sehra Sajjadi - Iran
c)
Other country representatives

2) Interactions from the floor
3) Suggestions for the People's Health Charter

15th January 2004
14.30-16.30

Environmental Justice and People’s Health - Confronting Toxics in our
Communities
Chair:
Moderators: Jeff Conant, Hesperian (USA) & Sarah Shannon (USA)
1)

Testimonies
a)
Save the Abra River Movement - Ana Leung (Philippines)
b)
Eloor Community Study - Bidan Chandra Singh, Sanjiv Gopal,
Greenpeace (India)
c)
Arsenic poisoning in water- Hilal Uddin (Bangladesh)

2)

Panelists:
a) Environmental Justice in South Africa - Ferrial Adam (South Africa)
b) Mining and Human Rights Abuse - Sofia Bordanave ( Argentina)
c) Citizen’s Action for Pesticides Elimination - Jayan, CHESS (India)
d) Health Impacts of Oil impact in the Amazon Rain Forests - Edgar Isch
Lopez (Ecuador)
e) Action on Medical Waste - Deepika D'Souza, Mumbai Medwaste Action
Network (India)

3)

Interactions from the floor

4)

Suggestions for the People's Health Charter

Parallel
Workshops 14

16.30-17.00

15th January 2004
17.00-19.00

Break

Reviving the Spirit of Alma Ata... the challenges before us
Chair: D. Banerjee (India)
Moderator: Pam Zinkin (UK)

Closing Plenary
1) Short inputs from six plenaries and fourteen workshops- from different regions to lead to the Mumbai Declaration

2) Additional responses from the floor
3) Releases
a) Charters in different languages,
b) Language editions of the Million Signature Campaign website
c) Some Alma Ata Anniversary publications
4) An overview - B. Ekbal, Convener PHM India

5) Concluding Remarks
6) Campaign Songs

Programme updated as of 8,n January 2004. Some of the speakers in the above programme are yet to be
confirmed. The programme schedule may be subject to some modifications, additions, and deletions.

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Subject:

CjX)

<ihdn3l@nid4.vsnt.n8tjn>
PHM-Secretariat(Giobai)" <secretariat@phmovement.org>; <ananth@diaib.greenpeace.org>;
"Kavitha KurugantT <k.2vriha_kurugsnt1@vahoo.com >: "'Jayan'" <thanal@vsnl.com>; "Manu
Gopalan" <mgopalan@dialb.greenpeace.org>; "Centre for Resource Education"
<creind@hcz dot net.in->; "Nityanand Jayaraman" <nity68@vsn!.com>; "Madhumita Dutta"
cmdutta@vsni.neP: <Bharat:ch@hotmail.com>
<pss@narniada.net. in>. Michael Mazgaonkar <mozda@softhome.nei>,
<rajanpatil@yahoo com>; <eji@vsm net>: <tlchennai@vsni.net>; <dcc_damodarp@yahoo com>;
<sochsra@vsni.com>: <cag@xlweb.com>; <fordisha@ca!2.vsnl.net.in>; <nidhi@cseindia.org>;
<umendradutt@rediffmail.com>; <shai.yashwant@dialb.gl3>; <ruchita@toxicslink.org>;
<deepikadsouza@hotmail.com->; <sambavna@sanchamet.in>
Monday, January 26, 2004 3:48 PM
Presentation or the CAPE.doc
Presentation of CAPE at iHF, Mumbai

Attached is the presentation of CAPE in the panel at tire International
Helath Forum on 15th January' 2004 at Mumbai. CAPE got an
opnununitv 10 nresent at the parallel workshop on Environmental
Health and Justice moderated by the Hesperian Foundation.

For the CAPE-Secrelarial (c/o Thanal)
sridliar

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1/27/04

v'

Presentation of the
CAPE — Position, Intentions anti Direction
3, the
W orksitop on Environment!}' Health mid Justice
at the International Health Forum on the 15th January 2004, Mumbai.

Pesticides and iis impact on the system have become loo ominous and threatening and yet
little considered when matters of health and environment are discussed, hi the last two or three years we
have seen that many communities all over the country’ have realised that they have been enslaved by
pesticide use end driven to suicides or have been living contaminated lives and our children and
grandchildren are being affected.

The Endosulfan affected villagers in Kasaragod came together under the banner of the
Endosulfan Spray Protest Action Committee (ESPAC) and together with Thanal have fought the pesticide
and the government sponsoring the pesticide and the industry as well, t he villagers of Warangal have
reported heavy death rolls due to pesticide use. especially in cotton farms and led by Sarvodaya and
Centre for Resource Education (CRE) have done a fact finding mission and released the book “The
Killing Fields” with the support of other organisations like Toxics Link. Community Health Cell. Groups
font Punjab. Maharashtra and Gujarat have also been fighting Pesticide poisoning issues. There has been
substantial work done by the Centre for Science and Environment in NewDelhi by' supporting this
community needs as well as hitting out hard at the pesticide contamination m drmkmg water and
beverages.
Even while the food safety, the life of the villages and the future of soil and water in the
country is being affected, possibly irreversibly, as evidence points out. it is quite an irony that the health
planning or even studies to that effect do not consider pesticides and its impact - both short and long term
and subtle - as a factor of importance. Here we feel that a realistic and better understanding of the impact
of pesticides on the health of the public and the environment need to be researched as well as considered
in both planning and implementation.

