PHM GHW
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- PHM GHW
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PHM _21_GHW_1_SUDHA
Report of PHM Steering / Support group meeting held at YMCA International
House, Mumbai on 12th, 13d1 and 16th January and two additional extended sessions
on 18th and 19th January at WSF Venue (Solidarity tent) and Hotel Columbus
respectively.
Preamble:
The Third International Health Forum in the Defense of People’s Health was organized
by the Global Secretariat of PHM and PHM India on 14
*
and 15,h January at rhe
International House. YMCA Mumbai, preceding the World Social Forum from 16
* to
21;l January also at Mumbai.
Due- to
unavoidable Constraints, the annual PHM Steering group, usually scheduled
in November each year by tradition. was postponed and linked to the Mumbai event. The
annual PHM Steering groujx.' therefore, was organized on 12th and 13<h of January at tfie
International YMCA.
Due to the unprecedented nature of participation at IHF / WSF, we not only had a full
sieeiing group presence ( ). but we also had many members from all over the world, who
support the secretariat-in separate functions as volunteers () and many country contact
points as well ().
The first two days. 12
* and 13
*
therefore, was a steering / support group and all those in
these different categories, other than steering group, were also invited to attend the
discussions in a spirit of transparency, as observers. participants.
On 16
*.
* and 19
18
* January, some extended sessions were held to make decisions and
evolve a plan for the next year, these meetings were attended primarily by steering group
members.
An agenda was sent out in advance of the meetings and a programme overview from 12
*
- 16
* January, was also circulated in which all the steering group agenda points were
allotted specific time slots on 12
* and 13
* January. However, due to delayed arrival of
some of the steering group members, sessions were interchanged and some extended
sessions wcre^hckl to increase the participator}’ nature of the steering ' planning exercise
and the group^iddressed some new issues that were brought up during the discussion.
The whole process was very interactive and participatory’ and the enclosed report written
in the order of the original agenda tries to capture the main issues and decisions that were
taken.
Since rhe compilation of the minutes report took a while, the secretariat team is also
appending a follow up report that tracks all the action that has been taken. Overall, the
nwcring proved to be a great
*
bat lory charge^ and‘energizer
the enthusiasm with
which rhe PHM steering group support group and country contacts have followed up on
their commitments has been most heartening, the PHM is definitely come to-stay and
1
I
I
!
evolving in enthusiasm^ content and impact, ^However, the evolution / mobilization of
PHM xtkra continues to show great regional variation and diversity. One of the biggest
challenges for PHM is to ensure that all regions / networks / countries are well
represented in (he evolving initiatives and this puts a special responsibilities on all those
who represent these regions that are lagging behind to make an extra effort to evolve
» ehcl^irdfiativcs and process in their region as we gear up lo-BHA—.• . . . j.y-K
*/
7
’
For do
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’*‘r A ,
MEMBERS PRESENT
V "
Ta-gh^xfa4ty to the-^e^esentatioiuaU the-^teering-- support-group^ mcedng, /the
participants have been classified into functional groups.
Steering Group'.
a. Network Representatives:
Maria Hamlin Zuniga - Nicaragua (IPHC); Zafrullah Chowdhury. Bangladesh
(GK); Prem John, India (ACHAN); Cannelila Canila, Philippines (CI): Evelyne
Hong. Malaysia (TWN); Nadia Van der Linde, Netherlands (WGNRR); Olle
Nordberg , Sweden (DHF). [Dr. Bala of HAI - AP could not attend)
b. Regional Representatives:
Pam Zinkin (Europe); Sarah Shannon, Hesperian Foundation ^USAg. Lanny
Smith. Doctors for Global Health ^USA ^North America); Hugo Icu Peren,
Guatemala (Central America and Caribbean); Arturo Quizhpe, Ecuador (South
America); David Sanders i Bridget Lloyd . South Africa (Southern Africa);
Mvvajutna S. Masaiganah, Tanzania (East and Central Africa): Fran Baum,
Australia (Pacific Australia and New Zealand); B. Ekbal Mira Shiva (India);
Eddina de la Paz, Philippines (South East Asia); Jihat/d Mashal, Palestine
(Middle Last and North Africa). [South Asia, China and West Africa‘*
nbt have
elected regional representatives)
c. Coordinators:
Qasem Chowdhury, GK - Bangladesh (Past coordinator); Ravi Narayan, India
(Present Coordinator)
d. Support Group
Andy Rutherford, One World Action - UK (Funding); Unnikrislman, India
(Media); Armando De Negre, Brazil (IHF - WSF); Jose Utrera, Netheriand
(Public Private Partnership circle); S.S. Prasanna (Website and Communication);
Rebecca Zuniga (Translations); Patricia Morion, (GHW)
e. Country Focal Points / Contacts
David Legge (.Australia); Julio Monsalvo (Argentina): A.H.M. Nouman
(Bangladesh); And Kapoor (Canada); Rani Scrag (Egypt): Malachi Orondo
Kenya:: Mohd. Aii Barzgar (Iran); Mars. Sandasi (Zimbabwe): Jagadish
•
. --
Goburdhun and R.K. Boodhun (Mauritius); Ayyaz Gui (Pakistan for Zafar
Mirza); Xiranjan Udugamalagala (Sri Lanka for Vinya Ariyaratne); Ghassan Issa
(Lebanon)
f.
Other’s
Fatemah AfzaKj Pedrain Rashidi and Re-zvan Moghadam (han); Alla Shakrollah
(Egypt); Bert de Beider (Belgium),
; a.
For the purpose of easy readability, the report will be devided into^PHM Global agenda
a^PPHM Regional agenda and the letter will focus on reports from regions and plans of
action emerging at region.
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\ & 2. Introduction and Finalization of .Agenda
The meeting on 12bl January started at 11.00am with a round of introductions and a
reMew of the agenda and programme overview that had been circulated in the file of
documents that was given to all participants. The agenda was accepted without any major
changes with the prcViso that since some of the participants were coming later 011 die 12th
or after - their presentations will be postponed and accommodated in the programme
whenever feasible.
On a query from Sarah, it was decided to lake uj^campaigrfin regional reports or regional
captation and on the suggestion of /Armando. it was decided io introduce a short input
into the inaugural session of the Forum on 14dl morning, liighlighting the earlier health
fora and the link with WSF. Ravi suggested that sub-groups of the PHM members
present, should meet in regional groupings io ^discuss regional level issues and
campaigns, because PHM would be stronger d&y«hPa.ll the regions became stronger and
evolved their own activities, framework and initiatives responding to local needs and
challenges. The morning of 16,h was one possibility for such a meeting.
3. Reports from Regions and Countries (
•.
< • *’
/ - ’■
I
v^ h‘- « O’
"(e
Since, some of the reports from the regions were circulated only some of the main issues
and points will be highlighted in a separate document and linked io the regional plans that
were discussed during various smaller region group meetings during IHF - WSF.
_L. Inicmatiansd I-k-fdth Forum / World Sack'd Forum
Amil
Joint Convener of PHM India (Jana Swasthya Abluyan) and
member of the organizing committee of the WSF. gave an overview of the
framework of WSF - TV. the background planning and challenges; the major
differences in situation . focus from previous WSF and the framevyork {oi,? ,
plenaries, seminars, workshops and street events. The four important panels and
seminars on 17UI and 18Ul January and the other 8 health related events at the
b. /$f. Ravi Xancisan gave an overview of the programme for IHF. which included
six plenaries
--------------- and the 14 workshops on-tlie theniejfl^^- p
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Tliis had evolved in an interactive, participatory way with suggestions from the regions
and members of the international orgar^lft%? suppoFt committee. The suggestions from
Latin America, Africa and Middle East^weref/articufarly useful.
He requested All the PHM resource persons present at the meeting tzf take note of rhesessions and roles, which they had been allotted and to participate actively in the next few
days to make these sessions workshops" ffdppcrijdf the PHM tradition of Ibtening-te
*
voices- and testimonies- and having panelists-■•respondHc- thethese voices ■> teslim<mesvf hanks to the enthusiastic supffgnM Dr. Prem Jater and others
from many regions, these voices and testimoniesywere strong at 1HF and mainly action"
oriented. He- higbligltte^jwo challenges for IHF sessions: (a) To ’move fe^oncVproblem
situation analysis to highlight examples of proactive action at various levels, (b) to
identify the key concerns and suggestions from each event to feed into a Mumbai
Declaration -- a document dial would be a definitive output of IHF - WSF and—a—
suppjementjas.. .well as 2004 update.) on the- People's Charter for Health and its concerns.
('see separate report of IHF WSF and updates on the website)
HuuiDe e !
c >(lc'’’ ’
5. Reports from Networks
:
,
*------------------------- --------While various members reported from regions and country circlesMhe eight founding
supportive networks that helped io organize the People’s Health .Assembly and have
continued to support the evolving PHM. also reported their main activities and thrust
areas.
CL
rI^21^1
(^ydyne )
The" main contribution of TWN was in spreading the word about PHA and the
People’s Charter and in focusing on issues relevant to PI IM PCH in TWN
publications, especially Resurgence.
.A special Alma Ata 25th anniversary feature was included in die July .August
2003 issue. It included the- reflections of David Werner, Debabar Banerji and
David Sanders: the People’s Charter lor Health and the suitemem on Primary
Health Care made by PHM at World Health Assembly, May 2003
fh. main campaign v a . U . ' ■ N Act < ? s to 1 k lih Co i >aig n in vi ch
PHM war an international aollhnratar and aka many PHM
persons and
articles were involved at different levels, including the .Advisor}' Group set up in
August 2003. Copies of the Charier were distributed ai all meetings of WGNRR
at all levels. This year, the May 28 , campaign will focus on Health lor All Health foi Women:
Health
|
have ... dp with fowLfe
requested PHM to join in a big
In 2003, the focus of the campaign wasro
make governments take more responsibility lor reproductive rights as well as
Primary Health Care. This year, the focus was on Health Sector Reforms and how
it improved or enhanced access.
WGNRR also supported actively the Million Signature Campaign and other Alma
Ala Anniversary Campaign and was also a co-sponsor of the PHM publication.
“Health for All Now - Revive Alma Ata”. In. October 2003, it organized an Alma
Ata Anniversary,in Netherlands. Due to the impact of conservative
right wing governments, which aimed io
health care disregarding
women’s rigtits and access to contraceptives and services. WGNRR has become
more proactive in Netherlands and also support the Europe^ Social Forum 2003
process (s-^-separaie
e.
International People's Health Council (Maria)
IPHC has been veiy actively involved in the organizational work related io PHA I and to the fonnation of PHM at international levels as well as the regional
promotion of PHM
*
IPHC has represented PHM actively at national and
international events and activities and will continue to do so. IPHC’s principle
contribution to PHM is its concerns, analysis and perspectives on the “Politics of
Health'' and its commitment phased on involvement of some of its members with
Primary Health Care programmes based ip. communities) to the Health for All and
Primary Health (’arc goals, reconfirmed in the People’s Charter. Recent!} IPHC
has undergone an external evaluation and will soon be evolving the future
development of IPHC as response to this evaluation and to the perception of its
members of the future directions, which should be taken by IPHC. 2L/ Zes: J- ■*
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Conveners of circles should use PH A - Exchange to brainstorm around
focus of circle; identify potential members of circle, who respond through \
the exchange to these circle derived communications; and put out '
reflections and further communications from the circle. The website can
also be designed to have a section for circle discussions (Ravi).
Circles need to be able to accommodate the complexities of members in the
context of the quality of the work and need to generate a process that
accommodates these complexities. Also since PHM is generating a density of
activity plus linkages, we have to be clear how we are going to proceed (Andy).
Are we going round in circles (David Legge)? There is some confusion about the
responsibilities and focus of the circles with some overlap. The needs to be
clarified by conveners (Deien).
Issue based circles need both depth, wide reach and relevance. A circle may be
required to study the issue of newer technologies and their impact on health, eg.
Biotechnology, IT,. We need to study positive and negative impacts.
L Campaigns / Advocacy
Members shared some ideas about campaigns and issue of advocacy relevant to
PHM, which should be considered by PHM in regions and supported by some of
the issue circles.
•
•
•
•
Having been present at WTO and WB meetings, there is need to use the health
impact as the measures of effect of all these policies on farmer’s livelihoods
(Evelyne).
There is need to write a position paper on the global fund for AIDS,
Tuberculosis and Malaria and track its evolution and experience (Evelyne).
There is need for a campaign strategy to promote comprehensive PHC in this
growing world of vertical strategies and evidence based planning. PHM needs
to define what is appropriate evidence based for PHC, then collect it through
our regional and global networks and put it together as a global evidence base
(Fran).
There is need to study the APAN statement submitted to WHO in May 2003
and the analysis how the global strategy suggested by APAN facts into PHM
framework. APAN is planning a Convention and PHM could place this
statement in that convention and work with APAN during the next WHA 2004 (Carmelita)
o
o
o
o
o
o
There is need to debate on environment and ecological issues related to
sustainable development
There is need to look at the efforts of WTO on agriculture and how they affect
farmer’s livelihoods (David Legge). [A small sub-group consisting of David
Legge, Sarah, Carmelita and Patricia decided to meet to discuss this issue and
suggest further action by PHM].
US is going towards bilateral strategies on trade with different countries. PHM
should develop alliances at country, regional and global level to counter these
( )
FCTC undergoing ratification. PHM should demand that their governments
should sign and ratify and implement the framework. There will be a Western
Pacific Regional Organization (WHO - WPRO) meeting soon about
implementation (Carmelita). [Carmelita was endorsed as PHM representative
at the meeting].
For every campaign, there is need to share information about the issue; get
commitment of people and groups to the campaign; and identify strategies at
country level (Maria).
For every campaign, there should be links between local work and
international campaigns - this benefits the international campaign, but also
helps the campaigns to be used locally to facilitate / mobilize and do strong
local advocacy work (Hugo).
Lonnlks witlh oOneir NeUvoiriks annd Movemeinilis:
One of the challenges for PHM regional and country level focal points and also
the secretariat at global level is to link with other networks and movements to
enhance collectivity and solidarity between movements and strengthen the health
agenda in all the movements, networks, campaigns and struggles. PHM members
are themselves linked to other network and movements. We need to manage these
dual or multiple identities effectively. Basically we need to be able to distinguish
between the PHM brand and the PHM badge with clarity.
In this precess of networking, we need to function with a certain degree of self
confidence eg., we are communicating and linking PHM to environmental
networks nationally and globally because environmental concerns are a major
section of the Charter and these groups were inadequately involved in national and
international PHA. A movement by its very definition needs to engage with
realities, with other partners and v/e don’t need to wait for approval (Thelma). As
v/e look to the future we need to be inclusive of new organizations (who were not
founding members). In terms of bringing in other networks, v/e need to use the
PHA video; share the Charter, give movement web site in meetings of other
networks and gradually link with them or link them with PHM (Mwajuma). The
Global Health Watch report may be a good way of forming these new linkages in
the next year (Patricia).
PHM India (JSA) has increasingly evolved linkages with networks (there are more
than 18-20 already working together at national level and their counterparts at
state level. In recent years PHM India is also linking with other national
campaigns around food, water, TRIPS, tobacco and also involving these campaign
groups in PHM India initiatives and campaigns. In some states, members of PHM
C:\WINDOWS\TEMP\Minutes - Steering group meeting.doc
the next coordinator (new region) overlapping for three months - around January
- March 2005.
It was suggested that a secretariat could have a term of three years with one year
overlap with the next secretariat (Abul).
If a secretariat was moved to a region and it was then found not to be able to cope
with the new responsibility what could be done (Bood
). It was noted that
such a contingency need not occur in the next secretariat was identified carefully
and systematically (Ravi).
hJ S
oto ©rgaisnzauhiniaS sunggestifoinis
While reviewing the evolving organizational structures and framework as outlined
in the background papers circulated some ideas and suggestions were made by
some of the members about the existing framework and organizational
assumptions. These could not be discussed at length but are being listed out to
ensure that they are kept in mind as the PHM organization experience evolved and
needs review.
c
o
o
o
o
There was need to prevent the movement from becoming too organised
and evolving too detailed a framework of rules and regulations. This
would bureaucratise and kill the spontaneous spirit of the movement. The
movement shoud be issue based campaign oriented and functional capacity
especially to emphasis health and social determinants at country and
regional level is more important than definitive organizational structure
(Ravi).
Too many issue circles is dividing the group and the problem. We are in a
way reproducing the fragmentation that we oppose and thereby creating a
barrier. There should be a main frame policy that can guide discussions in
individual groups and then a matrix of interconnected issues rather than
circles. It is particularly important not to fragment the process and
Organization so much that we lead to a situation where we loose our
capacity to be relevant (Armando).
One of the assumptions made while designing the thematic circles were
that there would be a coming together of these circles -however this did
not seem to be happening even though we are all activist. Not only issues
but regions should also link and work together. An area where this should
be happening urgently is in the issue of privatization of health services.
This is happening everywhere and there are negative impacts. We need to
build common concerns and strategies over regions (Andy).
While the issue circles were reaching out to people who are working on
those areas it is important to emphasis that the circle connect all its
members with PHM is linked to. Also if the circle activity could somehow
be linked to a certain degree of activism or action then issue circles would
succeed as an idea and a organic structure (Sarah).
We have circles for regions and each has a specific function -a specific
structure for specific needs. We must however integrate all these circles
successfully(David Legge).
C:\WINDOWS\TEMP\Minutes - Steering group mceting.doc
o
o
o
While the Charter was clear, it was now necessary to evolve a small
booklet describing all aspects of the evolving structures /framework of
PHM for easy reference by country level contact persons or focal points
(Malachi).
The steering committee is absolutely serious and important and the way
we organize ourselves should be based on what we want to do. It is
actions that have vitality rather than merely statements and plans. This
vitality groups from local grass roots action -so all PHM initiatives should
ultimately support, promote and derive from grass roots action (Pam).
PHM should be careful not to keep fishing in the same pond - among the
already converted. Can the PHM get involved in universities and there we
should involve young people in more depth (Julio).
V- P1HIM EvaOuaafiona
A PHA 11 PHM evaluation process was started in mid 2002 to assess the impact
of PHA-I on individuals who had attended the assembly and also to understand
the process of post Assembly follow up in regions and countries in terms of
processes, mobilization of circles; Charter translation and distribution; campaigns
and PHM inputs into national, regional and international events.
An initial dialogue of the main emerging findings of the evaluation by a three
member team lead by Andrew (Health link) was held in May 2003 in London just
before the WHA May 2003 in Geneva. Unfortunately, due to unavoidable
circumstances and constraints the PHM evaluation report has not yet become
available for a wider circulation and debate. While the note on objectives and
methodology of the evaluation was circulated as a background paper - the
summary of findings could not be accessed so it was a missed opportunity.
Pam and Andy were requested to follow this up with Andrew at the earlier and
facilitate prompt action which would greatly help the next project cycle. Ravi
shared three findings from the May meeting
(a) that PHA had made a major impact on all those who attended it as an
inspirational and energizing experience;
(b) only those who came representing networks I associations or campaign groups
and hence had a constituency to share the concerns and perspectives of the
Charter did some follow up work including distribution of Charter,
publications and some campaign initiatives in their region.
S. PHIM CoimsoMatodl staftegy snmdl target
a) A note discussed in London by a small representative funding group in 2003
was circulated to the steering group members. This included the following
components of an evolving global strategy.
ii.
iii.
iv.
v.
:\WINDQWS\TEMP\Minutes - Steering group meeting.doc
vi.
vii.
viii.
The group went through some parts of this note especially the earlier sections to
enhance the collective endorsement of the overall objectives and aims of PHM and
thekey thrusts and initiatives in the next 2-3 years.
(see separate document).
b) 'However, Ravi shared that the group was hampered by two important lacunae
in the planning effort and hence the document could not be converted into a
logical framework analysis to be sent to funding partners for the next phase.
(i)
There was no feedback or clarity about regional mobilization
efforts of PHM; evolution of regional and country level strategies
and initiatives and the expectations of support I coordination if any
from the global secretariat.
(ii)
There was no clarity about the next People’s Health Assembly and
its financial requirements.
It was expected that the present steering group meeting would enhance
the clarity of both these constituents of the PHM plan for 2004-2006.
Some idea of regional needs and requirement;
Some idea about PHA - II.
These would then be included in a revised plan of action and logical
framework exercise that the funding / planning group of PHM would
put together by April -May 2004.
e) The Tmnmdlnimg - ftwini Jamisairy 2®@3 -JaEaairy 204
Ravi and Andy gave a summary of the rather precarious (?innovative)
approach of PHM Secretariat to the financial requirements / implications of
current ongoing PHM initiatives, coordinated by the secretariat and supported
through the fund raising efforts of OWA in UK and Ravi from the Secretariat.
It was summarized as a two pronged process as of new.
i)
ii)
Scrounging - the balance from PHA - I fund raising efforts (after ail the
travel grants and organizational costs had been met and the post PH A H core group meeting held in Dhaka in November 2002) has been
scrounged for some of the support to the ongoing initiatives of PHM
including some of the secretariat costs.
Friends and neighbours policy -networks and friendly associations /
agencies that respect and trust PHM as an evolving movement have
responded to the coordinators appeals and have provided small grants
and contributions that have been used for specific initiatives. These have
included:
o
O
Christian Aid -12500$ for PHM resource centre in GK;
WCC -15000$ for PHM - WHA 2003
C:\WINDOWS\TEMP\Minutes - Steering group meeting.doc
In the months that followed, the Latin American PHM members met a
couple of times and wrote to Armando (Brazil) encouraging him to send
some sort of written commitment of the local hosting groups at Porto
Alegre so that the decision could be finalized and endorsed. However,
there was no follow up and over six months of planning time was lost.
o At the beginning of the steering group meeting in Mumbai, there were a
few informal discussions between all the participants from the Americas
region to sort out this matter since further delay in the decision would
jeopardize the planning process further. There was some concern from
other regions that the decision from a region should be consensual and the
PHM steering group not be faced with the option of selecting from two
potential venues from the same region.
o The decision about PHA-II was then finalized in two phases. In Phase I
Hugo representing the Latin American region made the following points at
the end of the first regional meeting:
o
The Latin American region 'would like to host the next
People’s Health Assembly;
- The region had the capacity and experience to host the
Assembly;
- The Assembly would be hosted in July 2005;
- He quoted a Latin American proverb -that it does not
matter if there is storm, thunder or lightening -we will carry
it out to emphasise the interest and the confident resolve of
the group from the region to host this important event.
A few days later, after the arrival of both Arluro and
from
Ecuador, life© proposaD of tfihe People’s IHIeaEfib awal a host of related
movements to feost the PHA HH m Qmto Ecniiadloir was pOaeedl before One
strag gi-’ocup amd nt was cnmanafimodDsBy accepted. It was decided that
Arturo Quizhpe would be the organizing committee and would be
supported by an International advisory group that would represent
different regions and help with all aspects of the planning. This group
would be constituted soon -so that it could start the planning and through
its regular deliberations it could start the PHA -II planning process.
It was also decided that the next International Health Forum - IV which
would be held next year in January 2005, when the WSF returns to Porto
Alegre, Brazil, would be an important complementary and pre PHA-II
meeting. Armando, the organizing secretary of this Forum IV would be a
member of the International Advisory Committee for PHA - II. The
forum could focus on Health Policy changes that are necessary to increase
the potential for Health for All, Now. The interesting examples and case
studies from Brazilian experience could be highlighted at this forum and
the Brazilian experience could be reflected upon by participants from other
regions. Policy initiatives from other parts of the world could also be
focused upon at the next forum eg., primary healthcare policy
endorsements by Karnataka, Orissa state in India and South Australia
region in Australia.
-
o
o
10. Regional Capacitation Process
C:\WlNDOWS\TEMP\Minutes - Steering group meeting.doc
A short paper by Prem about regional capacitation was circulated to all the
members in the file of background papers. The paper emphasized that for
increased capacity development in different regions and countries it was necessary
not only to improve the collectivity and representativeness and effectivity of the
existing steering group members and country level contacts but also identify the
framework of a capacity building process that includes the identification of new,
younger leadership and their sustenance and capacity building.
One of the challenges for PHM was to build develop capacity in a region
with little or no capacity. It was necessary to chose an area with such
limited capacity and bring it up to some level (Maria).
o One of the concerns was that if existing capacity especially for
networking, information sharing and communication was taken as a
necessary criteria for a region to have the qualities to take over the
secretariat than regions like Africa would be out of the contention for a
long time - may be even up to 20 years before Africa can join the
movement fully. Capacity building should be a two-way process. Visits
from PHM resource persons from other African region were given a
chance to move to other regions toleam from local processes that would
also be effective. Without this two-way precess, Africa would be
completely excluded. In some regions like in Africa communication was a
big problem. More media is privatized so paying for a spot on TV was
very costly (Mary Sandasis).
o It was suggested that the next secretariat be chosen based on the potential
to build capacity rather than the presence of actual capacity (budget).
o If we needed to grow as a movement then we need to consider the
possibility of setting up regional offices or secretariats. This will
especially address the needs of other languages (eg., Spanish speaking
regions (Armando).
o It was felt that regional offices may actually become the foci of capacity
building towards hosting ths secretariat in the future (Malachi).
o It was necessary to build capacity in a region by a definitive focus on
Human rights and health. This could be done in two ways :
o
1. as a distance education programme (being evolved)
2. as a part of capacity building programme especially of younger
recruits and leadership (Armando).
The most important capacity v/e should be building at regional and country
level is to promote the people’s Charter and to build a movement by
converting the Charter into action and campaigns. Promoting a movement;
facilitating a circle-country focused or issue focused; and hosting a secretariat
are three very different things and need different capacities. However, the
most important capacity to be built is to support movement. While doing s,
one must emphasise that it is not making new members or inviting people to
join but recognizing those who are already doing the actions / campaigns (that
v/e feel need to be done) as partners and linking them to PHM. All the
individuals who are interested must also finally get linked to organizations and
movement to be more productive, sustainable (Ravi).
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12. Advocacy and Dialogue with WHO
An overview of the history and process of advocacy and dialogue of PHM and
WHO was provided by Ravi, who had been convenor of the WHO-WHA
circle since 2002. These included in chronology:
PH Assembly disappointment at Dr. Gro’s absence from PH A in spite of
invitation and liaison about dates (also UNICEF absence considering
WHO/UNICEF were co-facilitators of Alma Ata conference.
o Record of this missing WHO in the PHA report and its interpretation as
lack of interest in people’s health;
o Specific exhortations to WHO incorporated in the Charter;
o The NCD division of WHO inviting Ravi to present the Charter in a
research seminar in April 200].
o Three in-house lunch time seminars by Ravi at WHO-HQ on PHA and
Charier. Distribution of Charter to all staff.
o PHM invited to WHA - May 2001 and interview with DG of six members
who represented PHM. DG referred to PHM is report and also announced
the WHO - Civil Society initiative. PHM made representations to WHOCSI.
o Presentation of the Charter by Ravi and Zafrullah at the GFHR Forum 5 in
Geneva in November 2001. Demand that Charter be presented at WHA.
o PHM invited to present Charter at WHA - May 2002 as a Technical
session. Ravi and Zafrullah present Charter and Maria, Mwajuma and
Ellen present evolution of movement in Latin America, Africa and Europe.
PHM represented by 32 delegates. Intensive advocacy and media strategy.
DG attends session chaired by Filipino Health Secretary but does not make
any commitments to further dialogue.
o In the 2003 elections for new DG - PHM plays active part in efforts to
make the elections more transparent and participates in debate I dialogue
with DG candidates.
o In may 2003 at WHA, 82 participants from 3C countries attend WHA
(Alma Ata Anniversary year) and support PHM statement on PHC;
support statement of TRIPS with Oxfam, MSFS, etc; support statement on
NGO civil society etc., advocacy and lobbying with delegates aster
advocacy training by Andrew and Carmelita for all PHM delegates.
Beginnings of an effective presence though more quantitative rather than
qualitative.
o The new DG designate Dr. Lee meets a small representative PHM
delegation and listens to concerns and initiatives including Million
signature campaign.
Requests PHM to keep WHO aware of the
marginalized.
o The informal dialogue with WHO during the present administration has
continued and PHM has been invited to engage with WHO on WTO /
GATS; the HiV-AIDS 3 by 5 initiative; the reiteration of primary health
care; and the dialogue on the recommendations and follow up of the
commission on Macroeconomics and Health while many members
welcomed these developments. There was a general concerns that we
should b e cautious in our expectations and watch the process carefully
o
C:\WINDOWS\TEMP\Minutes - Steering group meeting.doc
looking for policy / strategy change not only public statements and
pronouncements and also there was need to track unhealthy trends and
organize advocacy strategies to counter them. eg.
-
-
-
-
consultants who spoke out against WTO were facing a lot
of pressure and found their consultancies being cancelled
(Mira);
business and private enterprises (for pront) were being put
under the same categorization as NGOs and this was totally
unacceptable (Maria);
some developments in WHO were not very comforting eg.,
infant feeding was being merely reduced to an area of
information provision and not any more a technical area
(Pam);
the deplorable stake of people’s health was partly due to the
recent policies of WHO.
We need to keep this in
perspective -it is therefore people who will bring about this
changes by putting pressure on the system from below and
not or never the WHO (Prem);
since WHO is sending a team to IHF-WSF and we have a
special session with WHO team -it is at that session that we
need to get clarity about WHO’s role (Maria);
GATS and TRIPS were issues that were bridging sectors
but the main game was Agriculture. There is need to push
the dialogue to include the smallest farmers who were the
real losers (David Lege);
Also there was a continuous struggle within WHO and
within International health initiatives to continue
legitimizing the neo liberal economic policies and the need
to counter them through effective delegitimising strategies
- in these battles between legitimizing and delegitimisation
-we must not forget the real problems of the people (David
Legge);
Whatever the changes made by the DG at HQ level the
impact would be measurable only if there was a shift of
policy at regional and country level (Barzgar);
While there were nice words at the HQ/DG level there is
need to monitor the changes in actual functioning I
programmes. How do these changes translate into action at
region and country level and at Held level. Unless there are
changes at field I lower levels policies made at higher levels
is not enough (Jihad);
A check list should be prepared to measure WHO’s
commitment to the concerns of the Charter at global and
regional levels (Fran)
Keeping these caution in mind the process of dialogue
should be seen as a strategic opportunity and the dialogue
should continue and be particularly focused on a few thrust
areas:
:\WiNDOWS\TEMP\Minutes - Steering group meeting.doc
to remind / pressurize WHO of the principles of
primary health care and to re-endorse it as policy;
o to pressurize /advocate WHO to shift to a health
systems strengthening approach rather than selective
marketing of magical bullets through vertical
approaches;
o to dialogue with WHO to keep civil society / not for
profit NGOs distinct from private sector and
corporate sector;
o to dialogue on 3 by 5 initiative for HIV/AIDS but
strengthen the primary health care dimensions and
the health systems strengthening strategies.
o To continue to share PHMs concerns on Macro
economics and Health, various global funds and top
down international initiatives.
o
The continuing PHM dialogue with PAHO was outlined by
Maria. The main context were:
- PAHO is a much older organization than WHO and in this
region the new chief of the region
Mirta Roses was
elected over a WS supported neo liberal candidate.
PHM was invited by
Roses to make a critique of the PHC report;
PHM (Maria) was invited by PAHO to attend a ministerial meeting as a
motivational speaker and she particularly highlighted the role of WTO /
trade issues in health;
Along with governments; civil society organizations and private sector
they (PHM PAHO) were planning a PHC conference in Guatemala.
The situation in PAHO was strategic and PHM should support the DG to
make the region more relevant for primary health care development.
-
o
c
o
o
C:\WINDOWS\TEMP\Minutes - Steering group meeting.doc
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Page 1 of 1
ravi@phmovement.org
TOM fawthrop <tomf70k@yahoo.com>
Ravi Narayan <ravi@phmovement.org>
Saturday, April 01, 2006 6:54 PM
Re TomF
From:
To:
Sent:
Subject:
Dear Ravi.
I didm make it to WSF Karachi but trying hard to round off the Cuba doco with visit to earthquake
zone to film Cuban medical teams..
would greatly appreciate contact with PHM activists and contacts in Lahore and Islammabad..
hope all is well ,
best
L
Tom Fawthrop
Thailand
April 1st
Ravi Narayan <ravi@phmovement.org> wrote:
Dear Tom,
The person who was shooting the DVD video was Dr. Pervez Imam - a doctor film maker whodid it on I
behalf of the PHM Secretariat but on his own initiative. He is based in Delhi and we are hoping to
meet up soon to decide how to go about using all that footage to evolve some good 'teaching
documentaries' from PHA2 Cuenca. He stayed back for a few weeks after PHA2 for more shooting
and meetings with activists. His email is f20com@yahoo.com and drparvezimam@yahoo com and his
telephonic contacts are Mobile : 0091-98180-29792.
Best wishes,
Ravi
4/3/06
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PHM Notes regions
Couitfrtes
AuoeraaSa, New Z®aOg>ra®i), and! the Pacific
1. Raise profile of PHM
^e.'irrfc^
-^sponsored tours of key PHM people
- ” Discussion groups on: Trade & health, GPH€ do-n-y^-rc.Ac-a'-'e
_
2. Use networks in region - New Zealand, South Pacific, PNG
3. Perhaps, Plan a regional conference
Jd'dai website
Strengthening) A©ta
—-—
1.
2.
g.
e.
,
f
Maximiserexisting regional networks: ACHAN, IPHC, CIROAP, HAIAP, TbuM
Contact fnaterial~??-?-and networks directly
e-t'-.
consumer groups in each country
.
, ...
,r
health and no^health’.(and other health related ??-?)'
Cambodia & Japan (ACHAN)
3. Utilise existing / already planned activities ;
■> •••
<'
tJ7-/rzl
dm Cm
C ■■■“'' r
■■
- 7 * Feb 9 - wHeeting of pharmacologists in Indonesia where Deleu (?) is going as
a speaker on behalf of HA! AP/PM TL •fir™1 c° c'
June’’-meeting in Sri Lanka ••'IO
■' ■ '
- communicating for advocacy (PCH as advocacy issue)
Dec - meeting on safe home delivery in Bangladesh
4. Utilise publications available^ TWN publications .
hwope
- X) p
Le 1 ■'
\
1. Develop a plan to strengthen the regional coordination Z focal point tot
ejih ei"&upp©^©f regional coordination
2. Inviting other organisations to take part in the ?•? unions, academics, etc.
3, Priority: East European 'Crgasieatiori—
\ *c.
> ♦ ?
"rvC' '••a.t. :: ■>
3; Develop a circle on:
- privatisation
- promote the discussion about the effects of the action on European TNS
on health:
o pharmaceutical
‘ c-,
o financial
<zltf I
o
water/ electricity
.PHM sponsored short courses - University' based for grassroots leaders on
health systems, sociopolitical determinants of health, primary health care i.e. in
rivs.-pfges wasro ??■?■?
PHM) -
M^dAle i T-ji'"
iregteh
■
movements strengthening In eadiregtenc^no.'-. <
■ '
■
' '';
Th Invest in capacity building and resource production and ICT for health
(iAsw^?f^^focacy and. lobby for-PH ■<£
*-«• -K
2. Identified priorities - 7 issues of the region (piarrof action)
Strengthen networks and the above (?) with involvement of regional
networks at community level - based on events, issues, etc
c•
AusfiraSog) amH ir®<g(i©in)®[l ®teaDgiftih@BDmg)
'.
2.
3.
4.
5.
Tours of sponsored people -Australia and the region
Identification of
>•
Country regional meetings
Local website/ listserve
Discuss opportunities and resources for key issues e.g. badged ? as PHM
1. /Recruitment of supporter for Chinese ?-?? 6-!v»U ■> c•; ■"
2. Chinese language website
3. Chinese language listserve
4. Call for contributions on key issues <yvtrr>-> M d1
Lp'
’ ■'.v. u a- ^f?<l
Lafe Ameirifea
1. Establish specific programmes and campaigns (ALCA - Salud, FTAA -
'2. Glossary of PHC. Concepts - criteria
3. Strengthen/ promote inter-cultural dialogue ■ ■
SmifeXifroea ■
1. Invest resources in cultural communication,infrastructure and charter
printing and dissemination, in countries where there is already a viable
PHM activity.
2. To use planned Southern/ Eastern African PHM /? ? and society meeting
to run module/ course on PHM/ civil society organisation focussed on both
knowledge and skillsAo use opportunities (regional, national meetings,
'
regional national networks and sympathetic community based
organisations to build PHM.
3. In countries to use Charter to identity key national campaigning issues, i.e.
to link key national health issues to global issues to organise campaigns
around this to build PHM in African countries.
Sffcir®) Ameirfegi
'I. Developing effective regional coordination and communication between
the Canadian and US PHM events. Support each others efforts. This may
to Health & Trade, Endronrnstoal Health and nao'too, torro:
do not yet know the priorities.-)
2. - Resistance to US Government policy “Regime change begirfs at home”.
- Join campaigns and networks already active
- Promote and facilitate health within the campaigns (give suggestions and
plans?)
- Build awareness of the. inter-relationship between US policy and Social
injustice.
- Encourage the spectrum of grassroots action from the streets to legislation
3. Build the PHM within each country—
> d e-^ctoc.
t. Step up anti-war efforts and build alliances (3 campaigns and 2 events
tost will he launched tomorrow io a starter)
2. Target non-health summits and be visible in G-8, G-7, etc
3. Target youth groups and students (medical students would be a good
starting point)
4. Consider one PHM intervention in a war/ disaster spot every year (Unni
can take responsibility)
ACHEIVEMENTS
1. Charter widely disseminated '
2. Recognition that local & national groups exisHjiat still have commitment to People’s
Charter for Health and Alma Ata Principles
3. Persons interacting world wide
1. The successful launching and spreading of the Charter, translation, wide use
2. The slow but strong build up of the network with all its diversities. Transforming y/
PHA to PHM
3. Emerging dialogue with the WI-IO
1.
2.
3.
4.
5.
Right choice about international coordinator^/
Decision about PHA 2\X
Some break through with the WHO
Successful in different countries
IHF/PHM in Mumbai /
1. Translated People’s Charter for Health and distributed it, translation into other
languages
2. Mobilising on the People’s Charter for Health, training communities on communities
on advocacy
3. Encouraged communities to write own stories
1. Promoting the People’s Charter for Health as an inspiration for groups working on
health around the world
2. Having continuity of work based on the People’s Charter for Health vz
3. Getting recognition as a network with knowledge of what is happening at local level,
against institutions taking decisions in health at international level. \/
1.
2.
3.
4.
z.^5.
/ 6.
Uniting force for individuals, networks, institutions, NGOs
Advocacy, lobbying and changing force for/in the WHO '
Awakening involvement on health cars especially PHC issues IHHR xA tool for the revitalisation of CPHC/ Alma Ata within countries, WHO
Voices of the Unheard
Communication and joint action we cannot survive without this.x/
Spanish in red
1. Strengthening at the local, regional and national level. V
'—-2. Voice of public opinion
3. Permanent/ongoing activity Producer and distributor of ??
4. Learning from others experiences x /
1. Higher profile at the WHO
2. Improved networking
3. Excellent work and role of the secretariat
1. Network built with respect to both quality and quantity
2. Shake up the WHO that it now responds and to the PHM calls in the area of PHC '
3. The PCH exists and reaches many and is a framework for social development work
1. WHO turnaround
2. PHM established and growing v”
3. Inner, widening and deepening shared critique of verticality of ?????? V
1. The PCH coming from democratic process of Phal and its translation and distribution
2. Developing Phal into PHM fighting for Hfa now x/
3. Encouraging alternative analysis of the world’s economic system and its impact on
health
1.
ACHEIVEMENTS
1. Charter widely disseminated
2. Recognition that local & national groups existtjiat still have commitment to People’s
Charter for Health and Alma Ata Principles
3. Persons interacting world wide
1. The successful launching and spreading of the Charter, translation, wide use
2. The slow but strong build up of the network with all its diversities. Transforming vz
PHA to PHM
3. Emerging dialogue with the WHO "
2.
3.
4.
5.
Right choice about international coordinator^
Decision about PHA 2vZ
Some break through with the WHO
Successful in different countries
IHF/PHM in Mumbai /
1. Translated People’s Charter for Health and distributed it, translation into other
languages
2. Mobilising on the People’s Charter for Health, training communities on communities
on advocacy
3. Encouraged communities to write own stories
1. Promoting the People’s Charter for Health as an inspiration for groups working on
health around the world
2. Having continuity of work based on the People’s Charter for Health '
3. Getting recognition as a network with knowledge of what is happening at local level,
against institutions taking decisions in health at international level. V'
1.
2.
3.
4.
5.
6.
Uniting force for individuals, networks, institutions, NGOs
Advocacy, lobbying and changing force for/in the WHO k/
Awakening involvement on health cars especially PHC issues IHHR x/
A tool for the revitalisation of CPHC/ Alma Ata within countries, WHO x/
Voices of the Unheard
Communication and joint action we cannot survive without this.x/
Spanish in red
1. Strengthening at the local, regional and national level, v'
2. Voice of public opinion
3. Permanent/ongoing activity Producer and distributor of ??
4. Learning from others experiences . /
1. Higher profile at the WHO
2. Improved networking
j.
Excellent work and role of the secretariat
1. Network built with respect to both quality and quantity
2. Shake up the WHO that it now responds and to the PHM calls in the area of PHC '
3. The PCH exists and reaches many and is a framework for social development work
1. WHO turnaround
2. PHM established and growing
3. Inner, widening and deepening shared critique of verticality of ??????
1. The PCH coming from democratic process of Phal and its translation and distribution
2. Developing Phal into PHM fighting for Hfa now
3. Encouraging alternative analysis of the world’s economic system and its impact on
health
1.
Countries
Australia, New Zealand, and the Pacific
1. Raise profile of PHM
? sponsored tours of key PHM people
? Discussion groups on: Trade & health, CPHC
2. Use networks in region ? New Zealand, South Pacific, PNG
3. Perhaps, Pian a regional conference
4. Local website
0
'
j,
'
Strengthening Asia
' • Maximise existing regional networks: ACHAN, IPHC, CIROAP, HAI AP
2. Contact material ??? and networks directly
/ )
7-^
- consumer groups in each country
- health and no-health (and other health related ???)
g. Cambodia & Japan (ACHAN)
e.
3. Utilise existing / already planned activities
-eb S ? 10 meeting of pharmacologists in Indonesia where Deien (?) is going
as a speaker on behalf of HAI AP
June - meeting in Sri Lanka
- communicating for advocacy (PCH as advocacy issue)
Dec ? meeting on safe home delivery in Bangladesh
4. Utilise publications available ? TWN publications
Europe
■'. Develop a plan to strengthen the regional coordination ? focal point
for support of regional coordination
2. Inviting other organisations to take part in the ?? unions, academics,
etc. Priority: East European organisation
3. Develop a circle on:
- privatisation
- promote the discussion about the effects of the action on European TNO
on health:
? pharmaceutical
? financial
? water/ electricity
PHM sponsored short courses ? University based for grassroots leaders on
health systems, socio-political determinants of health, primary health care
i.e. in universities where ????
"’JENA rscbr:
Country movements strengthening in each region
1. invest in capacity building and resource production and ICT for health
(www, ?) Advocacy and lobby for ?
2. Identified priorities ? 7 issues of the region (plan of action)
3. Strengthen networks and the above (?) with involvement of regional networks
at community level - based on events, issues, etc
Australia and regional strengthening
1. "curs of sponsored people ?Australia and the region
2. identification of ???
3. Country regional meetings
4. Local website/ listserve
5. Discuss opportunities and resources for key issues e.g. badged ? as PHM
China
1. recruitment of supporter for Chinese ??
2. Chinese language website
3. Chinese ianguage listserve
4. Cail for contributions on key issues
Latin America
1. Establish specific programmes and campaigns (ALCA ? Salud, FTAA ? Health)
2. Glossary of PHC. Concerts ?criteria
3. Strengthen/ promote inter-cultural dialogue
South Africa
. invest resources in cultural communication infrastructure and charter
printing and dissemination, in countries where there is already a viable
Pi-.Vi activity.
2. To use planned Southern/ Eastern African PHM /? ? and society meeting
to run module/ course on PHM/ civil society organisation focussed on both
knowledge and skills. To use opportunities (regional, national meetings,
regional national networks and sympathetic community based organisations
to build PHM.
3. In countries to use Charter to identify key national campaigning issues,
i.e. to link key national health issues to global issues to organise campaigns
around this to build PHM in African countries.
North America
1. Developing effective regional coordination and communication between
the Canadian and US PHM events. Support each others efforts. This may include
Health & Trade, Environmental Health and Justice, Tobacco ? we do not yet
know the priorities.
2. - Resistance to US Government policy ?Regime change begins at home?.
- Join campaigns and networks already active
- Promote and facilitate health within the campaigns (give suggestions and
plans?)
- Build awareness of the inter-relationship between US policy and Social
injustice.
- Encourage the spectrum of grassroots action from the streets to legislation
3. Build the PHM within each country
Strengthening Campaigns and international advocacy
1. Step up anti-war efforts and build alliances (3 campaigns and 2 events
that will be launched tomorrow is a starter)
2. Target non-health summits and be visible in G-8, G-7, etc
3. Target youth groups and students (medical students wouid be a good starting
point)
4. Consider one PHM intervention in a war/ disaster spot every year (Unni
can take responsibility)
PLHIM StariEg I SEpjponT group mmeeHmg
Wd aC YMCA lEtaEa&EaD ffitase, Mmlban
amd
JaEEairy
and iw addotBOEaS extaded ssssboes ©e
aEd
JJaEESiry
aS WSF Vsee© (Sollsdaniy tali) aEd
C©Deiie"©es respecifivelly
PreaznibEe:
The Third International Health Forum in the Defense of People’s Health was organized by
the Global Secretariat of PHM and PHM India on 14th and 15th January at the International
House, YMCAjMumbai, preceding the World Social Forum from 16,h to 21st January also
at Mumbai.
Due to unavoidable constraints, the annual PHM Steering group, usually scheduled in
November each year by tradition, was postponed and linked to the Mumbai event. The
annual PHM Steering grouprfifireTdre, was organized on 12th and 13th of January 2004at
the international YMCA.
Due to the unprecedented nature of participation at IHF / WSF, we not only had a near
complete steering group presence &gk-but we also had many members from all over the
world, who support the secretariat in separate functions as volunteers (jgJ, and many
country contact points as well
The first two days, 12,h and 13th, therefore, was a steering / support group and ail those in
these different categories, other than steering group, were also invited to attend the
discussions in a spirit of transparency as observers / participants.
On 16th. !8,h and 19,h January, some extended sessions were held to make decisions and
evolve a plan for the next year. These meetings were attended primarily by steering group
members.
An agenda was sent out in advance of the meetings and a programme overview from 12lh
- 16‘" January, was also circulated in which all the steering group agenda points were
allotted specific time slots on 12th and 13th January. However, due to delayed arrival of
some of the steering group members, sessions were interchanged and some extended
sessions were held to increase the participatory nature of the steering I planning exercise
and the group also addressed some new issues that were brought up during the discussion.
The whole process was ver}' interactive and participatory and the enclosed report written
in the order of the original agenda tries to capture the main issues and decisions that were
taken.
Since the compilation of the minutes I report took a while, the secretariat team is also
appending a follow up report that tracks all the action that has been taken. Overall, the
meeting proved to be a great ‘battery charger’ and ‘energizer’ and the enthusiasm with
which the PHM steering group / support group and country contacts have followed up on
their commitments has been most heartening. The PHM is definitely come-to--slay-and
evolving in enthusiasm^content and impact. [However, the evolution / mobilization, of
PHM continues to show great regional variation and diversity. One of the biggest
challenges tor PHM is to ensure that all regions / networks / countries are well represented
in the evolving initiatives and this puts special responsibilities on all those who represent
those regions that are lagging behind to make an extra effort to evolve regional and
country circles and initiatives and process in their region as we gear up for the next
People’s Health Assembly in July 2C05 in Ecuador.
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qJ)
Members Present
The participants have been classified into functional groups.
Steering Gwwp'.
a, Network I&ejpireseEiitatiives:
Maria Hamlin Zuniga - Nicaragua (IPHC); Zafrullah Chowdhuiy, Bangladesh (GK);
Prem John, India (ACHAN); Carmelita Canila, Philippines (Cl); Evelyns Hong, Malaysia
(TWN); Nadia Van der Linde, Netherlands (WGNRR); Olle Nordberg , Sweden (DHF).
[Dr. Bala of HAI - A? could not attend)
b. RegHO®ffiD IRejpreseimteftDves;
Pam Zinkin (Europe); Sarah Shannon, Hesperian Foundation, USA and Lanny Smith,
Doctors for Global Health, USA - (North America); Hugo Icu Peren, Guatemala (Central
America and Caribbean); Arturo Quizhpe, Ecuador (South America); David Sanders I
Bridget Lloyd , South Africa (Southern Africa); Mwajuma S. Masaiganah, Tanzania (East
and Central Africa); Fran Baum, Australia (Pacific Australia and New Zealand); B. Ekbal
I Mira Shiva (India); Edelina de la Paz, Philippines (South East Asia); Jihad Mashal,
Palestine (Middle East and North Africa). [South Asia, China and West Africa did not
have elected regional representatives)
Cooirdlmatoirs:
Qasem Chowdhury, GK - Bangladesh (Past coordinator); Ravi Narayan, India (Present
Coordinator)
Support Group
do Secreiadai
*
swpjpoirt:
Andy Rutherford, One World Action - UK (Funding); Urinikrishnan, India (Media);
Armando De Negri, Brazil (IHF - WSF); Jose Utrera, Netherland (Public Private
Partnership circle); S.S. Prasanna (Website and Communication); Rebecca Zuniga
(Translations); Patricia Morton, (GHW)
5
oL O I
o
c-w-r-) c -t-1 o’L
* c Me -1 eA jP
©o CoMnniry Focal! Pointe I Comiiacte
David Legge (Australia); Julio Monsalvo (Argentina); A.H.M. Nouman (Bangladesh);
Atul Kapoor (Canada); Hani Serag (Egypt); Malachi Orondo (Kenya); Mohd. Ali Barzgar
(Iran); Mary Sandasi (Zimbabwe); Jagadish Goburdhun and R.K. Boodhun (Mauritius);
Ayyaz Gul (Pakistan for Zafar Mirza); Niranjan Udugamalagala (Sri Lanka for Vinya
Ariyaratne); Ghassan Issa (Lebanon)
£ ©Ubers
Fatemah Afzali, Pedram Rashidi and Rezvan Moghadam (Iran); Alla Shakrollah (Egypt);
Bert de Beider (Belgium); L.,11
(Uruguay); Thelma Narayan, JSA - (India),
Rakhal Gaitonde (rapporteur - India).
For the purpose of easy readability, the report will be divided into three sections - (A) PHM
Globa: agenda; (B) PHM Regional agenda (focus on reports from regions and plans of action
emerging at region); (C) Schedule of events and follow up in the phase February - April
2004)
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oJ
IPTOCIEIEiiJIINGS / MHNUTZS
A» PHM Gtotal Agemjfa
H <& 2. HratrodlMcCQoin! amd FmaDtadous of Agenda
The meeting on 12th January started at 11.00am with a round of introductions and a
review of the agenda and programme overview that had been circulated in the file of
documents that was given to all participants. The agenda was accepted without any
major changes with the proviso that since some of the participants v/ere coming later
on the 12,h or after - their presentations will be postponed and accommodated in the
programme, whenever feasible.
On a query from Sarah, it was decided to take up reports on campaign in regional
reports or regional capacitation and on the suggestion of Armando, it was decided to
introduce a short input into the inaugural session of the Forum on 14th morning,
highlighting the earlier health fora and the link with WSF.^avi suggested that sub
groups of the PHM members present, should meet in regional groupings to discuss
regional level issues and campaigns, because PHM would be stronger only if ail the
regions became stronger and evolved their own activities, framework and initiatives
responding to local needs and challenges. The morning of 16th was one possibility for
such a meeting.
3o J&epoirtis from U&egtas anndl Ccwiims (See secihmi ® for funrtlher details)
Since, some of the reports from the regions were circulated only some of the main
issues and points will be highlighted in a separate document and linked to the regional
plans that were discussed during various smaller region group meetings during IHF WSF.
4. UnBteinniaiBOEnal! FDeahEc Fonam I WorM SocfiaD Foram
a. Amit, Joint Convener of PHM India (Jana Swasthya Abhiyan) and member of the
organizing committee of the WSF, gave an overview of the framework of WSF IV, the background planning and challenges; the major differences in situation I
focus from previous WSF and the framework of plenaries, seminars, workshops
and street events. The four important PHM related panels and seminars on 17th
and 18th January and the other 8 health related events at the World Social Forum
v/ere also highlighted.
b. Ravi gave an overview of the programme for IHF, which included six plenaries
and the 14 workshops (see programme booklet circulated at IHF - WSF or
updated programme on PHM website).
This had evolved in an interactive, participatory way with suggestions from the
regions and members of the international organizing support committee. The
suggestions from Latin America, Africa and Middle East and Philippines were
particularly useful.
c. AH the PHM resource persons present at the meeting v/ere requested to take note
of the sessions and roles, which they had been allotted, and to participate actively
in the next few days to make these sessions I workshops
cc
‘.
d. Thanks to the enthusiastic follow up by Prem and others from many regions,
voices and testimonies (over 20 of them) v/ere strong at IHF and mainly
action oriented.
e. Two challenges for IHF sessions v/ere identified: (a) To move beyond problem /
situation analysis to highlight examples of proactive action at various levels, (b)
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to identify the key concerns and suggestions.. from each event to feed Jnto a
Mumbai Declaration - a document^that,.v/ould be a definitive output of.LEF,W§F,and a supplement (as well as 2004 update) on the People’s Charter for
Health and its concerns, (see separate report of IHF - WSF and Mumbai
Declaration on the website)
So Reiporrtts firoinro Wftworiks
While various members reported from regions and country circles (see section B), the
eight founding / supportive networks that helped to organize the People’s Health
Assembly and have continued to support the evolving PHM, also reported their main
activities and thrust areas.
Third World Network (Evelyne)
The main contribution of TWN was in spreading the word about PHA and the
People’s Charter and in focusing on issues relevant to PHM / PCH in TWN
publications, especially Resurgence.
A special Alma Ata 25th anniversary feature was included in the July / August
2003 issue. It included the reflections of David Werner, Debabar Banerji and
David Sanders; the People’s Charter for Health and the statement on Primary
Health Care made by PHM at World Health Assembly, May 2003
& Women ’s Global Networkfor Reproductive Rights (Nadia)
The main campaign was the Women’s Access to Health Campaigns, in which
PHM was an international collaborator and also many PHM resource persons and
articles were involved at different levels, including the Advisory Group set up in
August 2003. Copies of the Charter were distributed at all meetings of WGNRR
at all levels. This year,, the May 28th, campaign,will focus on GtaMlh ffcr AO? Healtih for Woincen: What do IHIealth sector iRefomsfeave'to db w:.tr it and
sEeTequested PHM to join in a big way. In 2003,'the focus of the campaign was
to make governments take more responsibility for reproductive rights as well as
Primary Health Care. This year, the focus was on Health Sector Reforms and how
it improved or enhanced access.
WGNRR also supported actively the Million Signature Campaign and other Alma
Ata Anniversary Campaign and was also a co-sponsor of the PHM publication,
“Health for All Now - Revive Alma Ata”. In October 2003, it organized an Alma
Ata Anniversary, Reception in Netherlands. Due to the impact of conservative
right v/ing governments, which aimed to privatize health care disregarding
women’s rights and access to contraceptives and services. WGNRR has become
more proactive in Netherlands and also support the European Social Forum 2003
process.
c, international People’s Health Council (Maria)
IPHC has been very actively involved in the organizational work related to PEA
- I and to the formation of PHM at international levels as well as the regional
promotion of PHM. IPHC has represented PHM actively at national and
international events and activities and will continue to do so. IPHC’s principle
contribution to PHM is its concerns, analysis and perspectives on the “Politics of
Health” and its commitment (based on involvement of some of its members with
Primary Health Care programmes based in communities) to the Health for All
and Primary Health Care goals, reconfirmed in the People’s Charter. Recently
IPHC has undergone an external evaluation and will scon be evolving the future
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development of IPHC as response to this evaluation and to the perception of its
members of the future directions, which should be taken by IPHC. It. looks
forward to continue to participate actively in the development of PHM in the
iulure7
Dag Hammarskjold Foundation - DHF (Olle)
DHF had supported the evolution of PHA particularly in Jhe^context of strategy and
finances. It had also supported the evaluation of PHAi the evolving PHM. asdriDHF was presently bringing out a report titled What Next?, which was a sequel to the
earlier report, What Now? - brought out in 1995, which looked at alternative
development ideas. The new report would focus on action and strategy in the current
global situation.
DHF was also involved with processes to evaluate new technologies in terms of
social and environmental implications and the Challenge of access by all. Both these
initiatives were of relevance to PHM. A speci^issue of Development Dialogue - the
DHF journal was also being planned in which some of the earlier background papers
(perhaps updated) and the report on the evolving movement and strategy by Ravi and
the evaluation findings by Andrew would also be featured.
e. Asian Community Health Network - ACHAN (Prem)
Efforts were being made gradually to use the already extensive network of ACHAN
members to strengthen PHM in various countries of the Asian region. ACHAN - Sri
Lanka had been revived (the main focus of the members was on promotion of
Primary Health Care), similar efforts were being planned for Cambodia, Thailand,
Indonesia and other countries with very limited resources and other constraints
/
Gonoshasthya Kendra - GK (Qasem)
GI< has continued as a PHM resource center even after the secretariat moved to
Bangalore. Its main functions are to continue to publish the newsletter and reprint old
publications and new ones whenever necessary. The center continues to get lots of
Charter endorsements, which are being forwarded regularly to the new secretariat for
follow up action. It has also been supporting actively the autonomous development of
PHM in Bangladesh at the national and regional levels.
g. Consumer International - kOA P (Camellia)
Cl had been supporting PHM through Carmelita, whose presence for advocacy
training and action at the WHA - May 2003 was particularly valuable. She had also
agreed then to be a Convener of the Food and Nutrition Circle, which would focus on
a range of issue - junk foods, sugar lobby and work closely as PHM representative
linked to UBFAN, APAN and other networks.
Recently, since she is no longer with CI, the secretariat will follow up with C1ROAP
and explore a replacement for the steering group to continue the linkage with CL
k Health A ction International - Asia Pacific, HA I- AP
While Bala was not able to attend the continuing support of HAl - AP and its
excellent work on the Drug policy issues, in which many PHM members in the region
were involved, was noted with appreciation. A special issue of _H_AI_ journal
(December 2003) on People’s Health Movement v/as released affflF - WSF.
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6. Oirgaftozatitea 1 Ovemew a®dl Assessment
This was an important agenda item and various dimensions were discussed in response to
agenda 6 and 10, but also came up in different v/ays during the discussion on most of the
other points as well. The meeting was an opportunity to assess the organizational
diagrams and guidelines that had been circulated at the pre - WHA May 2003 PHM
meetings.
So SSeerag Gsrocup:
The Steering Group was still incomplete because three regions - South Asia, China
ana West Africa did not still havTelecfed / hominated-representatives.
SocDib Ash was in directly represented by Zafrullah, Qasem, Prem, Bala - who were
in the steering group in other capacities but efforts to get PHM Sri Lanka,
Bangladesh, Nepal, Pakistan (PHM Maldives and Bhutan had not yet evolved) to
meet at some event and nominate a steering group member to represent the region
was necessary.
CShnna: David Legge, who travels to China on other duties had offered to help
identify potential resource persons and PHA - I participants to evolve a PHM China.
Other members who had contacts were requested to put them in touch with David.
Wesi Afrto: WGNRR had been requested to get their representative Elvira to be the
contact person for the region. All the members who had other contacts in the region
should put her in touch with them to evolve the regional circle and find more country
representatives. Recently there have been enquiries to the secretariat from Sierra
Leone and Ghana. The secretariat was following this up.
In SouUh East! Asia - Deien of Philippines would continue as the regional contact
point till more country circles were evolved.
In the India IRegte - While Ekbal was already representing the region, the steering
group suggested that a dialogue with PHM India would explore a role for Mira, who
is also from the same region and had been asked to continue in the steering group,
because of her contribution to PHA - I and the rational drug policy and other issues.
It was suggested that NorlDn Africa be separated from the Middle East as a separate
region (Malachi).
b. <C<o>ammCiry Level Circles amd ^egfiomal LgsUs of CoanroUriess
Ravi mentioned that country level circles with country contact points were increasing
(see the website for the latest position). The presence of so many of them at IHF WSF was very heartening,
While regional representatives should continue to assist the secretariat in evolving
country circles and finding countiy contact points, it was also reiterated that country
circle contact points should increase their representativeness in the ..country by
involving more networks, associations campaign groups,.NGOs in the country circle..
There was a question whether Israel should be included in the Middle Eastern Region
(Hani). It was felt that the inclusion of Israel in the present situation, when it was the
cause of so much suffering to neighboring states, was not appropriate. The inclusion
of one state may jeopardize the involvement of nearly 20 Arab states.
The regional representatives were requested to keep track of all the countries allotted
to that region and~/7ork tov^^
7 focal points'in all of them.' This'
list was included in the background file.
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c. ilratoir regteaE efftorto to spread PHM amid MEd htor-regiioaE eftorfc amid
nMatoves:
Ravi highlighted 7 examples of inter-regional efforts and suggested that PHM would
grow faster, if there were more of similar efforts.
°
°
0
o
o
°
□
fa Bast A&lgA various PHM steering group members visited in a sort of relay to
mobilize for PHM. Qasem (GK) and Maria (IPHC) visited Arusha for a WABA
meeting in October 2002 when a PHM session was held. Later Ravi and Thelma
from India visited Kempala, Nairobi, DarOes Salam enroute to Arusha for the
GFHR meeting in November 2002. At each of these places, there were PHM
meetings bringing together NGOs and resource persons from networks and
campaigns. This lead to the strengthening of the East Africa region and evolving
circles in Kenya, Uganda and Tanzania.
1“ EISA, Zafrullah, Ravi and Thelma were invited as special invitees to an
International Public Health Conference in Berkeley and then visited 10 cities and
8 universities to address PHM meetings. This led to the further development of
PHM-USA.
!n Geneva, at the World Health Assembly, May 2003, 82 PHM members from 30
countries attended a PHM get together to share ideas and perspectives and attend
the WHA to advocate for many concerns of the Charter. Over 67 members came
on their own with local I regional support. It was a special Alma Ata anniversary
year get-together but it greatly increased the credibility of PHM in WHO and the
new DG designate had an informal dialogue with 6 PHM members.
In Italy, AiFO has been the key promoter I mobiliser for PHM in Italy. AIFO
'gave the Raoul Follereau Award to PHM at its Biennial meeting in October 2004
and invited three representatives from Asia, Latin America and Africa to receive
the award. There were opportunities to share about PHM concerns from the
regions and build south-north and south-south solidarity.
Global antLwar campaigns : The spontaneous response of PHM related groups to
the anti-war campaigns and rallies ail over the world and the focus on war and
health as a PHM global concern was well done.
lbS-fiioba]_Health Forum has been taking note of PHM evolution and involving
it in the annual forums.
In Forum 5, Geneva, (December 2002) the concerns of the Charter were
presented [Ravi (India) and Zafrullah (Bangladesh)]
In Forum 6, Arusha, Tanzania (November 2002), there were research
inputs in a PHM context by David (South Africa), Zafrullah
(Bangladesh), Thelma and Ravi (India). Mwajuma (Tanzania) also
attended.
In Forum 7, Geneva, (December 2003), there were inputs by David
(South Africa) Maria (Nicaragua) and Ravi (India) and
In Fqrum 8 in Mexico (November 2004) David represents PHM on the
organising committee and David and Ravi have been put on a Task
Force Hb~ promote 'Health"Systems'Research’which will report at the
Mexico MmisteriarSumniiF/ Forum 8.
In Germany, Zafar Mirza (Pakistan) and Thelma (India) did a lecture tour in
November 2003 at the request of BUKO - Pharma Kampagne to promote PHM
mobilization in many cities and with many groups in Germany.
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d) Secinetiariiafc
o
Ravi reported in brief the experiences of the secretariat over the last one year which
included:
shift from GK-Savar to CHC-Bangalore over a transitional phase January March 2003.
Decision to keep PHM secretariat separate from CHC the host - NGO in the
Indian region - hence separate accommodation, telephone and team.
Ravi and Secretary (Srinidhi) being seconded full time from CHC to PHM
Secretariat from January 2003 till December 2004 extendable as of now till
March 2005 only.
The appointment of a full time communication officer - Prasanna with IT /
management background who gradually took over the web site management from
Nand (Costa Rica) in October 2003.
The decision in GI< - Savar (November 2003) to appoint a separate Technical officer
(to help the full time coordinator of the Secretariat with day to day activities, planning
and response to a large number of technical request that come to the Secretariat) was
deferred due to non-availability of a specific suitable person. However this lacunae
was filled by (1) support of CHChtechnical team and fellows (2) support by various
members of the steering group tozemail referrals of such technical requests^/oe^e me.
o
The efforts at decision making through email communication with steering group
members^ There were some difficulties with this and many unmet expectation from
the Secretariat team since many steering group members just did not respond to the
mail from the Secretariat, and many steering group members who did respond felt
that the secretariat did not send the collated response (final decision) promptly, (see
separate section (No. 14) on decision making and suggestions for improvement post
1HF-WSF).
e) Osssse foasedl cMes
Secretariat Coordinator was requested to outline the issue based circles that had been
initiated and comment on their functioning and development.
o
The WHO-WC-3A cfircBe (ccmveiniors - IRsvq
Zafrullab)
This was veiy active and especially since the presentation of the People's Charter for
Health at WHA, May 2002 was beginning to upscale its advocacy, strategy with some
useful results (see item 12 separate section on Dialogue with WHO). Due to Ravi’s
preoccupation with PHM secretariat he felt that Zafrullah needed to take more
proactive role in WHA circle and others should support him as well.
o
The Poverty am-di ADDS Cnirde
This was set up after a dialogue with UNAIDS Peter Piot and team (Convenor :
Dorothy Logie). However, this was not veiy active because it could not find a
specific PHM point of action. However, now with the dialogue opportunities opening
up v/ith the WHO 3x5 initiative and the presence of the WHO 3x5 team and PHM
related HIV-AIDS activists from many parts of the world at IHF-WSF (for the 5
special plenary and workshop) there was a new opportunity to revise the circle and
give it a relevant and challenging focus.
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o
Wairs, Dnsastteir amdl HwaraDteiriiain) ciiirclle (CoKiveswirs " lUaum <& RoscSn© Beini©!!!!)
This was a very active circle and had been regularly promoting I catalyzing PHM
responses to various crisis - Palestine, Iraq war, etc.
o
Htaeaireila Circle ((Coiraveimoir - HDsjvnafl Samdieirs)
While some efforts in communication to evolve focus and strategy for this circle had
been initiated by David Sanders and PHM v/as getting involved in making inputs into
GFHR and other research forums to provoke greater facilitation of health systems
research and research on social determinants the process needs further strengthen^ rvj,
o
Wwenn’s IHIeaEllb) CfircDe (Coimvemoir - WGNRR)
This was convened by WGNRR and PHM was closely involved with all the
campaigns of WGNRR as co-sponsor and active participant. The women’s access to
health campaign and other initiative of WGNRR had been actively supported.
o
Three circles have been formed (one continued from the past) and these need
further clarity and framework whicfTwill evolve in 2004.
IMSto of Health Circle (Maria - IPHC) : Its strategy has not yet been
shared in the PHM circle with clarity.
Macro ecoEomncs amd Hea^fe - the role and contribution of Medact and
Mike Rowsen in particular in the area of macro economics and concerns
about CMH report is noted and this circle will be supported as it evolves
further.
Time PnjMcc-lPirDvatt© pairtoefrsihBjp CdtcD© with Jose Utrera of Wemos as
Convenor recognizes the continuous and ongoing involvement of wemos
in their area and also the recent network of researchers exploring this
topic which has facilitated.
o
o
Food arad NMUsrStioua CircOe - at WHA - May 2003, Carmelita v/as invited by
PHM to be the convenor of a Circle that collates PHM concerns on a range of
Food and Nutrition issues including junk foods, sugar lobby, infant nutrition, the
UNICEF and Macdonald partnership, etc., and work closely v/ith IBFAN and
APAN.
CommcDMtatita! CaircEe - An effort was made by the Communication Officer of
the Secretariat in coordination with Andrew (Health Link) to evolve a
communication strategy, starting with a background paper by Andrew and
followed up by a strategy paper. It was primarily an effort to bring PHM five
communication initiatives into an integrated strategy, (web site, newsletter,
email/listserves, exchange and Charter translations/publications). (see item 13 for
the details).
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Some general points emerged from the overview presented by Ravi:
o
When the Circles are responding to specific events or focused campaign issue, they seem to
work well.
o
When the circle evolves primarily as a study circle, it is not progressing well. Perhaps there
is need to gear up to definitive outputs focused on specific events / initiatives related to the
theme of the circle.
o
Because of limited time and the various other demands on PHM members energy levels to
work through issues based circles is limited.
Some interesting discussion about issue based circles and their strengths and weaknesses, lead to
some interesting observations and questions.
o
Many circles are cross cutting and need good evidence, research is crucially important for
campaigns (David).
o
Circles can be formed spontaneously; individuals with enthusiasm can make it happen; does
not need to be endorsed but welcomed (Andy).
o
Circles should not be launched with a single point person but a team of individuals. Also
one of the role of circles is to find way of working with other networks and groups who are
interested in the same issue (Sarah).
o
Lots of groups are already working on these issues and therefore the challenge is to make
contact and work with them around campaigns (Maria).
o
Circles need research and analysis skills and also campaigning and advocacy skills.
Therefore each circle must also recruit members with this sort of expertise (Prem).
o
Circles should put out facts and figures and their plans of action from time to time; one page
enough but this would greatly help PHM media team for advocacy (Unni).
o
The Global Health Equity Watch report may be a good focus for all the circles to come
together and work together (Patricia).
o
Tnere are issues that are important to regions and so issue based circles and regional circles
need to link and respond to realities in the region (Jose).
o
In response to Carmelita’s question on relation between steering group and circles, Ravi
clarified from the process paper that country circles group to form regions and regional focal
points are members of steering group.
o
Convenors of issue based circles are convenors of circles of PHM member drawn from
different regions who are interested in the issue. These convenors are not formal members
of the steering group but are included as members of the Secretariat support group because
they support the Secretariat in evolving clarify of perspective and PHM responses to specific
issue.
o
Conveners of circles should use PHA - Exchange to brainstorm around focus of circle;
identify potential members of circle, who respond through the exchange to these circle
derived communications; and put out reflections and further communications from the circle.
The website can also be designed to have a section for circle discussions (Ravi).
Circles need to be able to accommodate the complexities of members in the context of the quality of
the work and need to generate a process that accommodates these complexities. Also since PHM is
generating a density of activity plus linkages, we have to be clear how we are going to proceed
(Andy).
Are we going round in circles (David Legge)? Tnere is some confusion about the responsibilities and
focus of the circles with some overlap. The needs to be clarified by conveners (Deien).
issue based circles need both depth, wide reach and relevance. A circle may be required to study the
issue of newer technologies and their impact on health, eg. Biotechnology, IT,. We need tp study
positive and negative impacts.
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C Oojpaigms / Advocacy
Members shared some ideas about campaigns and issue of advocacy relevant to PHM,
which should be considered by PHM in regions and supported by some of the issue
circles.
o
o
o
□
o
o
o
o
o
o
Having been present at WTO and WB meetings, there is need to use the health impact
as the measures of effect of all these policies on farmer’s livelihoods (Evelyne).
There is need to write a position paper on the global fund for AIDS, Tuberculosis and i
Malaria and track its evolution and experience (Evelyne).
There is need for a campaign strategy to promote comprehensive PHC in this growing
world of vertical strategies and evidence based planning. PHM needs to define what '
is appropriate evidence based for PHC, then collect it through our regional and global ;
networks and put it together as a global evidence base (Fran).
1
There is need to study the A PAN statement submitted to WHO in May 2003 and the j
analysis how the global strategy suggested by APAN facts into PHM framework, s
APAN is planning a Convention and PHM could place this statement in that j
convention and work with APAN during the next WHA - 2004 (Carmelita)
There is need to debate on environment and ecological issues related to sustainable J
development
There is need to look at the efforts of WTO on agriculture and how they affect /
farmer’s livelihoo’drfDavid Legge)/ [A small sub-group consisting of David Legge,
Sarah, Carmelita and Patricia decided to meet to discuss this issue and suggest further
action by PHM].
US is going towards bilateral strategies on trade v/ith different countries. PHM should
develop alliances at countiy, regional and global level to counter these ( )
FCTC undergoing ratification. PHM should demand that their governments should
slgh~ahd~ratify and implement the' framework. There will be a Western Pacific
Regional Organization (WHO - WPRO) meeting soon about implementation
(Carmelita). [Carmelita was endorsed as PHM representative at the meeting].
For every campaign, there is need to share information about the issue; get
commitment of people and groups to the campaign; and identify strategies at country
level (Maria).
For every campaign, there should be links between local work and international
campaigns - this benefits the international campaign, but also helps the campaigns to
be used locally to facilitate / mobilize and do strong local advocacy work (Hugo).
g. Lirolks wnilhi odfoeir N©twoiriks amid Movements:
One of the challenges for PHM regional and country level focal points and also the
secretariat at global level is to link v/ith other networks and movements to enhance
collectivity and solidarity between movements and strengthen the health agenda in all the
movements, networks, campaigns and struggles. PHM members are themselves linked to
other network and movements. We need to manage these dual or multiple identities
effectively. Basically we need to be able to distinguish between the PHM brand and the
PHM badge with clarity. S
a
e-sc. vspe c.
' -L. •
$ In this process of networking, v/e need to function with a certain degree of self confidence
eg., v/e are communicating and linking PHM to environmental networks nationally and
globally because environmental concerns are a major section of the Charter and these
groups were inadequately involved in national and international PHA. A movement by
its very definition needs to engage with realities, with other partners and v/e don’t need to
wait for approval (Thelma). / As v/e look to the future we need to be inclusive of new
organizations (who were not founding members). In terms of bringing in other networks,
we need to use the PHA video; share the Charter, give movement web site in meetings of
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other networks and gradually link with them or link them with PHM (Mwajuma)^The
Global Health Watch report may be a good way of forming these new linkages in the next
year (Patricia).
PHM: India (JSA) has increasingly evolved linkages with networks (there are more than
18-20 already working together at national level and their counterparts at state level. In
recent years PHM India is also linking with other national campaigns around food, water,
TRIPS, tobacco and also involving these campaign groups in PHM India initiatives and
campaigns. In some states, members of PHM India are also beginning to influence state
health policies (Maharashtra, Rajasthan, Chattisgarh, Orissa, Karnataka) (Thelma).
A consensus from the discussion was then articulated by Andy, as steps towards linking
with other networks:
o Follow your own judgement and using the PCH as a context;
o Mention PHM as you feel appropriate
o Be accountable for the way you use the PHM name or the Charter;
c Communicate the link established to the Secretariat and steering gro.up.
h) Sih® ©f tfoe Secreftmal
Ravi shared the fact that CHC had agreed to host the PHM Secretariat on behalf of the
Indian region for 2 years, starting January 2003 till December 2004, extendable till the
end of the financial year ie., March 2005. He and a Secretary had been seconded from
CHC to PHM Secretariat for this period. The Communication Officer - Prasanna was
also appointed for the same period.
If the Secretariat had to be shifted to another region early next year, then it was important
to start the process of identify! ngthe next region with potential to host the Secretariat.
The next region and the potential coordinator could then work closely with the Bangalore
secretary so. that the shi§ over would be planned and smooth.
; .'S'- ?
A process of selection ofThe.next secretariat could start by the preparation of a note on
the secretariat and its responsibilities by Ravi, Prem, Jiheo, Sarah and Lanny. This could
then be circulated end March or early April so that different regions could review their
own potential to host the Secretariat.
Ravi clarified that though the Bangalore secretariat had also recently taken over the web
site from Nand (Costa Rica) because of the availability of Prasanna - the Communication
Officer, who had an IT / Management background it was not necessary that the secretariat
and website be managed by the same team in the future as well. If any^regipn was willing
to consider to take over the responsibility of the v/eb site, this could be a separate process
and a different regional responsibility not linked to the next secretariat.
(The web site was discussed further during the session on communications - see item 14).
It was suggested that if a region v/as chosen to host the secretariat, then someone from
that region and the organization in the region which would actually be hosting the
secretariat could spend a few weeks in Bangalore to learn the ropes from the present
secretariat (Prem).
It was also emphasized that as was done during the shift of secretariat from Bangladsh to
India - that a period of overlap v/as allowed with the outgoing coordinator and the
incoming coordination being co-coordinaters for three months - a similar process would
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be followed this time as well with Ravi (Bangalore) and the next coordinator (new region)
overlapping for three months - around January - March 2005.
It was suggested that a secretariat could have a term of three years with^one year overlap
with the next secretariat (Atul).
If a secretariat was moved to a region and it was then found not to be able to cope with
the new responsibility what could be done (Boodhun). It was noted that such a
contingency need not occur in the next secretariat was identified carefully and
systematically (Ravi).
Scot® crgasizadionisD suggestions
While reviewing the evolving organizational structures and framework as outlined in the
background papers circulated some ideas and suggestions were made by some of the
members about the existing framework and organizational assumptions. These could not
be discussed at length but are being listed out to ensure that they are kept in mind as the
PHM organization experience evolved and needs review.
o
o
o
o
o
o
o
o
There was need to prevent the movement from becoming too organised and
evolving too detailed a framework of rules and regulations. This would
bureaucratise and kill the spontaneous spirit of the movement. The movement
should be issue based campaign oriented and functional capacity especially to
emphasis health and social determinants at country and regional level is more
important than definitive organizational structure (Ravi).
Too many issue circles is dividing the group and the problem. We are in a way
reproducing the fragmentation that we oppose and thereby creating a barrier.
There should be a main frame policy that can guide discussions in individual
groups and then a matrix of interconnected issues rather than circles. It is
particularly important not to fragment the process and organization so much that
we lead to a situation where we loose our capacity to be relevant (Armando).
One of the assumptions made while designing the thematic circles were that
there would be a coming together of these circles -however this did not seem to
be happening even though we are all activist. Not only issues but regions
should also link and work together. An area where this should be happening
urgently is in the issue of privatization of health services. This is happening
everywhere and there are negative impacts. We need to build common concerns
and strategies over regions (Andy).
While the issue circles were reaching out to people who are working on those
areas it is important to emphasis that the circle connect all its members with
PHM is linked to. Also if the circle activity could somehow be linked to a
certain degree of activism or action then issue circles would succeed as an idea
and a organic structure (Sarah).
We have circles for regions and each has a specific function -a specific structure
for specific needs.
We must however integrate all these circles
successiully(David Legge).
While the Charter was clear, it was now necessary to evolve a small booklet
describing all aspects of the evolving structures /framework of PHM for easy
reference by country level contact persons or focal points (Malachi).
The steering committee is absolutely serious and important and the way we
organize ourselves should be based on what we want to do. it is actions that
have vitality rather than merely statements and plans. This vitality groups from
local grass roots action -so all PHM initiatives should ultimately support,
promote and derive from grass roots action (Pam).
PHM should be careful not to keep fishing in the same pond - among the
already converted. Can the PHM get involved in universities and there we
should involve young people in more depth (Julio).
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PH Mi lEvahartitoini
A PH A I / PHM evaluation process was started in mid 2002 to assess the impact of PHAI on individuals who had attended the assembly and also to understand the precess of post
Assembly follow up in regions and countries in terms of processes, mobilization of
circles; Charter translation and distribution; campaigns and PHM inputs into national,
regional and international events.
An initial dialogue of the main emerging findings of the evaluation by a three member
team lead by Andrew (Health link) was held in May 2003 in London just before the WHA
May 2003 in Geneva. Unfortunately, due to unavoidable circumstances and constraints
the PHM evaluation report has not yet become available for a wider circulation and
debate. While the note on objectives and methodology of the evaluation was circulated as
a background paper - the summary of findings could not be accessed so it was a missed
opportunity.
Pam and Andy were requested to follow this up with Andrew at the earlier and facilitate
prompt action which would greatly help the next project cycle. Ravi shared three findings
from the May meeting
(a) that PHA had made a major impact on all those who attended it as an inspirational
and energizing experience;
(b) only those who came representing networks / associations or campaign groups and
hence had a constituency to share the concerns and perspectives of the Charter did
some follow up work including distribution of Charter, publications and some
campaign initiatives in their region.
o
So TOM Comsoitfteed stattegy airad badges 204-2<0)®(c>
a) A note discussed in London by a small representative funding group in 2003 was
circulated to the steering group members. This included the following components of
an evolving global strategy.
(A) Goal (B) Objectives I purpose (C) Measurable indicators (D) Means of
verification (E) Important assumptions and (F) Specific objectives / initiatives (I.
Building strategy for change; 2. Campaigns 3. Alternative People’s Health Report
(GHEW) 4. Advocacy for Change 5. Reaching the Unreached 6. Building the
Movements (G) Funding : Principles and Strategies.
The group went through some parts of this note especially the earlier sections to
enhance the collective endorsement of the overall objectives and aims of PHM and
the key thrusts and initiatives in the next 2-3 years.
(see separate document).
b) However, Ravi shared that the London discussions were hampered by two important
lacunae in the planning effort and hence the document could not be convened into a
logical framework analysis to be sent to funding partners for the next phase.
(i)
There was no feedback or clarity about regional mobilization efforts of
PHM; evolution of regional and country level strategies and initiatives
and the expectations of support / coordination if any from the global
’
secretariat.
(ii)
There v/as no clarity about the next People’s Health Assembly and its
financial requirements.
It was expected that the present steering group meeting would enhance the
clarity of both these constituents of the PHM plan for 2004-2006.
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Scmejdea^f regiona[needs an^equirement;
Some idea about PHA - H._..
These would ..then be. jnplucied.. in. a..revised., plan, of action and logical
framework exercise.that.the funding I planning group of PHM. would put
Together by April -May 2004.
c) Tike faradlmg : mma JJamory
-JJamiary
Ravi and Andy gave a summary of the rather precarious (?innovative) approach of
PHM Secretariat to the financial requirements / implications of current ongoing PHM
initiatives, coordinated by the secretariat and supported through the fund raising
efforts of OWA in UI<and^vU?om-the-Secretar!at.
It was summarized as a two pronged process as of now.
ii)
Scrounging - the balance from PHA^Ji,.fund raising- efforts (after al! the travel
grants and organizational costs had been mg^^the_oost ^H^-p core group
meeting held in Dhaka in November 2002; has seen ’^croungearor some of the
support to the ongoing initiatives of PHM including some of the secretariat
costs.
Friends£9^ -networks and friendly associations I agencies
that respect and trust PHM as an evolving movement have responded to the
coordinators appeals and have provided small grants and contributions that
have been used for specific initiatives. These have included:
o
.. -- - o
o
o
o
o
o
Christian Aid,-lz500$ for PHM resource centre in GI<;
WCCJ5000S for PHM-WHA 2003
WCC^^zGFp^imall grants to support PHM East Africa mobilization
DHR -'1'500’0$ to support PHM secretariat costs
A!FO"^§CuO$ - Human rights award to PHM grant used for publications
Hesperian Foundation^15000$ grant from Ford Foundation to support
secretariat I coordination related travel
CHC p^he PHM Secretariat hosting organization^ in India has covered
various office costs, capital equipment - computers and furniture and the
rental advances, etc.
Ip For 1HF-WSF - a special fund raising effort by the secretariat specially for IHF WSF has lead to contribution from the following sources :
o Medico Intemational^sSob^
o Action Aid, Bangkok - 5000$
o Cordaid, Netherlands - 12500$
o Misereor, Germany -2500$
o WHO Geneva via WR India -12000$
o Physicians for Smoke Free Campaign -10060$
—f »
»
ftr/ g
5 Am A,
|
While this ‘hand to mouth’ existence of PHM is very creditable for a movement in the
sense there is no wasteful infrastructure development or central largesse that is distributed
to regions thereby creating unnecessary centralized dependence it is still probably not the
best way to proceed.