We understand that “Self Reliance in Food'1 is a glorified campaign - a campaign that
enslaved the farmers into technology, chemicals and hybrid seeds that failed the fanner and eventually led
to suicides. And there has been no study', no facts that prove that chemical input - especially pesticide
has helped increase food production Ironically, in India, more that 50% of the pesticides are used only' in
one crop - Cotton - which is not a food crop. Officials of the IRRI and the FAO have no qualms in
revealing that pesticides have not helped increase food production. So, we need to question the hype and
look at the whole fashion of “Food Security” from the Sovereignty' and the Safety’ angle. Food
Sovereignly is a fundamental issue and cannot be achieved with policies that make more and more
farmers slaves of MNC’s and Pesticide Corporates. Food Safety (from chemicals and manipulated seeds)
cannot also be achieved by' continuing the policy' of poison production and use.
Wc also need to ask a number of questions and answer them with hard, researched facts questions such as who benefited from the fifty years of chemical agriculture? - the country, the farmers or
the big corporate pesticide companies ? We also need to find and expose what the pesticide companies
have inflicted on the workers, the nearby communities and the farmers communities. We need to come
together in fighting the pesticide industry all the more strongly because today' the pesticide manufacturers
are threatening people who have complained against pesticide use with legal measures. We have been
able to fight back these threats but the industry and the agriculture scientists in unholy liaison with them
cannot be allowed to continue poisoning people and the environment.
The Endosulfan Tragedy has shown clearly that the Government of India - its agriculture
Ministry has built itself a big wall against the people’s voices and put its army' of agriculture experts officials of the Department and scientists of the ICAR - on this side to protect the wall. This army has
repeatedly lied to the people. Even when health studies clearly pointed to the effects of Endosulfan, the

Government asked the agric-scientists to review the health reports and they candidly liasoned with the
pesticide industry to sabotage the findings. Finally the Agriculture minister sent a one liner- Nothing was
wrong and Endosulfan is safe for use. In Kasaragod, when qualified medical practitioners in the
communin' pointed out to the pesticide endosulfan for poisoning their community, the Government
preferred to accept the asric-scientists version that Endosulfan was safe. When the Hiah-level ICMR
doctors confirmed in their studies that endosulfan caused the health problems in Kasaragod, again the
Minisin of Agriculture intervened and installed a committee under the Agriculture department which
looked at the health study. This Dr. Dubey committee has rejected the study and recommended that
another health study- be done under the auspices of the Plant Protection and Quarantine Department.
-%ddminsult to mjur* the head of mo coinmiucc Dr Dubey has been ofnctally patted on the back tor the
"commendable" work he has done. In this country, it is evident that Environmental health will not find
listeners until the health professionals and activists do not respond to this hijacking of health sciences by
vested non-experts. Now the same partem of sabotage, the same drama is probably going to be repeated
in the "Pesticides in Bottled water1’ issue as well.
This being the miserable state of affairs in the country, the farmers, activist groups,
public health professionals, researchers and voluntary organisations came together and formed themselves
a platform - the Community Action for Pesticide Elimination (CAPE) to take forward the joint struggle to
keep our fields, food and lives free from pesticides.

Lu the Global scene, we see dial some very positive steps are being taken. The Rotterdam
Convention, the Stockholm Convention, the Code of Conduct of the FAC) and the WHO are some to be
named. The Fourth Inter-governmental Forum for Chemical Safety (IFCS) held in November 2003 have
gone ahead to recognise the need for a special programmes on Children and Chemical safety, Acutely
Toxic pesticides which not only includes pesticides in the la and To classification of WHO but also
pesticides associated with frequent and severe poisoning incidents like Endosulfan and Paraquat, hi such
forums we see that the NGO’s, and Voluntary Agencies and Independent Research, findings are getting
more and better spaces and consideration, and we also see that the Government of India is mute and
poorly represented and performing pitiably in rhe discussions and negotiations. And in India, these global
efforts arc not reflected in the policies and decisions and the wall stands masking, these global changes
or ri CLlOrtc

So, in this situation the Community Action for Pesticide Elimination (CAPE) believes
that much work is needed to achieve the a im of pesticide elimination by taking the following direction Consolidate the experiences of the fanners, the affected communities as well as the work done
in the pesticide contamination and death or effect related cases and also consolidate whatever
information is available from the States regarding pesticide manufacture, use and impacts.
2. Share ihe information on the public domain and Gather together io fight the policy of
poisoning - Farming is a creative activity and there should be no space for poisoning.
3. The Fundamentals that we stand on needs to be clear - that we advocate no pesticide use,
because pesticides have basically only been a negative technology and have been harmful rather
that useful. Moreover, we have no belief on lite corporate sponsored science" of Maximum
Residue Levels (MRL’s) and .Admissible Daily Intake (ADI’s).
4. And firstly Expose at the Community level, the National level and the International level the
vested science and corporate-profit driven planiuiig that has resulted in contamiriaimg ourselves
and our environment with chemical pesticides. We also need to expose with the intention of
informing and taking positive action the unholy nexuses between the poison industries, the
agric-scientists and the government agencies that have together taken us for this toxic ride.

l.

Tb/s was presented by Sridhar R, CAPE-Secretariat, c/o Thanal, L-14 Jawahar Nagar, Kowdiar,.

'Tniruvananthapuram — G35 003. uianal^^vsnl.com

Media: RF_COM_H_79_SUDHA.pdf

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