7
A concerted effort has to be made in the next few months to ensure that a core grant to
support the main plan of action of PHM for’the next phase 2004-2005.is negotiated and
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then supplemented by the sorts of small grantsjhat have been tapped^fbi^specific
initiafvesanS "events infne'last'one
*
year and listed above.
esL Regional! Fowdliijng
1
A greater clarity has to emerge in the PHM planning and strategy to balance the fund
raising by the PHM secretariat supported by the PHM funding group for the secretariat
and global initiatives and the fund raising efforts at the regional and country level to
support local, national and regional initiatives. It is also imperative that regions which are
better resourced need also to tap funding sources to help the
* secretariat, raiss.resources for
global initiatives and needs as well
9o PeupOe’s IHIeallft AsseiwBy - HH
o
o
o
o
0
In May 2003 at the PHM Geneva get together, it was unanimously endorsed that
the next People’s Health Assembly - II would be held in July 2004 at Porto
Alegre in Brazil. A four member core planning committee was constituted which
include Maria (Nicaragua), Armando (Brazil), Amit (India) and Mwajuma (East
Africa). The group met and prepared a brief outline of the framework of the next
PHA-II which was then circulated for wider dialogue and consideration.
In the months that followed, the Latin American PHM members met a couple of
times and wrote to Armando (Brazil) encouraging him to send some sort of
written commitment of the local hosting groups at Porto Alegre so that the
decision could be finalized and endorsed. However, there was no follow up and
over six months of planning time was lost.
At the beginning of the steering group meeting in Mumbai, there were a few
informal discussions between all the participants from the Americas region to sort
out this matter since further delay in the decision would jeopardize the planning
process further. There was some concern from other regions that the decision
from a region should be consensual and the PHM steering group not be faced
with the option of selecting from two potential venues from the same region.
The decision about PHA-II was then finalized in two phases. In Phase I Hugo
representing the Latin American region made the following points at the end of
the first regional meeting:
The Latin American region would like to host the next People’s
Health Assembly;
The region had the capacity and experience to host the
Assembly;
The Assembly would be hosted in July 2005;
He quoted a Latin American proverb -that it does not matter if
there is storm, thunder or lightening -we will carry it out to
1V
emphasise the interest and the confident resolve of the group
from the region to host this important event.
A few days later, after the arrival of both Arluro and
from Ecuador, tGne
©trojposaO of flhe PeojpBe’s IHIeaiUfe send) a
of reDaHedl movemeouls it© host One
PHXTTlm QSWTEcSSoFwS's gii'acedf befeire
stemg girolp amid! h was
"accejp®^ It was decided that Arturo Quizhpe would be the
organizing committee'and would be supported by an international advisory group
that would rep'resehrdifferent regions and help with all aspects'©! the planning.
This group would be constituted soon -so that it could start the planning and
through its regular deliberations it could start the PHA -II planning process.
it was also decjded..that the next International Health Forum - IV which would be
held next year in January 2G05, when the WSF returns to Porto Alegre, Brazil,
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would be anijmpprtant complementary and pre BHA-II meeting. Armando, the
organizing secretary of this Forum I V would be a. member of the'.International
Havisbry'Tommirtee for ?HA - T. The forum could focus on Health Policy
changes tnaf are necessary to increase the potential for Health for All, Now. The
interesting examples and case studies from Brazilian experience could be
highlighted at this forum and the Brazilian experience could be reflected upon by
participants from other regions. Policy initiatives from othen parts of the world
could also be focused upon at the next forum eg., primary healthcare policy
endorsements by Karnataka, Orissa state in India and South Australia region in
Australia.
_&> RegteaB CapacfiUatiBOim Process
A short paper by Prem about regional capacitation was circulated to all the members in
the file of background papers. The paper emphasized that for increased capacity
development in different regions and countries it was necessary not only to improve the
collectivity and representativeness and effectivity of the existing steering group members
and country level contacts but also identify the framework of a capacity building process
that includes the identification of newa. youngeQeaBersfiipfand"'their~s^gnancFahd
capacity building.
o
o
o
o
o
o
One of the challenges for PHM was to build develop capacity in a region with
little or no capacity. It was necessary to chose an area with such limited capacity
and bring it up to some level (Maria).
One of the concerns was that if existing capacity especially for networking,
information sharing and communication was taken as a necessary criteria for a
region to have the qualities to take over the secretariat than regions like Africa
would be out of the contention for a long time - may be even up to 20 years
before Africa can join the movement fully. Capacity building should be a twoway process. Visits from PHM resource persons from other African region were
given a chance to move to other regions toleam from local processes that would
also be effective. Without this two-way process, Africa would be completely
excluded. In some regions like in Africa communication was a big problem.
More media is privatized so paying for a spot on TV was very costly (Mary
Sandasis).
It was suggested that the next secretariat be chosen based on the potential to build
capacity rather than the presence of actual capacity (jJ^dget).
If we needed to grow as a movement then we need to consider the possibility of
setting up regional offices or secretariats. This will especially address the needs
of other languages (eg., Spanish speaking regions (Armando).
It was felt that regional offices may actually become the foci of capacity building
towards hosting the secretariat in the future (Malachi).
It was necessary to build capacity in a region by a definitive focus on Human
rights and health. This could be done in two ways :
1. as a distance education programme (being evolved)
2. as a part of capacity building programme especially of younger recruits
and leadership (Armando).
The most important capacity we should be building at regional and country level is to
promote the people’s Charter and to build a movement by converting the Charter into
action and campaigns. Promoting a movement; facilitating a circle-country focused
or issue focused; and hosting a secretariat are three very different things and need
different capacities. However, the most important capacity to be built is to support
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movement. While doing s, one must emphasise that it is not making new members or
inviting people to join but recognizing those who are already doing the actions /
campaigns (that we feel need to be done) as partners and linking them to PHM. Ail
the individuals who are interested must also finally get linked to organizations and
movement to be more productive, sustainable (Ravi).
LL GSoW
Eqmtiy Wafcfe ReipoirC
A background note about a Global Health Equity Watch had been circulated to all the
participants. Patricia, a full time worker on the project with Medact gave a short summary of
the initiative and sought PHM steering group endorsement. The initiative had been given the
general okay by PHM at the May 2003 meting in Geneva.
° The People's Health Movement together with Medact and the Global Equity
Gauge Alliance (GEGA) was proposing the development of an annual Global
Health report to be known as Global Health Equity Watch (GHW).
o The report would be different from other annua! health and development reports
for the following reasons:
Equity and not poverty at the center of analysis
Providing an inclusive platform for civil society
Providing a platform for amplifying the ‘voices of the unheard’
Promote the PHC approach
Place health and health inequities within a broader politicaleconomic perspective and a multisectoral perspective
Link research and analysis to advocacy.
While the report will primarily be an analytic and evidence based document it
will be coupled with descriptive elements of realities on the ground (case
studies and testimonies) and on a sound justification of normative principles
and values described above.
o
o
Approximate size of the report: 150000 words.
An initial structure and chapter headings of the proposed report v/as also
circulated for comments.
After the presentation, the following decisions were made:
1. PHM steering.grQup~endorse.dlh.ejdea_ofthe.GHEW.report;
2. P?1M will be a major contributor and the core of the effort working closely with
GEGA and Medact as part of an advisory technical committee;
3. we will raise part of the support for the initiative by adding our contribution into
our annual budget;
pr i nc rpl c
4. ^the-3ec?etar4a^RN-) will be the PHM lOcaLpoint for the initiative working closely
with the secretariat to be hosted by Medact.
5. PHM will particularly focus on case studies, testimonies of action; voices of the
unheard; and regional perspective;
6. David a'nd’Abhayv/l'ir represent PHM in the discussions till a clearer framework
of organization and responsibilities emerges.
7. A meeting in March 2004 of all the stakeholders will evolve a framework for
actionT
''
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£2. Advocacy acad Dnahgwe wntUa WIHO
An overview of the history and process of advocacy and dialogue of PHM and WHO
was provided by Ravi, who had been convenor of the WHO-WHA circle since 2002.
These included in chronology:
c PH Assembly disappointment at Dr. Gro’s absence from PHA in spite of
invitation and liaison about dates (also UNICEF absence considering
WHC/UNICEF were co-facilitators of Aima Ata conference.
o Record of this missing WHO in the PHA report and its interpretation as lack of
interest in people’s health;
o Specific exhortations to WHO incorporated in the Charter;
o The NOD division of WHO inviting Ravi to present the Charter in a research
seminar in April 2001.
o Three in-house lunch time seminars by Ravi at WHO-HQ on PHA and Charter.
Distribution of Charter to all staff.
o PHM invited to WHA - May 2001 and interview with DG of six members who
represented PHM. DG referred to PHM is report and also announced the WHO Civil Society initiative. PHM made representations to WHO-CSI.
o Presentation of the Charter by Ravi and Zafrullah at the GFHR Forum 5 in
Geneva in November 200!. Demand that Charter be presented at WHA.
o PHM invited to present Charter at WHA - May 2002 as a Technical session.
Ravi and Zafrullah present Charter and Maria, Mwajuma and Ellen present
evolution of movement in Latin America, Africa and Europe. PHM represented
by 32 delegates. Intensive advocacy and media strategy. DG attends session
chaired by Filipino Health Secretary but does not make any commitments to
further dialogue.
o in the 2003 elections for new DG - PHM plays active part in efforts to make the
elections more transparent and participates in debate / dialogue with DG
candidates.
o In may 2003 at WHA, 82 participants from 30 countries attend WHA (Alma A.ta
Anniversary year) and support PHM statement on PHC; support statement of
TRIPS with Oxfam, MSFS, etc; support statement on NGO civil society etc.,
advocacy and lobbying with delegates aster advocacy training by Andrew and
Carmelita for all PHM delegates. Beginnings of an effective presence though
more quantitative rather than qualitative.
o The new DG designate Dr. Lee meets a small representative PHM delegation and
listens to concerns and initiatives including Million signature campaign.
Requests PHM to keep WHO aware of the marginalized.
o The informal dialogue.. with 'WHO during the present administration has
continued and PHM has been invited to engage with WHO on WTO / GATS; the
HIV-AIDS 3 by 5 initiative; the reiteration of primary health care; and the
dialogue on the recommendations and follow up of the commission on
Macroeconomics ’ and ' Health ^Wnile many numbers welcomed these
developments/There was a general concerns that we should b e cautious in our
expectations and watch the process carefully looking for policy / strategy change
not only public statements and pronouncements and also there was need to track
unhealthy trends and organize advocacy strategies to counter them. eg.
consultants who spoke out against WTO were facing a lot of pressure and
found their consultancies being cancelled (Mira);
business and private enterprises (for profit) were being put under the same
categorization as NGOs and this v/as totally unacceptable (Maria);
some developments in WHO were not very comforting eg., infant feeding
v/as being merely reduced to an area of information provision and not any
more a technical area (Pam);
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-
the deplorable stake of people’s health was partly due to the recent policies of
WHO. We need to keep this in perspective -it is therefore people who will
bring about this changes by putting pressure on the system from below and
not or never the WHO (Prem);
since WHO is sending a team to IHF-WSF and we have a special session
with WHO team -it is at that session that v/e need to get clarity about WHO’s
role (Maria);
GATS and TRIPS were issues that were bridging sectors but the main game
was Agriculture. There is need to push the dialogue to include the smallest
farmers who were the real losers (David Lege);
Also there was a continuous struggle within WHO and within International
health initiatives to continue legitimizing the neo liberal economic policies
and the need to counter them through effective delegitimising strategies - in
these battles between legitimizing and delegitimisation-we must not forget
tKere^probiems of the people (David Legge);
"Whatever the changes made by the DG at HQ level the impact would be
measurable only if there was a shift of policy at regional and country level
(Barzgar);
While there were nice words at the HQ/DG level there is need to monitor the
changes in actual functioning / programmes. How do these changes translate
into action at region and country level and at field level. Unless there are
changes at field I lower levels policies made at higher levels is not enough
(Jihad);
A check list should be prepared to measure WHO’s .commitment to the
concerns of the Charter at global and regional levels (Fran)
Keeping these caution in mind the process of dialogue should be seen as a
strategic opportunity and the dialogue should continue and be particularly
focused on a few thrust areas:
"o to remind / pressurize WHO of the principles of primary health care and
to re-endorse it as policy;
o to pressurize /advocate WHO to shift to a health systems strengthening
approach rather than selective marketing of magical bullets through
vertical approaches;
o to'dialogue with WHO to keep civil society / not for profit NGOs distinct
from private sector and corporate sector;
o to dialogue on 3 by 5 initiative for HIV/AIDS but strengthen the primary
health care dimensions and the health systems strengthening strategies.
o To continue to share PHMs concerns on Macro economics and Health,
various global funds and top down international initiatives<o^<sA.
\ cv
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f'Jc.
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DaaEogiuie m IPAEdO iregcoro
We I |!,
The continuing PHM dialogue with PAHO was outlined by Maria. The main
context were:
PAHO is a much older organization than WHO and in this region the new
chief of the region Dra Mirta Roses was elected over a WS supported neo
liberal candidate.
o PHM was invited by Dra Mirta Roses to make a critique of the PHC report;
o PHM (Maria) was invited by PAHO to attend a ministerial meeting as a
motivational speaker and she particularly highlighted the role of WTO / trade
issues in health;
o Along with governments; civil society organizations and private sector they
(PHM & PAHO) were planning a PHC conference in Guatemala.
o The situation
*
id . PAHO was strategic and PHM should support-the DG to
make the region more relevant for primary health care development.
(rooti comipMedo Sedtfoim IB Fofliows)
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t
iZC
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Report of PHM Steering I Support group meeting held at YMCA International
House, Mumbai on 12th, 13th and 16th January and two additional extended sessions
on 18th and 19th January at WSF Venue (Solidarity tent) and Hotel Columbus
respectively.
Preamble:
The Third International Health Forum in the Defense of People’s Health was organized
by the Global Secretariat of PHM and PHM India on 14th and 15th January at the
International House, YMCA Mumbai, preceding the World Social Forum from 16th to
21st January also at Mumbai.
Due to unavoidable constraints, the annual PHM Steering group, usually scheduled in
November each year by tradition, was postponed and linked to the Mumbai event. The
annual PHM Steering group, therefore, was organized on 12lh and 13Ul of January 2004at
the International YMCA.
Due to the unprecedented nature of participation at IHF / WSF, we not only had a near
complete steering group presence ( ), but we also had many members from all over the
world, who support the secretariat in separate functions as volunteers 0 and many
country contact points as well ().
The first two days, 12th and 13th, therefore, was a steering I support group and all those in
these different categories, other than steering group, were also invited to attend the
discussions in a spirit of transparency as observers / participants.
On 16th, 18th and 19th January, some extended sessions were held to make decisions and
evolve a plan for the next year. These meetings were attended primarily by steering group
members.
An agenda was sent out in advance of the meetings and a programme overview from 12th
- 16lh January, was also circulated in which all the steering group agenda points were
allotted specific time slots on 12th and 13th January. However, due to delayed arrival of
some of the steering group members, sessions were interchanged and some extended
sessions were held to increase the participatory nature of the steering / planning exercise
and the group also addressed some new issues that were brought up during the
discussion.
The whole process was very interactive and participatory and the enclosed report written
in the order of the original agenda tries to capture the main issues and decisions that were
taken.
Since the compilation of the minutes / report took a while, the secretariat team is also
appending a follow up report that tracks all the action that has been taken. Overall, the
meeting proved to be a great ‘battery charger’ and ‘energizer’ and the enthusiasm with
which the PHM steering group / support group and country contacts have followed up on
C:\My Documenls\Minutes of Steering group nieeting_1904.doc
their commitments has been most heartening. The PHM is definitely come to stay and
evolving in enthusiasm content and impact. [However, the evolution / mobilization of
PHM continues to show great regional variation and diversity. One of the biggest
challenges for PHM is to ensure that all regions / networks / countries are well
represented in the evolving initiatives and this puts special responsibilities on all those
who represent those regions that are lagging behind to make an extra effort to evolve
regional and country circles and initiatives and process in their region as we gear up for
the next People’s Health Assembly in July 2005 in Ecuador.
MEMBERS PRESENT
The participants have been classified into functional groups.
Steering Group’.
a. Network Representatives:
Maria Hamlin Zuniga - Nicaragua (IPHC); Zafrullah Chowdhury, Bangladesh
(GK); Prem John, India (ACHAN); Carmel ita Canila, Philippines (CI); Evelyne
Hong, Malaysia (TWN); Nadia Van der Linde, Netherlands (WGNRR); Olle
Nordberg , Sweden (DHF). [Dr. Bala of HAI - AP could not attend)
b. Regional Representatives:
Pam Zinkin (Europe); Sarah Shannon, Hesperian Foundation, USA and Lanny
Smith, Doctors for Global Health, USA - (North America); Hugo Icu Peren,
Guatemala (Central America and Caribbean); Arturo Quizhpe, Ecuador (South
America); David Sanders / Bridget Lloyd , South Africa (Southern Africa);
Mwajuma S. Masaiganah, Tanzania (East and Central Africa); Fran Baum,
Australia (Pacific Australia and New Zealand); B. Ekbal I Mira Shiva (India);
Edelina de la Paz, Philippines (South East Asia); Jihad Mashal, Palestine (Middle
East and North Africa). [South Asia, China and West Africa did not have elected
regional representatives)
c. Coordinators:
Qasem Chowdhury, GK - Bangladesh (Past coordinator); Ravi Narayan, India
(Present Coordinator)
d. Support Group
Andy Rutherford, One World Action - UK (Funding); Unnikrishnan, India
(Media); Armando De Negre, Brazil (IHF - WSF); Jose Utrera, Netherland
(Public Private Partnership circle); S.S. Prasanna (Website and Communication);
Rebecca Zuniga (Translations); Patricia Morton, (GHW)
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e. Country Focal Points I Contacts
David Legge (Australia); Julio Monsalvo (Argentina); A.H.M. Nouman
(Bangladesh); Atul Kapoor (Canada); Hani Serag (Egypt); Malachi Orondo
(Kenya); Mohd. Ali Barzgar (Iran); Mary Sandasi (Zimbabwe); Jagadish
Goburdhun and R.K. Boodhun (Mauritius); Ayyaz Gul (Pakistan for Zafar
Mirza); Niranjan Udugamalagala (Sri Lanka for Vinya Ariyaratne); Ghassan Issa
(Lebanon)
f.
Others
Fatemah Afzali, Pedram Rashidi and Rezvan Moghadam (Iran); Alla Shakrollah
(Egypt); Bert de Beider (Belgium); Thelma Narayan, JSA - (India)
For the purpose of easy readability, the report will be divided into three sections - (a)
PHM Global agenda; (b) PFIM Regional agenda and the latter will focus on reports from
regions and plans of action emerging at region; (c) Follow up in the phase February April 2004 and schedule of events.
R.
7 Globe!
Proceedings / Minutes
p)
C. : O 4? :. ■
A. PHM Global Agenda
1 & 2. Introduction and Finalization of Agenda
' •
•
? e v- vT
‘
<
.
The meeting on 12th January started at 11.00am with a round of introductions and a
review of the agenda and programme overview that had been circulated in the file of
documents that was given to all participants. The agenda was accepted without any major >
changes with the proviso that since some of the participants were coming later on the 12th
or after - their presentations will be postponed and accommodated in the programme,
whenever feasible.
On a query from Sarah, it was decided to take up reports on campaign in regional reports
or regional capacitation and on the suggestion of Armando, it was decided to introduce a
short input into the inaugural session of the Forum on 141’1 morning, highlighting the
earlier health fora and the link with WSF. Ravi suggested that sub-groups of the PHM
members present, should meet in regional groupings to discuss regional level issues and
campaigns, because PHM would be stronger only if all the regions became stronger and
evolved their own activities, framework and initiatives responding to local needs and
challenges. The morning of 16th was one possibility for such a meeting.
3. Reports from Regions and Countries (See section B for further details)
Since, some of the reports from the regions were circulated only some of the main issues
and points will be highlighted in a separate document and linked to the regional plans that
were discussed during various smaller region group meetings during IHF - WSF.
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,
•
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vA .
4. International Health Forum I World Social Forum
a. Amit, Joint Convener of PHM India (Jana Swasthya Abhiyan) and member of the
organizing committee of the WSF, gave an overview of the framework of WSF IV, the background planning and challenges; the major differences in situation /
focus from previous WSF and the framework of plenaries, seminars, workshops
and street events. The four important PHM related panels and seminars on 17th
and 18th January and the other 8 health related events at the World Social Forum
were also highlighted.
b. Ravi gave an overview of the programme for IHF, which included six plenaries
and the 14 workshops (see programme booklet circulated at IHF - WSF or
updated programme on PHM website).
This had evolved in an interactive, participatory way with suggestions from the
regions and members of the international organizing support committee. The
suggestions from Latin America, Africa and Middle East and Philippines were
particularly useful.
c. All the PHM resource persons present at the meeting were requested to take note
of the sessions and roles, which they had been allotted and to participate actively
in the next few days to make these sessions / workshops
d. Thanks to the enthusiastic follow up by Prem and others from many regions, these
voices and testimonies (over 20 of them) were strong at IHF and mainly action
oriented.
e. Two challenges for IHF sessions were identified: (a) To move beyond problem /
situation analysis to highlight examples of proactive action at various levels, (b)
to identify the key concerns and suggestions from each event to feed into a
Mumbai Declaration - a document that would be a definitive output of IHF WSF and a supplement (as well as 2004 update) on the People’s Charter for
Health and its concerns, (see separate report of IHF - WSF and Mumbai
Declaration on the website)
5. Reports from Networks
While various members reported from regions and country circles (see section B), the
eight founding I supportive networks that helped to organize the People’s Health
Assembly and have continued to support the evolving PFIM, also reported their main
activities and thrust areas.
a. Third World Network (Evelyne)
The main contribution of TWN was in spreading the word about PHA and the
People’s Charter and in focusing on issues relevant to PHM / PCH in TWN
publications, especially Resurgence.
A special Alma Ata 25th anniversary feature was included in the July / August
2003 issue. It included the reflections of David Werner, Debabar Banerji and
David Sanders; the People’s Charter for Health and the statement on Primary
Health Care made by PHM at World Health Assembly, May 2003
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b. Women ’s Global Network for Reproductive Rights (Nadia)
The main campaign was the Women’s Access to Health Campaigns, in which
PHM was an international collaborator and also many PHM resource persons and
articles were involved at different levels, including the Advisory Group set up in
August 2003. Copies of the Charter were distributed at all meetings of WGNRR
at all levels. This year, the May 28th, campaign will focus on Health for All Health for Women: What do Health sector Reforms have to do with it and
she requested PHM to join in a big way. In 2003, the focus of the campaign was
to make governments take more responsibility for reproductive rights as well as
Primary Health Care. This year, the focus was on Health Sector Reforms and how
it improved or enhanced access.
WGNRR also supported actively the Million Signature Campaign and other Alma
Ata Anniversary Campaign and was also a co-sponsor of the PHM publication,
“Health for All Now - Revive Alma Ata”. In October 2003, it organized an Alma
Ata Anniversary, Reception in Netherlands. Due to the impact of conservative
right wing governments, which aimed to privatize health care disregarding
women’s rights and access to contraceptives and services. WGNRR has become
more proactive in Netherlands and also support the European Social Forum 2003
process.
c. International People’s Health Council (Maria)
IPHC has been very actively involved in the organizational work related to PHA I and to the formation of PHM at international levels as well as the regional
promotion of PHM. IPHC has represented PHM actively at national and
international events and activities and will continue to do so. IPHC’s principle
contribution to PHM is its concerns, analysis and perspectives on the “Politics of
Health” and its commitment (based on involvement of some of its members with
Primary Health Care programmes based in communities) to the Health for All and
Primary Health Care goals, reconfirmed in the People’s Charter. Recently IPHC
has undergone an external evaluation and will soon be evolving the future
development of IPHC as response to this evaluation and to the perception of its
members of the future directions, which should be taken by IPHC. It looks
forward to continue to participate actively in the development of PHM in the
future.
d, Dag Hammarskjold Foundation - DHF (Olle)
DHF had supported the evolution of PHA particularly in the context of strategy
and finances. It had also supported the evaluation of PHA - the evolving PHM
and I. DHF was presently bringing out a report titled What Next?, which was a
sequel to the earlier report, What Now? - brought out in 1995, which looked at
alternative development ideas. The new report would focus on action and strategy
in the current global situation.
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DHF was also involved with processes to evaluate new technologies in terms of
social and environmental implications and the Challenge of access by all. Both
these initiatives were of relevance to PHM. A special issue of Development
Dialogue - the DHF journal was also being planned in which some of the earlier
background papers (perhaps updated) and the report on the evolving movement
and strategy by Ravi and the evaluation findings by Andrew would also be
featured.
e. Asian Community Health Network -ACHAN (Prem)
Efforts were being made gradually to use the already extensive network of
ACHAN members to strengthen PHM in various countries of the Asian region.
ACHAN - Sri Lanka had been revived (the main focus of the members was on
promotion of Primary Health Care), similar efforts were being planned for
Cambodia, Thailand, Indonesia and other countries with very limited resources
and other constraints
f. Gonoshasthya Kendra - GK (Qasem)
GK has continued as a PHM resource center even after the secretariat moved to
Bangalore. Its main functions are to continue to publish the newsletter and reprint
old publications and new ones whenever necessary. The center continues to get
lots of Charter endorsements, which are being forwarded regularly to the new
secretariat for follow up action. It has also been supporting actively the
autonomous development of PHM in Bangladesh at the national and regional
levels.
g. Consumer International - ROAP (Carmelita)
CI had been supporting PHM through Carmelita, whose presence for advocacy
training and action at the WHA - May 2003 was particularly valuable. She had
also agreed then to be a Convener of the Food and Nutrition Circle, which would
focus on a range of issue - junk foods, sugar lobby and work closely as PHM
representative linked to UBFAN, APAN and other networks.
Recently, since she is no longer with CI, the secretariat will follow up with
CIROAP and explore a replacement for the steering group to continue the linkage
with CI.
h. Health Action International — Asia Pacific, HAI - AP (Bala)
While Bala was not able to attend the continuing support of HAI - AP and its
excellent work on the Drug policy issues, in which many PHM members in the
region were involved, was noted with appreciation. A special issue of HAI journal
(December 2003) on People’s Health Movement was released at IHF - WSFZ
6. Organizational Overview and Assessment
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This was an important agenda item and various dimensions were discussed in
response to agenda 6 and 10, but also came up in different ways during the discussion
on most of the other points as well. The meeting was an opportunity to assess the
organizational diagrams and guidelines that had been circulated at the pre - WHA
May 2003 PHM meetings.
a. Steering Group:
The Steering Group was still incomplete because three regions - South Asia,
China and West Africa did not still have elected / nominated representatives.
South Asia was in directly represented by Zafrullah, Qasem, Prem, Bala - who
were in the steering group in other capacities but efforts to get PHM Sri Lanka,
Bangladesh, Nepal, Pakistan (PHM Maldives and Bhutan had not yet evolved) to
meet at some event and nominate a steering group member to represent the region
was necessary.
China: David Legge, who travels to China on other duties had offered to help
identify potential resource persons and PHA - I participants to evolve a PHM
China. Other members who had contacts were requested to put them in touch with
David.
West Africa: WGNRR had been requested to get their representative Elvira to be
the contact person for the region. All the members who had other contacts in the
region should put her in touch with them to evolve the regional circle and find
more country representatives. Recently there had been enquire to the secretariat
from Sierra Leone and----------------. The secretariat was following this up.
In South East Asia - Deien of Philippines would continue as the regional contact
point till more country circles were evolved.
In the India Region - While Ekbal was already representing the region, the
steering group suggested that a dialogue with PHM India would explore a role for
Mira, who is also from the same region and had been asked to continue in the
steering group, because of her contribution to PHA - I and the rational drug
policy and other issues.
It was suggested that North Africa be separated from the Middle East as a
separate region (Malachi).
b. Country Level Circles and Regional Lists of Countries:
Ravi mentioned that country level circles with country contact points were
increasing (see the website for the latest position). The presence of so many of
them at IHF - WSF was very heartening,
While regional representatives should continue to assist the secretariat in evolving
country circles and finding country contact points, it was also reiterated that
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country circle contact points should increase their representativness in the country
by involving more networks, associations campaign groups, NGOs in the country
circle.
There was a question whether Israel should be included in the Middle Eastern
Region (Hani). It was felt that the inclusion of Israel in the present situation, when
it was the cause of so much suffering to neighboring states, was not appropriate.
The inclusion of one state may jeopardize the involvement of nearly 20 Arab
states.
c. *nter *reg onaV eff°rts t0 spread PHM and build inter-regional efforts and
initiatives:
Ravi highlighted 7 examples of inter-regional efforts and suggested that PHM
would grow faster, if there were more of similar efforts.
In the East Africa, various PHIyf Steering group members visited in a sort of relay
to mobilize for PHM. Qasem (GK) and Maria (IPHG) visited Arush£ for a WABa
meeting in October 2002, w^n a PHM session was held. Later Rayi and Thelma
from India visited Kampala, Nairobi, Dar-es-Salam, enroute to Arusha for the
GFFIR meeting in November 2002. At each of these places, there were PHM
meetings bringing together NGOs and resource persons from networks and
campaigns. This lead to/the strengthening of the East Africa region and evolving
circles in Kenya, Uganaa and Tanzania.
Zafrullah, Ravi and^Thelma visited USA as special invitees to an International
Public Health confidence in Berkeley and then visited 10 cities and 8 universities
to address PHM meetings. This led to the further development of PHM - USA
/
At the World Health Assembly - May 2003, 82 PHM members from 30 countries
attended a PHM get together to share ideas and perspectives-and attend the WHA
to advocate fqr many concerns of the Charter. Over 67 members cam on their own
with local //regional support. It was a special Alma Ata/Anniversary year get
together, but it greatly increased the credibility of PHM in WHO and the new DG
designate had an informal dialogue with 6 PHM members.
The AIFO (Italy) has been the key promoter / mobilize!
*
for PHM in Italy at its Bi
annual meeting
/
•
In East Africa, various PHM steering group members visited in a sort of relay to
mobilize for PHM. Qasem (GK) and Maria (IPHC) visited Arusha for a WABA
meeting in October 2002 when a PHM session was held. Later Ravi and Thelma
from India visited Kempala, Nairobi, DarOes Salam enroute to Arusha for the GFHR
meeting in November 2002. At each of these places, there were PHM meetings
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bringing together NGOs and resource persons from networks and campaigns. This
lead to the strengthening of the East Africa region and evolving circles in Kenya,
Uganda and Tanzania.
• Zafrullah, Ravi and Thelma visited WSA as special invitees to an International Public
Health Conference in Berkeley and then visited 10 cities and 8 universities to address
PHM meetings. This led to the further development of PHM-USA.
• At the World Health Assembly, May 2003, 82 PI-IM members from 30 countries
attended a PHM get together to share ideas and perspectives and attend the WFIA to
advocate for many concerns of the Charter. Over 67 members came on their own
with local I regional support. It was a special Alma Ata anniversary year get-together
but it greatly increased the credibility of PHM in WFIO and the new DG designate
had an informal dialogue with 6 PHM members.
• The A1FO (Italy) has been the key promoter / mobiliser for PHM in Italy. AIFO gave
the Raoul Follereau Award to PHM at its Biennial meeting in October 2004 and
invited three representatives from Asia, Latin America and Africa to receive the
award. There were opportunities to share about PHM concerns from the regions and
build south-north and south-south solidarity.
• The spontaneous response of PFIM related groups to the anti-war campaigns and
rallies all over the world and the focus on war and health as a PHM global concern
was well done.
• The Global Health Forum has been taking note of PFIM evolution and the concerns of
the Charter was presented [Ravi (India) and Zafrullah (Bangladesh)] in GFHR Forum
6, Arusha, Tanzania - November 2002, there were research inputs in a PFIM context
by David (South Africa), Zafrullah (Bangladesh), Thelma and Ravi (India).
In
Forum 7, Geneva, December 2003, there were inputs by David (South Africa) Maria
(Nicaragua) and Ravi (India) and in GFHR - Forum 8 in Mexico, David represents
PHM on the organising committee and David and Ravi have been put on a Task
Force to promote Health Systems Research at the Mexico Summit in November 2004
(GFHR Forum 8).
• Zafar Mirza (Pakistan) and Thelma (India) did a lecture tour in Germany in
November 2003 at the request of BUKO - Pharma Kampagne to promote PFIM
mobilization in Germany in many cities and with many groups.
d) Secretariat
•
Ravi reprted in brief the experiences of the secretariat over the last one year which
included:
- shift from GK-Savar to CFIC-Bangalore over a transitional phase January March 2003.
Decision to keep PFIM secretariat separate from CHC the host - NGO in the
Indian region - hence separate accommodation, telephone and team.
- Ravi and Secretary (Srinidhi) being seconded full time from CHC to PFIM
Secretariat from January 2003 till December 2004 extendable as of now till
March 2005 only.
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The appointment of a full time communication officer - Prasarma with IT /
management background who gradually took over the web site management
from Nand (Costa Rica) in October 2003.
The decision in GK - Savar (November 2003) to appoint a separate Technical
officer (to help the full time coordinator of the Secretariat with day to day
activities, planning and response to a large number of technical request that come
to the Secretariat) was deferred due to non-availability of a specific suitable
person. However this lacunae was filled by (1) support of CHC technical team
and fellows (2) support by various members of the steering group to email
referrals of such technical requests.
•
|
‘
The efforts at decision making through email communication with steering group
members. There were some difficulties with this and many unmet expectation from
the Secretariat team since many steering group members just did not respond to the
mail from the Secretariat, and many steering group members who did respond felt
that the secretariat did not send the collated response (final decision) promptly, (see
separate section on decision making and suggestions fro improvement post IHFWSF).
e) Issue based circles
ro A,
•
/
•
Ravi was requested to outline the issue based circles that had been initiated and
comment on their functioning and development.
The WHO-WHA circle (convenors - Ravi & Zafrullah)
This was very active and especially since the presentation of the People’s Charter for
Health at WHA, May 2002 was beginning to upscale its advocacy, strategy with some
useful results (see item 12 separate section on Dialogue with WHO). Due to Ravi’s
preoccupation with PHM secretariat he felt that Zafrullah needed to take more
proactive role in WHA circle and others should support him as well.
•
The Poverty and AIDS Ciecle
This was set up after a dialogue with UNAIDS Peter Piot and team (Convenor :
Dorothy Logie). However, this was not very active because it could not find a
specific PHM point of action. However, now with the dialogue opportunities opening
up with the WHO 3x5 initiative and the presence of the WHO 3x5 team and PHM
related HIV-AIDS activists from many parts of the world at IHF-WSF (for the 5
special plenary and workshop) there was a new opportunity to revise the circle and
give it a relevant and challenging focus.
•
Wai- and Disaster circle (Convenors : Unni & Rosclie Bertell)
This was a very active circle and had been regularly promoting I catalyzing PHM
responses to various crisis - Palestine, Iraq war, etc.
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S ec ftvn 5
•
Research Circle (Convenor - David Sanders)
While some efforts in communication to evolve focus and strategy for this circle had
been initiated by David Sanders and PHM was getting involved in making inputs into
GFHR and other research forums to provoke greater facilitation of health systems
research and research on social determinants the process needs further strengthen.
r
•
I
•
9
Women’s Health Circle
This was convened by WGNRR and PHM was closely involved with all the
campaigns of WGNRR as co-sponsor and active participant. The women’s access to
health campaign and other initiative of WGNRR had been actively supported.
Three circles have been formed (one continued from the past) and these need further
clarity and framework which will evolve in 2004.
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I
I
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•
•
A
Politics of Health Circle (Maria - IPHC) : Its strategy has not yet been shared
in tKe PHM circle with clarity.
Macro economics and Health - the role and contribution of Medact and Mike
Rowsen in particular in the area of macro economics and concerns about
CMH report is noted and this circle will be supported as it evolves further.
The Public-Private partnership Circle with Jose Utrera of Wemos as Convenor
recognizes the continuous and ongoing involvement of wemos in their area
and also the recent network of researchers exploring this topic which has
facilitated.
Food and Nutrition Circle - at WFIA - May 2003, Carmelita was invited by PHM to
be the convenor of a Circle that collates PHM concerns on a range of Food and
Nutrition issues including junk foods, sugar lobby, infant nutrition, the UNICEF and
Macdonald partnership, etc., and work closely with IBFAN and APAN.
Cornmunication Circle - An effort was made by the Secretariat in coordination with
Andrew (Health Link) who circulated a paper.
While this was sent to steering group, it was primarily an effort to bring all those
supporting communication efforts of CHC into one interactive circle (see item 14 for
further details).
Some general points emerged from the overview presented by Ravi:
•
•
•
When the Circles are responding to specific events or focused campaign issue, they
seem to work well.
When the circle evolves primarily as a study circle, it is not progressing well.
Perhaps there is need to gear up to definitive outputs focused on specific events /
initiatives related to the theme of the circle.
Because of limited time and the various other demands on PHM members energy
levels to work through issues based circles is limited.
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Some interesting discussion about issue based circles and their strengths and weaknesses,
lead to some interesting observations and questions.
•
•
•
•
•
•
•
•
•
•
Many circles are cross cutting and need good evidence, research is crucially
important for campaigns (David).
Circles can be formed spontaneously; individuals with enthusiasm can make it
happen; does not need to be endorsed but welcomed (Andy).
Circles should not be launched with a single point person but a team of individuals.
Also one of the role of circles is to find way of working with other networks and
groups who are interested in the same issue (Sarah).
Lots of groups are already working on these issues and therefore the challenge is to
make contact and work with them around campaigns (Maria).
Circles need research and analysis skills and also campaigning and advocacy skills.
Therefore each circle must also recruit members with this sort of expertise (Prem).
Circles should put out facts and figures and their plans of action from time to time;
one page enough but this would greatly help PHM media team for advocacy (Unni).
The Global Health Equity Watch report may be a good focus for all the circles to
come together and work together (Patricia).
There are issues that are important to regions and so issue based circles and regional
circles need to link and respond to realities in the region (Jose).
In response to Carmelita’s question on relation between steering group and circles,
Ravi clarified from the process paper that country circles group to form regions and
regional focal points are members of steering group.
Convenors of issue based circles are convenors of circles of PHM member drawn
from different regions who are interested in the issue. These convenors are not
formal members of the steering group but are included as members of the Secretariat
support group because they support the Secretariat in evolving clarify of perspective
and PHM responses to specific issue.
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PROCEEDINGS / MINUTES OF THE STEERING / SUPPORT
GROUP MEETING - MUMBAI, JANUARY 2004
SECTION B : REPORTS FROM THE REGIONS AND THE REGIONAL
INITIATIVES
13. Report from the Regions
All regional focal points and many of the country focal points reported about issues
and initiatives from the regional and country contexts. Some had circulated actual
reports, which will be available on the website. In this section, we just list out the key
points made to give an overview of the regional challenges of PHM.
AMERICAS
Maria - Latin America
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The problem of many languages was mentioned.
The most important problem that was recognised is health and trade. Four
governments of Latin America had signed a free trade agreement with USA. It
was important to highlight to the people that the governments were in the
pockets of Bush. The only way out it seemed was if the proposal was defeated
in the US congress.
There were gaps in the report due to the lack of a good communication system
in the region.
The long history of militancy and revolutionary struggle in the region had a lot
to teach the PHM - especially in the field of participatory decision-making.
Lanny - U.S.A.
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Agreed and endorsed what maria said.
Noted that the PHA exchange was always in English. Some of the experiences
of the militant groups in Spanish could not be exchanged with the English
reading world and vice-versa.
The problem/with the server, which was donated to them and had the
condition that they would carry things only in English. However now the
PHM website had Spanish material and pages (Maria).
Armando - Brazil
•
•
In 2002 the lsl I HF attempted to make a connection with the PHM. The second
IHF in 2003 where the PHM was invited was meant to give visibility to the
PHM and to connect the Latin American movements with movements in the
rest of the world.
Suggested the setting up of a Social Observatory to do three main things
- Monitor equity
- Course on human rights and health
- Deliberations leading up to an agenda for PHA II (?)
2
In Brazil this movement led to the inclusion of health as important agenda in
the international agenda. Brazil had a universal health care system and was
resisting privatisation - going against the grain of the policies of the World
Bank and the IMF. It was important to project this example.
The Brazilian experience should be added to the IHF / PHM agenda as it was a
concrete example of what was possible in a developing country with a fairly
large population, in today’s environment of globalisation.
•
•
Sarah - USA
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•
Launched in Feb I Mar 2003. Coinciding with the trip of Zafrullah, Ravi
Thelma.
There were 5 main issue circles
o Access to Health in USA
o Health and War - especially war profiteering
o Globalisation and health - especially health and trade.
o Environment health and justice - keeping peoples health over profits
o Community based action in the USA.
There were two other important issues highlighted
i.
ii.
•
•
One was the increasing lack of access of health care to large sections
of populations in the US.
It was the policies of the US government that is, the cause of ill health
of peoples all over the world.
The coming year is the electoral year - the first priority of course is to see that
Bush was not re-elected - but more importantly to see how we could change
US policy.
Another challenge was coordination with Canada - after they had talked
among themselves and come up their own agenda.
Atul - Canada
■
■
The main issues of coordination were - health, trade and environment
An example may be learnt from Canada that has introduced compulsory
licensing of drugs for HIV I AIDS.
AFRICA
Mwajuma - East Africa
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The activities are mainly of South I East and Central Africa.
There was the launch of the PHM in Kenya in 2003.
There was an attempt to link with other organisations to address the problem
of health for all.
The movement was merged with a Tanzanian NGO which agreed to donate
office space. This was essential as NGO’s had to register in Tanzania and new
registrations were a problem so it was easier to work from within an already
registered NGO.
An east African office had been set up with a young doctor volunteering to
spend three days a week to help (Upendo-John-Mwin-gira).
3
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■
They were tying up with a youth group in Tanzania in campaigns against
drugs.
A ver)' important issue was the impact of HIV I AIDS. In this connection it
was important to learn from the example of Uganda where the infection rate is
inTact coming down. However there was very little contact with Uganda.
They were also connecting up with the African Women’s Leadership
Organisation.
Bridgett - South Africa
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s
There were many organisations working separately but not coordinating.
While previously the civil society in .south Africa had united against apartheid
I in the struggle against apartheid^ Jftowever post apartheid the role of civil
society in the new South African society was yet to be clearly defined.
There was need to involve people from the rural areas the academics, trade
unions, and the NGO’s .
There was increased participation of community health workers - especially as
many of them were being retrenched.
The special interests of the South African groups were as follows:
> Globalisation
> Basic services
> Poverty with the various sub themes
o Social security
o Food security
o Child support etc
> HIV/AIDS
o Equity in access to AIDS drugs
> Brain drain
> Demystification of GATS
In all these issues certain outlooks crossed right through - including Human
rights / gender I equity.
■
There was also a close association with the Treatment Action Campaign.
There was need to discuss how to strengthen the health systems approach to
get treatment to reach the patients.
■
Challenges for the Future
o Need to expand to other provinces
o Health workers campaign
o HIV I testing and treatment
■
There was the problem of stigmatisation of and from health care workers
towards patients with HIV I AIDS.
■
David Sanders has completed a paper on Health research and Civil Society for
the Bulletin 0f WHO.
e
4
Man' - Zimbabwe
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The particular circumstances under which the NGO movement in Zimbabwe had
to function included the repressive laws enacted to paralyse NGO’s in Zimbabwe,
the REPUBLIC ORDER SECURITY ACT. Under this act you needed permission
for more than 5 people to gather together. All NGO’s also had to re-register. Thus
it was only possible to work with groups already workings new groups were not
possible in the present scenario.
Participation in the treatment access movement.
The presidential elections where the phm and other organisations got the chance to
actually be invited to monitor the elections. This was due to the translation of the
charter - so people came to understand the interconnections in health.
Various innovative ways had come up
to deal with repressive laws. For
example with the campaign for AIDS drugs they planned a Cemetry Prayer for
which permission was given and a large procession was allowed at the cemetery
after the prayer there were speeches that highlighted the fact that many or all of
the people who had died could have been saved if they had had access to drugs.
In spite of all the repressive laws they had managed to arrange 6 public meetings
that covered topics like HIV I AIDS^drugs access and prevention of transmission.
The other obstacles to the functioning of NGO’s;
Z Most of telephones were bugged
Z Postal system was almost non-functional and sometimes letters never
reached.
Z E-mails also monitored and many never reached.
J Some of the NGO’s have been infiltrated by government staff so one
has to be very careful about who one employs.
Malachi - Kenya
The highlights of the work in the Kenyan region:
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Main activity was lobbying with CBO’s and drug organisations
There was support for the movement from the Kenyan Ports Authority
There was a very cordial relation with the Kenyan Government
PHM was registered with the Kenyan Government.
It w.aWwas attempting to be an umbrella NGO.
They meet every Wednesday
In the ICASA meeting the PHM was invited to participate and the Kenyan
delegation represented.
The challenges:
Z There were nearly 29 million HIV positive people in Africa (?)
J There was still not a very strong PHM representation
J HIV/AIDS
Z Lack of IT equipment
The PHM presence should be strengthened in the African Union, especially on
the issues of killings. We need to do this so that our voices may be heard
against the genocide.
5
Jagdish - Mauritius
■ PHM was an NGO registered in Mauritius legally.
■ Mauritius has taken the Alma Ata declaration as a guiding principle.
■ They have a community health fund which supports Primary Health Care
Development in the country.
■ There is an Institute of health which was doing research on primary health
care - funded by the WHO and the UNICEF
■ It was ironic that the PHM in Mauritius was trying to the salvage the good
work of the governments in the past, especially there efforts to strengthen the
primary health care set up.
MIDDLE EAST
Jihad - Palestine
There were specific challenges as a region the first and foremost was the definition of
the region as a whole especially as Arabs were all over (and needed to be united)
■ Also the problem of language - Arabic, French and English.
■ Also various countries had NGO’s at different levels of development and this
was an impediment.
■ There was involvement with NGO’s for development - this also ensured
connectivity.
■ While other regions may be facing lack of access or efficiency this was not a
problem in the region - however what was a problem was the continuance of
conflict.
■ The struggle was represented by a continuum from - access to health
(physical) - GATS - and conflict - occupation and war.
■ Plan of action - (Cyprus meeting)
o Commitment of countries towards PHM
o Launch of the Million Signatures Campaign in Arabic
o Representatives of the movement met with the regional office in Cairo
o E-group
■ We need to do something for Iraq. It has the worst possible set of experiences
- first embargo'J’then collapse of the health system^and finally war and
occupation.
r’
3-'
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Barzgar - Iran
■ The movement in Iran was moving fast, especially after the Alma Ata
anniversary program. This was supported by the government allocating money x
for the meeting, and ’tfie presence of senior PHM persons, being physically
present,This was a great boost.
■ There was also the need for a workshop to promote PHM approaches.
■ A framework of analysis was also proposed when the events were divided into
pre-event \ events \ and post events stages. The pre-event stage was basically
about (maintaining! sustainable development - this was essential to avoid loss
duringt.the event. This included emergency preparedness and the provision of
basic itjinimu'm needs. Again in the post-event situation there was a
highlighting^of sustainable development and human centred development.
■ Poverty and underdevelopment were the main causes of the extensive death
and destruction in the earthquake. However the quake or any crisis was also an
opportunity. In Iran this was happening as it is recognised that to get the
6
■
assistance to the people who really needed it it was important to get the
NGO?s involved - it is thus decided to bring all the NGO’s under one
umbrella. This was to have a unified system of organising the people.
The basic minimum needs program was seen as a strategy to work with
communities.
Hani - Egypt
■ THE Cyprus meeting was the first time commitments were made by the
various countries attending...
C (<».< J < r i f p L
■ The meeting with the regional office of the WHO was also highlighted where
there were specific decisions especially to build up a partnership.
■ More meetings were suggested. Three priorities:
o Effects of HSR and privatisation
o GATT and implications on the pharma industry
o Free trade and its effect on health
o Malpractice in the medical profession
o Peoples rights
■ Egypt had also got lots of organisations, who wish to take up PHM on their
own agendas.
o h
AUSTRALIA , NEW ZEALAND AND THE PACIFIC
Fran - Australia
The main activities of the PHM Australia were summarised:
■ Spreading the word of PHM
■ Teaching I publications
■ Working through existing networks - especially political economy group (?)
■ South Australia - involved in the relaunch of tff^primary health care
movement
►
■ There was a discussion on how to communicate global issues to the population
- it was suggested by the Australians that one strategy was to highlight areas
of people to people solidarity.
■ Another issue was the draconian laws regards refugees \
\
■ The anti - free trade movement
\
■ Aboriginal health issues.
■ Factors that slow us down:
o Flow do we make people living in Australia understand that what they
do can affect the people all over the world?
o It was also important to the answer the question - why should we
support the PHM rather than any other movement.
■ Melbourne conference April 2004 - invited applicants from the phm
EUROPE
Pam - Europe
■ Focal point - was elected to be David Woodward.
■ The organisation of huge anti-war demonstration in Florence and the biggest
anti-Bush demonstration when he came to meet the queen,
•. <
u'
■ Again language was identified as a problem. S-)
c ••• •■ Italy - there was a good movement
o Many people signed the charter
o There was the development and distribution of a PHM calendar.
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BUKO - Germany was active.
There was also a group active in Netherlands
The Eastern European countries - especially those under the former Soviet
Union were difficult to coordinate except the city of St. Petersburg that had a
very active movement especially on the issue of poverty.
Ukraine had a strong environmental movement especially after Chernobyl.
Also highlighted were the various resolutions of the British Medical
Association that included the statement opening with “This organisation
opposed the promotion of the American model of health.” (?)
The environment was one issue where it was felt that the younger groups were
willing to get involved.
Anti-privatisation was also a good campaign platform as the effects were
already a reality and were already visible.
Suggestions / direction
o The organisation was still not very organised
o NGO’s still don’t like working with unions.
o We need to talk about the brain drain to run our health system
o We need movements / campaigns that people could join but not loose their
identity.
ASIA
Deien - Philippines
■ The main activities were:
o Translation
o Development of brochure
o Community based health program - most discussion being at the grass
root level
o Health students association.
The main circles are:
o Women’s issues
o Militarization
o Privatisation
o Access
■ It was pointed out that after 9/11 the Philippines was labelled a terrorist state
and the US stationed its army in the country purportedly for security reasons however it was obvious that this was to control natural resources. In this
regard statements were brought out against the US action and also against
WTO and its effect on medicines.
■ Another issue was how PHC was to be implemented in spite of the
government’s problems. During-the-meeting itwas very nice to see the seniors..
and the juniors getting together.
■ A meeting in July where Mongolia, Sri Lanka, Japan, Indonesia were invited
(supported by health links), will be a good opportunity to grow in the region.
■ There was good PHM participation in International Conference against
Globalisation and War. Unni helped in media projection. There was a
symbolic breaking of the wm built by Israel. Also the make health not war
campaign evolved here and'Filipino translation of the charter was released.
■
8
Nouman - Bangladesh
■ Talked about the gradual decentralization of the PHM committees with the
development of National then Divisional and then sub-divisional.
■ The details of the various issue-based circles is given in the book, prepared
especially for IMF - WSF.
■ There was concerned about how the issue-based circles were going to
coordinate with the geographical circles.
■ There was also the translation of the charter.o popicy “v c'‘
i
■ Noted that the villagers were conceiving of health in rather a different way and
were prioritising water, livestock and micro-credit.
■ For all the work done a rough break up of the source of funding was as
follows:
o 50% - own funding
o 25% - local government / partnership
o 25% - central government I donor.
■ The contribution of the other players was absolutely crucial for the success of
the program especially for PRSP.
■ An important new challenge for the world B2 = Bush X Blair
Niranjan - Sri Lanka
■ 20 organisation were involved in PHM Sri Lanka.
■ The main activity was a popularising of the peoples health charter.
■ The main health challenges were
o Privatisation - especially with the planning in the country done by
Japanese International Development Agency
o The country’s budget was cut down by 10 - 15%
o Malnutrition is increasing - and nearly 1 /3rd of the preschool children
were malnourished.
o There was concerned' that the government was not supporting the
indigenous health practitioners
o There was no powerful pharmaceutical sector in the country.
■ The need for formation of a Pharmaceutical or drug bank - this can help the
development of the drug industry and production capacity in countries that
don’t have the production capacity.
■ The government did not have a proper sector dealing with the effects of the
war. Some people were still living with pieces of shrapnel and
there was
no proper mental health services for those affected.
Ayyaz - Pakistan
■ Felt that the SAARC regional body should be made use of to promote the
people’s health movement.
■ Felt that a regional getting together was a good strategy.
■ Felt the social charter (signed by SAARC) - was an opportunity, as it was
rather ambiguous and that the PHM could make it more clear and relevant.
■ Need to revitalize PHM Pakistan with inputs from PHM in India and other
South Asian neighbors.
•
9
Ekbal - India
■ There were altogether 18 networks with almost 2000 grassroots level
organisations
■ All these organisations were already involved in health and were working on
various issues such as access to health / drugs / gender / medical education
etc.,
■ The following were the challenges:
o The presence of numerous languages
o The new national economic policy - where the government was
moving out of spending on health and education. This was almost
completely endorsed by the new health policy.
o Warned of the internal privatisation of the public sector ( internal brain
drain from the public to the private sector), ((here will be no external
manifestations but the haemorrhage will kill) J)
■ Noted the ‘model’ patents act of the 1970 and how we are now changing /
changed to a more TRIPS synclj” regime.
■ The style of PHM campaigns in India was that there were some campaigns
that all states did. Some specific campaigns based on local issues were taken
up at state level. The National Campaigns were:
o The right to health
o Observance of the 25th anniversary of the Alma Ata.
■ Noted with concern that GATS will be signed by 2005 and that needs to be
taken into account for advocacy by PHM.
14. Planning Exercise
A planning Exercise was conducted in five stages with all steering group members
reflecting on each exercise and writing down their idea and suggestions on sheets of
paper. They were then shared and discussed. The exercises were on five themes
(a) Achievements of PHM to date, (b) Movement Strengthening (c) Regional and
Country Strengthening plans (d) Campaigns and Advocacy (e) Expectations of the
Secretariat and Commitments of Support
:
' < ■ ■
X :
a. PHM Achievements
Tlie steering group members were invited to write down the key achievements of
PHM in the last two years. These were than shared as an assessment of where we are
as a movement today. These could be collated into six key achievements and a few
others in the member's own words.
1. People’s Charter for Health:
• Widely disseminated and distributed
• Successful launch and spreading of Charter
• Many translations
• Promoting charter as an inspiration for groups working on health
around the world
• Mobilizing on the charter and training I communications with
communities as an advocacy tool.
10
•
•
The charter increasingly recognized as a framework for social
development work
The charter recognized as arising out of a democratic process of
consensus building.
2. People’s Health Movement Evolution, post PHA -1
• The slow but strong build up of the network with all its diversities
transforming PHA to PHM.
• Uniting force for individuals, networks, institutions and NGOs.
• Gradual strengthening at local, regional and national level.
• Improved networking built with respect to both quantity and quality.
• Persons interacting worldwide through PHM and its communication
strategies.
3. The WHO Turnaround-fo-r-n
/<=>
c
.eJcrejpAC •
• The dialogue and higher profile at the WHO
• The breakthrough as an advocacy, lobbying and changing force in the
WHO
• The shake up of the WHO that it now responds to the PHM calls in the
area of PHC.
• A force for revitalization of comprehensive Primary Health Care and
Alma Ata principles within WHO.
4. Re-endorsement and Revitalization of Alma Ata Declaration and HFA
goals
• Established that local and national and international groups exists that
still have commitment to Alma Ata principles endorsed in the People’s
Charter.
• Increased awareness and involvement in Primary Health Care issues.
• The Charter as a tool for the revitalization of comprehensive Primary
Health Care / Alma Ata principles within countries.
• Development of PHM as an organization fighting for Health for All,
Now...
: /
•
-
5. The PHM Secretariat
• Excellent work and role of the secretariat
• Right choice of the International Coordinator
• Increasing capacity for communication and joint action (we cannot
survive without this)
• Improved networking and learning from regions and each others
experiences.
6. Towards an alternative analysis of World Health
• Encouraging alternative analysis of the world’s economic system and
its impacts on health
• Inner, widening and deepening shared critique of vertical ity of health
programmes.
• Voices of the unheard - encouraging communities to write own stories.
• Increasing recognition as the voice of public opinion with knowledge
of what is happening at local level and being taken seriously.
11
•
Recognised as a network with concerns against institutions taking
decision in health at international level.
7. Others
• IHF-PHM in Mumbai,
• Decision about People’s Health Assembly - II
Pl&n
j f. y f cjt eCae. .
<=-7-*< 1 e
*
b^Movement Strengthening
*
me/oi-tcr
’
Most of the issues discussed regarding organizational. strengthening; issue based
circles; campaigns and advocacy; PH A - II; Global Health Equity Watch Report etc.,
have been included in the relevant sections in Section A of the proceedings / Minutes X
circulated.
*.
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r >*:<♦ ir
•••)<’
>•
c.ARegional and Country Strengthening
Due to the enthusiastic level of participation from most regions of the world (with a
few exceptions tike China, Eastern Europe, North and West Africa), the Mumbai
meeting provided opportunity for some reflections on regional needs and plans.
These regional reflections are an initial checklist of concerns, options and ideas for_
follow up by regional focal points withjheir own regional and country level circles.
Regional initiatives for the future
A. EUROPE
1. Develop a plan to strengthen the regional coordination - focal point to
enhance regional coordination.
2. Inviting other organisations to take part in PHM activities - unions, academics,
etc.
3. Priority: East Europe - involve more organisations in that specific region
4. Develop a circle on:
Privatisation
Promote the discussion about the effects of the action of European
Trans National Organization on health
• Pharmaceutical
• Financial
• Water, Electricity.
5. Promote / facilitate PHM sponsored short courses in universities for grass root
leaders on health systems, socio-political determinants of health, Primary
Health Care etc.
B. SOUzUHERN AFRICA
1. Invest resources in cultural communication infrastructure and Charter printing
and dissemination, in countries where there is already a viable PHM activity.
2. Use planned Southern I Eastern African PHM and society meeting to run
module / course on PHM I civil society organisation focussed on both
knowledge and skills.
3. Use opportunities (regional, national meetings, regional / national networks
and sympathetic community based organisations to build PHM.
12
4. In countries to use Charter to identify key national campaigning issues, i.e., to
link key national health issues to global issues to organise campaigns around
this to build PHM in African countries.
C. NORTH AMERICA
1. Develop effective regional coordination and communication between the
Canadian and US PHM events. Support each other’s efforts. This may
include Health and Trade, Environmental Health and Justice, Tobacco (we do
not yet know the priorities).
2. Resistance to US Government policy “Regime change begins at home”.
Join campaigns and networks already active;
Promote and facilitate health within the campaigns (give suggestions
and plans);
Build awareness of the inter-relationship between US policy and Social
injustice.
Encourage the spectrum of grassroots action from the streets to
legislation.
3. Build the PHM within each country.
D. AUSTRALIA, NEW ZEALAND AND THE PACIFIC
1. Raise profile of PHM in the region
By sponsored tours of key PHM people;
Discussion groups on : Trade & Health and Comprehensive People’s
Health Care.
2. Use networks in region - New Zealand, South Pacific, PNG
3. Perhaps, plan a regional conference and I or country regional meetings.
4. Initiate Local website/ List serve
5. Tours of sponsored people to Australia and within region
6. Discuss opportunities and resources for key issues. Eg., Badged as PHM
E. ASIA
I. Maximise involvement and inputs of existing regional networks: ACHAN,
IPHC, CIROAP, HAI AP and TWN.
2. Contact networks directly; and distribute materials to all the group?.
- Focus on consumer groups and health and nd’health' in eacfi country.
Eg., Cambodia & Japan (ACHAN)
3. Utilise existing / already planned activities for adding PHM agenda
- February 2004 meeting of pharmacologists in Indonesia where Deien
is going as a speaker on behalf of HAI AP;
April 2004, Dialogue with CMH at regional level in Sri Lanka
- June 2004, Meeting in Sri Lanka, communicating for advocacy (PCH
as advocacy issue)
December 2004 - meeting on safe home delivery in Bangladesh
4. Utilise publications available to spread PHM perspectives and reports on the
movement. Eg., TWN publication?, Newsletter, HAI Newsletter
*
13
F. LATIN AMERICA
1 .Establish specific programmes and campaigns (ALCA - Salud, FTAA C
Health).
p
1. Produce Glossary of PHC Concepts and criteria.
r
2. Strengthen / promote inter-cultural dialogue (links between Spanish - c
Portuguese and English - PHMs)
S
G. Middle East>
1. Promote country circles in each country of the region
2. Invest in capacity building and resource production and ICT for Health
including Health.
3. Enhance advocacy and lobby activities
4. Identify the priority for the regions
5. Strengthen the network and increase involvement of these networks at
community level, based on specific events and above priority issues.
H. China
1. Recruitment / identification of focal point of China to start mobilization
process
2. Chinese language website
3. Chinese List serve
4. Calls for contribution on key PHM issues from that region.
[Any members who have suggestion for these, please sent to PHM Secretariat and
copy to David Legge, Australia].
I. India
.d. Campaigns and Advocacy
The result of this exercise have been integrated into the earlier section A , item 6
(0.
F X C.e. VX? JC
c., Expectations of the Secretariat and Commitments of Support
The compilation of this exercise to be done by one of the steering committee
members has not yet been done and will be circulated as soon as we received it.
1'5> Decision Making and Communication Process'^
Decfcfcnrmarki n g
Andy commenced with six propositions:
1. We have enormous collective experience in working in networks
2. PHM is young and learning and evolving. However there are some issues
we know need attention: information sharing, decisions (prompt,
strategic), cornmunication (especially between members and secretariat)
3. Certain projects are underway
.
• I
. >
4. Sometimes we need rapid political decisions; sometimes looking for
contributions to analyses or suggestions about strategy
Ravi outlined some history concerning the development of current structures and
procedures. Composition: 8 networks and 13 regions, coordinator, ex-coordinator.
But patchy representation of regions.
& Yahoo based listserve had been set up to facilitate communication within and across
the Steering Group.
•3 Then followed a long discussion in which different views about problems and
difficulties were interspersed with different views about solutions and directions,
£<svc|eA r>
Among the difficult Les:
•
Who is on the Yahoo List serve list?
•
Why do some people bounce?
•
Most people don’t acknowledge most messages from the Secretariat
•
Some emails call for big decisions and some are simply for
information: importance of adequate signposting of the category of
message and kind of response needed and relative urgency
•
Some decisions call for a vote in advance; some for consensus in
advance; some call for executive action and post-hoc accounting
•
With large group comes the risk of diffusion of responsibility and a
paradoxical lack of support to the coordinator
Some people reply to Ravi when it might have been more
appropriate to reply to the List.
e Among the important principles:
')
•0
•
&■
•
Clear signposting by sender of the category of message, the kind of
response needed and relative urgency;
•
Preparation of documents to support decision-making
•
Possible value of an ‘executive’ type structure —
gc : rdLooc t-fc *
• <*
:
Consideration of how to ensure the available technologies are most
appropriately used (could include web-phone teleconferencing,
bulletin board
•
Fortnightly preparation of a summary of key issues transacted over
Decisions about decisions
® Carmelita undertakes to prepare fortnightly email minutes
.a^Appointment oflsxecutive type group to support Coordinator in. urgent decisions..and
in operational issues. Executive groupie include: Maria, Prem, Pam, Brigid-(or
\ >rDelen.
3 Exec to draft a set of terms of reference and operating guidelines for interim guidance
and subsequent consideration by the Steering Group. A
'
Sarah offered to prepare draft guidelines about decision-making more generally
o
Yah • k-Yf.dv.’
From:
To:
Cc:
Sent
Subject:
°
Secretariat <sscretaru;t@piu icve ren:..;-^
Hesperian Foundation <hftravel@hftrav.5.:.cr;c ne:> 'sa^ns-gnesoena^
<arutherford@onewortdactior? org>
Saturday, Apnl 24, 2034 4.33 PY
Re: iViinuies from Strengthening •>?£ TO'.emu.: c.-c Cam oa urn wscussww
Dear Sarah.
Greetings from PHM Secretarial (Global):
I was really surprised to get your methodically ckusiucci Y- .
strengthening the movement. I v ish you had .-em
a. us hen yen
forwarded it io Andy some weeks ago. We kwe had x siniggk dr-rough ah
sorts of notes (Rakhal’s - CHC rapporteur. Dawd Lugge's and Andy ■•)• Your
e been great help. I a
.
he
i die .
...
to over 5-6 reminders as well. Any way, it came just beiorc section B wc
*.
hed. S
: . . ill ki ■
i
.
. y ell
manned and imegraied. 1 am jus; working on h and vj.i; gei wv w ;o you <.-r.
the other points you ha\e raised in the nc\t two days.
Best wishes
Ravi Narayan
Coordinator. People’s Health Xlovcmml S-r.:cuiruiiCglo’un;
CHC-Bangalore
-367 “Srinivasa Nilaya"
hk
.... ra 1st Main
uKoram
B a n galore-560t ■<> - ■
Tel: 00 91 (0) SO 51280009 (Diivcr) Fax: 00 ;Y. ;.)/ 80 25YYY
\V.• bsiie: w;vw.phmeye\nennorg
Page I of 1
From:
To:
Cc:
Sent
Aaach:
Subject
Hes peria r. Foundation < hftrave i @ hft rave I. cnc. n et>
PHM Secretariat <secretariat@phmovement.org>
Sarah Shannon <sarahs@’nesperian.org>
Tuesday.. April 27, 2004 9:01 AM
PHM Strengthening the Movementdoc
Minutes Pom Strengthening the Movement and Campaign discussions
Dear Ravi.
Greetings': I am writing from New York where I am doing fundraising and
networking visits for Hesperian. The Methodist Church kindly' put us up
again al the Alma Mathews House where we stayed last March. It brings back
memories of our tour
*
By the way. I had a positive meeting with Larry Cox
at the Ford I in
lay i a aii
inters
indie
IM and i
looking ar his budget and also talking with some colleagues Io see if there
jos ibilib for Ford fi ling fi the Fall ’04 - Fall’05 to help u
with >he PH A Ik also travel fluids for the Secretariat, etc. I will write
mere to you and to Andy about this after I have a chance to do some further
follow up with Larry. (Larry did not naw any funds available al all for
the Faii'03 - FalF04 funding year, as all his hinds bad been committed in
2002 when bis budget was ut by more than 60° 6).
I sent Andy Rutherford — some lime ago — the summary of the two sections
ofihe planning meeting that I had the responsibility' for processing. This
was so that he could integrate those two discussions info the rest of the
meeting summary he was generating. I had assumed that litis is what
occurred, and that what he sent you contained these pieces. However., i am
'
■■ . chment the same wri ’ that I sent
yin case he
orpon this cont it in
e proble n ci rred.
Attached are the transcribed and re-grouped' collated summaiy of the ideas
thi....... ■
■ for 1 di us’ • ■:
mgfl ■ n ■
it ■■■■
hen a more detailed discussii
1
(Campaign
I
ime places
handwriting was impossible io decipher and I made a note ofo.he person who
wrote the un-decipucrable content as possible. I did do some organizing of
similar ideas together, but did not attempt to ec’h io deal with any
redundanc z wh
>x ?r jssed sirnilt
ights.
Io ha
■
.People
me 1
them or io send them in the mail to you or to And}’.
27/4
<5G.-<p vuz>
Zo
( Cols
y evx.
['
c.
j
Streagtfheminig tlh© Movement
Structure, Coordination and Communication:
3
Coordination with the Secretariat; with more concrete and responsive steering by the
steering committee.
3
Steering committee commitment to allocate time for the work.
3
Help transition secretariat beyond Asia. Supporting a new region as potential
coordinator so that the secretariat can build capacity to take over from Jan 2005.
3
Hand over website now to a new region or circle coordination
3
Strengthen the structure and effectiveness of the PHM based on the realities of the
region.
3
Be transparent - issues of governance.
3
Active/ full involvement of others in decision making
3
Follow-up with and implement today’s decision-making discussion.
3
Continued commitment to regular correspondence and sharing of views/ opinions.
3
Share successful experiences amongst ourselves.
3
Transparency in every sense of it.
3
Helping to evolve 2-3 year plan
3
Involvement of additional delegated people on specific issues, e.g.: media,
documentation, communication, work with UN organizations.
3
Internalizing the principles of the charter as a part of the work of each of us.
3
Taking active part in securing the continuity of the movement (at operational and
strategic levels)
, tempter
*
c
Regional Development:
3
Allocate resources to Africa regional development.
I 3
Provide support to needy areas.
3
Improving capacity of weak regions e.g. Africa.
3
Ariveli- written and realistic plan for the Africa region. .
3
Creative financial resources which include ability to support, strengthening of Africa
region.
3
Broaden network in Southeast Asia.
2^
Improve/ support communication for regional/ country/ institutions that don’t have
access to information.
33
Invest proactively in capacity development in regions, especially the weakest.
Advocacy efforts
3
More positive policy strategies to move from critique to proposing new directions.
3
Regional and country-wide campaigns
3
Deeper analysis of the issues: stronger analytical work.
3
Influencing national policies and activities for health for the majority.
3
Influencing UN agencies, especially WHO.
3
Identify global, cross-cutting issues around which peoples’ campaigns can be built
and nurtured.
3
Support campaigns especially “No WTO, No War” to fight for People s Health.
3
3
3
3
3
3
Representation in policy making forums at the national and international levels to
push the charter’s agenda.
Strengthen grassroots activism in conjunction with international advocacy through
strategic global campaigns. Greater coordination, planning and focus on campaigns
and on the relationship between grassroots activism and international advocacy.
Use campaigns to strengthen and build relationships with other networks.
Using the analytic work, select a few (2-3) issues to campaign for globally.
Suggestions include: globalization’s impact on health (esp. WTO, Trips, Gatts,
WB/IMF, PRSPs, overseas aid, etc.)
Focus advocacy on Health systems/ PHC.
Perceived lobbying and advocacy activities which are recognized by the PHM as
“theirs”.
Contribute to the Global Analysis of health in a globalized world in the Arab context.
Reaching new networks, mobilizing and organizing
3
Return to focus of promoting/ advocating sharing the charter with non-health groups,
academics, research and policy makers, taking advantage wherever strategic
opportunities emerge.
3
Build up networks and grassroots XXXXX (Prem?)
3 Teaching and Seaming/ reflection from experience and analysis
3
Integrate PHA principles/ PHC in my day to day work and promote this to others:
teaching medical students, organizing health workers, education, organizing,
mobilizing, communities.
3
Involvement of more marginalized peoples e.g. indigenous Australians.
3
Work through and use the strength of existing like-minded networks, connecting new
with networks.
3
Have the charter translated into languages in which it has not been translated in South
East Asia (Lao, Bahasa, Indonesian, etc.)
3
To incorporate the People’s Health Charter in an undergrad education related to
health (i.e. medical, nursing, paramedical, public health, and social sciences).
3
Involve other stakeholders, training stakeholders and regions.
3
Share achievements and failures.
3
More involvement of other institutions, networks and communities.
3
A systematic way of supporting the voices of the voiceless to bring their situation
more into focus.
3 Reach out to many other networks/ individuals while renewing commitments to
existing networks.
3
Promote and educate about the movement on multiple levels, including health and
non-health based conferences, university settings, civic group meetings and writing.
3
XXXX and seek to include new groups, communities, movements and people with
the PHM through meeting them and specific, XXXXX (Lanny?)
3
Widening the ownership of the charter among health and non-health organizations.
3
Continuing to share the principles of the charter with others, including those outside
of the health sector.
3
Appreciation and building on XXXXX activities and for XXXX to see some of their
activities to be more PHM activities. (?)
P S<
Increase our visibility:
3
Make visible the work of the PHM at a community level and a national level.
3
Clone Unni for each region to increase publicity and media coverage of PHM.
3
Write/ analyze/ publish more popular press.
3
Support groups through our publications, e.g. articles in TWR magazine: features,
position papers, etc. These materials can be used as campaign materials, to educate
people, and as PHM’s input on policy initiatives with WHO, UNICEF, etc.
° Utilize TWR’s contacts and also PHM contacts to disseminate information.
3
More articles written, serious and popular.
Strengthen the media support to the secretariat and the regions.
3
Continue but strengthen the analytic work and it’s dissemination in different foms:
scientific articles, popular articles, media releases, website.
3
IPHC can use the web site actively, draw in other sectors and respond pro-actively. (3
points are condensed)
ampangms
GENERAL:
Campaign for WHO’s Global Strategy in Nutrition and Prevention of Diseases based on
A?AN Agenda/ Statement at the WHA 2004. Start lobbying departments of health now
until May to build international pressure. Resist pressure of US government on countries
to sign trade agreements violating farmer’s rights and affecting our food security. This
should be linked with other trade issues such as TRIPS. Research on health impacts of
trade agreements (e.g. TRIPS, TRIPS+, etc) and research into whether your government
is implementing this agreement or not. Resist WTO/ with focus on impact on health join networking focusing on this.
Participate in campaigns for the ratification and implementation of the FCTC. There is a
regional meeting March 3-5 WPRO; also the intergovernmental working group meeting
will be in Geneva in June 2004.
Develop a continuous campaign against privatization of health care. It is taking place
around the world, it is a priority for many of the country-level PHM participants (we can
exchange experiences), and it allows discussion of globalization (role of the state) linking
national elites to international capital, and integrating issues of health care and equity.
Campaign to explain CPHC: in context, and construct a concerted effort to build/ provide
evidence of success of CPHC through: stories, research. Adapting this information to
context. This effort could be launched with seminars in every region followed by
discussion. A publication could be produced to address CPHC in different regions.
PHM needs to make presence at international level and respond to the processes at WTO,
'World Bank and IMF as well as WHO through press conferences, petitions and press
releases, etc.
PHM needs to have position papers on impact on health with case studies and intellectual
analysis on “AOA”, global Health Fund, HIV AIDS, occupation, etc.
At a national level PHM needs to support national struggles with campaign materials,
memorandum to governments, etc. Send letters of support to national groups at meetings,
support causes, highlighting their problems with international alerts on hot spots, and
focus on issues such as Palestinian refugees, etc.
We need to develop specific campaign circles with links to other activists, and we should
limit this to a few, maybe 5. Privatization is a good topic for an international campaign.
To develop campaigns we need to work in coordination at a local, national, regional and
global level.
Coordination groups (cross-regional) to focus on developing key messages for selected
international campaigns. These messages would then be shared for input. These groups
could also support/ inform different advocacy actor such as the WHA circle and the
secretariat.
PHM should choose a few strategic issues on which to campaign. Elements to consider
in identifying strategic campaigns are: will this bring in new networks to the movement?
Will it have impact? Is it cross-cutting? Will it link grassroots activism and concrete
policy change suggestions for advocacy work?
Take advantage of the fires generated by social injustice around the world - concerning
health issues - and help create awareness of these fires. In other words, promote the
voice of the unheard and - in the news flashes at their being heard, ever so briefly - take
the long-term advantage of that happening)
Share information on issues, commitment to campaign on an issue, develop response for
local and regional campaign in order to implement it. Suggested issues: War and Trade,
Militarization (not to war, no to WTO).
In India there are a number of campaigns being carried out by PHM. These include:
Right to Health Care Campaign; Right to Food Campaign; Access to Essential
Medicines; Health Policies for Primary Health Care — using evidence based
information; and against Tobacco - with an effort now pushing for the ratification of the
FCTC including a June 2004 International meeting about the FCTC.
Campaigns are important for linking with other networks. In India links are being made
with women’s networks, with environmental networks, and with Dalit organizations.
There is also an on-going effort called “reaching the un-reached” to bring information
about the PHM to academics, students and youth.
AFRICA'.
in Africa the crisis is HIV and AIDS. Campaigns currently running in the region are on
access to treatment. PHM internationally could assist the region with information and
approaches to deal specifically with the issue of pharmaceuticals, patent laws and TRIPS
and other trade agreements as these issues should be incorporated into campaigns.
HIV/AIDS demands a CPHC approach. Use HIV/AIDS to show that there can be no
solution without 1) confronting economic/social determinants of poverty and
vulnerability; 2) rebuilding comprehensive and community-based health systems and
confronting health declines from privatization of health and drugs. Campaign addressing
WTO, WTO and governments. Link this to grassroots awareness building.
Campaigns (with necessary research to support) on: The impact of culture on women in
relation to policy; women’s access to health; and in Tanzania and Uganda a campaign can
iso be built around the public-private partnership work with WEMOS. Involve PHM in
ngoing campaigns.
LATIN AMERICA'.
Revive the spirit of Alma Ata through continuing the “Million Signatures Campaign” and
through training/ education on the principles of integrated primary health care. Another
campaign we are beginning to work on is: Militarization, occupation, War: Resources for
Life and No to War. This includes opposition to Plan Columbia. Finally, we care
continuing our campaign to oppose the WTO and to the FTAA in particular demanding
universal access to medicines, and opposing the privatization of social security systems.
I ranslate information for cross-regional sharing, and to make it possible for campaign
materials to be used throughout the world.
Page 1 of 1
Main Identity
From:
To:
Sent:
Attach:
Subject:
David Legge <d.Iegge@latrobe.edu.au>
'PHM Secretariat' <secretariat@phmovement.org>
Thursday, February 19, 2004 4:43 PM
Mins040117PHMSteeringGroup.doc
Steering Group Meeting minutes
Hi Ravi,
I am very sorry to have taken so long. I finished the minutes during the WSF and then my computer crashed
and I have been basically computer-less up until early this week.
Finally herewith the minutes.
Again I am very sorry.
cheers
From: PHM Secretariat [mailto:secretariat@phmovement.org]
Sent: Tuesday, 17 February 2004 11:15 PM
To: d.legge@latrobe.edu.au
Subject: Steering Group Meeting minutes
Dear David,
Greetings from PHM Secretariat^Global)!
This is the second SOS for the minutes of the Steering meetings that you so hopefully entered on your laptop
on 17lh and 18lh January. Our rapporteurs have sent in the minutes of 12th, 13lh and 16lh and Sarah’s and
Andy’s report of the exercises is on its way as well. Prompt follow up will help to keep up the spirit of
collectivity and enthusiasm that was generated in Mumbai. 1 am sure you must be busy with other demands so forward the minutes without further editing, if necessary. I shall integrate all of this in some practical and
sensible way.
Best wishes,
Ravi Narayan
Coordinator, People’s Health Movement Secretariat(global)
CHC-Bangalore
#367 "Srinivasa Nilaya”
'
I
Jakkasandra 1st Main, I Block Koramangala
Bangalore-560034
Tel: 00 91 (0) 80 51280009 (Direct) Fax: 00 91 (0) 80 25525372
Website: www.phmovement.org
Join die "Health for all, NOW!" campaign in the 25di anniversary year of the Alma Ata
declaration visit www.TlieMillidnSignatureCampaign.org
4/7/04
Peoples’ Health Steering Group - Full Meeting 18/1/2004
Attendance
Andy, Jose, Lanny, Fran, Sarah, David S, Prem, Deien, Ravi, David L, Evelyne, Unni,
Hugo, Rebecca, Carmelita, Olle, Zafrulla, Mwajuma, Mary, Patricia, Mira, Maria, Jihad,
Arrangements
Minute taker (DL) appointed. Time keeper (Carmelita) appointed.
Agenda setting
Proposed agenda (for the two day discussion) outlined and discussed.
1. Decision-making and communications processes (~45’)
2. Planning exercise, to be conducted in five stages (achievements, movement
strengthening, country and regional strengthening, campaigns and advocacy,
expectations of secretariat)
3. Networks and linkages
4. Fundraising,
5. Assessment and reflection following IHF
Agenda discussed and adopted.
Need to review Mumbai Declaration noted. Carmelita and Lanny deputed.
Decision making
Andy commenced with six propositions:
1. We have enormous collective experience in working in networks
2. PHM is young and learning and evolving. However there are some issues we
know need attention: information sharing, decisions (prompt, strategic),
communication (especially between members and secretariat)
3. Certain projects are underway
4. Sometimes we need rapid political decisions; sometimes looking for
contributions to analyses or suggestions about strategy
Ravi outlined some history concerning the development of current structures and
procedures. Composition: 8 networks and 13 regions, coordinator, ex-coordinator. But
patchy representation of regions.
Yahoo based listserve had been set up to facilitate communication within and across the
Steering Group.
Then followed a long discussion in which different views about problems and difficulties
were interspersed with different views about solutions and directions.
Among the difficulties:
C:\WlNDOWS\TEMP\Mins040! I7PHMSteeringGroup.doc
Last saved: 19/02/2004 10:07 PM
-2-
o
Who is on the Yahoo Listserve list?
o
Why do somepeople bounce?
o
Most people don’t acknowledge most messages from the Secretariat
o
Some emails call for big decisions and some are simply for information:
importance of adequate signposting of the category of message and kind of
response needed and relative urgency
o
Some decisions call for a vote in advance; some for consensus in advance;
some call for executive action and post-hoc accounting
o
With large group comes the risk of diffusion of responsibility and a
paradoxical lack of support to the coordinator
o
Some people reply to Ravi when it might have been more appropriate to
reply to the List
Among the important principles:
o
Clear signposting by sender of the category of message, the kind of
response needed and relative urgency;
o
Preparation of documents to support decision-making
o
Possible value of an ‘executive’ type structure
o
Consideration of how to ensure the available technologies are most
appropriately used (could include web-phone teleconferencing, bulletin
board
o
Fortnightly preparation of a summary of key issues transacted over the last
fortnight (email ‘minutes’)
Decisions about decisions
Carmelita undertakes to prepare fortnightly email minutes
Appointment of executive type group to support Coordinator in urgent decisions and in
operational issues. Executive group to include: Maria, Prern, Pam, Brigid (or Mwajuma),
Deien.
Exec to draft a set of terms of reference and operating guidelines for interim guidance
and subsequent consideration by the Steering Group.
Sarah offered to prepare draft guidelines about decision-making more generally
Planning Exercise
Six stage planning exercise undertaken including achievements, movement
strengthening, country and regional strengthening, campaigns and advocacy, expectations of
secretariat.
Not completed on 17th; adjourned for completion on 18th.
Separate report to be prepared incorporating the responses of all participants.
-3-
Reconvening (18/1/04)
Announcement
Scholarships to iUHPE: Maria, Arturo, Deien (not Unni, ?? Prem),
Arrangements
Timing: need to conclude at 11.00am
Attendance
Andy, Mary, Deien, Arturo, Rebecca, Maria, David S, Thelma, Fran, David L, Ravi,
Prem, Mwajuma, Carmelita, Jose, Patricia, Lanny, Evelynne, Jihad, Hugo, Zafrulla, Unni
Thelma here as PHM (India)
Agenda review
Announcements
Complete presentations from yesterday
o
expectations of and from secretariat
Process for selection of next secretariat (and website)
Linking with other networks and movements (how rather than who)
Reflections from IHF
Comments on Mumbai
I
Circles
Focus group on funding
Next steps with WHO
More announcements
Announcements
David Sanders announces two meetings, in June 04 (6-12/3) two meetings in South
Africa: International Society for Health Policy (6-8) (Pres Alexis Bennos) jointly with PH A
SA on theme “Building progressive partnerships in Public Health” (go to website; put in
abstracts).
Following International Society for Equity in Health (ISEQ) (also see website)
David to send an email
Patricia: also meeting on Global Health Watch there abouts
Planning exercise (continued)
Campaigns and advocacy
\y Evelynne: being present at WB and WTO meetings; farmers livelihoods use the health
impapt as the measure; position papers on GFATM etc, campaign materials
Mary: supporting access to treatment campaigns at the country level
-4-
Maria: sharing of information about the issue; commitment to campaign; identification of
strategiees at country level
Hugo: local work on international campaigns, benefits, needed locally, use campaign as a
way to facilitate and str advocacy work
Arturo: [environment very noisy]
Fran: comprehensive PHC, world of vertical and evidence-based; what is an appropriate
evidence base for PHC; and then collect it; create global framework; and collect data from
regions; global evidence base
Carmelita: move to resolution, global strategy, APAN submitted statement to WHO in
April 03; have to analyse Global Strategy where it fits into PHM frameworks; 5 mo before
May; APAN planing a convention; APAN statement;
US going towards bilateral strategies on trade; PHM to develop alliances at the country,
regional and global levej, missed the opportunity when Cambodia joined the WTO;
FCTC undergoing ratification; demand govt to sign ratify and implement the
Framework; WPRO meeting soon about implementation; Carmelita participating (endorse
Carmelita as PHM representative)
DL: WTO Ag on Ag and Farmers’ Livelihood; campaign strategies
[Andy: Procedural suggestion: focus on Themes and Circles]
es and Circles
lavi: where the circle is responding to a particular issue it seems to work; study circles
: seem to work so well;
indy: what are we discussing
y David S: would be useful for Ravi to list and indicate which circles are functional
Jose: important to note regional structures should have priority; issues circles
organisations of individuals; regional circles will respond to realities;
Ravi: In May 03 we identified circles: WHO (ZC and RN); Poverty and AIDS (dialogue
with UNAIDS) - non functional; War and Disaster (Unni and Rosalie Bertell);
Macroeconomics (Mike Rowson and Medact as contact); Politics of Helatgh (IPHC);
Women’s Health active (WGNRR); Food and Nutrition (to work with APAN and IBFAN) active; Public Private Partnerships (Jose and others, Wemos);
Research Circle (DS, looking for a focus on what to do) linked to GFHR;
Communications Circle (Secretariat in touch with members but they are not working sc
well together)
Summary: two issues: because of our limited resources (time and other demands) at
present the energy level only increases when there are specific opportunities; those which are
not linked to strategic opportunities
Patricia: Global Health Watch might provide such a focus
-5-
Sarah: one of the roles of circles can be to find ways of working with other networks; a
critical function of circles (or at least some circles); communications and research (generic)
may not be best dealt with through; how are we going to do our private planning; some of
^,these topics are still in this formative stage; does not make sense for a circle to launch with a
single point person; need a team;
7 David S: some circles are cross cutting; research crucially important; campaigns need to
/be founded on research
i
/ Ravi: not to have one person responsible; but to have one person as focal point; links to
/ GHW useful; limited resources a problem;
Andy: circles can be formed spontaneously; individuals with enthusiasm can make ij
^happen; does not need to be endorsed but welcomed; but nobody reads the papers (see
’^Website)
Prem: research and analysis - campaigning advocay and lobbying specific skills; need to
recruit some of this expertise
/
Unni: facts and figures, on the spot; one page;
Maria: lots of groups already working on all of these issues; eg launching a campaign
about sugar tomorrow; so many people working on these issues but contacts not so;
Andy: PHM generating a density of activity plus linkages; how are v/e going to proceed
/ DL: going round in circles
^//^Delen: confusion between responsibilities of circles
^DL: small groups now?
Ravi; use PHA-Exchange; should talk about precess of how not what,
/ Plan on a group meeting this morning (Ev, Sarah, Carmelita, Patricia, DL) on food,
'''WTO, farmers’ livelihood
Carmelita: what is the link between circle and Steering Group?
— Ravi: reads from relevant bit of Process Paper;
Andy: Greenpeace varies widely in quality of its work and usefulness as a partner; we
nebd'to generate a process which accommodates these complexities
Linking with other Networks and Movements
yftavi: branding and badging; management of dual and multiple identities;
/ Andy: appoint two volunteers to clarify process
Thelma: we function with a certain degree of self-confidence; communicate; linking with
environmental networks, nationally and globally; don’t need to wait for approval! a
x-*rnovement by definition has to be based on certain realities; v/e just engage;
/ Mwajuma: look to the future; need to be inclusive of new organisations (who were not
^founding members); in terms of how we bring in other networks; at what point are we
-6-
allowed to taik about PHM - depends where you are and how you feel (example about using
the/HA video; giving movement website); look forward
Patricia: GHW a good way of forming these linkages
Amdy: ©oHtaDato comiserosQDss cllmlk Gibe meiwoirlk fif yomi cana (annd) roeed) It©); Mow
y©njr owqd jandgeinnieal;
MM as y©M teQ approprogjirnalie; comiiwrotatf© CfeaG ttfee
' Bibik foas fesern inraadle; fee aceoianatafeQe flor Cfee way yoon nnse ©user sDamnie; case Clhie Cfoaffta
*
z-z Thelma: outline the campaigns run with and through PHM (India): Food, TRIPS, PHC,
tobacco campaign; Using innovative methods; We are influencing state policies
Unni: keep aware of the use of the Internet
Planning exercise resumed (expectations of and commitments to the secretariat)
Expectations and commitments written and shared.
Andy: summarising. Much was to do with us as a movement rather than specifically
about the secretariat. Should have begun this exercise with a resource reality check (includes
time).
V
-----Ten Reality Points
Ravi offered ten points for consideration.
Don’t blame technology. The problem of non-response is not due to lack of
receipt.
''
2. Must address the problem of non-representation of certain regions (including
/
Mira’s position iri-the SG which is not understood in the PHM (India). Please
clarify what Mira represents.)
1.
3. PHM secretariat started with negative emotions after PH A1. Took a lot of work
to bring the alienated networks back. Ill-feelings in the evaluation. Gradually
4. Inheritance of the website, /d^and found it very frustrating. Cannot make this
website anything but archival; no inputs. Now on sick leave. Don’t have unreal
expectations of the website. Prasanna has been quite frustrated by lack of
response and contribution to the website. Website needs (i) a commitment from
members; (ii)
5. Capacity building. Secretariat identified this as top priority. African visiting
project. Linked our present coordinators to our networks. Those networks have
not been sustained. Rockefeller willing to support PHM in Africa. Must be able
to help people who are there. Handicapping Africa by trying lots of outside
attempts. But if it doesn’t happen from Africa.
We have a/HM evaluation..But the evaluator is not responding to anything.
Very frustrating. Please can AR and PZ winkle it out.
7/ WHO circle needs a new circle coordinator. Need a capacity to respond to their
X/ documents. Need a 5-6 member circle who can go to Geneva.
\
8. Translations and Websites and multilingual listserves vital.
9. Network dialectics. Networks need to respond to the five questions (from June
email). Why do we have IPHC in privileged position on our letter head?
10. Need constantly different representations in different meetings. Last year RN
found that he circulated notices of events but got no response. Last year RN
went but not in 2004. If none of you are going to volunteer to travel; to be
present and to understand and to represent PHM. From next wedk, WHO (HIV)
wants an input; MSF (Bangkok) wants an input. RN can’t travel 52 weeks.
Rollback Malaria in Africa in Feb.
Commits self (RN) constant feedback to all of you of responses to communication.
Monthly update.
Andy: meeting for 3 days, we should have had this report three days earlier. Must begin
our meetings in future with a secretariat report. Ten vital issues have been identified.
Africa
group met yesterday; have produced some notes which will be developed and
communicated to Africa and developed for SG consideration.
Clarification of representations and networks.
Maria and Carmelita to produce a draft discussion paper for circulation to SC- before the
end of Jan.
WHO circle
The circle needs a new coordinator. ZC will give more time to this work. Zafrulla to
work with Ravi on sharing the work and taking over the role of liaison with WHO.
RN lists some other considerations associated with WHO.
Website
Needs a different organisation.
DL needs a continuing home with security.
Sarah may be able to find some volunteers. Will investigate.
Process of selection of next secretariat
Process of selection of next secretariat. Prem, Ravi, Jihad, two reps from the Americas
to be circulated to SG by end of March. Timetable, process, etc
Mumbai declaration
Carmelita and Lanny, to work with Indian group and make input to final document in the
next week or so.
Carmelita. There are real problems with content and structure. Must provide feedback
by the end of today, Sunday to Cannel ita
-8-
Recognition
Andy summed up our collective response to the huge work of Ravi and his colleagues.
Unanimous recognition and appreciation.
Evaluation
Andy and Pam to speak with Andrew
*
Chetley about the Evaluation Report.
Membership of SG issues
/
IPHC and Indian group to address sharecfproblems.
Scheduling of SG meetings
Sarah: Appreciation of Ravi’s management of the concurrent SG meeting. But perhaps
we should schedule SG meetings for after the events rather than concurrent as this time
Prem: need three clear days for every SG meeting. Andy: perhaps two days. Ravi: it was
a problem but saves money. Usually in November.
SeMns n up and making it happen!
A Guide for
Equity Gauge
Design and Implementation
Setting it up and making it happen!
A Guide for Equity Gauge Design and Implementation
BACKGROUND
This guide has two primary purposes. The first is to provide existing and potential
individual Equity Gauges with some guidance in the design, planning and
implementation of their strategies and actions. The second is to ensure some
commonality around the key principles and concepts of Equity Gauge design between
different individual gauges - an important requirement for an effective and cohesive
global alliance of Equity Gauges.
This guide has been developed by a "GEGA core group”12funded by the Rockefeller
Foundation, and follows field testing in Chile, Uganda, South Africa and Kenya. It also
builds on work conducted by the Global Health Equity Initiative (GHEI) and their book,
"Challenging Inequities in Health"". Finally, it has benefited from feedback and input of
the all gauge members of GEGA.
1 Core group members responsible for drafting this guide were: David McCoy (Health Systems Trust,
South Africa), Meg Wirth (Rockefeller Foundation), Paula Braveman (University of California), Jeanette
Vega (), Antoinette Ntuli (Health Systems Trust, South Arica), Davidson Gwatkin (World Bank), Tim
Evans (Rockefeller Foundation), Pat Naidoo (Rockefeller Foundation) and Mushtaque Chowdury (BRAC).
2 Challenging Inequities in Health: From Ethics to Action. 2001. Edited by Tim Evans, Margaret
Whitehead, Finn Diderichsen, Abbas Bhuiya and Meg Wirth. New York: Oxford University Press.
2
SECTION 1: THE PRINCIPLES OF EQUITY GAUGE DESIGN AND
IMPLEMENTATION
The importance of equity in health and health care is not new. For example, equity was
listed as one of the key principles of the 1978 Alma Ata Declaration on Health for All.
International health and development agencies, researchers and activists have been
pointing to inequities in health and health care between different countries, between rich
and poor, and between men and women, for many years.
So what is different or distinctive about an Equity Gauge?
The first distinction is that an Equity Gauge is an active approach to monitoring and
addressing inequity in health and health care. It moves beyond a mere description or
passive monitoring of equity indicators to a set of concrete actions designed to effect real
and sustained change in reducing unfair disparities in health and health care. This entails
an on-going set of strategically planned and coordinated actions that involves a range of
different actors who cut across a number of different disciplines and sectors. It is not a
typical health research project or even limited to actions in the public health domain.
The second distinctive feature of an Equity Gauge is that it is explicitly based on 3
"pillars of action", each considered to be equally important and essential to a successful
outcome, and which should all be represented in both the design and implementation of
an Equity Gauge. The three pillars are:
• Advocacy
• Public participation
• Measurement and monitoring
An Equity Gauge is therefore an approach consisting of a set of actions, and is not, as the
name might suggest, just a set of measurements.
3
Although this set of three actions is portrayed as a set of independent pillars (Figure 1), in
practice, they overlap and inter-connect with each other. For example, the selection of
equity indicators to measure and monitor should be informed by the views of community
groups and by a consideration of what would be useful from an advocacy perspective. In
turn, the advocacy pillar relies reliable indicators developed by the measurement pillar
and may involve community members or public figures.
Another important feature of the three pillar design of the Equity Gauge is that they do
not relate to each other in any temporal sequence. Often research projects tend to collect
information, disseminate it and then undertake advocacy activities in that order. This
linear approach to changing policy or affecting change has often been found to be
ineffective. In an Equity Gauge, the actions of all three of its pillars should be happening
concurrently.
Pillar 1: Advocacy
This pillar refers to a broad set of actions designed to lead to real change in levels of
inequity in health and health care. Effective advocacy is increasingly being recognised as
a challenging and creative skill that researchers, health professionals and public health
initiatives should be equipped with. An ideal Equity Gauge would incorporate and
develop the skills and imagination required to raise the profile of equity in health policy
and planning, and to turn data and information into appropriate action.
Advocacy actions can take form in a number of ways:-
4
> Effective and strategic dissemination of information, education and communication
(1EC) materials3
> The construction of convincing and effective arguments, policies, proposals and
recommendations for improving levels of equity
> Direct engagement and active lobbying of policy makers, decision-makers and other
potential change agents
> Empowering the poor and disadvantaged, and their advocates, with knowledge, skills
and other resources
> Civil society campaigns and challenges to policies I actions designed, or likely, to
lead to greater inequities
An Equity Gauge is not expected to engage in all of the types of advocacy actions listed
above, as they may not all be appropriate in a given setting. For example, direct
challenges by civil society may not be strategic if a more co-operative approach with
government is likely to be more effective. What is important is that advocacy should
extend beyond a passive and unimaginative dissemination of information on levels of
inequity.
The targets of advocacy may also vary from situation to situation. In many instances,
policy and decision makers (the government as a whole, ministers and parliamentarians
etc.) will be critical advocacy targets to help ensure that equity is a political priority. The
civil service and health sector bureaucracy may also be an important target, as it has
been found that even in counties with a pro-equity policy environment, inequities may
continue to persist because of poor policy implementation. In countries where
government is weak, donor agencies and multi-lateral organisations such as the World
Bank may be important. It is also important to see the advantaged and rich sections of
society as being important targets of advocacy - if redistribution is to occur in pursuit of
equity, gaining as much support and understanding from those who are advantaged and
privileged may be very important to mitigate potential resistance to redistribution.
Finally, there may be other stakeholders with a vested interest in opposing change in
favour of equity - for example, private medical insurance companies may oppose
attempts to abolish individual risk-rating.
Pillar 2: Public participation
This pillar refers to the involvement of community groups and stakeholders in health
policy formulation and health sector reform, as well as the principles of community
empowerment (moving away from the notion of the poor being passive beneficiaries of
pro-equity and developmental initiatives), bottom-up development and public
accountability.
Community groups and stakeholders include the general public, with a particular
emphasis on the poor, the illiterate and the impoverished, and the community-based
organisations (CBOs) and non-government organisations (NGOs) that represent them.
■’ This includes appropriately packaging IEC in different ways for different audience groups.
5
The rich and powerful members of a society are also stakeholders who must be engaged
if inequities are to be reduced through redistribution.
Other important actors include other religions organisations, trade union organisations,
traditional leaders, women’s organisations, civic groups, human rights agencies and
academic institutions. Health workers and community health structures such as clinic
committees and hospital boards might be important group to involve. Finally, journalists
and the media (print, radio and television) are an important constituency whose
participation in an Equity Gauge should be encouraged.
In terms of actions, the 'public participation' pillar might include using CBOs to help
determine appropriate measures of inequity; facilitating discriminated and disadvantaged
community groups to express their health needs in their own words as part of an
advocacy strategy; employing 'participatory research' techniques in the measurement and
description of inequities; and actively encouraging the media to take an interest in health
policy and health systems.
Pillar 3: Measurement
This pillar refers to the identification of inequities that are important for an Equity Gauge
to describe, measure and monitor.
Part of identifying the inequities that are relevant to an Equity Gauge is deciding on the
'population groups' that form the basis of the inequities. This is because measures of
inequity have to be framed in terms of comparisons between groups that are 'advantaged'
versus groups that are 'disadvantaged. Population groups can be constituted in a variety
of ways, and an Equity Gauge should identify the most relevant groups for comparison:
> Socio-economic status (e.g. comparing the health status differential between socio
economically advantaged and disadvantaged groups)
> Race, religion, language and I or ethnicity groups
> Gender
> Geography and spatial location (e.g. comparing urban and rural populations, or
different states or provinces in a country)
> National origin (e.g. the differential between immigrants / refugees with local
nationals)
> Sexual orientation
> Age (the elderly and children are often at a disadvantage in many societies)
> Disability
In addition to comparisons between different population group categories, measures of
inequity can be reflected according to various dimensions of health:
• the underlying determinants of health and poverty
• health outcomes
• health financing
• access to health care
6
•
•
quality of health care
consequences of ill health
An Equity Gauge needs to then determine how it will actually measure these health
inequities. While there are hundreds of indicators that can be selected and measured to
describe inequity, the point about an Equity Gauge is less to do with painting a
comprehensive and detailed picture of health inequities, than it is with producing enough
data, that is reliable and valid, to influence change.
While the monitoring of equity is typically done through the collection of quantitative
indicators, 'inequities in health' can also be described in other ways. For example, the
problems that the poor and marginalised experience in accessing health and the
devastating consequences of ill health on the socio-economic status of families can
sometimes be better described through the use of descriptive or qualitative information.
Not only can this describe the situation of inequity and the impacts of inequity, they also
provide useful advocacy material.
Using a case study approach to describe the situation of health and health care in a
particularly under-resourced and impoverished area can also act as a powerful lens
through which health policies and health systems reforms can be evaluated in terms of
their impact on improving the health care of the poorest and most marginalised.
In some situations, an Equity Gauge may not have to collect new data - if enough data
and information of acceptable quality already exists, an Equity Gauge might concentrate
more on the analysis and use of existing data to support advocacy.
7
SECTION 2: AN EQUITY GAUGE APPROACH TO EQUITY AND HEALTH
There are different definitions of and conceptual frameworks for equity and inequities in
health and health care. In order to establish a strong global alliance of Equity Gauges, it
would be important for Gauges to share underlying principles and theories of equity and
health inequalities.
An Equity Gauge places health equity squarely within a larger framework of social
justice. While some health variations between people are inevitable (most notably the
fact that an elderly person will generally have less good health than a younger person),
many health inequalities are avoidable and associated with unjust social constructs. It is
these inequalities that are unfair, unjustifiable and avoidable that Equity Gauges are
concerned with.
An Equity Gauge perspective therefore means striving towards a world in which
disadvantaged population groups (whether defined by age, gender, race-ethnicity, socio
economic class or residence) can achieve their full health potential, as indicated by the
health standards of those groups in society who are most advantaged. It calls for
affirmative and preferential action to improve the health of those with the poorest health
and who face the greatest obstacles to achieving their full health potential.
Placing the Equity Gauge within the larger framework of social justice is primarily a
moral consideration based on humane and ethical values. It also arises out of the
empirical evidence in both rich and poor countries, that health is closely associated with
social position, and the underlying political, economic and cultural causes of social
position.
Poverty and marginalisation
In all countries and situations, poverty and marginalisation are underlying and
fundamental causes of inequities in health. Poverty results in certain groups being unable
to access the basic needs of life, and is accentuated by marginalisation through exclusion
due to factors of geography, ethnicity, language, race, disability or illness. Pail of the
answer to redressing health inequities therefore lies in eliminating structural poverty,
tackling racism and prejudice and making the opportunities of society more accessible to
the excluded. In addition, ill health and its consequences is also a potent generator of
poverty, emphasising the importance of health interventions as a means of poverty
reduction.
Educational opportunity
In country after country, inequalities in health are robustly associated with educational
attainment. Those with higher levels of education enjoy greater life expectancy and lower
levels of ill health or disability compared to those with less education. Moreover,
education attainment exerts a strong influence on income and standards of living. As a
particularly modifiable determinant of health, improved education and literacy levels of
disadvantaged and marginalised groups is thought to be an effective strategy for reducing
health inequities.
8
Gender
Gender is a key 'social stratifier' that interacts with other factors like economic class or
race because the broad social and economic determinants of health affect men and
women differently. For example, occupational roles carrying different health risks may
be assigned differently between men and women. Various social and cultural
expectations and constraints can also shape the lives of women differently from men.
Health systems and health care
Although factors outside the health sector are key determinants of health inequities, the
health sector plays a pivotal role in health equity. Through promoting good health, and
providing accessible, appropriate and comprehensive PHC to marginalised groups, health
systems can do much to reduce health inequalities. Conversely, and all too often, health
systems without a focus on equity have the potential to exacerbate or create health
disparities by neglecting the needs of vulnerable populations and ignoring cultural,
physical and financial barriers to accessing health care.
9
SECTION 3: CONTEXTUAL MAPPING
An important aspect of Equity Gauges is that they are contextualised. There is no
standard formula or recipe for an Equity Gauge. An appropriately designed Equity Gauge
is one that fits the circumstances, needs and conditions of a given country, region or city.
This document merely describes the general principles, approaches and characteristics of
Equity Gauges, However, in order to assist Equity Gauges to develop their plans, a set of
generic questions on the social, political and economic context have been formulated. By
answering these questions, it is hoped that Equity Gauges will be stimulated to think
through the many complex and challenging issues that are inherent in any initiative
designed to impact on equity and promote justice.
3.1 The general state of inequity
This section is designed to sketch out the broad picture of inequity and injustice. It should
help to identify andjustify the selection ofpopulation groups that are to be compared
against each in order to describe and quantify inequities in health.
> What is the degree and extent to which your country, region or city is socio
economically stratified? In other words, to what extent are there class divisions, and
how large is the differential between these classes? What have been the general trends
in socio-economic equity over the past 50 years? Has the country seen increasing or
decreasing inequities? What are the underlying causes of this trend?
> Are there any identifiable populations who are socially and politically discriminated
against or persecuted? Are any groups marginalised or disadvantaged on the basis of
gender, religion, race, language, ethnicity or sexual orientation? If so, who are they,
what is the size of these groups, what is the nature of their discrimination /
persecution / marginalisation, how severe is it, what evidence is there of this and what
are their historical roots?
> Is there a rural-urban divide in terms of wealth and poverty? Are the interests and
needs of the rural population adequately represented in government? Is this reflected
by inequities in health between the rural and urban populations?
3.2 Government
This section is designed to sketch out the nature ofgovernment which may help inform an
appropriate advocacy strategy and prompt Equity Gauges to think how best they can
engage with 'government' to promote pro-equity change and action.
r What is the system of government and electoral representation? Is there democratic
representation through fair and free elections? Is there "good and just" governance? Is
there a culture of transparent and accountable government?
10
> To what extent would the government support the objectives of an Equity Gauge and
be responsive to its findings and recommendations? Is it likely that the Equity Gauge
will be able to promote equity through an open and constructive dialogue with
government?
> Within government, to what extent is health appropriately considered a priority?
What proportion of GDP and the government budget is spent on health care and other
social sector services? Should advocating for a higher proportion of government
spending on the social sector be linked to efforts to reduce inequities in health?
> What health equity issues are on the “radar screen” of policy-makers? What important
health equity issues aren’t on the agenda but should and could be with reasonable
effort in the near future?
> Is there an independent legislature (or other body) with the responsibility, authority
and procedures for monitoring the role and performance of the executive arm of
government? Could it be persuaded by an Equity Gauge to act as advocates on behalf
of the poor and marginalised in society? If so, how can they be reached and lobbied?
3.3 Other decision-making and power-brokering institutions
In some countries, the formal structures of government may be weak or disempowered.
This section is designed to prompt Equity Gauges to consider other targets for their
advocacy strategy'.
> To what extent are social, public and economic policy decisions influenced by
external agencies such as the WB or IMF? How much of social sector spending
comes in the form of external aid / assistance? Is there an externally imposed
Structural Adjustment Programme in place, and to what extent does this programme
reflect equity concerns? Should donors or multi-lateral agencies be a target for Equity
Gauge advocacy initiatives?
> Are there other powerful or influential non-governmental institutions that need to be
considered as targets for advocacy in favour of greater equity in health? Who might
be your allies and who might be your opponents?
3.4 The advocacy and public participation environment
Th is section is designed to sketch out other aspects of the environment within which an
Equity Gauge would operate. It hopes to identify potential collaborators, synergies and
levers to an effective advocacy strategy.
Judicial and legal system
> Is there a human rights culture or a commitment to any conventions or declarations on
human rights? What international conventions or declarations on human rights (which
11
could be used as an advocacy lever) is your country, region or city a signatory of?
Have these been officially ratified?
r Do individuals and communities have any constitutional or legal rights to their basic
social and economic needs? To what extent is recourse to the courts a viable method
of advocacy in favour of the poor? Do the poor have access to legal representation?
Could this form the basis of an advocacy strategy for the Equity Gauge?
> Is there an independent and functional judiciary? How sympathetic is it to the plight
of the poor and discriminated? Could it be persuaded to advocate on behalf of the
poor and marginalised in society? If so, how can they be reached and lobbied?
Other non-governmental agencies and initiatives
> Is there a vibrant non-govemment sector in the city, region or country? Are there
other groups or initiatives working on human rights, poverty alleviation and social
justice who might be potential collaborators of an Equity Gauge? For example, if
there are groups suffering from discrimination, persecution or a denial of basic human
rights, are there efforts, initiatives or movements designed to overcome this?
> Do any of the following groups offer the possibility of working as partners to the
Equity Gauge or as advocates for improved equity in health: religious organisations,
trade unions, women's groups and academic institutions?
The media
'r Is there a free press / media? How sympathetic is the press / media to the plight of the
poor and discriminated? Does it play a role in upholding fair and accountable
government? How can the media be invited to participate in the Equity Gauge?
> Is there a growing information and communication gap between the poorer and richer
sections of society? To what extent is low literacy a barrier to the poor accessing
information? How can IEC from an Equity Gauge be best communicated to the poor
and marginalised through the mass media?
3.5 Macro-economic environment and public policy
This section is designed to sketch out the broader economic and public policy
environment which may help identify some of the underlying causes of health inequities
as well as help inform appropriate recommendations for reducing inequities.
> How rich is the country, region or city? For example, is it a high, middle or low
income country and what is its GDP? What is the stability and growth of the country's
economy? What proportion of total government spending is used on servicing debt re
payments? Is this hampering the capacity of government to strengthen social sector
services, particularly those targeting the poor and marginalised?
12
> What is the ideological / theoretical background of the country’s economic and public
policy? To what extent is equity a key objective of public policy, and to what extent
should economic and public policy be challenged from an equity perspective? For
example, to what extent is public sector policy and macro-economic policy neo
liberal and to what extent does the notion of an interventionist welfare state exist?
3.6 The health system
This section is designed to sketch out the health sector in more detail.
> Flow equitable is the health care sector? What evidence and information currently
exists to demonstrate the state o f inequity in health?
> To what extent is the health care system horizontally fragmented? For example, is
there a two-tier or three-tier health care system? Do the poor and the rich use different
health care services / systems?
> What is the size of the private health care sector? Has it grown or shrunk in the
country? What effect does it have on the state of inequity or equity in health and
health care?
> Have there been any significant health sector reforms in the country over the past 15
years, and what were they? Flas this led to a worsening or an improvement in health
and health care inequities? Where have these reforms come from? What are the key
upcoming issues in health policy-making? Are there any future policies or reform
efforts that are being planned, and which may have equity implications?
> Is decentralisation and / or devolution of the health care system happening or being
planned? What effect has this had or will have on health inequities?
> How is health financing organised and how progressive is it? Have there been
changes in the way health care is financed, and have they been more progressive or
regressive? Where and how are decisions about health financing made, and should
they be a target for Equity Gauge advocacy actions?
> To what extent are marginalised groups provided with an opportunity to influence
decision-making within the health system? Do clinic committees and hospitals boards
offer a formal platform and mechanism within the health system for promoting the
needs of the most disadvantaged and marginalised?
13
SECTION 4: A STRATEGIC PLAN AND DESIGN FOR YOUR EQUITY GAUGE
Having conducted a mapping of the context, Equity Gauges can now proceed to develop
their plans for each of the three pillars accordingly (see Figure 2). The following section
of this guide is a guide to developing an Equity gauge plan on the basis of the contextual
map. Appendix 2 provides an example of what such a plan for a hypothetical country
might look like, and is included in this document as a further guide to Equity Gauges..
Figure 3
Selection of EG indicators and
research questions
Social
Political
Economic
Context
Identification of
appropriate and
effective
advocacy
strategies
14
Identification of
appropriate and
effective
methods for
community
involvement and
action
4.1 What inequities will the Equity Gauge focus on?
The population groups
In order to help choose an appropriate focus based on the contextual map, the following table is designed to help Equity Gauges to
identify and justify their selection of population groups to focus on. NB. This table is not constructed to be filled in, but merely
represents a framework and template to assist Equity Gauge design.
Categorisation of
population groups
Socio-economic:
Race and / or ethnicity:
Religion:
Language:
Gender:
Geography and spatial
location:
{National origin (e.g.
immigrants / refugees
versus local nationals):
Sexual orientation
Age
Disability
Disparities in health outcomes
(magnitude of difference between
advantaged and disadvantaged
group(s))
High
Moderate
Low
Size of disadvantaged group
(proportion of the overall
population that comprises the
disadvantaged groups)
High
Moderate
Low
Public aw areness (degree of public
attention paid to health of
disadvantaged group
High
Moderate
Low'
Dimensions of health
Having identified the type(s) of population group(s) that are to be the focussed upon, the following table is designed to help Equity
Gauges determine the dimensions of health inequity that will be focussed upon. NB. This table is not constructed to be filled in, but
merely represents a framework and template to assist Equity Gauge design.
Dimensions of
health
Type of
Population group
(to be filled in)
Underlying health
determinants
- Socio-economic
- Behavioural
- Occupational
- Education
- Environmental
Health status
Health care financing
16
Access to health
care
Quality of health
delivery:
e.g. MCH
e.g. communicable
diseases
e.g. trauma
e.g. mental Health
The consequences
of poor health on
social and
economic status
4.2 Planning for effective advocacy (Pillar 1)
Based on the contextual mapping exercise and the focus of health inequities identified in the preceding section, the following table is a
template framework to assist Equity Gauges to map out their advocacy strategy. NB. This table is not constructed to befilled in, but
merely represents a framework and template to assist Equity Gauge planning.
Advocacy actions
Effective and
strategic
dissemination of
IEC materials
Constructing
convincing and
effective arguments,
policies, proposals
and
recommendations
for improving levels
of equity
Direct engagement
and active lobbying
with policy makers
and decision-makers
Empowering the
poor and
disadvantaged, and
their advocates, with
knowledge and
other resources
Actors
Who are your allies
and potential partners
in pursuing these
activities? Who might
be your opponents?
Strategy
What are the key
action points, how will
they be implemented
and which groups will
be targeted? How will
the media be used?
Resources required
What resources are
available and what
additional financial
and human expertise
are needed?
Outputs
Timeframe
Civil society
campaigns and
challenges to policies
/ actions designed,
or likely, to lead to
greater inequities
Other
18
4.3 Planning for effective public participation (Pillar 2)
The plan and actions for effective public participation overlaps with the plan and actions for advocacy. The following table may
duplicate some information from the table above, but should help to provide a holistic and analytic map of an Equity Gauge's public
participation strategy. NB. This table is not constructed to be filled in. but merely represents a framework and template to assist Equity
Gauge planning. Some useful generic questions to consider in the use of this table are:
> What amount and proportion of time and funds will be allocated to working with each community groups and promoting public
participation?
> To what extent can your Equity Gauge be influenced by the community’s agenda? For example, health service planning and policy
are not necessarily priorities for the most marginalised, for whom poverty reduction may be the biggest priority (as well as the
most vital contribution to promoting equity in health).
> How will you overcome the potential power imbalance between community groups and academics / professionals?
Community groups
Rationale and purpose for choosing Involvement with the Equity Gauge
this community group
Timeframes and outputs
The general public
CBOs or community
representatives of the poor and
marginalised
CBOs or community
representatives of the rich and
advantaged
Civic organisations and
consumer groups
Women’s groups
Religious organisations
Trade unions
1
Traditional leaders
19
Health workers
Allopathic public
Allopathic private
Traditional health practitioners
Health science students
Clinic committees, hospital
boards etc.
Media and journalists
Other
20
4.4 Measurement (Pillar 3)
Having selected the types and dimensions of health inequity that your Equity Gauge will be focussing on (section 4.1), the following
table is designed to elaborate the actual data and actions required to fulfil the measurement pillar of the Equity Gauge. NB. This table
is not constructed to be filled in, but merely represents a framework and template to assist Equity Gauge planning
Some useful questions to consider when using this table are:
> Why have the following indicators been selected?
> Was / will input from different stakeholders be solicited on the choice of indicators? How meaningful are the selected indicators
likely to be to decision-makers and the public? Will information on these indicators be likely to move people to take action?
> Have you considered “participatory” approaches that combine the goal of collecting information with promoting stakeholder
involvement?
Selection of quantifiable and measurable indicators
Population
group
Dimension of health
Selection of quantitative
indicators
Source and methodology of data
and information
Quality and reproducibility of data
Are the selected indicators measurable, of
acceptable quality and possible to use over
time so that you can evaluate the effects of
policies or plans to reduce inequity?
Qualitative data and information
What forms of qualitative data and information will be used in the Equity Gauge? Will descriptive case studies, in-depth interviews
and focus group discussions form part of the data collecting exercise of the Equity Gauge?
Appendix 1: The Diderichsen model
Many analyses of health inequities have used Diderichsen's social determinants
framework which consists of four broad mechanisms that play a role in generating health
inequities. The way it works is that social stratification (I) leads to a separation o f people
into different social positions. These differential social positions in turn lead to a
differential exposure to causes of illness, disease or injury (II), a differential susceptibility
to causes of illness, disease or injury (III) and a differential consequence of illness,
disease or injury (IV). These differential social consequences of ill health then have the
consequence of reinforcing social stratification, thus setting into place a vicious cycle of
increasingly widening disparities.
For example, low income workers are more exposed (I) to occupational injuries and
unsafe working environments than high income professionals. Or, a malnourished child is
more susceptible (II) to developing severe respiratory complications following a measles
infection, than a well nourished child. And finally, in societies with inadequate social
security nets, the consequence (IV) of the cost of health care on a poor household can be
further or complete impoverishment, and thereby a worsening of social position.
SOCIETY
INDIVIDUAL
What is also important about this model is that each of the mechanisms
described above can be countered by specific pro-equity policies or by a
modification of the social context. These are to influence and modify the pattern
and extent of social stratification (A), to preferentially decrease exposures
amongst the poor and vulnerable (B), to preferentially decrease differential
susceptibility amongst the poor and vulnerable (C) and to prevent unequal social
consequences (D).
Equity Gauge
Subject: Equity Gauge
Date: Thu, 29 Nov 2001 14:58:14 +0200
From: "David McCoy" <hstmccoy@ct.stonrinet.co.za>
To: sochara@vsnl.com
Dear Ravi Narayan,
I am writing to you on David Sanders' recommendation.
I am a public health doctor working for an NGO in South Africa. I
am also part of a group of people who are trying to establish a
global movement around the issue of equity and health, based on
based projects called "Equity Gauges".
An "Equity Gauge" is defined as an active approach to monitoring
inequity in health and health care, based on three clearly defined
"pillars of
action":
* Advocacy and action to reduce inequity
* The measurement and description of inequity in health and health
care
* Public participation and community involvement in measurement
and advocacy
At the present moment there are 11 such "Equity Gauges" in
various countries across the world, mostly in Africa. These are
being sustained by grants from the Rockefeller Foundation.
The reason for this e-mail is to ask if you would be able and willing
to participate in a meeting to help us develop our programme of
work in the field of advocacy and action around reducing health
inequities.
David Sanders felt that you would bring valuable insights in the
challenge of lobbying, campaigning and advocating at both a
country and regional level.
Most of the Equity Gauge projects are being managed by public
health professionals who do not have that much experience in
advocacy, and we are therefore
looking to develop their capacity in
this "pillar of action.
The meeting I refer to will be held in february (week of the 11th) in
Kampala. Representatives from 11 Equity Gauge projects from
across the world will be present at the meeting, including a number
of senior representatives from multi-lateral and donor agencies.
We would be able to pay for your travel costs and time should you
come.
I look forward to hearing from you. Attached is a document that
gives further background to what it is we are trying to accomplish.
Yours sincerely,
Dr. David McCoy
Health Systems Trust
509 Premier Centre
451 Main Road
Observatory 7 92 5
Cape Town
1 of2
ft
Jl
i
0+^
z
V
-Jr
1/8/02 1 1:54 AV
Equity Gauge
South Africa
Tel: 021-4476330
Fax: 021-4476302
Cell: 083-3013681
E-mail: hstmccoy@ct.stormnet.co.za
The following section of this message contains a file attachment
prepared for transmission using the Internet MIME message format.
If you are using Pegasus Mail, or any another MIME-compliant system,
you should be able to save it or view it from within your mailer.
If you cannot, please ask your system administrator for assistance.
--File information ----------File:
EG Manual draft 3.doc
Date:
8 Aug 2001, 20:34
Size:
141312 bytes.
Type:
Unknown
EG Manual draft 3.doc
2 of 2
Name: EG Manual draft 3.doc
Type: Winword File (application/msword)
Encoding: BASE64
1/8/02 11:54 A.\
Re: Meeting
Subject: Re: Meeting
Date: Fri, 30 Nov 2001 16:08:15 +0200
From: "David McCoy" <hstmccoy@ct.stoiTnnet.co.za >
To: Community health cell <sochara@vsnl.com>
Dear Ravi,
Many thanks for your e-mail. I think you would be a great addition
to the meeting in Kampala. I would be pleased if you would formally
diarise the dates.
There are now things left to do. First is to arrange for your travel
and visa requirements. Someone called Pat Naidoo will be in touch
with you about this.
The second will be to discuss your input. This might be best done
through a phone call in the first instance. Is this possible?
There are some other people involved in the meeting who will also
be there as "advocacy experts". They are Dorothy Logie (Jubilee
2000), Mike Rowson (Medact), Monica Naggaga (Oxfam) and Mark
Heywood (Treatment Action Campaign and AIDS Law Project).
Look forward to hearing from you again
Dave
Date sent:
From:
To:
Subject:
Fri, 30 Nov 2001 17:44:30 +0530
Community health cell <sochara@vsnl.com>
hstmccoy@ct.stormnet.co.za
Meeting
> Dear Dr. David McCoy,
>
> Greetings from Community Health Cell, Bangalore. Thanks for the
> invitation to be a resource person on Advocacy and community Health
> Action at your meeting on Equity Gauges'. For the present the week
> starting 11th February seems convenient,
and I confirm my
> availability. I look forward to hearing more about the meeting its scope
> and structure
- so that it would help me to decide how I could
> contribute.
>
> I am a Public Health Professional with training at the London School of
> Hygiene and Tropical Medicine and the All India Institute of Medical
> Sciences. I was an academic / researcher and a faculty member of the
> Department of Community Medicine at St. John's Medical college,
> Bangalore for a decade and also an overseas lecturer of the School. In
> 1984, along with a small group of colleague, we quit our faculty
> positions to initiate a centre working with NGOs peoples movement, civic
> society and more recently governments and universities on Community
> Health Action and Health Policy Advocacy. Its been 17 years in this
> exciting work and the high point was the Peoples Health Assembly in
> Calcutta (2500 Health and Development Activists and Professionals in
> India) and the Global Assembly in Bangladesh 1500 participants from 92
> countries. JVe are all now lobbying with the People's Health Charter
> which evolved at this assembly.
>
>
>
>
>
>
1 of2
You can access our centres website for more information.
web site address: www.geocities/sochara2000.
With best Wishes,
Dr. Ravi Narayan,
1/8/02 11:53 AV
Re: Meeting
> Community Health Advisor.
> CHC
Dr. David McCoy
Health Systems Trust
509 Premier Centre
451 Main Road
Observatory 7925
Cape Town
South Africa
Tel: 021-4476330
Fax: 021-4476302
Cell: 083-3013681
E-mail: hstmccoy@ct.stormnet.co.za
2 of 2
1/8/02 11:53 A.X
’irnpala meeting
Subject: Kampala meeting
Date: Fri, 14 Dec 2001 10:39:23 +0200
From: hstmccoy@ct.stonrinet.co.za
To: sochara@vsnl.com
Dear Ravi,
I have haor. having acairuo prohlorr.s t,z±fch. my Q —mail
ca you muy hjxvo
already responded to my previous e-mail. I just wanted to conform
your attendance at the Kampala meeting and to make sure that
you don’t have problems with arranging flights and visas.
I thought it would also be useful to talk on the phone - would this
be oossible.
fl
12/14/01 2:43 PM
•>. Workshop in Uganda - Invitation
Snhiect: GFGA Workshop in TTannda - Invitation
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f rom: "Dr. Far Naidoo” <rpihav(fl'irnul.com>
To? s(?ch.ar?^YSiil.co!ii
Dear Dr. Ravi Narayan;
Greetings I
Thanks for agreeing to participate in the GEGA workshop Advocacy pillar
agenda. I am looking forward to meeting and working with you in Uganda.
please fine attached you invitation co one workshop from Dr. Fred Wabwire,
the director or I PH which is hosting the workshop.
Please dont hesitate to get in touch with me if you require any further
information.
forward to seeing you m Uganoa,
Regards,
Pat Naidoo
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OFFICE OF THE DIRECTOR
* December 2001
18
Dr. Ravi Narayan
Cornniuiiity Health Advisor
Community Health Cell
email: sochara®ysnl.com
Dear Dr. Naravan,
RE:
Rescheduled Global Workshop on Health Equity. February 2002
1 am pleased to invite you as a resource panellist, to attend the Global Equity Gauge
*t viivuiivy
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workshop will be held at the Imperial Botanical Beach Hotel in Entebbe, Uganda
2002.
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I believe rhe conference will greatly benefit from your presence and input and we look
forward tv a very productive and fruitful meeting.
A
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make scientific presentations on the status of then equitv gauges at the workshop. In
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technical needs identified
by the individual counity gauges.
The objectives of the workshop are:
1. To bring together experts, international researchers and donor agencies in the area of
health equity to discuss health equity and its assessment.
2. To critically examine the design of existing equity gauges and to see how each of
them can be supported and strengthened appropriately.
3. To advocate for the establishment of health equity gauges as a means of monitoring
equity in heahh and health care
1
4. To develop consensus on the core concepts of" the equity gauges i.e. advocacy,
measurement and community participation and their use in narrowing equity gaps
within nnd between countries
The workshop format will provide for an in-depth discussion on the various technical
aspLvtS vi rlcaltit Equity as they pertain to active monitoring, evaluation and
implementation within various contexts.
The workshop will also attempt to develop standardised tools for the design,
implementation and evaluation of health equity gauges ^nd it also hoped that key
strategic issues including long term co-ordination and funding for GE GA and die way
forward for Equity Gauge Initiatives will he discussed.
My Institute and will provide for your accommodation and all meals during your
viivanvv a* the orkshop. We can also make all the necessaiy arrangOxixvnts xO
* ^our
travel to Uganda. Alternatively, you are free to make your own travel arrangements, if
you sc prefer, ^cu v/otdd ho"^xz,°*'
let
know as soon as possible (before
January 7) if you require us to arrange your travel and if you choose to make your own
uq have vonr itinerary as coon as noccible
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Pieace note a1co ' that
ilicic is a ceiling foi icimbuiscmcut of travel expenses for participants who make then
own travel arrangements. This is based on the lowest, most direct round-trip economy
class fare available from your port of embarkation to Uganda. Our travel co-ordinator,
Juddv (Jtti. will be able to provide vou with more specific details regarding tlus ceiling
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We took forward to vour
presence and participation at the Uganda Workshop.
e'
Please let me know, at your earliest convenience, if there is anything further I can do to
help.
A
A
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Sincerely vours
Dr. Fred Wabwke-Mangcii
Director. Institute of Public Health
?
JL
Greetings
Subject: Re: Greetings
Date: Fri, 04 Jan 2002 14:39:09 +0300
From: "Dr. Pat Naidoo” <rpillay@imul.com>
Io: Community health cell <sochara^vsnl.com>
Hi Ravi,
Sorry to hear that you’ve been having some difficulties with your health, I
wish you well and a speedy recovery. I’m still hopeful that you will be
able to attend our meeting. I was so looking forward to meeting and working
with you. Dave McCoy is organizing the advocacy pillar sessions so it is
his call regarding the resource participants for this pillar, although at
this stage I don’t foresee any difficulties regarding an alternative person
from People’s Health Movement if this is necessary. In order to facilitate
the travel and other logistics in time we would need to confirm this fairly
soon though.
Dave would probably talk with you soon on the phone about this.
In any case lets stay in touch and 1 wish you a speedy return to health.
Best wishes for the new year,
regards
Pat Naidoo
At 16:00 28/12/01 -0530,
you wrote:
/-‘Dear Dave and Patz
>Greetings from Community Health Cell.
^Apologies for the delay in replying to your recent emails but an attack
>of my recurrent spondylosis problem has resulted in some temporary
dislocation of my work including some travel restrictions.
This setback
>Aas injected an uncertainty about my participation at your workshop -
>which I am still really looking forward to attend.
I should know in a
>weeks time after physiotherapy etc how the condition progresses.
While
>wishing you all.best wishes for the New Tear, I must apologise for this
>sudden uncertainty.
We could chat on the phone around 3 - 5th January
J^^^nake a final decision (my residence number is GG91 - 80 - 5533064 and
>office 0091-30-5531518). In case I am unable to attend would you
>consider another colleague from the Peoples Health Movement Mobilization
>process in India - with a similar background replacing me.
There are
>several in mind but I did not want to approach them till I have a
>tentative okay from you on this.
>Regards,
>Ravi Narayan
>Community Health Advisor,
>CHC
1
1/7/02 12:29 PM
< Meeting-'
Subject: Greetings
Date: Fri, 28 Dec 2001 16:00:36 -1-0530
From: Community health cell <sochara@vsnl.com>
To: rpillay@imul.com, hsUnccoy@ct.stormnet.co.za
i
< r Dave and Pat,
ei. ings from Community Health Cell.
Ap■-logics for the delay in replying to your recent emails but an attack
<-i my recurrent spondylosis problem has resulted in some temporal ',
(h Location of my work including some travel restrictions.
This cd: b irr
h.i.-. injected an uncertainty about my participation at your workshop
which L am still really looking forward to attend.
I should know in a
w- uks time after physiotherapy etc how the condition progresses.
While
wishing you all best wishes for the New Year, I must apologise fox Chis
midden uncertainty.
We could chat on the phone around 3
5t:h Januar .
• • make a final decision (my residence number is 0091 - 80
5533064 ind
-it ice 0091-80-5531518). In case I am unable to attend would you
c •nsi.de) another colleague from the Peoples Health Movement Mobilisation
1'i.^cd^s in India - with a similar background replacing me.
There are
!■' ’era 1 in mind but I did not want to approach them till L have a
t< i.tative okay from you on this.
!••• lards,
• i Narayan
-..muniry Health Advisor,
I ..f 1
I lo*ll ‘I
Dr. Ravi's address
Subject: Re: Dr. Ravi’s address
Date: Wed. 09 Jan 2002 16:49:30 +0300
From: "Dr. Pat Naidoo
*
1 <rpil1ay@imul.com>
To: Community health cell <sochara@vsnl.com>
Hi Ravi,
Many thanks for your note.
Please find attached the tentative agenda for the Uganda Workshop
I’ll have our travel person send you the tentative itinerary for your travel
If you need to reach her directly she can be reached on email as follows:
■Juddy otti c/o "Ms. Annette N. Kironde” <afrique@infocom.co.ug>
At 13:29 09/01/02 +0530,
>Dear Dr. Pat Naidoo,
you wrote:
>Greetings from Community Health Cell
- Bangalore!
>Further to your discussion you had with Dr. Ravi Narayan today, please
>find his office and residence address and phone numbers :
>Office :
>Dr. Ravi Nara ya n,
>Community Health Cell,
>367 , 'Srinivasa Nilaya'
>Jakkasandra I Main,
Block, Koramangala,
^Eangalore - 560 034,
>Karnataka,
>India.
>Telephone : 091 - 80 - 553 15 18,
>
091 - 80 - 552 53
>
>Telefax :
091 - 80 - 552 53 72
>e-Mail
:
sochara@vsnl.com
>Residence :
>Dr. Ra vi Naraya n,
># 326, 5th Main Road,
>lsc Block, Kcramar.gala,
>Bangalore - 560 034.
>
> Tel eph one : 553 3064
i2
Dr. Ravi's address
jof»
/0/'/c2^
1/10/02 9:38 -IM
• > Thanking you,
>'/ . i\'.
2-..a QO 27a.g a. Roo
?
Name: Uganda Workshop Progranime.doc
jyjUganda Workshop Programme.doc j
Type: Winword File (application/msword) ;
;Encoding: base64
1/10/02 9:38 ?JvI
Global Equity Gauge Alliance
Technical Workshop for Equity Gauges
February 11th to the 15th 2001
Draft Programme
The workshop aims to:
o Strengthen, participants understanding of the concept of Equity as well as a Framework for Equity
Gauges;
® Strengthen participants awareness of the place and scope of advocacy, public participation and
monitoring and measurement within an Equity Gauge;
•3 Provide a forum for undertaking some strategic planning for the Global Equity Gauge Alliance
(GEGA):
Create an opportunity for Equity Gauges to exchange ideas and information.
Monday February llrh
8.30am
9.30am
10.00am
11.00am
11.30am
1.00pm
2.00pm
2.45pm
4.00pm
4.15pm
5.30pm
Welcome
Ugandan Institute ofPublic Health
Setting the Context for the Workshop
Dr. Tim Evans and Ms. Antoinette Ntuli
Plenary: A Framework for Equity
Dr. Paula Braveman and Dr. Jeanette Vega
Break
Plenary: A Framework for an Equity Gauge
Dr. David McCoy
Lunch
Plenary7: Individual Gauge Presentations - Chile and South Africa
Group Discussion: Framework for Equity and an Equity Gauge
Tea
Plenary: Feedback from small groups
Day Ends
Tuesday February 12th:
Plenary’: Strengthening the Three Pillars of an Equity Gauge
Introduction to Advocacy (Dr. David McCoy)
Working at the level of the community (Dr Ravi Narayan)
Using the law and community mobilisation - the experience of TAC and the
AIDS Law Project in South Africa (Mark Heywood)
0830:
0840:
0910:
Ity.
0940:
Working through information, pressure and lobbying - the experience pf Jubilee
2000 and Medact (Dorothy Logie)
1000:
Tea
1030:
1040:
Introduction to Measurement: Dr. Jeanette Vega
Concepts of Equity and the implications for measurement. Theoretical frameworks for
health inequalities pathways Margaret Whitehead
How to select the indicators to measure Equity: Selection criteria for Health status, health
care and socioeconomic indicators. Level of aggregation. Paula Braveman
1110:
1145:
1200:
1230:
Introduction to Public Participation: Antoinette Ntuli / Mushtaq Chowdury
Why participation is a vital component of promoting Equity (Susan Rifkin)
Case Study: Abbas Bhuiya
2.00pm
Plenary: Individual Gauge Presentations - Nairobi, Cape Town and Ecuador
3.15pm
Tea
3.30pm
Parallel Sessions
1 Advocacy anti Public Participation
1 Question-Answer session based on
i plenary inputs to be facilitated by
i presenters.
* What is ‘advocacy’ and ‘public
participation’ - what are their
differences and what are their
*?
synergies
® Developing consensus on definitions
of "community", "participation" and
"empowerment".
5.30pm
Day Ends
Wednesday February 13th
8.30am
Parallel sessions
Measurement
Group Exercise
® Outline of the conceptual framework
being used in each gauge (alternatives
models can be considered to do this)
® What are the indicators being used or
considered in each gauge?
i
1
|
|
Guided discussion Limitations and strengths i
of using different sources of information
(primary vs secondary, individual vs
aggregate, qualitative vs quantitative, etc)
j
based on gauge sources and approaches
; Advocacy
j Case study: Mount
i Frere - David Sanders
Policy Maker - a tool
1o help develop an
advocacy strategy Hilary Brown
Participation
: Group work: Examining
assumptions about the critical
role of participation
Sub-themes: Does
participation promote
sustainability? Does
participation ensure capacity
building?
Facilitated discussion:
Examining issues around
power and control.
Sub-Themes: How do
attitudes and behaviours of
professionals promote or
inhibit participation? What
are the causes and
consequences of manipulation
by a participator/ approach?
i Measurement
•~r~r----------------Lecture: 'Measuring the
size of the Gap” Norberto
Dachs /Adam Wagstaff
Group Exercise
What measures will be used
in each specific gauge and
why?
Lecture: Qualitative aspects j
of Health Equity
measurement Timothy Evans '
1.00pm
Lunch
2.00pm
3.15pm
Plenary: Individual Gauge Presentations - Thailand, Bangladesh and China
Tea
3.30pm
Parallel Sessions
Advocacy
Public Participation
Measurement
Case study: Uganda
Oxfam - Monica
1 Naggaga
Group work: Assessing
participation and facilitating
changes for wider
participation.
Sub themes: Experiences of
assessment and how to
develop assessment tools to
reflect local situations.
Group Exercise: Discussion 5
of the qualitative techniques
being considered to collect
information in each gauge?
Group Work - three
i gauges to work on
plans for their own
individual Equity
Gauges and to use
these as a basis for
developing skills
Skills for advocacy using the media (1
hour)
Identification of key factors
that promote participation and
review of factors as possible
indicators for participation in
an Equity Gauge
Developing Criteria for Public
Participation - who would
Equity Gauges want to
involve, and for what ends?
5.30pm
Day Ends
Lecture: Measurement of
!
household expenditures for |
health care (Adam Wagstaff i
and Martin Valdivia)
Group Exercise: Putting
together your gauge summary of the theoretical
framework and complete
methodology for
measurement in each gauge, i
i
Thursday February 14th
8.30am
10.30am
Plenary: Individual Gauge Presentations - Uganda, Zambia and Zimbabwe
Field Trip: organised by Ugandan Institute of Public Health
Friday February 15th
8.30am
Plenary: A Global Equity Gauge Alliance - The Way Forward
o Update on GEGA activities: September 2000 to September 2001
a Key Strategic Issues from the parallel sessions - (presentations from resource
people)
o Examples of how individual Gauges might have a global impact
Monitoring Immunisation in Bangladesh - Mr. Mushtaque Chowdury
Training for Equity - Dr. Jeanette Vega
Plenary Discussion: Strategic Vision of GEGA
12.30pm
1.00pm
Closure and vote of thanks: Ugandan Institute of Public Health
Lunch
atiOilS for KAMPALA
Subject: Reservations for KAMPALA
Date: Wed. 9 Jan 2002 17:14:21 -t-0530
From: "Suchi" <suchi@iraveJexchange-india.com>
To: <ashokaiyar@yahoo.com>, "Community health cell" <sochara@vsnl.com>
ATTN: Dr.Ravi Narayan
This is in reference to Mr.Ashok Aiyer 's telephone call
enclosing
the reservation made for your trip to Kampala.
Visa requirements for Uganda
1) Applicant should have a valid passport [minimum 6 months)
2U Two Visa forms
^^Chree passport photographs
4) return confirmed ticket
5-/Covering letter from community health center mentioning purpose of visit
6)Vaccination certificate for cholera and yellow fever
7} Invitation from Kampala
8} Sufficient funds to support self in Kampala
9{ Consulate in Delhi and time taken 5 working days.
Fare for the routing
RS 41756+TAXES RS 6000 ON KENYAN AIRLINES
pi
Record Locator: MQDOZS
If
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NAPA.YAN, RA.VIDR
L- bi Frequent Flyer Numbers
Phones
Type
Travel
5 City
iPhone
Travel Agent ;(MAA)TRAVELEXCHANGE REF SUCHI-
bl b3 Itinerary
1/10/02 10:02 .AM
s for KAMPALA
9W - Jet Airways
Flight Number: 442 Booking Code: M
Date:
10 February - Sunday
From: BLR - Hindustan Arpt, Bangalore India
To:
BOM - Chhatrapati Shivaji Airport, Mumbai India
Departs: 8:30 PM
Arrives: "
10:05 PM
*1
*
Status:
HK - Confirmed Sell Type:
# Seals: 1
S - Super guaranteed sold
KQ - Kenya Airways
Flight Number: 201 Booking Code: Q # Seats: 1
Date:
11 February - Monday
From: BOM - Chhatrapati Shivaji Airport, Mumbai India
To:
NBO - Jomo Kenyatta Inti, Nairobi Kenya
Departs: 3:10 AM
Arrives:
6:45 AM
Status: UK - Confirmed Sell Type:
O - Secure sold
KQ - Kenya Airways
Flight Number: 410 Booking Code: Q # Seats: 1
Date:
11 February - Monday
k „, From:
NBO - Jomo Kenyatta Inti, Nairobi Kenya
To:
EBB - Entebbe Airport, Entebbe Uganda
V
Departs: 7:30 AM
Arrives:
8:40 AM
Status: HK - Confirmed Sell Type:
O - Secure sold
3
KQ - Kenya Airways
Flight Number: 413 Booking Code: Q # Seals: 1
Date:
15 February - Friday
From: EBB - Entebbe Airport, Entebbe Uganda
To:
NBO - Jomo Kenyatta Inti, Nairobi Kenya
Departs: 3:10 PM
Arrives:
4:20 PM
Status: HK - Confirmed Sell Type:
O - Secure sold
4
■a.
i
6
KQ - Kenya Airways
Flight Number: 200 Booking Code: Q # Seats: 1
Date:
15 February - Friday
From: NBO - Jomo Kenyatta Inti, Nairobi Kenya
To:
BOM - Chhatrapati Shivaji Airport, Mumbai India
Departs: 5:20 PM
Arrives:
2:00 AM
Saturday
Status: HK - Confirmed Sell Type:
O - Secure sold
9W - Jet Airways
Flight Number: 411 Booking Code: M
# Seats: 1
Date:
16 February - Saturday
From: BOM - Chhatrapati Shivaji Airport, Mumbai India
'"ZA To:
BLR - Hindustan Arpt, Bangalore India
Depans: 6:40 AM
Arrives:
8:15 AM
Status: HK - Confirmed Sell Type:
S - Super guaranteed sold
1/10/02 10:02 AM
c: Greetings
Subject: Re: Greetings
Date: Thu. 10 Jan 2002 08:23:13 +0200
From: hstmccoy@ci.stormnet.co.za
To: Community health cell <sochara@vsnl.com>
CC: Pal Naidoo <rpillay@imul.com>
Dear Ravi,
It was good talking to you on the phone, and its made me hope
even more that you will be able to make the trip out to Kampala’
I am attaching the draft programme agenda. As you will see, the
day of the field trip is in fact thursday and NOT Wednesday. So if
you needed to cut your trip short, you could miss the 4th and 5th
day quite conveneintly.
| have inserted into the programme the three ideas we had about
incuts from yourself. Two of which you say you would already have
prepared, and the one using the example of India’s different states
being something you might need to prepare. I hope I’m not being
over-demanding'
In any case, we will talk again on Saturday. In the meantime I hope
that Pat will be able to find suitable travel arrangements for yourself.
With best wishes,
Dave
David McCoy
Healtn Systems Trust
Tel: 021-4476330
Fax: 021-4476302
~>
To /T fobey
O. fo 1 Ftzytll'i
<Xo
JUS zZo C
r^l
J he following section of this message contains a file attachment
Prepared for transmission using the Internet MIME message format.
If you are using Pegasus Mail, or any another MIME-compliant system,
you should be able to save it or view it from within your mailer.
If you cannot, please ask your system administrator for assistance.
---- File information -----------Uganda Programmes.doc
File:
9 Jail 2CC2, 23:44
Date:
Size:
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Type:
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; j<r| Uganda Prograirune2.doc
Name: UgandaProgramme2.doc
Ty pe: W'inword File (a pplicaiioiv ms word)
..Encoding; BASE64
1 •10.02 4:55 PM
Global Equity Gauge Alliance
Technical Workshop for Equity Gauges
February 11th to the 15th 2001
Draft Programme
The workshop aims to:
0 Strengthen participants understanding of the concept of Equity as well as a Framework for Equity’
Gauges;
® Strengthen participants awareness of the place and scope of advocacy, public participation and
monitoring and measurement within an Equity Gauge;
° Provide a forum for undertaking some strategic planning for the Global Equity Gauge Alliance
(GEGA);
o Create an opportunity for Equity Gauges to exchange ideas and information.
Monday February 11th
8.30am
9.30am
10.00am
11.00am
11.30am
1.00pm
2,00pm
2.45pm
4.00pm
4.15pm
5.30pm
Welcome
Ugandan Institute ofPublic Health
Setting the Context for the Workshop
Dr. Tim Evans and Ms. Antoinette Ntuli
Plenary: A Framework for Equity
Dr. Paula Braveman and Dr. Jeanette Vega
Break
Plenary: A Framework for an Equity Gauge
Dr. David McCoy
Lunch
Plenary: Individual Gauge Presentations - Chile and South Africa
Group Discussion: Framework for Equity and an Equity Gauge
Tua
Plenary: Feedback from small groups
Day Ends
Tuesday February 12th:
Plenary: Strengthening the Three Pillars of an Equity Gauge
0830:
0840:
0910:
Introduction to Advocacy (Dr. David McCoy)
X
Micro-level case study
^
*
Building coalitions?? (Dr Ravi Narayan) V
Using the law and community mobilisation - the experience of TAC and the
AIDS Law Project in South Africa (Mark Heywood)
Workill■-2 tbrnnoh
infnrrn.'uwYn
nresscnre and Inhhvind — rho fvnorionre of -hihilpp
* ""O"
*
'
•
*
-■
-- —w
0940:
2000 and Medact (Dorothy Logie)
1000:
1030:
1040:
1110:
Tea
.
Introduction to Measurement: Dr. Jeanette Vega
Concepts of Equity and the implications for measurement. Theoretical frameworks for
health inequalities pathways Margaret Whitehead
How to select the indicators to measure Equity: Selection criteria for Health status, health
care and socioeconomic indicators. Level of aggregation. Paula Braveman
1145:
1200:
1230:
Introduction. to Public Participation: Antoinette Ntuli / Mushtaq Chowdury
Why participation is a vital component of promoting Equity (Susan Rifkin)
Case Study: Abbas Bhuiya
2.00pm
Plenary: Individual Gauge Presentations - Nairobi, Cape Town and Ecuador
3.15pm
Tea
3.30pm
Parallel Sessions
Advocacy and Public Participation
Question-Answer session based on
plenary inputs to he facilitated by
presenters.
» What is ‘advocacy’ and 'public
participation’ - what are their
differences and what are their
synergies?
« Developing consensus on the
meaning of ’'community'1,
"participation” and "empowerment".
5.30pm
Day Ends
Wednesday February 13th
8.30am
Parallel sessions
’ Measurement_________________
Group Exercise
® Outline of the conceptual framework
being used in each gauge (alternatives
models can be considered lo do this)
o What are the indicators being used or
considered in each gauge?
Guided discussion Limitations and strengths
of using different sources of information
(primary vs secondary, individual vs
! aggregate, qualitative vs quantitative, etc)
I based on gauge sources and approaches
1
Advocacy
Public Participation
Measurement
Case study: Mount
Frere - David Sanders
Group work: Examining
assumptions about the critical
role of participation
Sub-themes: Does
participation promote
sustainability? Does
participation ensure capacity
building?
Lecture: "Measuring the
size of the Gap77 Norberto
Dachs/Adam Wagstaff
Facilitated discussion:
Examining issues around
power and control.
Sub-Themes: How do
attitudes and behaviours of
professionals promote or
inhibit participation? What
arc the causes and
consequences of manipulation
by a participatory approach?
Lecture: Qualitative aspects j
of Health Equity
measurement Timothy Evans
Adjusting the advocacy
• strategy to the political
environment - Ravi
i Narayan
i
Policy Maker - a tool
to help develop an
1 advocacy strategy ' Hilary Brown
\
1
__
Group Exercise
What measures will be used
in each specific gauge and
why?
1
1.00pm
Lunch
2.00pm
3.15pm
Plenary: Individual Gauge Presentations - Thailand, Bangladesh and China
Tea
3.30pm
Parallel Sessions
: Advocacy-'
Public Participation
Measurement
Case study: Uganda
Oxfam - Monica
Naggaga
Group work: Assessing
participation and facilitating
changes for wider
participation.
Sub themes: Experiences of
assessment and how to
develop assessment tools to
reflect local situations.
Group Exercise: Discussion
of the qualitative techniques
being considered to collect
information in each gauge? j
Group Work - three
gauges io work on
1 plans for their own
individual Equity
Gauges and to use
these as a basis for
developing skills
Skills for advocacy using the media (I
hour)
Identification of key factors
that promote participation and
review of factors as possible
indicators for participation in
an Equity Gauge
Developing Criteria for Public
Participation - who would
Equity Gauges want to
involve, and for what ends?
l
i
5.30pm
,
Day Ends
Lecture: Measurement of
household expenditures for 1
health care (Adam Wagstaff i
and Martin Valdivia)
Group Exercise: Putting
together your gauge summary of rhe theoretical
.
framework and complete
methodology for
measurement in each gauge, i
11
Thursday February 14th
8.30am
10.30am
Plenary: Individual Gauge Presentations - Uganda, Zambia and Zimbabwe
Field Trip: organised by Ugandan Institute of Public Health
Friday February 15fll
8.30am
Plenary: A Global Equity Gauge Alliance - The Way Forward
o Update on GEGA activities: September 2000 to September 2001
o Key Strategic Issues from the parallel sessions - (presentations from resource
people)
o Examples of how individual Gauges might have a global impact
Monitoring Immunisation in Bangladesh - Mr. Mushtaque Chowdury
Training for Equity - Dr. Jeanette Vega
Plenary' Discussion: Strategic Vision of GEGA
12.30pm
1.00pm
Closure and vote of thanks: Ugandan Institute of Public Health
Lunch
Global Equity Gauge Alliance
Technical Workshop for Equity Gauges
February 11th to the 15th 2001
Draft Programme
The workshop aims to:
• Strengthen participants understanding of the concept of Equity as well as a Framework for Equity
Gauges;
• Strengthen participants awareness of the place and scope of advocacy, public participation and
monitoring and measurement within an Equity Gauge;
• Provide a forum for undertaking some strategic planning for the Global Equity Gauge Alliance
(GEGA);
• Create an opportunity for Equity Gauges to exchange ideas and information.
Monday February 11th
8.30am
9.30am
10.00am
11.00am
11.30am
1.00pm
2.00pm
2.45pm
4.00pm
4.15pm
5.30pm
Welcome
Ugandan Institute of Public Health
Setting the Context for the Workshop
Dr. Tim Evans and Ms. Antoinette Ntuli
Plenary: A Framework for Equity
Dr. Paula Braveman and Dr. Jeanette Vega
Break
Plenary: A Framework for an Equity Gauge
Dr. David McCoy
Lunch
Plenary: Individual Gauge Presentations - Chile and South Africa
Group Discussion: Framework for Equity and an Equity Gauge
Tea
Plenary: Feedback from small groups
Day Ends
Tuesday February 12th:
Plenary: Strengthening the Three Pillars of an Equity Gauge
\
Introduction to Advocacy (Dr. David McCoy)
0830:
Micro-level case study + Building coalitions?? (Dr Ravi Narayan)
0840:
0910:
Using the law and community mobilisation - the experience of TAC and the
AIDS Law Project in South Africa (Mark. Heywood)
0940:
Working through information, pressure and lobbying - the experience of Jubilee
2000 and Medact (Dorothy Logie)
1000:
Tea
1030:
1040:
Introduction to Measurement: Dr. Jeanette Vega
Concepts of Equity and the implications for measurement. Theoretical frameworks for
health inequalities pathways Margaret Whitehead
How to select the indicators to measure Equity: Selection criteria tor Health status, health
care and socioeconomic indicators. Level of aggregation. Paula Braveman
1110:
1145:
1200:
1230:
Introduction to Public Participation: Antoinette Ntuli / Mushtaq Chowdury
Why participation is a vital component of promoting Equity (Susan Rifkin)
Case Study: Abbas Bhuiya
2.00pm
Plenary: Individual Gauge Presentations - Nairobi, Cape Town and Ecuador
3.15pm
Tea
3.30pm
Parallel Sessions
Advocacy and Public Participation
Question-Answer session based on
plenary inputs to be facilitated by
presenters.
• What is ‘advocacy’ and ‘public
participation’ - what are their
differences and what are their
synergies?
• Developing consensus on the
meaning of "community",
"participation" and "empowerment".
5.30pm
Day Ends
Wednesday February 13th
8.30am
Parallel sessions
Measurement
Group Exercise
• Outline of the conceptual framework
being used in each gauge (alternatives
models can be considered to do this)
• What are the indicators being used or
considered in each gauge?
Guided discussion Limitations and strengths
of using different sources of information
(primary vs secondary, individual vs
aggregate, qualitative vs quantitative, etc)
based on gauge sources and approaches
Advocacy
Public Participation
Measurement
Case study: Mount
Frere - David Sanders
Group work: Examining
assumptions about the critical
role of participation
Sub-themes: Does
participation promote
sustainability? Does
participation ensure capacity
building?
Lecture: "Measuring the
size of the Gap” Norberto
Dachs / Adam Wagstaff
Facilitated discussion:
Examining issues around
power and control.
Sub-Themes: How do
attitudes and behaviours of
professionals promote or
inhibit participation? What
are the causes and
consequences of manipulation
by a participatory approach?
Lecture: Qualitative aspects
of Health Equity
measurement Timothy Evans
Adjusting the advocacy
strategy to the political
environment - Ravi
Narayan
Policy Maker - a tool
to help develop an
advocacy strategy Hilary Brown
Group Exercise
What measures will be used
in each specific gauge and
why?
1.00pm
Lunch
2.00pm
3.15pm
Plenary: Individual Gauge Presentations - Thailand, Bangladesh and China
Tea
3.30pm
Parallel Sessions
Advocacy
Public Participation
Measurement
Case study: Uganda
Oxfam - Monica
Naggaga
Group work. Assessing
participation and facilitating
changes for wider
participation.
Sub themes: Experiences of
assessment and how to
develop assessment tools to
reflect local situations.
Group Exercise: Discussion
of the qualitative techniques
being considered to collect
information in each gauge?
Group Work - three
gauges to work on
plans for their own
individual Equity
Gauges and to use
these as a basis for
developing skills
Skills for advocacy using the media (1
hour)
Identification of key factors
that promote participation and
review of factors as possible
indicators for participation in
an Equity Gauge
Developing Criteria for Public
Participation - who would
Equity Gauges want to
involve, and for what ends?
5.30pm
Day Ends
Lecture: Measurement of
household expenditures for
health care (Adam Wagstaff
and Martin Valdivia)
Group Exercise: Putting
together your gauge summary of the theoretical
framework and complete
methodology for
measurement in each gauge.
Thursday February 14th
8.30am
10.30am
Plenary: Individual Gauge Presentations - Uganda, Zambia and Zimbabwe
Field Trip: organised by Ugandan Institute of Public Health
Friday February 15th
8.30am
Plenary: A Global Equity Gauge Alliance - The Way Forward
• Update on GEGA activities: September 2000 to September 2001
• Key Strategic Issues from the parallel sessions - (presentations from resource
people)
• Examples of how individual Gauges might have a global impact
Monitoring Immunisation in Bangladesh - Mr. Mushtaque Chowdury
Training for Equity - Dr. Jeanette Vega
Plenary Discussion: Strategic Vision of GEGA
12.30pm
1.00pm
Closure and vote of thanks: Ugandan Institute of Public Health
Lunch
Dear Dave, Pat and David,
Greetings from Community Health Cell!
Further to all the telephonic conversations we have had over the last few weeks and the email dialogue,
this is to confirm that Dr. Abhay Shukla, a public health professional and activist, who is presently with
the Centre for Enquiry into Health and Allied Themes (CEHAT) in Pune, Maharashtra, and a colleague
of the medico friend circle (mfc) will stand in for me at the Workshop because as of now my recovery
from acute cervical spondylosis has not been good enough to ensure my definitive participation and I
felt the uncertainty was not good for the workshop organisation.
I have noted the three 'inputs' that David would like me to have made (a) Micro level case study (b)
Building Coalitions (c) Adjusting the advocacy strategy to the political environment. I have discussed
these with Abhay and 1 am quite confident that he will make these inputs rather well, since his recent
advocacy / campaign with the Peoples Health Assembly mobilization process in Maharashtra has been
among the most effective. He also builds on other experiences of advocacy and campaigning. We both
are going to be m touch as he evolves these inputs. David has been kind enough to suggest that I
should continue to keep the option of participation if the condition improves, which I shall do.
However if I do not make it, 1 still look forward to the proceedings and would like to keep in touch.
I do not know if you are aware of the International Poverty and Health Network (IPHN), which some
of us have initiated after attending some WHO policy meetings on Equity and Sustainability. We
hosted the South Asian Dialogue of IPHN in November 1999. It has a emailed newsletter and website
( e-Mail : richardson.v@healthlink.org.uk Website : http://www.iphn.org) It would be nice for both
your equity guage network and IPHN to link up. Shall send you some more materials of IPHN
separately.
Keep in touch.
With best wishes.
Yours sincerely,
Ravi Narayan,
Community Health Advisor,
Community Health Cell.
P.S : Dr. Abhay Shukla’s address and other details for communication are as follows :
Dr. Abhay Shukla,
B-l, Nilgiri Apartments,
Karve Nagar,
Pune-411052.
Phone : (Q20) 5465936
,
GE i-l FIT- L«li > —
s^^.0 - t, q W ^7.^
e-mail :/abhayshk@hotmail.com / abhayseema@vsnlrcom
Dear Abhay,
Further to our telephonic conversation over the weekend, I am forwarding the last message from David
McCoy, which gives the three small presentations that I was supposed to make :
a)
b)
c)
Micro level case study;
Building coalitions;
Adjusting the advocacy strategy to the political environment.
In (a) I would add socio-economic-cultural as well not only political.
David McCoy of Health Systems Trust in Cape Town, South Africa is coordinating this ‘pillar; of the
Workshop and would have got in touch with you by now.
If not please get in touch
hstmccoy(a>ct.storninet.co.za and Pat Naidoo - rpillayfc) imul.com is in charge of travel and local
arrangements in Kempala and will also be getting in touch with you.
After seeing the programme, I felt you would be the best replacement for me, especially because of the
PHA campaigns that you have so effectively mobilized. We could dialogue around item ‘c’ but items
and ‘b' should not be a problem for you - since it is in line with all your recent work.
I am also sending you an itinerary which my travel agent had forwarded to me a few days ago It has
one set of options on Kenya Airways plus all other requirements as well. Pat could make alternative
arrangements from their side as well. You can follow this up when he calls.
1 am glad that you are able to stand in for me. The doctor has suggested two months of restriction on
travel to ensure relief from symptoms. Hence there is a good chance I will not be able to make.
Anyway, we shall be in touch.
All the best,
C.C. : (1) David McCoy (2) Pat Naidoo.
iida Mating
Subject: Uganda Meeting
Date: Tue, 15 Jan 2002 13:25:32 +0530
From: Community health cell <sochara@vsnl.com>
To: hstmccoy@ct.siormnet.co.za, rpillay@imul.com, lmartin@uwc.ac.za
y S A'-cx Rl c.
Dear Dave, Pat and David,
Greetings from. Community Health Cell!
Further to all the telephonic conversations we have had over the last
few weeks and the email dialogue, this is to confirm that Dr. Abhay
Shukla, a public health professional and activist, who is presently with
the Centre for Enquiry into Health and Allied Themes (CEHAT) in Pune,
Maharashtra, and a colleague of the medico friend circle (mfc) will
stand in for me at the Workshop because as of.now my recovery from acute
cervical spondylosis has not been good enough to ensure my definitive
participation and I felt the uncertainty was not good for the workshop
organisation.
•
I have noted the three ’inputs’ that David would like me to nave made
(aj Micro level case study (b) Building Coalitions (c) Adjusting the
advocacy strategy to the political environment.
I have discussed these
with Abhay and 1 am quite confident that he will make these inputs
rather ’•.’ell, since his recent advocacy / campaign with the Peoples
Health .Assembly mobilization process in Maharashtra has been among the
most effective.
He also builds on other experiences of advocacy and
campaigning,
'.ie both are going to be in touch as he evolves these
inputs.
David has been kind enough to suggest that I should continue to
keep the option of participation if the condition improves, which I
shall do.
However if I do not make it, I still look forward to the
proceedings and would like to keep in touch.
I do not know if you are aware of the International Poverty and Health
network -'IPHN;, which some of us have initiated after attending some WHO
policy meetings on Equity and Sustainability.
We hosted the South Asian
Dialogue of IPHN in November 1999.
It has a emailed newsletter and
website ( e-Mail : richardscn.vQhealthlink.org.uk
Website :
zp: / ,/ww. iphn. orgIt would be nice for both your equity guage network
i IPHN to link up.
Shall send you some more materials of IPHN
separately.
e
Keep in touch.
R a v i N a r a y a n,
Zommun i t y Hea 11h Advi so r,
Communetv Health Oen.
P.S : Dr. Abhay Shukla's address arid other details for communication are
a s r c 11 c s :
Phone : 0091- 2.C - 5465936 CEHAT 'Off.) 0091 - 20 - 444 3225
e-mail : abhayshkQ: . cmail. com / cehacpunQpn3. vsnl.net. in
1/17,02 10:36 AM
* Uganda Meeting
Subject: Re: Uganda Meeting
Date: Week 16 Jan 2002 16:36:24 +0200
From; hstmccoy@ct. stonnnet. co. za
To: hstmccoy@ct.stormnet.co.za. rpillay@imul.com. lmartin@uwc.ac.za.
Community health cell <sochara@vsnl.com>
Dear Ravi,
I haven’t been able to contact Abhay by phone. I think I may have
taken down the number wrongly. Wpuld you mind re-sending it te
rne .
Thanks
Dave
> Dear Dave, Pat and David,
>
> Greetings from Community Health Cell!
^gfurther to all the telephonic conversations we have had over th
> few weeks and the email dialogue,
this is to confirm that Dr. /
>ala meeting
Subject: kampala meeting
Date: Sun, 13 Jan 2002 17:57:53 ^-0200
From: hstmccoy@ct. stormnet.co.za
To: tnaravan@vsnl.com, Community health cell <sochara@vsnl.com>
CC: Antionette Ntuli <ant@healthlink.org.za>
I will join you in being an optimist and continue to hope that you
will be able to join us in Kampala. I am however glad that your
physician is helping make sure that you safeguard your own health
first and foremost.
Thankyou very much for arranging to have Abhay stand in for you.
If you are still able to come,
both of you there.
we would only be too pleased to have
In terms of reimbursement, we are able to provide some
J^hwnpense. We have budgeted for a daily rate of up to a limit of
uso400 for the 5 days of the meeting. If you are unable to come
but have spent a significant amount of time contributing to the
presentations that Abhay will be making, then please make out an
invoice to the Health Systems ’Trust.
I will in the meantime make contact with Abhay.
I hope your neck gets better, and I look forward to meeting you in
Kampala or somewhere else one of these days.
Dave
David McCoy
Health Systems Trust
Tel: 021-4476330
Fax: 021-4476302
c
‘ioala meeting
■
j
Subject: Kampala meeting
Date: Sun, 13 Jan 2002 17:57:53 -0200
F ro m: hstmccoy@ct. stormnet. c o. za
To: Cehatpiin@pn3.vsiil.net.in
CC: tnarayan@vsnl.com, Community health cell <sochara@,vsnl.com>, Pat Naidoo <rpillay@Tmul.com>
I have just spoken with Ravi about your agreement to participate in
the meeting in Kampala. Many thanks for this. I look forward to
me et ing wi th you.
I understand that you and Ravi have already been discussing the
three themes / presentations. Attached is a draft programme which
will give you a rough idea of the programme in Kampala. I will
contact you by telephone (91-20-5465936) to discuss the
programme in due course.
in the meantime, Dr Pat Naidoo will be sending you a formal
invitation to the meeting which is required for your visa application.
He will also be arranging your travel arrangements with you. Should
you have a preference for your travel itinerary you could forward him
rhe details.
?Je are onlv able co provide economy class travel, but we are able
to reimburse you and your organisation for the five days of the
meeting up co a maximum daily race of US$400.
I 'will call you by telephone in the week
David McCoy
Health Systems Trust
Tel: 021-4476330
021-4476302
The following section of this message contains a file attachment
prepared for transmission using the Internet MIME message format.
If you are using Pegasus Mail, or any another MIME-compliant system,
you should be able to save it or view it from within your mailer.
If vou cannot, please ask your system administrator fcr assistance.
-— File information----------File:
Uganda Programme!.doc
Dace:
S Jan 2002, 23:44
Size:
37376 bytes.
Type:
Unknown
: H/lUganda Prograrome2.doc •
Name: Uganda Programme2.doc
?
Type: Winword File (appUcatioivinsword);
-Encoding: BASE64
?
115 02 10:40 AM
Subject: Re: Kampala meeting
Date: Mon. 21 Jan 2002 17:01:35 +0530
r roni: ccnai ^chatpun^vsril.corri^
To: hstmccoy®ct.stormnel.co.za
CvD-hhui1ity health cell *
,<SOChara(^'VSill.COjll^
PalrvaidvO ^Fpilhp/^iiTiul.COni^
•3iT. zzrrv for the delay in responding to your e-mails. The reason is because
I have gone through the programme ana also had some discussion with Dr. Ravi
Narayan about the workshop. The idea of the Equity Gauge does seem interesting
and could be a very effective tool to advocate for the right to health care
and healthy living conditions. The effort of bringing together health
fee
l
il over the world to develop a common strategy in tr.is
regard is indeed commendable.
As far as my participation is concerned,. I could definitely contribute to the
’■'i cro-.level case study on advocacy / building coalitions, drawing upon our
'•'.z'C:'. ~ f developing health v.cver.er.os in the content of various peoples
r.-.u vemen ts. 'Adjusting the aovccacy strategy to toe po-icica^ environment
is a
somewhat broader issue where perhaps 1 could share the PHA process in India
and how it has evolved in a few different states.
My major constraint is that I need to reach back to Mumbai on 14th Feb.
x'%'.a meeting and
tari cn wish the Global health council and
other participants from various parts oz the country. So I may nave to leave
from Uganda on 13th afternoon to return. My travel agent has informed, me tnat
there is a flight from Entebbe to Dubai at 4 pm and a connecting flight from
Pimai to MumbajS which won In enable me r.o reach Mumbai on 14 th morning. Hc-wever
z
~
qy
1 ■■ chu s ch ^d
* <1 o
h ■ h enables x-<c to "tach Mu■ Joa ■' r 1 4 th Feb.
vino is line.
Regarding coming,
I can follow the same itinerary from Mumbai as that planned
for Ravi. I would go from Pune (where I am based; to Mumbai by bus. Then I
could ’eave Mumbai bv Kenva Airways cn 1 1 th Feb at 3.10 am, and via Nairobi
—;ch Entebbe on 11th morning at 8.40 am.
.nough j. would be j.h teres u.e.u in ail the sessions, Lnere seems to be no
presentation expected from my side after 13th noon. So I hope such an
arrangement should be OK.
f i
te whether ouch a schedule could be worked out. Also, given
this, how I should go about obtaining the visa, tickets and other details.
Kindly try to reply by 23rd noon since I will be going out for a couple of
days on 23rd afternoon. You are welcome to phone me at home (91-20-5465936'
office '91-20-4 4 4 3225} if uecessarv.
1 co lock forward to participating in and contributing to the workshop and
interacting with all of you,
with regards,
Jdd.ay Ghukla,
L EHRI
. dliipa] d tu M CJ E£
or
• IVciiJjJ'dl.x <
'k.i
Subject: Re: Kampaiu meeting
Date: Mon. 21 Jan 2002 17:01:35 +0530
From; cehat <cehatpurv@vsn1.co»ii>
To: hsimccoy®cust orm.net. co.za
CC: Community health cell <sochara@vsnJ.com>; Pal Naidoo <rpillay@imuLcom>
Dear Dav lei,
Greetings:
I am sorry for the delay in responding to your e-mails. The reason is-because
I was in the field last week and returned to office just today.
7 nave gone through the programine and also had some discussion with Dr. Ravi
Narayan about the workshop. The idea of the Equity Gauge does seem interesting
and could be a very effective tool to advocate for the right to health care
■■■ ’ eal.thy livi
conditions. The effort sf bringing boge.th
*
.jss
....
develop a common
■ he<
regard is indeed commendable.
As far as my participation is concerned, I could definitely contribute to the
Micro-level case study on advocacy / building coalitions, drawing upon our
work cf developing health movements in the context of various peoples
i : aments-. 'Adjusting the advocacy strategy tc the political environment' is a
somewhat oreader issue where pernaps 1 could share the PHA process in India
and ho:-.' it has evolved in a few different states.
My major constraint is that I need to reach back to Mumbai on 14th Feb.
morning for a meeting and presentar ion with the Global health council and
particij j ts :roi
various parts .1 the count! .. Sc
have tc leave
from Uganda on 13th afternoon to return. My travel agent has informed me that
there is a flight from Entebbe to Dubai at 4 pm and a connecting flight from
...
.
...... ... . . -
..
. .
.
.
....
morning.
any ether flight schedule which enables me to reach Mumbai on 14th Feb.
morning is fine.
Regarding coming,
I can follow tne same itinerary from Mumbai as that planned
for Ravi. I would go from Pune {where I am based) to Mumbai by bus. Then I
cov'd ; eave Mumbai by Kenya Airways on 11th Feb at 3.10 any. and via Nairobi
|^ch Entebbe on 11th morning at 3.40 am.
SRhvugh 1 would be interested in all the sessions, there seems to be no
presentation expected from my side after 13th noon. So I nope such an
arrangement should be OK.
Please inform me whether such a schedule could be worked cut. Also, given
:r.isr how I should go about obtaining the visa, tickets and other details.
Kindly try to reply by 23rd noon since I will be going out for a couple of
days on 23rd afternoon. You are welcome to phone me at home. (91-20-5465936)
office (91-2C-4443225.1 if necessary.
or
1 do look forward co participating in and contributing co the workshop and
interacting with all of you,
??itr regards,
1/22 02 9:39 .13
ainpaU met tug
2.5
to participate in
Ravi about your
Many thanks for
ic you and Ravi have already been discussing the
>resentations. Attached is .
of the programrr,.
amn.a 1 a
nc von a
C-I
lb
Na id 00 wilJ
r-oarea
a
transmission using me internet MIME message tormat
ing Pegasus Mail
5ny another MIME-compliant sys
informa cion
ProarammeP
•? - 4 z»
V-iJ/'VL’KL/ El
3ASE64
. Kaulpsld llid-Jiina.
Subject: Re: fiampaia meeting
Dale: Fri. 25 5nn 2002 13:07:41 -0530
r i'O’iiK CCnut <Cciiaipuij
’Sili.COiTP'
To: hsttnccoyci. si ormnet. co. za
Z** ’ "f .► tikHuj€inu.
•.»..••»’ * • < ■ y' v‘•Mji.vviH.
• 1 z> . , «.% v, v'unLiuiui
w s J-S <v’ 1n r> 1 > 1a <% / . 1 1 ^buvnui^hu^
/> . » 1a r. <’z>
svojh
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• ■» >-** ^
"** h D «r» t K T«-. n • 1
? i at x^uLk.i\ju
Cuba! ~c Xur-.c.-.i wr.icn would, enable me co reach Mumbai on 14th morning.
•« 1 I rsx% .zt iincH• •» 1 /-% z-» • * •.
pmu
g in ■
.
. _
~
' '■ e
e
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-
. ~ k: :
t. Al sc,
*
vc obtaining the visa,
1 sn:
tickets and ocner
-• -- — •
- try ': reply by 23 rd noor since . will '■ .
interac: ng with ail
yiti* regards,
- --- foi
■
■-
)£ you,
hs ci ic co vis cc . stonnner. co. za wrote:
?■ h? a
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c r o q ra
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s c>: you cy r
,i .ice cion
Should
e von r.'/.c vcur oic/a
■
> David y-cCoy
auvoe^y pi’og.r?,■or Kampala meeting
:cw?; Sun, 3 1 cb 2iX 2 23:29:35 -0200
? ronr. hstmcccy b ci.stonnnet.co.za
Tt\°
"^cr?'Z?' snl.coni>, kaziin@neiaciivc.co.za.
Logie-D<jroih\-D\PHivi-BHB <doroihy. logic a borders. scoLnhs.iik>,
’Tynette Martin” <linartin@invc.a$za>
wliuK 1~1Jv Wvvd
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■'JiC’. WOOuIh £t laW. WjiS.3C.Za>,
SiOvVlL uuiui'\
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"Dr. Par Natdoo” <rpihav@iinul.com>, Community health cel! <sochara@.vsnl.com>
•
.... -. .-.— cc- d --~ .J
.1,
inputs ana ai scussiors as a basis tor
?;1 n’n? vis a vis
.... ... .....
_ ....
ar.-.*: j.-.-?.-’
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r;irr“ ■ 7'■ r-?.
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'.■ .
; ' . ■ • ■ .• ; to the inputs a
Global Equity Gauge Alliance
Workshop for Equity Gauges
Februarv ll‘h to the 15"' 2001
Ol's P Fro-rramme
The workshop aims io"
«•• Strengthen participants understanding of the concept of Equity as well as a Framework for Equity
Gauges:
ji-tli.jj\,;t p<’-<
a»<i.; viivob of the place and scope oj ciU’v uc<sC\, ptiulic participation and
monitoring and measurement within an Equity Gauge;
•? Provk le a forum for undertaking some strategic planning for the Global Equitv Gauge Alliance
/r.irr
V.VJi-vJ. "V• < reate an opportunity for Equity Gauges to exchange ideas and information.
Monday February 1 l,h
8.30am
9.30am
IG.OOajn
J 1.00am
11.30am
1 .00pm
2.00nm
2.4 5 pm
4.00pm
4.15 pm
5.30pm
Welcome
Ugandan Institute ofPublic Health
Setting the Context for die Workshop
Dr Tim Evans and Ms. Antoinette Ulu!i
Plenary: A Framework foi Equity
Dr. Paula Bravcman and Dr. Jeanette Vega
Break
Plenary: A Framework For an Equity Gauge
Dr. David McCoy
Lunch
Plenarv: Individual Gause Presentations - Chile and South AHrica
Group Discussion: Framework for Equity and an Equity Gauge
Tea
Pienaiy.’ Feeuback Lorn small gioups
Day Ends
Tuesday Februarj 12'’’:
^trengthet’ing the Three Pillars of an F.qnjtv Gauge
*
Plenary
0830:
Ou-iG:
0915;
luiTody.cnon Vo_Adyocacy (./>. Z
'frCoy.1
Working ihrougn mlo/iih-uiori, pressure and l</bby.i4ig - luc experience of
2000 and Medact (Dorothy Logie]
Micro-level case study: Advocacy ' building coalitions, and d:\-elo;dng health
movements in the context of various peoples
nioteuras.
A'.n/y -mvnc/u/
luvu.
. 030.
'liLL
\ 1.0:
1M5
12£ .
OuVvJiKik?n ivNkaSurcDiCiu: Dr. Jeanetic- 7eza
Concepts of E-quitv and the implications for measurement Theoretical frameworks for
b :uhh inequalities pathways Margaret Whitehead
Hoiv ;o select the indicators io ineasurc Equity. Selection ciliciia lot I lealih siaia-x health
care and socioeconomic indicators. Level of aggregation. Pania Braveman
Introduction to Public Participation: Antoinette Ntnli TMiishtaq Chow;htry
1230
Why padicipalion is a vital component oi promoting Equity (Susan Rifkinj
Case Study: Abbas Bhuiya
2 •' h »pm
Plenary: Individual Gause Presentations - Nairobi. Cape Town and Ecuador
3.15 pm
{ea
3.3upm
Parallel Sessions
AiiViiiWWX <Cid Piiblk Pardt ipatiuii
AlcaSiireiiieni
bawd on
nJenan■ b7::>< ■■: t>i:’>inn' : r? wnfefs
, bibhay, Doroihy, S
. Abbas;
Group Exercise
®
ujch
. ®
5 30pm
V* nal is auvocac}' and public
parucipatton - what at e their
differences ?md wMt ?rc their
synergies0
jJu\<-jOphSii COiiiC:iSU3 OK JiC
meaning of community ,.
"participation" and "empowerment".
Day Ends
Wednesday Februan
S.30am
Parallel sessions
-=»
Outline of the conceptual fraunewmk
being used in each gsuge (akey mTvcs
mouei.s can be cun.sjdeied lu do ibis)
What are the indicators being used or
Cfl- / ■ .
. . . ge9
■_/J: ■■ . i .
. ......
oi using different sources of information
(primary vs secondary individual vs
aggregate, qualitative vs quantitative, etc)
b?
s
id i] )< h
XtV'VOCacy
Adj’"-i. mg the advocacy
‘ ti Lt i $ c the j
Cu \ 1 ."O l j ilicfii - A uhijy• bhukla
1 C?.se study: Mount
, Frere - David Sanders
■ Policy Maker - a tool
1 to help develop an
advocacy strategy ■ Hilary Brown
Public Participation
Group work: Examining
Measurement
}.'U-lure: ‘Wlca^virg ’he
. size of llic Gap” 3.Arb&-A
Dadij • Aidum ■■",
assumptions about the critical
role oi pdmcipauuii
i sub-themes; Does
Group Exercise
■ participation promote
sustainability? Does
What measures will be used
in each specific gauge and
, participation ensure capacity
{ building?
j why?
I
> Facilitated discussion:
Lecture: Qualitative aspects •
of Health Equity
‘ Examining issues around
measurement TimothyE
*.a:--’ power and control.
, SuO- EucHIcS.' iCJVi do
j artkudes and behaviours of
professionals promote or
■ inhibit participation? What
' are the causes and
. consequences of manipulation ;
, by a pan^gaiory approach ?
1.00pm
Lunch
2.00pm
3. < 5 pm
Plenary: Individual Gauge Presentations - Thadand, Bar'glcidedi end China
Tea
3.30pm
Parallel Session.-*
Cnse Stiiciv- i A ■
Treatment Action
Cdiiiudigil - Siid;(j
\ Mthathi
; lobbying and
: dialogue .Pil. decisionIlidkcrs - Dui ui!-i \
Parties, uion
ork; Ass
*
ing
j icij k n m 1 facilitating
changes fui vudei
panicipaucHi.
Sub themes: Experiences of
assessment mid how to
develop asscsnoc.-.: tools to
reflect IulM siiUdiiuiis.
■ Logie
■/< Lswrara •
■
•Disci ion
' of the qualitative techniques
being considered to collect
i information in each gauge1'
' I.erpjvc- Measurement of
... ...
:
healui cai t (Adani Aagiiail
and Martin Valdivia)
Identification of kev factors
i Discussion on planning
, an advocacy suaiegy
. based on one of the
existing countiy gauges
that promote participation and
. is.?, of Lcio: ., as ;ssible
lijdiCatC'j ■> iui paitiCipauOH in
an Equity Gauge
Developing Criteria fev Public
Participation - who would
E juity (range»iva i
involve, and for what ends?
5.30pm
Day Ends
Group Exercise- Putting
together you:- gauge
iummaiy of t.'ie iheoieiica.I
framework and complete
methodology for
measurement in each s.nuge
■
I
>st..
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‘iGi v hU x i <j i • <-• C \‘cSCniui i OiiS " ij§£/?<./u', /‘.ifiltjiu Cliltt /.tri/bcib tl'e
Held fng: organised by Ugandan [nstitute-of Public Health
F r id a ■ ■ F •■? b r u 2 r ■•. * 5r1 1
8.30am
Plenary: A Globa! Equity Gauge Alliance - The Way Forward
® < /pdate on GFGA a cm ernes. September 2000 to September 200»
0 'Ki-v Sinneaic Issues from the parallel r.ossipns - (p.resenlaiions from nesonre
peopiu)
Examples of how individual Ganges might have a global impact
xViomiormg imiiiiirnSdiion m Bangladesh
.iviusliiuciue Gbowciniy
Training for Equity - D>\ Jeanette 7ega
E'.:u.} f/lSCUSSlOm
ViSiOii C'l G:'.^GA
-— >
i -00pm
i
Lunch
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vvorksJiop
Subject: Re: GEGA workshop
Date: Fri, 1 Ivia.r 2002 16:20:26 “0200
From: listrnccoy@ct.storijinet.co.za
To: abhay shukla <abayscma@pn3.vsnl.net.in>
CC: Antionette Ntuli <antS’healthlink.org.za>, Community health cell <sochara@,vsnl.com>
Dear Abhay,
I’m glad to hear that you have arrived safe and sound in India.
Thankyou very much tor the contributions you made to the
workshop. I thought you made a real difference to getting the group
to understand many important issues about the politics of healtln.
I really think that your presentation about fitting one’s advocacy
strategy to the socio-political context (using 4 examples) should bo
written up into an article for wider dissemination. Can GEGA
commission you to write such an article??
In any case, Health Systems Trust have been mandated to play a
leadership and secretariat role for the development of GEGA, and
we would like to explore ways in which you / Ravi can become
^krmally associated with GEGA, as well as to explore the potential
connections between GEGA and the People’s Health Assembly.
Please keep up your good work, and doing it in such a friendly ana
positive manner’’ We will proceed with the invoice.
Dave
PS. Ravi - thank you for making it possible for abhay to join us'.’
Dear David,
> Greetings’
.
> Hope this retail finds you fine. Sorry for the delay in writing - I was
in the field and returned just yesterday. I first of all wish to thank
> you for giving me the opportunity to attend the stimulating sessions
> and interactions that I had during the GEGA. workshop. I do hope that
> the subsequent sessions during the GEGA consultation were also
> Informative and productive. Hope you would have recovered Iv sc '.he
> exhaustion of organizing rhe event by now!
look forward to reading the report of the workshop including the
> plan of future action. Although in India we are not directly part of
> the GEGA process, we do look forward to keeping in contact and
> learning from this important process, using some of the tools in our
> situation and also contributing our experiences and perspective
> wherever relevant. Flease Include my e-mail address in the final
> participant list that is circulated, since it was inadvertently left
> cut of the list circulated during the workshop. De convey my
> congratulations and regards to Pat Naidoo and other organisers who
> made it a fruitful and pleasant experience. I will also be writing to
> David Sanders separately.
> I am attaching a brief invoice for my consultancy and local travel
> (Fune-Muinbal and Mumbai-Pune) with respect to the workshop. I have
> also given my bank details as you had suggested. Please let me know if
> any modifications are required or additional information needs to be
> given. I can send the same by Fax if necessary.
>
> 1 nope rest is tine at your end. it would be interesting to see now
> the international determinants of intra-national inequity get
> addressed durico further acclicatfu.t of the cavoes, and also how the
> massive global Inequl L les. being exa'tefba Led by the processes ci
> inetjuitous globalisation, are included while addressing ine-yaity in
2 4 AM
jZJ
'q|3^2'
woikshop
t orocess.
QCV
fv’irh war.m regards,
> Abhay Shukla
'. David McCoy
a lti
Qh h
i\
L lie.
C£ n^L^hhc
fl _.^1
cA. t^iU
Z/Vc^~€->
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Z^2.
Greetings from Ravi CHC
Subject: Re: Greetings from Ravi CHC
Dare: Fri, 15 Mar 2002 16:29:53 -r0200
From: h^mccoy^ct.stonrjnef co.za
Toi CoHlillUllii'y' IxCaltil cdl '^SOCil<ira(i^VSijl.COixk->
•I
CC: abhay shukla <abavsemafa’pn3. vsnl.net.in>, "Antoinette Ntuli" <anuajheaithlmk.org.
T’hanks and all this sounds great. As far as the WHA meeting is
AnrjcArned
~
not. aware it anvone ffrym
Is ab.t°ndino.
think we should he there. Z weu_d certain.!’7 like to ^o
'ou
and Z
I'i you tuxiiK it wouid be usefux fur G.&GA co be trier e, cou±u you xet
us know??
a\s far as institutional linkages arc concerned, it sounds like PHA
ijlndia) would act as an umbrella for both CEHAT and CHC, and
would therefore make sense from that anole.
a ?>is for the artcile, I look forward to it. Would it be useful if we wore
to formally "commission” you ano Abhay to write this and incxuds a
•v^|^dget ror its purposes as well??
Wr Regards,
DAvo
> Dear David
<
y -F *- >- - - r- v- — r~ -r- f - -7 - — r-U- 7~ Z- - - r ~
~r~
A rlarcli. I am 1'^aj.j.y c/iad ciiac Aoiiay mad^ a ctooci corrcriouZiori anu nis
> inputs were meaningful and relevant ror the process, tie has been in
> touch as well,
greatly appreciating the cpportunitv and experience.
>'. Ho has also written about the article and I have agreed to work with
> him on it. It seems a good idea to evolve a formal association with
> rrC
*r/z2 »
octh r>f
1 d do Tt ,r?lg~>iLirr (fibhav) and C’-iC
*>- ----<? ■> n <»y- ----- --------- ---o --T-T/>—
o -’ *...
M -□<>-I-J j r -----D C" f?■ s--■>“ h - _£.-----■»' y #■z.■n--yzr? c;- -- --■*
>
cxiiu rnA
ana Hca^^h. Cr a^cornutivcxy ;;c
(Gl^jJaj.) .
cgUxQ
associate as IHh (India)
'"« g: PH.4 coiitsicts in Th&ilsnd]
Subject: |Fwd: PHM contacts in Thailand)
Date: Tue, 24 Sep 2002 18:26:41 -0530
From: Community Health Cell <sochara@vsni.com>
To: abhayseema@vsnl.com
CC: ctddsf@vsni.com, gksavar@citechco.net, achan2000@vsnl.com
Dear Abhay,
Greetings froip. Cowjnunity Health Cell!
Please write to Dr.Qasem (PHM Secretariat - Savar) and Dr.Prem John of
Asian Community Health Action Network about THAI contacts. I am
forwarding your letter to both of them but please contact directly as
well.
I shall confirm wirh Srinath Reddy about ASF and participation in the
Right to Health Care workshop since I shall be in Trivandrum (25-27th
September' for the India Clinical Epidemiologists Network Annual
^fsgtinci. I am soeakinc on a alternative P.e search Framework using the PH
Charter and Dr.Ekbal is speaking on GA.TTS, as guest speakers. Sunoar s
outline has just come in - of ASF health related activities. We all need
to add further details to it.
P.avi Narayan
CHC / PHM
Subject: rHM contacts in Toaihrnd
Date: Tue, 24 Sep 2002 09:12:07 -0530
From: "Abhay Sccma1 *
^abhaysccma@vsnl.com >
Reply-To: "Abhay Seema" <abaysema@pn3.vsnl.net.in>
To: <sochara@vsnl.com>
CC: <ctddsf@vsnl.com>
^^ear Ravi and Amit,
*
Greetings
As you know, a process of developing 'Health equity gauges' in various developing countries is underway, which is
trying to document health inequity snd supporting advocacy efforts to bring about greater equity in health care and
health determinants. I am involved in supporting this process (yet to start in India) and Thailand is one or the
countries where public health academics have developed an equity gauge. However, they are yet to develop linkages
with grassroots groups, people's organisations or PHM groups who could tap this information and expertise, for
advocacy So it would be useful if you could forward any addresses of health groups or even non-health community
organisations / advocacy groups who may be involved in PHM / WSF activities and might be interested in
collaborating with the Equity Gauge in Thailand.
Amit, since you were recently in Thailand for ASF, I thought you would have WSF / PHM contacts there, which you
could send. Ravi, you would also be aware of PHM groups in Thailand. Even if you know of some ‘link contacts' who
could help identify other relevant groups in Thailand, it would be useful.
Incidentally. Thailand has recently developed a system for universal health care coverage which might be a useful
mode! for us to study in the context of Right to Health Care in India.
I think we should go ahead with the process of contacting speakers for the 'Right to Health Care' workshop during
ASF now. I will circulate a draft programme and list of speakers soon.
Hope rest is fine at your end.
With warm regards,
Abhay
PS: Amit, please forward to me Srinath Reddy's e-mail address so i can confirm with him about his participation in the
ASF workshop. I had talked to him briefly on the phone when I was in Delhi and he was positive, but you should also
9/25/02 10.29 AM
kL PrT.M contacts iii Thrtil«ndl
talk tO him.
Let's all join the fight, for health as a basic right!
Abhay Shukla
B-1 Nilgiri Apartments, Karvenagar, Pune 4110052
Maharashtra, India
Phone: 020-546 5936
e-maii: abhayseema(a}vsni.com
of2
9/25/02 10.29 AM
PHM contacts ir> Thailand
Subject: PHM contacts in Thailand
Date: Tue, 24 Sep 2002 09:12:07 +0530
From: "Abhay Seema” <abhayseema@vsnl.com>
Reply-To: ’’Abhay Seema" <abaysema@pn3.vsnl.net.in>
To: <sochara@vsnl.com >
CC: <ctddsf@vsnl.com>
Dear Ravi and Amit,
Greetings!
As you know, a process of developing 'Health equity gauges' in various developing countries is underway, which is
trying to document health inequity and supporting advocacy efforts to bring about greater equity in health care and
health determinants. I am involved in supporting this process (yet to start in India) and Thailand is one of the
countries where public health academics have developed an equity gauge. However, they are yet to develop linkages
with grassroots groups, people’s organisations or PHM groups who could tap this information and expertise, for
advocacy. So it would be useful if you could forward any addresses of health groups or even non-health community
organisations / advocacy groups who may be involved in PHM / WSF activities and might be interested in
collaborating with the Equity Gauge in Thailand.
Amit, since you were recently in Thailand for ASF, I thought you would have WSF I PHM contacts there, which you
could send. Ravi, you would also be aware of PHM groups in Thailand. Even if you know of some 'link contacts’ who
^ould help identify other relevant groups in Thailand, it would be useful.
Incidentally, Thailand has recently developed a system for universal health care coverage which might be a useful
model for us to study in the context of Right to Health Care in India.
I think we should go ahead with the process of contacting speakers for the ’Right to Health Care1 workshop during
ASF now. I will circulate a draft programme and list of speakers soon.
Hope rest is fine at your end.
With warm regards,
Abhay
PS: Amit. please forward to me Srinath Reddy's e-mail address so I can confirm with him about his participation in the
ASF workshop. I had talked to him briefly on the phone when I was in Delhi and he was positive, but you should also
talk to him.
Let's all join the fight, for health as a basic right!
Abhay Shukla
B-1 Nilgiri Apartments, Karvenagar, Pune 4110052
Maharashtra. India
Phone: 020-546 5336
e-mail: abhayseema@vsnl.com
O
9/24/02 11.19 AM
Page 1 or 1
Comm u nityj-lealihjCel I
From:
To:
Sent:
Subject:
Community Health Cell <sochara@vsnl com>
Claudio Schuftan <aviva@netnam.vn>; Abhay Shukla <abhayshk@ho‘mail.com>
Monday, February 17, 2003 4:04 PM
Hello
Dear Lexi,
Thelma and I met Pat Naidoo in Kempala (not the local guage) and had a very good
dialogue with David and colleagues in Nairobi (the iocai urban guage). We were very
impressed with the work in Nairobi. Abhay Shukla (PHA.-lndia / CEHAT) who stood in for
me at the Makerere meeting has been invited to be on a GEGA committee so he keeps
in touch with me on this. At the .Asia Social Forum in Hyderabad in January he made a
special presentation on GEGA at the workshop on Taking the PHM Forward. We look
forward to getting some idea about your meetings in different parts of the world this year
since it’s the Alma Ata Declaration anniversary year and we could think of three small
additions in each of your GEGA meetings this year with at least one or two PHM
resource persons attending each of these meetings (a) A presentation on PHM (b)
launch of signature campaign (c) A short discussion on how GEGA-PHM could
collaborate.
We have announced PH Assembly - I! in Porto Allegre in July 2004. By that time GEGA
should have evolved a meaningful relationship with PHM constituents. Lets work towards
it proactively. I shall request Claudio Schuftan who manages the PHM exchange to put
you on the list. By the way, since we lost corresponded i have become the Coordinator of
the PHM Secretariat which has now moved to CHC Bangalore for 2-3 years.
Rest wishes,
Ravi Narayan,
PHM / CHC.
Dr. Ravi Narayan
Coordinator, People’s Health Movement Secretariat
Community Health Cell
#367 ’’Srinivasa Nilaya"
I Block Jakkasandra. I Block Koramangala
Bangalore-560034
Join the "I leakh for all. NOW” campaign in the 25th anniversary year of the Alma Ata
declaration visit wmv .CheMd ho nSignawreCampaign.org
2/18/03
o1
3 «
Community Health Cell
From:
To:
Sent:
Subject:
Alexandra Bambas <lexi@hst.org.za>
Community Health Cel! <sochara@vsnl.com>
Thursday, February 13, 2603 6:4^ PM
RE: PHM - GEGA
Dear Ravi and Thelma,
i do hope all is well with both of you-congratulations on your launch of
the Million Signature Campaign!
1 am (very belatedly!) following up with you on a couple of issues. My
apologies for not getting back, io you sooner-we have been very busy making
preparations for the next round of activities in the Gauges, and for
planning our global efforts in training, advocacy, and collaboration.
■0 SvJ)
First, I wanted to find out whether you were able to meet with any of the
Gauges during your visit to Nairobi. I suspect that this activity was not as
organised as it could have been, from our end...
Also, i know that you had intended to be at GEGA's Makerere meeting last
February (1 had not come on board at that time), specifically to work with
us on advocacy issues. There may be upcoming opportunities io pick up on
this line of work, which I would be very interested in discussing with you.
Given the structure of our organisations, it seems there would be
possibilities for linking both at the country and international levels. I am
fairly familiar with the activities of the individual Gauges at this point,
and, as the Coordinator, also have a broad overview of the organisation and
the directions we are moving in.
Please let me know if you would like to discuss areas of mutual cooperation.
i look forward to hearing from you!
^2.1^3
Best wishes,
Lexi
N<d-_LnGtO i
M. *********************************
Alexandra Bambas, PhD, MPH
Coordinator of the Global Equity Gauge Alliance
Health Systems Trust
PO Box 808
Durban, KwaZuiu-Natai
South Africa 4000
no
email: lexi@geoa.org. z;
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Page 1 of 1
Main Identity
r. ,.*n
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From:
Cc:
Sent:
Subject:
PHM Secretariat <phmsec@touchtelindia.net>’
Abhay Shukla <abh2yshk@h0tmail.com>
David Sanders <lmartin@uwc ac.za
*
Wednesday, March 26. 2003 CHC4 PM
GEGA Meeting in Nairobi
Dear Abhav
Greetings from People’s Health Movement Secretariat at CHC, Bangalore!
It was nice catching up with some news, the other day. Hope you were able to meet Jose Utrera. The
travels are becoming too much and I have to consider some only if really important. I am the key
note speaker in the PHM - Sri Lanka (7th to 9th April 2003) meetings - then onto Delhi for JSA —
NCC. Does GEGA really require my presence especially when you and David are already there and
linked to it? Perhaps we can evolve a potential linkage email dialogue between the three of us and you
both present it on 16ul. I shall consider only if you both think its really crucial!! Perhaps you need to
let me know why?
Best wishes.
Ravi Narayan
Coordinator
PHM Secretariat
CHC-Bangalore
#36 7 "Srinivasa Nilava”
JJJIoch Jokkasandra, I Block Koramongala
Bangalore-560034
join the "Health for all, NOW" campaign m the 25th anniversary year of the Alma Ata
declaration visit www.TheMilbonSignarureCampaign.org
Page 1 of 2
Main Identity
From:
To:
Cc:
Sent:
Subject:
Abhay Seema <abhayseema@vsni.com>
Community health cell <sochara@vsnl.com>
<secTetariaf@phrnovement.org>
Thursday, March 20, 2003 CHC11 PM
GEGA meeting in Nairobi
Dear Ravi,
There is a GEGA coordinating committee meeting (including representatives
from all the country gauges) from 16 to 18 April in Nairobi. There is a plan
to invite on 16th selected representatives of other networks to develop
collaborations, I have strongly suggested your name as coordinator of the
global secretariat of PHM (see below), with the idea that we should
strengthen GEGA’s links with PHM at country and international levels. One
particularly interesting activity is the Global Health Equity Watch planned
by GEGA.
I suppose Lexi will contact you formally shortly, do block the dates.
More later about this and JSA matters,
Abhay
CC •
/Th? hr —I
Cc-l'c- A-
— Original Message —
From: Abhay Seema <abhayseema@vsnl.com>
To: Alexandra Bambas dexi@hst.org.za>
Cc: Pat Naidoo <PNaidoo@rockfound.orq>; Abbas Bhuiya <abbas@icddrb.orq>;
Antoinette Ntuli <ant@healthlink.org.za>: Banza Baya
<bayabanza@hotmail.com >; David Acurio <Aldes@etapa.com.eo; David McCoy
<Dayid.McCoy@jshtrTiac.uk>: David Sanders <dsandera@uwc.aoza>: Jeanette Vega
<;eanvega@terra.cl>: Mushtaque Chowdhury <mc2218@columbia.edu>; Paula
Braveman <pbrave@itsa.ucsf.edu>: Pierre Ngom <pnqom@aphrc.orq>; Rene
Loewenson <rene@tarsc.orq>: Siriwan Grisurapong <shsgs@mahidol.ac.th>; TJ
?
Ngulube <chessore@zamnet.zm>
o /Le. pt-trl- S
Sent: Friday, March 14, 2003 10:59 AM
Subject: Re: External partners and the GEGA meeting in Nairobi
yx.)
> Dear All,
> I would strongly recommend inviting Ravi Narayan, who is now the
Coordinator
> of the Global Secretariat of the People's Health Movement. Linking GEGA
with
> PHM in multiple countries, and also at the global level in the context of
> the Global Health Equity Watch could give significant boost to advocacy
> activities of Gauges and of GEGA, which would definitely be positive. !
feel
> Ravi Narayan is one of the best persons to help build such collaborations,
> David Sanders and myself would of course also help in building such
linkages
with PHM.
> Contact e-mails of the Global PHM secretariat and for Ravi are:
> secretariat@phmovement.org
> phmsec@touchtelmdia.net
> Regards,
> Abhay Shukla
lyi-a-A
«»♦ (.\HQ Ejanoaiore!
. -.
Af.e:t form the short notice(even though
u.cit out annual .am»iy holiday is from 13tn to 1otn April
nee aonav ana David win oe attending - PHM is strongly
Collaboration through an email dialogue. We
>jovo4
V’poacy/st
seting Ca
some of you join if you are
4/1/03
Page 1 of 2
Mam
From:
To:
Cc:
Sent:
Subject:
Alexandra Bambas <-iexi@hst.org.za>
Rev: Narayan <secretarict@phmoverr.ent.org>
David Sanders <.dsanders@uwc.ac.za
*;
Abnay Shukla <abaysej]|a@pno.vsnl.netin«>
Friday. March 28. 2003 CHC9 PM
GEGA meeting in Nairobi
Dear Dr. Narayan,
As Abhay has marifionsd to you, ws would very much be interested in having
your participation in the upcoming GEGA planning meeting in Nairobi, April
16-13. !n particular, we would hope you could participate on the first day
of the meeting, when we will be discussing our plans for developing our
Globa! Health Equity Watch as well as other global advocacy initiatives.
W
The Global Health Equity Watch will be an effort to bring out particular
equity issues related to supra-national processes. Although the specific
topics of the Watch have not yet been decided, we have been talking about
addressing issues of PRSPs, trade agreements, MDGs, and/or regional
agreements, linking these processes to their impact on the health of the
poor and on the health of those in the South and East, in the next months,
GEGA will also be initiating Regional Networks to support health equity as
well as curricula and training courses io support pro-equity monitoring,
policy, and support for community empowerment, always with an aim to support
voices from the South and East.
We would very much appreciate your input so that we might plan cur
activities and approaches to be as supportive to PHM as possible, and we
would make time at the meeting not only for discussion, but also for you to
present any PHM efforts that you think might be of particular interest io
GEGA.
Dc^<AyT ‘SXu.xU.tc.
I do realise this is short notice, for which I apologize, but I hope that
you wiil consider attending the meeting.
in any case, we look forward to strengthening our ties to PHM in the future.
Best regards,
Lexi Bambas
Alexandra Bambas, PhD, MPH
Coordinator of the Globa! Equity Gauge Alliance
/o me
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PHM Secretariat
From:
To:
Cc:
Sent:
Subject
Alexandra Bambas <lexi@hst.org.za>
PHM Secretariat <phmsec@touchtelindia.net>; David Sanders <dsanders@uwc.ac.za>;
Abhay Shukla <abaysema@pn3.vsnl.net.in>
Antoinette Ntuli <ant@healthlink.org.za>; Paula Braveman <pbrave@itsa.ucsf.edu>; David
McCoy <David.McCoy@lshtm.ac.uk>
Monday, April 07, 2003 2:32 PM
RE: GEGA Meeting in Nairobi
Dear Ravi, David, and Abhay,
I hope this note finds you all well. Following up on Ravi's email of last
week, I am hoping we might be able to get your thoughts on particular areas
of GEGA work that are of interest to PHM, and how we might move towards a
coordinated collaboration. At the Nairobi meeting, we are planning to meet
with representatives from Indepth and the Millennium Development Project,
and will also meet with Wemos in the coming month, to discuss areas of
possible overlap and specifically some work on PRSPs.
I've included below a short summary of some of the resources/activities that
may be useful in discussing collaboration with PHM, and some veiy
preliminary thoughts, and would be happy to hear your thoughts, so that we
£ght have further discussion with the Gauges in Nairobi on what might be
feasible for them.
1) the monitoring and advocacy work developed by our Gauges; there is now a
wealth of equity-sensitive information made available by the Gauges, as well
as a number of advocacy initiatives being pursued; we are currently
collecting this information, and will hopefully have an overview assembled
soon of cross-cutting themes among the Gauges;
2) a specific regional initiative in Africa, in cooperation with Equinet, to
support Parliamentary Portfolio Committees on Health in a number of
countries by linking them with technical resource personnel in their own
countlies, with teams from other countries, and with SADC officials, in
order to address policy issues at the national and regional levels;
3) a recent initiative to develop curricula for training in Assessing and
Monitoring health equity, advocating for pro-equity policy, and working with
^pimunities;
4) the Global Equity Gauge Watch, which is currently being defined and
discussed, and will possibly look at the impact of macro level forces on
health equity’;
5) our emerging initiative to build regional networks on health equity in
Latin America, Africa, and Asia to support sharing of information as well as
support collaboration for Equity Gauge-type projects.
People’s Health Movement/ International People’s Health Council
Contacts: Ravi Narayan, Abhay Shukla, David Sanders, Maria Zuniga
|A h r
Page 2 of 3
Likely areas of collaboration: Dissemination, technical support for
advocacy, possible advocacy cooperation
focus
, PHM provides a SouthenvEastem voice for health promotion focused on health
as a human right, community based care, and people-centered approaches to
policy and development. The organisation is a loose network of partners from
countries all over the world, and includes regional chapters that engage
more focused advocacy initiatives. PHM is generally critical of
privatisation efforts, of World Bank/IMF-led initiatives and actions, and of
other neoliberal oriented efforts.
Overlap with GEGA
Because PHM is a very large and diverse organisation, identifying specific
areas of overlap is a little difficult. But in general, there are many
general issues, including health inequalities; strengthening of health
systems, including human resources; and macro influences on health equity.
It would be useful to hear more about PHM
*s
specific advocacy campaigns
(existing and upcoming) to see how we might support them through the
information the Gauges have collected.
More specifically, GEGA and the Gauges may be able to effectively link with
groups within PHM, and getting a better sense of target groups and their
projects within the organisation would be useful also.
potential value of collaboration
I has a large constituency, is well-known and respected in general, and
ingoing relations with various organisations that GEGA may also want to
connect with, including WHO (Civil Society Initiative) and Wemos, which
would provide additional opportunities for networking and mutual support.
Additionally, PHM
*s
capacity to launch advocacy initiatives and to
disseminate information could be helpful to our efforts. The networking
function of PHM, both through listserves and through meetings, would be
additional opportunities for GEGA to network with specific groups and to
promote the Equity Gauge Strategy.
(Abhay: do you have comments in relation to your experience at the Asian
Social Forum, or on other aspects of this discussion?)
As GEGA grows, and as we are able to collect lessons and data, there may be
opportunities to provide an evidence base to PHM work and advocacy
initiatives, especially if we were to approach such efforts through a
planned strategy incorporating other groups collecting data on equity.
Links with smaller groups witliin PHM, such as regional networks and even
individual members/institutions, could also provide support while feeding
our own goals for capacity building.
C
Thanks veiy much, and I look forward to hearing back from you.
Best regards,
Lexi
>fc »Jc >jc r’c >j< >jc >J< >j< >|c >J«
>Jc >Jc >J< >’< >}< >Jc >•<
>Jc »;<
Alexandra Bambas, PhD, MPH
Coordinator of the Global Equity Gauge Alliance
4/7/03
Page 3 of 3
Health Systems Trust
PO Box 808
Durban, KwaZulu-Natal
QzvifS
jnnn
email: lexi@gega,org.za
---- Original Message----From: PHM Secretariat [mailto:phmsec@touchtelindia.net l
Sent: Tuesday, April 01, 2003 9:06 AM
To: lexi@hst.org.za
Subject: GEGA Meeting in Nairobi
Dear Lexi,
Greetings from People’s Health Movement Secretariat at CHC, Bangalore!
Thanks for your invitation to attend the GEGA planning meeting. Apart form
the short notice(even though Abhay had spoken to me about it last week), I
discover that out annual family holiday is from 13 th to 18th April 2003 and
its too late to make any changes. Since Abhay and David will be attending PHM is strongly represented and I shall plan a framework of a PHM - GEGA
Collaboration through an email dialogue. We meet in Geneva on 16th-17th May
2^)3 for a PHM policy/strategy meeting. Can some of you join if you are
trending the World Health Assembly on the following week?
Best wishes,
Ravi Narayan '
Coordinator, People’s Health Movement Secretariat
CHC-Bangalore
#367 ’’Srinivasa Nilaya”
Jakkasandra 1st Main, I Block Koramangala
Bangalore-560034
Join the ’’Health for all, NOW” campaign in the 25th anniversary year of the
Alma Ata
declaration visit www.TheMillionSignatureCampaign.org
4/7/03
P»ee 1 nF 9.
PHM Secretariat
From:
To:
Cc:
Sent:
Subject:
___ __________
PHM Secretariat <phmsec@touchtelindia.net>
Alexandra Bambas <lexi@hst.org.za>
<abaysema@pn3.vsnl.netin>; David Sanders <lmartin@uwc.ac.za>; Eric Ram
<eric__ram@wvi.org>
Tuesday, April 08, 2003 2:04 PM
Re: GEGA Meeting in Nairobi
Dear Lexi,
Greetings from People’s Health Movement Secretariat at CHC, Bangalore!
I meet Abhay in Delhi on 11th April and will discuss some of the ideas with him. If your briefing document
arrives by then perhaps I may be able to focus on ‘specifics' as well.
1.
lam writing to Eric Ram of (ex-World Vision) who organized a series of reflections on a Global
Health Watch in which I was actively involved for many years. He will forward some reports of a
project proposal that did not get followed up due to unavoidable circumstances but would definitely
be helpful to GEGA especially when it looks at the determinants of Global Inequity and critiques
international initiatives from a Equity perspective.
Hope we can follow all this up more concretely in Geneva meeting, building on your reflections in
Nairobi on the 16th.
2. oAs a General principal I believe we should try and link our PHM contacts to each of your country
gauges so that PHM members advocacy / campaign's experience compliments the GEGA Equity measurement experience, thereby linking ‘evidence’ to campaigns in a creative way.
^est wishes,
Ravi Narayan
Coordinator, People's Health Movement Secretariat(global)
CHC-Bangalore
#367 "Srinivasa Nilaya"
Jakkasandra 1st Main, I Block Koramangala
Bangalore-560034
Join the "Health for all, NOW" campaign in the 25th anniversary year of the Alma Ata
declaration visit www.TheMi11ionSignatureCampaign.org
— Original Message —
From: Alexandra Bambas
To: PHM Secretariat
Sent: Tuesday, April 01, 2003 2:31 PM
Subject: RE: GEGA Meeting in Nairobi
P
Q,
1^
W
4/8/03
Dear Ravi,
4/8/03
PHM Secretariat
From:
To:
Sent
Subject:
Alexandra Bambas <lexi@hst.org.za>
PHM Secretariat <phmsec@touchtelindia.net>
Tuesday, April 01, 2003 2:31 PM
RE: GEGA Meeting in Nairobi
Dear Ravi,
I understand that the short notice was a bit of a problem (though a family holiday sounds
like fun in any case!). I very much welcome an email dialogue on possible collaboration. I
would be able to send you a briefing document on our activities by next week, if that
would be helpful, although I would also welcome any comments or questions you have in
the meantime.
Thanks very much for the invitation to the strategy meeting in Geneva-I'll get back to you
as soon as I can talk with others.
Kind regards,
Lexi
----- Original Message----From: PHM Secretariat [mailto:phmsec@touchtelindia.net]
Sent: Tuesday, April 01, 2003 9:06 AM
To: lexi@hst.org.za
Subject: GEGA Meeting in Nairobi
Dear Lexi,
Greetings from People’s Health Movement Secretariat at CHC, Bangalore!
_
A9L2 to f
Thanks for your invitation to attend the GEGA planning meeting. Apart form the short notice(even
though Abhay had spoken to me about it last week), I discover that out annual family holiday is
from 13th to 18th April 2003 and its too late to make any changes. Since Abhay and David will be
attending - PHM is strongly represented and I shall plan a framework of a PHM - GEGA
Collaboration through an email dialogue. We meet in Geneva on 16^-17th May 2003 for a PH
policy/strategy meeting. Can some of you join if you are attending the World Health Assembly
the following week?
Best wishes,
Ravi Narayan
Coordinator, People's Health Movement Secretariat
CHC-Bangalore
#367 “Srinivasa Nilaya"
Jakkasandra 1st Main, I Block Koramangala
Bangalore-560034
Join the "Health for all, NOW" campaign in the 25th anniversary year of the Alma<Atejz
declaration visitwwwTheMillionSjgnatureCampaign.org
bJfXeie
<=u-sC- SA-o-wic^
PlJrt
jc
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PH^LSecretariat
(2^
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Page 1 of 1
PHM Secretariat
From:
To:
Cc:
Sent:
Subject:
PHM Secretariat <phmsec@touchtelindia.net> Eric Ram <eric_ram@wvi.org>
David Sanders <lmartin@uwc.ac.za>; <abaysema@pn3.vsnl.net.in>; Alexandra Bambas
<Iexi@hst.org.za>
Friday, April 11, 2003 12:27 PM
GEGA Meeting in Nairobi
Dear Eric,
Greetings from People’s Health Movement Secretariat at CHC, Bangalore!
PHM is gradually getting linked in a collaboration way with a Global Equity Guage Alliance (GEGA). I
believe this group (included David Sanders from South Africa and Abhay Shukla from India) may have the
structure, energy and resources to take our Global Health Watch forward. Can you please forward the
jeports and summaries (whatever is possible through email) to David (lmartin@uwc.ac.za), Abhay
^baysema@pn3.vsnl.net.in) and Lexi Bambas (of GEGA - lexi@hst.org.za)) so that we can continue the
dialogue? In May, we may be able to set up a small meeting to take this cross-fertilization process
forward. Did you get my earlier communication?
Best wishes,
Ravi Narayan
Coordinator, People's Health Movement Secretariat(Global)
CHC-Bangalore
#367 "Srinivasa Nilaya"
Jakkasandra 1st Main, I Block Koramangala
Bangalore-560034
Join the "Health for all, NOW" campaign in the 25th anniversary year of the Alma Ata
declaration visit www.TheMiHionSiqnatureCampaign.org
Page 1 of 10
PHM Secretariat
From:
To:
Sent:
Subject:
PHM Secretariat <phrnsec@touchtelindia.net>
Alexandra Bambas <lexi@hst.org.za>; David Sanders <lmartin@uwc.ac.za>;
<abaysema@pn3.vsnl.net.in>; <David .McCoy@lshtm.ac.uk>
Thursday, April 17, 2003 6:51 PM
Fw: GEGA Meeting in Nairobi
Dear David, Lexi, Dave, Abhay and others,
Greetings from People’s Health Movement Secretariat at CHC, Bangalore!
I returned from the PHM Sri Lanka meetings and the PHM - India (National
Coordination Committee meeting) in Delhi (where I had just a few minutes
with Abhay about GEGA - Nairobi meeting over breakfast) and saw the dialogue
on ‘values”. I think it’s a very pertinent point but having been a coalition
wuilder for years, I would like to straightaway caution that we need clarity
between -values' and ‘ideological positions’, since values can unite when
they are shared and ‘ideological positions’ especially if they are strong
and inflexible can divide. Our discussions to explore clarity in this area
must focus on shared values and respecting diversities in ideological
positions.
I have suggested that GEGA and PHM could continue the dialogue in Geneva on
the 18th (Sunday). WEMOS may organize a workshop for PHM participants on WTO
GATTS etc but we can find time during the day. On 17th, we shall also flag
PHM - GEGA linkage at the PHM strategy meeting (agenda point - linkages with
other networks).
I
Will someone be able to attend the Geneva events, in addition to David, who
is also IPHC / PHM? Perhaps Lexi, Abhay and some one else who can make it!
West wishes,
Ravi Narayan
Coordinator
PHM Secretariat (Global)
P.S: Prof. Hans Rosling email is Hans.Roslinq@phs.ki.se. Abhay knows the
context in which this is being sent.
Dr. Ravi Narayan
Coordinator, People's Health Movement Secretariat(global)
CHC-Bangalore
#367 "Srinivasa Nilaya"
Jakkasandra 1st Main, I Block Koramangala
Bangalore-560034
4/21/03
PHM Secretariat
From:
To:
Cc:
Sent:
Subject:
Alexandra Bambas <lexi@hst.org.za>
David McCoy <David.McCoy@lshtm.ac.uk>; <abaysema@pn3.vsnl.net.in >;
<phmsec@touchtelindia.net>; <dsanders@uwc.ac.za>
<ant@healthlink.org.za>; <pbrave@itsa.ucsf.edu>
Tuesday, April 08, 2003 2:11 AM
RE: GEGA Meeting in Nairobi
<7^1^
CV
Dear Dave and David,
Thanks for raising the issue of values, as it is one that the Gauges
themselves occasionally raise, and also comes out indirectly (for example,
in our discussion last week about the Drop the Malaria Tax Campaign). I
don't want to take the discussion here too far from our original task of
discussion with Ravi, but perhaps it is also useful to look at the issue a
bit early on in our discussions (part of the pain of a growing
organisation).
Or V, cA
Le Y> , Uav<4.
PUM
<PL* 'C.
Pl-f rp
cI
•nf"
The question of values doesn't just relate to the values of the Gauges
themselves--it also relates to how GEGA and the Gauges are able to position
gjemselves in terms of cooperative relationships and securing a space for
Glassy advocacy." For instance, if we want to be able to work with groups
cm '
like MDP and Indepth, it is important, as Dave notes, for our conclusions
(that is, our advocacy message) about what works and what doesn't to be (as
much as possible) evident from the empirical data with which we are working,
along with some general values (e.g. basic tenets of democracy and
democratic societies, and of human development). Couching the issues in
these terms can often lead to conclusions/arguments that are, in essence,
contra a neoliberal agenda without necessarily forcing neoliberal vs
anti-neoliberal stances.
pcmp
b e<^>
rc.tji l/icm b a. I
I think the more sensitive area will be at the national level: ensuring that
GEGA’s advocacy activities and collaborations don't affect Gauges'
relationships with government in specific countries, which can sometimes
take suspicious views of activities.
finally, GEGA's positioning has implications in terms of defining future
Gauges and affiliate groups-that is, who we would want to feel comfortable
in adopting the Equity Gauge Strategy, which could very well be quite a
broad group.
I think there are some positions/principles that GEGA could take that would
meet the approval of all the Gauges (and that would not be very
controversial, in themselves), including (but not limited to) support for
1) transparent and accountable government, including regional and global
governance (implications for state responsibility for monitoring and
releasing information related to broad policy effects)
2) human development and opportunities for all (with implications for
prioritising the needs of the worst-off)
yu
3) universal access to basic needs (e.g. water/sanitation, education) and
Ye>
4/8/03^ f}C^c
Page 2 of 8
&
S
To/GZ^rr^j
primary health care (perhaps no need to adopt a monolithic view of now sucj}t<^
l.r1 u».ri
’U- ■
nar+iri ilz>r
3
Cached
phu
models in terms of their effects)
Or are these too broad to be satisfying? Of course, the tension will always
come in the interpretation of the data, and drawing lines about when
standards are satisfied, but perhaps laying out the principles to which the
organisation subscribes is a start. Perhaps we could draft a proposal for
GEGA principles for discussion/revision/adoption at the meeting? This would
obviously help ground our discussions with other groups, too, and support
consistency in our approach.
-Lexi
----- Original Message-----From: David McCoy [mailto:David.McCoy@lshtm.ac.ukl
Sent: Monday, April 07, 2003 9:35 PM
To: lexi@hst.org.za; David McCoy; abaysema@pn3.vsnl.net.in;
phmsec@touchtelindia.net; dsanders@uwc.ac.za
Cc: ant@healthlink.org.za; pbrave@itsa.ucsf.edu
Subject: RE: GEGA Meeting in Nairobi
Dear David,
I left out values because I assumed common values. I know the wemos, IPHC,
PHM and medact positions fairly well, but you are right in pointing out that
the gega alliance is much more of a diverse group of people who may not
subscribe to an anti-neoliberal ideology.
It's something we need to discuss as gega -1 personally feel that gega
needs to be bound by some common values or have a fairly common
understanding of political and economic theory.
But I also think we should be arguing as much from a non-ideological
perspective
i.e. use empiricism and logic to show the fundamental
^ntradictions between neo-liberalism and equity / social justice.
But thanks for the amber light
Paula, antoinette, abhay ... what assumptions can we make about gega's
positioning re: neo-liberalism, the state, democratic accountability, health
as a public good and the inherent market failure characteristics of health
care?
Dave
4/8/03
Page 3 of 8
>>> "David Sanders" <dsanders@uwc.ac.za > 04/07/03 18:53 PM >>>
Dear Dave,
I i ldllKS> I Ul
1 uliiiilv
!-•«- viuC.ii
*
v i iu . C. a »u jvv.o. Vi v»i 7i i-y
the lines you suggest. However, as one of those associated with the
initiation of the.IPHC and PHM and now with GEGA, there is an important
dimension you h?ve left out. That is the dimension of "values" or, dare
I say "ideology".
In my view IPHC and PHM are founded on an explicitly anti -neoliberal
ideology. But I don't think GEGA as an alliance (and still less the
Millenium Development Project and INDEPTH) necessarily subscribes to
such values. Nor should it necessarily- altho some of us within GEGA
might believe that health equity cannot be achieved in a
neoliberal-dominated world. So, the issue of values needs to be taken
into account when we explore WHAT KIND of collaboration/synergy is
possible or desirable.
I hope you don't mind such words of caution/scepticism from an old (and
probably time-expired) lefty!
Regards and see you in Nairobi,
David.
>>> "David McCoy" <David.McCoy@lshtm.ac.uk> 04/07/03 03:32PM >>>
Dear Ravi, David and Abhay,
^rst of all, greetings to you all! Lexi, your e-mail has listed a
range of topics that I also wanted to discuss in Nairobi, and it’s
good to discuss these a little by e-mail before we meet. All the more so
given that Ravi will not be able to join us.
As background, I should mention that over the couple of last two months
I have been doing a consultancy with “Health Counts” (which consists
of Medact and Wemos) to develop some ideas on a Novib-funded IPHC-Health
Counts project on ‘globalisation and health’. This has included the
following activities:
- Assessing IPHC’s organisational and communication strategy,
which includes its relationship to PHM (I had been hoping to discuss
this with Ravi in Nairobi). This will be leading into a set of IPHC and
PHM meetings in May.
- Assessing the broader NGO environment to identify an appropriate
fciche for IPHC-Health Counts (which has also been of use in my GEGA
capacity).
- Developing some ideas around analysis, communication and
advocacy strategies on: 1) trade / GATS / WTO; 2) health sector reform /
structural adjustment / PRSs; 3) Global health governance (WHO; PPIs).
This is being done together with Medact, IPHC and Wemos. It's work in
progress at the moment.
All in all, my impression is that GEGA, PHM, IPHC, Wemos and Medact
share a number of values and interests that we really should attempt to
4/8/03
PHM Secretariat
*
~sa
“X.
rrom:
To:
Sent
Attach:
Subject:
PHM Secretariat <phmsec@touchtelindia.net>
David Sanders <imartin@uwc.ac.za>; <David.McCoy@lshtm,ac.uk>; <lexi@sirian,hst.org.za>;
<abaysema@pn3.vsnl.net.in>
Thursday. April 24, 2003 3:33 PM
participation form.doc
PHM GEGA
Dear Davqr. Lexi, David, Abhay,
Greetings from People’s Health Movement Secretariat at CHC, Bangalore!
I heard about the hiccough at GEGA meeting from Abhay (telephonically and email) arid Dave
tenail). Not surprising, because some of the National gauges could have seen Global Equity
^age as raising broader issues that might affect relationship with funders and international
agencies!! But perhaps we should just be patient and not too judgmental.
Lexi could make a short presentation on 17th and we could all meet on 18tiS morning informally
with all out
* 6hats', somewhere in Geneva. Any suggestions? WEMOS lias organized a workshop
on WTO and Public Health in the afternoon, which may be interesting for you all as well Out
last communication III sent to potential participation enclosed.
Best wishes,
Ravi Narayan
Coordinator,
|HM Secretariat (Global)
Communication - iil
22,2003
Dear PHM Geneva 2003 participants and PHM friends.
April
- 2c.<o >
PP
Greetings from People's Health Movement Secretariat (Global) at CHC, Bangalore!
4/24/03
C& A
Page 1 of 11
PHM Secretariat
From:
To:
Cc:
Sent:
Subject:
______________
David McCoy <David.McCoy@lshtm.ac.uk>
<ant@hst.org za>; <lexi@sirian.hst.org.za>; <phmsec@touchtelindia.net>
<!exi@hstorg.za>; David McCoy <David.McCoy@lshtm.ac.uk>: <abaysema@pn3.vsnl.net.in>;
<imartin@uwc.ac.za>
Wednesday, April 23, 2003 8:33 PM
Re: Fw: GEGA Meeting in Nairobi
Ravi,
Greetings.
If you have had an opportunity to talk with Abhay you will know that there was a slight
hiccough at the GEGA meeting in Nairobi, because a substantial number of people felt
uncomfortable about GEGA running a 'Global Health Equity Watch' project. We are not
Entirely sure what tne reason(s) for this was (there are many theories!), but are still hopeful
that there will be a change in mind.
I also discussed some other options with David Sanders and Abhay. We all fee! that there is
vaiue in setting up a Global Health Equity Watch, and that if GEGA is not willing to convene
this, we should then discuss some other alternatives. In any case, it is something that we
would like to continue to discuss in Geneva.
Abhay and I felt that it would be good to discuss such ideas on the 18th. I could present
some ideas to start off a discussion, and depending on what happens within GEGA, I may
either wear a GEGA hat or a medact hat.
As for more general GEGA-PHM links, Lexi is better placed to present the country-level work
on the 17th.
,
best wishes
^ave McCoy
>>> <lexi@sirian.hst.orq.za> 04/20/03 15:56 PM >>>
Dear Ravi,
Thanks very much for the clarification between values and ideologies--very
appropriate and helpful. I'm sure we'll continue to have these discussions...
I would be happy to attend the May PHM meeting in Geneva, as I have additional
business in the area.
d-
Looking forward to seeing you there!
-Lex;
cf'
hYc.
fl-ycY
PC
PHM Secretariat
From:
To:
Sent
Subject:
<abhayseema@vsnl.com>
<phrnsec@touchteiindia.net>
Wednesday, April 23, 2003 8:54 PM
Global Health Equity watch
Dear Ravi
Dave McCoy’s e-mail more or less summarises what happened in Nairobi. I would just like to
realistically comment that it would be better not to count on GEGA to host a Global watch in the near
future. However, given Dave's initiative and the interest from the rest of us PHM-wallahs. some way
should be found to go ahead with the idea (including accessing funding) and a discussion in Geneva
would definitely be useful to move towards this objective.
Regards.
Abhay
David.McCoy@lshtm.ac.uk wrote
Ravi.
Greetings.
If you have had an opportunity to tail; with Abhay you will know that there was a slight hiccough at the
GEGA meeting in Nairobi, because a substantial number of people felt uncomfortable about GEGA
running a 'Global Health Equity Watch' project. We are not entirely sure what the reason(s) for tills
was (there are many theories!), but are still hopeful that there will be a change in mind.
I also discussed some other options with David Sanders and Abhay. We all feel that there is value in
setting up a Global Health Equity Watch and that if GEGA is not willing to convene this, we should
then discuss some other alternatives, hi any case, it is something that we would like to continue to
discuss in Geneva.
Abhay and I felt that it would be good to discuss such ideas on the 18th. I could present some ideas to
start off a discussion, and depending on what happens within GEGA, I may either wear a GEGA hat or
a medact hat.
for more general GEGA-PHM links, Lexi is better placed to present the country-level work on the
Wth.
best wishes
Dave McCoy
4 /24/03
PHjVI Secretariat
From:
io:
Cc:
Sent:
Subject:
<lexi@siriarkhstorg.za>
PHM Secretariat <phmsec@touchtelindia.net>
Alexandra Sambas <!exi@hst.org.za>; David Sanders <lmartin@uwc.ac.za>;
<abaysema@pn3.vsnl. net. in>; <David.McCoy@lshtm.ac.uk>
Sunday, April 20, 2003 8:27 PM
Re; Fw: GEGA Meeting in Nairobi
Dear Ravi
Thanks ven- much for the clarification between values and ideologies—very
appropriate and helpful. Fm sure we'll continue to have these discussions...
I would be happy to attend the May PHM meeting in Geneva, as I have additional
business in the area.
Looking forward to seeing you there!
-Lexi
Quoting PHM Secretariat <phmsec@touchtelindia.net--:
> Dear David, Lexi, Dave, Abhay and others,
> Greetings from People's Health Movement Secretariat at CHC. Bangalore!
> I returned from the PHM Sri Lanka meetings and the PHM - India (National
> Coordination Committee meeting) in Delhi (where I had just a few minutes
> with Abhay about GEGA - Nairobi meeting over breakfast) and saw the dialogue
> on ’values". I think it's a very pertinent point but having been a coalition
> builder for years, I would like to straightaway caution that we need clarity
> between Values' and 'ideological positions', since values can unite when
> they are shared and 'ideological positions' especially if they are strong
^and inflexible can divide. Our discussions to explore clarity in this area
"must focus on shared values and respecting diversities in ideological
> positions.
> I have suggested that GEGA and PHM could continue the dialogue in Geneva on
> the 18th (Sunday). WEMOS may organize a workshop for PHM participants on WTO
> / GATTS etc but we can find time during the day. On 17th, we shall also flag
> PHM - GEGA linkage at the PHM strategy meeting (agenda point - linkages with
> other networks).
> Will someone be able to attend the Geneva events, in addition to David, who
> is also IPHC / PHM? Perhaps Lexi, Abhay and some one else who can make it!
4/21/03
PHM Secretariat
From:
To:
Cc:
Sent:
Subject:
David McCoy <David.McCoy@lshtm.ac.uk>
<laxi@hst.org.za>; David McCoy <David.McCoy@lshtm.ac.uk>;
<abayserna@pn3.vsnl.net.in>; <phmsec@touchtelindia.net>; <dsanders@uwc.ac.za>
<ant@healthlink.org.za>; <pbrave@itsa.ucsf.edu>
Tuesday. April 08, 2003 5:53 PM
RE: GEGA Meeting in Nairobi
Dear all,
Please see below message about
report 2004.
Something else for discussion? Also something that GEGA should respond formally to. I suspect
that the WB's strategy' fro making services work for people is by "unburdening the public sector of
the empfyed and the rich so that the public sector becomes a service for the poor; promoting market
incentives for companies to reach the poor; targeting the poor etc. But little on redistribution; cross
subsidisation; risk pooling; etc.
World Development Report 2004:
Making Services Work For Poor People: e-Discussion
E: Discussion from April 14 - May 30, 2003
ptirf
Buring a 7-week period from April 14, 2003 through May 30, 2003, the World Bank and Public
World will co-host a moderated electronic discussion on the forthcoming WDR 2004: "Making
Services Work for Poor People". The e-discussion is an opportunity for a wide range of
stakeholders from government, business, and civil society to exchange views about the content and
main ideas of the draft report.
Each of the seven weeks will have its own theme:
Week 1: Overview of "Making Services Work for Poor People"
Week 2: What accounts for success and failure in serving poor people, and what are the obstacles
to overcoming failures and building on successes?
Week 3: Is the draft report imbued with the values, informed by the principles and aiming for the
goals that are required to make services work for poor people?
Week 4: What changes are required that would lead policy makers to produce policies that are more
beneficial to poor people?
Week 5: What changes are required in the relationships between policy makers and service
providers that would lead to the latter meeting the needs of poor people more effectively?
week 6: What changes are required to enable poor people to exercise more influence over the
decisions and behavior of service providers so that their needs are more fully and effectively met?
Week 7: Does the WDR rise to the challenge it sets itself? How can donors, governments and other
actors rise to its challenge?
Please read our announcement which further defines the role of this e-discussion and weekly topics,
as well as "rules of engagement", and details on availability of the comments and draft in various
langugages.
The World Bank and Public World Announce e:Discussion on "Making Services Work for Poor
People"
If you would like to request a printed version (in English) of the public draft, please send an email
4/9/03
Page 2 of 2
to: world dev^report®,worldbank.org with the words "e:discussion" in the subject line.
*
*
#. *
This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to
disseminate information
related to Equity, Health inequality; socioeconomic inequality in health; socioeconomic health
differentials. Gender,
Violence, Poverty, Health Economics, Health Legislation, Ethnicity, Ethics, Information
Technology and Virtual Libraries,
Research & Science issues.
PAHO/WHO Website: http//www.paho.org/English/HDP/
EQUID AD List - Archives - Join/remove: http://listserv.paho.org/Archives/equidad.html
4/9/03
?o:
Cc:
Sent:
Attach:
Gw<Davjd.McCoy@lshtm.ac.uk>
<phn'isec@toucntelindia net>; <fm,artin@uwc.ac.za>
dev@hst or;yza-'- <mikefowson@medact org>: <abayserna@pn3.vsnl.netir>
“:..'scay May 29, 2003 8:29 PM
GHE?/ proposaLdoc
Subject
GHEW
Dear 3avi rnr David.
a;: ‘ I hope you both had safe hips back home.
(
c;
*
::
attached a document on the global health {equity) watch idea we discussed in geneva.
- raten /:•«< document so as to help ensure that we arc all operating from the same understanding ■ a’ -o be t:scd <s a template for sharing with other organisations and as a fending proposal.
: have indicated in rhe document what I consider to be the next steps for the next six weeks or so. and
ek' be gratefel xbr your quick feedback (you can skip the iirst two pages of introductory comments)
N-.W:
The document is headlined by PHM. GEGA. and Health Counts (which is. Medact ■ Wcmos)
2. The budget is incomplete -1 need some help with this
3. i i- .: suggested chapter headings structure of the document are open to discussion and change
1 b;<;k ibru/arc to hearing back from you soon
. ill L?:e best
Eave
Peoples Health Movement
Global Equity Gauge Alliance
Health Counts1
Concept
for the Development of an Annual Global Health Equity ;<Vatsh
Background
Every day 30,000 children die of preventable causes’. The HLV'/AIDS epidemic continues to
escaiare. with the situation in sub-Saharan Africa already tragic, and large parts of Asia about
+o follow suit. Worldwide, poverty at the country, loca’ and household level remains the biggest
underlying cause of morbidity and premature death. 1.2 billion people, mostly women and
children, live on less than US$1 a day.
Added to this ere ever-growing inequities. Whiie tne poor are getting poorer, and the sick are
getting sicker and dy;ng earlier; the healthy are getting healthier, and rhe rich are living longer
and consuming more. The world's 25 richest people have, income and assets worth US$474
bhlion - more than the entire GNF of Sub-Saharan Africa’.
In spite o’; the economic growh and -/echnolcgical advances of the’fast forty years, for mTions
of people, this has not resulted in any development. Trickle down has not worked, and worst sti;1
.,
the social and economic deveiepmenr of some seems to have come at the cost of impoverishmenT
to others.
In spite of growths in agriculture? productivity, in some parts of Africa and Asia there s
/amine, arc across then world, 214 million people orc so under-nourished that they cannot work
or care far Themselves.r
In the health sec.or. while the top 1C U.S. drug companies made profit’s of $37 bilhor, in .2001 .
millions of people are unable to access even the most basic PH(j drugs, let alone hove access to
of fordable anT:*etrovira'
treatment.
The resounding failure of the globai community to achieve Health for Aii by the Year 2000" has
At r time in which the state of health within countries is increasingly affected by w prj.d'mw
cf.o global forces, most disappointing has been rhe iack of leadership shown Dy me VVor;d
Health OrganisaTion. Instead of oointing to the need for a drastic and profound re-think of
global strategies to (insure equitable development and health fo
* Cn# (\- ;.1QS become a w.J'
pfayer on the global health and development poke/ stage (increasingly dominated by the ,Vc c.
BanKj, Even the World Trade Organisation and the .'international MoneTarv Funo have poremw?y
'
Cour-'-? - M.gdoct <• W^-rnos.
fr C2,'. -Ci'f.:sty .-?,r the Mil’xnnkjm, T/or-kJ Sank. XVachznglon CC, .JC'C'i.
fro;'!< rork e;-y.
of Siib-Iaharar; Africa .-.•r.-j L:~o31b biKo.a in 1999r.AG. 2CO2. The r'crc c? food in.vcu.’ii/
■•.' ini- .C'- l<on.2
Pubiic Citizen. Apri: 2002. Pha-’rnac/u.itais .<ank as Most Proi'.'iatle Again.
'”4.
nec:?;< policy playas by dMue of The impact of trade policies cwc.
j
s~ .;t?r pM'wvc on health end health care.
otc
u Aim- Ava ccc.G; GTicn which enshrined the principles of equity, social medicine, appropriate
"?. ■ v rtcy,. ccw.'ss to comprehensive health care and sound public health approaches to disease
;w.wwion ana mcnagement, has /irtuaily disappeared from the V-/HC agenda, and when w does
reappear >r is apparent that the conceptual meaning of the THC Approach
*'
is no longer
wide stood bywho frequently confuse it with primary 'eve! care.
Instead, WHO has become increasingly tied no with vertical disease-based aoproaches and
cues'-icp.'cii ecc.r.omeVric, .-.umber-cr.unch'ng exercises. (Others have pointed to its support of
wic f>G.vEa analysis and recommendations of trie Commission on Macro-economics and Healin,
arc tne increasing influence of the corporate and private sector.
"rc V./oHd Sank on the other hand has continued to foist discredited, neo-liberai solutions to
global development and poverty alleviation. Rather than supporting the development of public
redth systems, riiey have promoted the fragmentation of health systems and increasing
privatisation. Health sector liberalisation with an increasingly under-funded resourced public
sealer safety-net for the poor remains the stock solution - in spite of its glaring failures. On
rop cf /.'is, marxet-based reforms of the public secror are offered as solutions to many of th?
otirenucroTic inefficiencies that result from demoralised, under-skilled and under-paid civil
servants.
Poverty Reduction Strategies which were supposed to herald a new democratic and participatory
approach to development have turned’out to be aid wine in new bottles’,. and many of the lessons
from the 7vcrid Bank's own internal assessments of its failures have not been heeded.
reated to
Tile, year after year, the war
2 hts . sal
*
a id ra
ew set of commi
ror development and health - The latest being The millennium development goals. While making
grand pnor.oijn cements on deb
*
relic r. 7--2 de reform aid and HIV/A.L‘>5, the truth is that
overseas development assurance has dec-.ined, wmiy? t.-ie trade ana investment environment
have become ever more unfriend^ to the development aspirations of poor countries, The
commercial imperatives of He b-country companies and multi-national corporators have
consist air.-iy taken precedence over social deveiopmenT, peveriy alleviction, equity and economic
feirness.
Although corrupt, inefficient, iinethicai and undemocratic government within many developing
CQurtries ere major hinderances ’i’o equitable deve’ooment which require local solitions, the
poiiti
/hie
/ith
;
01
such gov
*
ints
1
be
te e
biishe
also have external global comributor-y end causal factors.
In response to the situation descrioed aoove, people from aii over the world have been
partaking in a variety of grassroots 'struggles far heart''. More and more heafrh workers
realise that the principles of the Alma Ata Ceclaration no longer guide health vector
developmei
■
A/oric I
.. .
3Ith Organisatio
.
* with n mo
imer s.
.More and more communities and academics are noting how the international economic svsfem
and glot h'sa
2
.
increasing inequities. The lack of credible and
2h<
effective global public health leadership has become increasingly evident.
nee, i
rye
I
s
2
.
alth-Assembly was
-“r? nrindmes of the Alma Awe ■declaration, including the right < f pco^ ? tv hcaWn and
rc. :
:
erce-
..
r
p-eg
"-x.-:
mN
•_c - c
.is
NAC-s research msritutions and ade unions} have
,-W
' • 7 ■:<?>•? \sU-'h .hNvement :n order to promote more eqt.Nable and
‘ ho UN sccecuivent, within a more just international economic arc politica1
“
^L_
W orccr
:>..pLor'' a
ecuuy-criented approach to global health., the Peoples Heerh
■•/,.: .-emer- has endorsee The annual publication of a "Global Health Equity Watch" which would
present •::ycc. people's perspec' ive on developments in the health sector globally.
>■ !~’r3V/'-<'• creduces cr zmiti health report, and other UN agencies such as UNICEF and
UNiAIDS pred-aae periodic end regular world reports; and although the Wor ld Bank produces its
World. UeveioprrenT Report once every two years, tnese inadequately reflect the views and
5p
■; ■■<
Peop’es i'-’ccit'i Movement, progressive health non-covernment organisations
arc
nter .rational public health academics.
T’ U c?c:.<ce’!s cut c proposal to fill this current gap in the analysis and promotion o
gbbu: heabn.
Niche of vhe GlcixG Health Eq u fry Watch
Th: G-.c-bo Hcaith Equity Watch would represent an aiternative world health report, wh'di
would cnaiyse and report on developments in ine health sector globally annually from:
An >-.q'j-y. end reu:stribu'iion perspective - this stands in contrast to the poverty reduction
aj!?r-\'’.ch v/h«ch emohasises the poor ana the marginalised, without relating them tc the rich and
power f Ji.
/' pub:< sector / counter-neoliberal perspective - this stands m contras4’ to the dominant
dev? c:
1 discourse amongs i’tnc mNvi- iWs.ra' cevelop.T.ert agencies ard OECU countries.
A ^'-.C Aprr'oach p^^rspertive - this stares in contrast to the vertical, disease-based approach tc
s/ste;cs devclopmer;;', and amphc;s:ses vh^ suc;ai and public heath approach to hea'rh
syste ms ae ve io p me nt.
A Poi-Ticu- Economy pc-speetve - ”nis stands in contrasr ”o the Tendency for global heaiTh
problems to be described in isolation of the global political economy - one of the purposes of
this drcijrr??.nt wjil be to highlight the political economy as a central public health issue.
Civil socleW perspective - this stands in contrast to the publication of annual health reports by
UN acencies. It also allows the per f or r. .a rue of the official global health and d: -e-op me nt
mstrutions (suer, gs tre UN agencies - WHO, UNICEF and UNAIUS; the global PPIs; ana the
Wcrid Bank) to become the sub,iect of an annuo’ health report.
GHEW Strategy
The idea is not to base GHEW on new research and new analysis - there are many NGOs.
progressive groups and academics who have done the research and analysis - the Global Health
Equity Watch will provide a platform for the compilation of this work under a broad civil society
/ PHM banner.
The idea is that the chapters would be written by an eclectic group of different individuals and
NGOs.
The document would be primarily an analytic document that is targeting global and national
policy makers and the World Health Organisation, anc which could be used to support the
advocacy activities of progressive health and development groups around the world It should
avoid rhetorical argument. and base its arguments on a mix of explicit normative principles.
sound argument and evidence.
A platform that is shared by a number of networks and NGOs would also result in a process of
mutually beneficial learning, synthesis and analytic integration., as well as joint advocacy. In
particular, GH.EW would be an opportunity to develop strategic alliances between PHM and
pregressive health NGOs, with those organisations and institutions whose expertise are in the
fields of international finance, macro-economic policy, trade international relations, global
governance and agriculture.
It would therefore try and be inclusive of progressive networks and NGOs (the more NGOs and
networks that we can get to contribute to. and be associated with GHEW, the more weight t
will curry); and of o!i geographic regions (if this is to an 'alternative world health report, then
we would want contributions and input from al! regions of the world).
G H E W Man agem e nt
M.sdcct and GEGA to oct cs cooi donating secretariat for GHEW, in close consultation with PMM
Research and Macro-economic Circle members. Their responsibilities will be to:
° finalise lay-out and structure of the document
define detailed chapter outlines
® identify and commission chapter authors / contributors
= seT up on editorial committee
« fundraise
® manage the finalisation and publication of rhe report
und Biic.ce;
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12 months
Including printing, computer, $6,000
telephone, fax and other office
. COSTS
Honoraria A_-cuT-iors
cor*?:h:.* crs
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Pri.n-i'.ng and Dubhca'.ior.
Launch and PR
...I2TZL_
and
$500 x 25
$12,500
?
?
?
_____________________ !
Way Forward (n j;:r 6 weeks)
*
*
«
c
«
Agree or
:.' collaboration and relationships: between AAedact, GE6A and PHAA.
CircuxTe proposed structure of report for comment.
Invite suggestions about ootential authors
c;nahse budget
Deve.op a funding proposal
Beoin to identify donors / funders who might wont to support This, and seek expressions of
Interest rram Them
Timeframes
. .. - ------,„ -_____ — - — — - — ---- ———~-r- - — . -- - — ....... ........... ............... ........ ... .......... ... — - --- ... -----Jun
Jul : Aug • Sep
Oct . Nov
Dec
Jan ■ Feb
Mor Apr
1
Initiate fundraising
c c rivtie s
■ Finai'se structure of
&
' reprrt
J ri'c: ■"•?? ?ltd
- ,
, o.';3 ;<■ ".?.r seen
chapter
V’
Confirm agree me r»T
Jun
May
1
, from aur'nors /
contributors
Hrs? draft of
ch apt err.
Secona draft of
chapter
r na.; draft
1
—----- |
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-iMeaith
Water: will consist of a compilation of chapters cn various global health
■s.i.? Ea;': chapter should be able to stand on its own, but together, represent a
ccmorenen^ve overview of trie key global health issues from the perspectives described earlier,
Each c.'Cp'.’er .vighi. If appreprieve, culminate in a set of recommendations and ■’demands" from
the Pr—
wnich would provide some basis for on-going monitoring.
Where appropriate, and as much as possible, there would be case studies and testimonies from
tne ground (collected through the PHM Network).
Approximate size of the report: 100,000 words
A cetaiied structure end lay-out of each chapter of the report will be developed. An initial set
of proposed chapter headings for discussson ore laid out below:
6
orriicfure and Lay-out of SHEW
Fc Oiscussioft
t“TTTO‘< •
-f-. - r?->-■r.a-;-:o-:Q: Pchtxcl Economy of Health
r 1: Overview and introduction
Irrrocuce rhe socio-economic determinants of health
of Tie distribution of wealth / health / health care resources', and the growing
.r.ec-uir es Describe growth in poverty levels (counter WB assertion that poverty declining and
"’■at povertv reduction and efforts at global development are generally moving in the right
a: rset ion)
Sketch how economic end health resources are generated, controlled and distributed.
Introduce:
'' Unfairness of current trading systems
Deciining levels of ODA
«» Unfairness of debt and inadequate debt relief
<’ Dominance, of political economy by OECD countries / US / EU
3 Capture of power and influence by corporate sector
• Declining levels of democratic accountability at a general global level
. .rgee that a new international political economy is necessary for improvements in health, and
for reductions in health inequities. This is a priority public issues for health professionals
bec:~h c.-Hcrs and alobd health ir.stitutbns such as the WHO to pr'oritUe.
The following chapters in Section A wi'l argue these points in greater detail
A2. Development and Social Sector Policy end .ideology
Summarise the overall picture / trends re: development policy and economic growth strategies;
the debate on ideological models; and the current pre-eminence of neo-liberal ideologies and
approaches. This would include c cr.tique and summary of the policy convergence among WB,
IA\r and bilaterals.
?rov;ae evidence and argumenrs of how this is inappropriate for developing countries, and how
Wash inerror. Consensus policies have generally been unsuccessful in LDCs.
Another increasingly dominant policy / approach within development and social service deiivc. /
is the new public management - the promotion of market-based, private solutions to r.rblic
sector manegemenr. Describe ex"en.t to which this is being promoted end cridgue.
A3. World Eonk and IP’s
»
®
®
Crifioue of World Development Report
Critique, of WB governance
Recommendacions
•
- ‘c x ?. ..
■< u.;?
'*
.. r •<■3’- bcmg ’effected within them?
Describe row ;rcde is currently unfair, and trade policies and structures are port of the
::c.
' "c; ’het many peer countries ore in. Describe to whom and to where the benefits of
■ race accrue. Descrioe the double-standards being applied re: subsidies and tariffs.
Describe Free . rede Agreements, and their impact (or likely impact) or. health, as well as SA i S
and its impact on health.
Desc ':j'S tr.e campaign to reform trade and to mitigate the harmful effects of &A 15.
?\6: »rans-national corporations and conglomerations
De sc: b< ths concentration of economic power and profits amongst fewer and fewer TN.Cs.
Describe the iccx of adequate systems for the national and global regulation of TNCs ana the
■xa?<ct;on o* prof its. Describe their influence on national end global governance.
.47. global economic governance
Topics:
governance of trade at a global levs! To. -’he 'World Trade Organisation) - fund a me nt a lb/
unfair, non-transparent end built on non-humanitarian objectives.
» governance of the WB and its secrecy -• links to TN£s.
decline n influence of UNCTAD, UNDP
5 iimwea progress towards appropriate and effective civil society engagement.
A6. Liberalisation of basic services - wafer and electricity
•
«
Explain importance of basic utilities to health
Describe trends in terms of coverage, access and utilisation (including inequities in
consumption)
Describe trend and ef fects of liberalisation in these sectors
/.?. Agriculture and food securrry
Describe state cf hunger and malnutrition, and efforts to address this problem
Critique of agri-business, SMOs, TRIPS
Ju- of US ! Conor / -AO approach to household food security
-ramose a‘:te-’f.a«ive strategies
v.-.t 7 or: fr
i hue Th sector perspective - what is to be done?
J.t:
A10. Mil-Mi.Ax. a?:d heal.M
Effects of military expenditure / opportunity costs
Ef fects of war, violence and conflict
Highlight ... Afghanisatan, Iraq, Congo, Columbia and Palestine / Israel
Descr’be nuclear weapons threats
0
0
♦
<•>
Section B: The health sector and health programmes
•y.. o/erv’evv chapter on health Inequities trends
GJoumiy, inter-regionai and in-country
Use Hans Rosling data
B2. The liberalisation and privatisation -:-f health
0
•
Describe the trend
Discuss what is wrong with the ± rate
33. Global heath governance
•
0
World Health Organisation
UNAIDS
UNICEF
84. GPPIs in health
»
®
Focus on GF ATM?
Discuss the global verticolisa+ion of health interventions'
35. Tu. PHC
•
:■
:xarr
Illustrate how the PHC Approach is misunderstood ana misapplied
Describe c; rec-ily is about
Ljik PAC Approach to organisational and health systems issues
36. /Access to medic Lies ana the pharmaceutical industry
:
and the implementation of ihe Doha agreement
10
:e
xcaceuScd ir.cv<t-y vTt.hin WHO
t
?7. Hedth personnel
I^equ teb'e distribution, - brain drain etc.
o /-/hat is being done about this
*r “
Po
e of ri :h countres. to adopt ethical and fair positions
/ . {t
■- / . .
B3. Breastfeeding and the baby food industry | ><..-•••
'
B9. Hedfh ?
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A *•' ?
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P^cc-^ess or. the 10:90 gap
2r ’G’j t;cs lithic vhe global health research communny
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Secretariat
PHM Secretariat <phmsec@touchtelindia.net >
David McCoy <david.mccoy@lshtm.ac.uk>
D?Ud Sanders <martin@uwc.ac.za>; Alexandra Sambas <lexi@hst.org za>
Friday, June 06. 2003 6:07 PM
GHEVv Concept Review
Froru:
To:
Cc:
Sent:
Subject:
Dear Dave.
Greetings from People’s Health Movement Secretariat (Global) at CHC; bangalore!
:: sr got time to review your GHEW concept paper. I think its very well done and the main ob'ecuves;
potendai. framework and linkages are well outlined. ■ have the following comments at this stage:
a Mention PHM and Charter as exception to the whimper on page one.
b. There is corruption and mismanagement in developed countries as well and as the recent US
revelations of MNCs and government's are being exposed, our comment on corruption should be
addressed to both North and South ooun-riaa. The North is not corrupt and the South is corrupt is an
old stereotype which does not hold good any longer (reference page 2).
c. Before the endorsement of the watch - mention the charter for health again and take a small quotation
relevant to GHEW (see below). Then talk about endorsement by PHM (page 3).
Health is primarily determined by-he po^ic-J. economic, social and physical environment
«
A iarge proportion of the world’s population still Isck access to food, education. safo drinking water
sanitation, shelter, land and its resources, employment and health care services. Discrimination continues io
c-e za;'. it afteczs born the occurrence of disease ano access to neaith care.
Build and strengthen People’s organization to create a basis for analysis and action.
>ridge : ild n , / c
I tion develo i g
ft ■
or the future
m
f tl e Sloba -lea
(NGO Forum for Health;, Global Health Chart (Centre for International Health, Karolinska) as other
initiatives which we car. iink with. I was invowed with both.
e. i have some ideas on the budget - so in any circulation for comment io a larger group at this stage -this can be left out for the time being.
f Regarding structure and lay out., a few thoughts
What all would you include in G-PP1? Thelma says there are 80 of them now!-
'Macro-economic Commission on Health Report and our cnricue must be
mentioned separately. ‘
in.
Breast Feeding and Baby • -ood Industry should be replaced oy Food and Nuiriuon
Security, 'he reoemiy formed A.P.AN ''Aifi^noe for People's Action in Nutrition’, nas
ciT.i.iaierj a acct: merit or. rwi rxenange vmcn nas rnf-: crcaoer • inaersnjncnng
6., ■ U3
■;v"e snoum mention.box items of studies ana case studies which focus on
prelvems analysis and action / campaigns (this will tap the cHiv' potential)
g. Link ~ GHE’/V to PHA - li, as an important backgrounder for the event and for future action
a. Send i: to ai! concerned - a larger circle for ideas suggestions - minus the budget.
b. Once you have David mine, GtGA, Medact views on budget, we can send another supplementary
com m t: n ication a bout it
Hope you received the PHlVi Geneva report. GHEW is mentioned in section 6.
Best wishes.
rxavi Narayan
Cocrdinacor. People's Health Movement Sscre«:anat(globai)
C HO-Ben 73 fore
£367 ‘’Srinivasa Nilaya”
Jakkasandra Is-Mam, i Block Koramvngala
E-anga lore- 56C034
Jo;n the ’’Heaith for aii, NO'vV" campaign in me 25th anniversary year of the Alma Ata
■ eciarat-on /isit way.TheivliiiionSignatureCarnpaigrrorg
j
r r0 j\ i.
7g:
Sent:
Si
Da- :c :;'cOoy <Da\;d..'vlcDoy@iShtm.ac.uk>
< on r- ■ sec@tou chteI i nd i a.. n et-; < i ma rti n @ uwc. ac. za>
■•’•j.osday. June 03, 2003 10:02 PM
^Jocai neaitn equity watch
Dear Ravi and David,
T
InU<£f'U f°* SOme feedback 011 the Giy -lV Soncepc paper. I would fifce to get moving on
Page 1 of
PHM
::jV^zszr-z:■ :.,- - • •. •
From:
To:
Cc:
Sent:
Subject
Lynette .Via n- n < I mard r.@ uwc. ac. za>
■<David.MoCoy@ishtm. ac uk>: <phmsec@iouchteiindia.net>
<!ex:@hst.org.za>: ; mikerowson@medact.org>; <abaysema@pn3.vsnl.net.in>
Friday, June OS, 2003 4:59 PV
Re: GHBW
Dear Davc5
«
Thanks for this. Il is a very good first
and quite comprehensive.
Since 1 ;mi in a rush this will be a brief first comment. I can give more later when I have thought about
it more.
i 1) The background is generally fine but needs some tweaking. For example. I do not think we can say
that there has beer, "no devGopmer.f. Vfo need for example io be able to explain the success of the
".Asian tigers".
2) Suggesiwd structure:
Most of the necessary chapters r.re there, however I would rearrange them somewhat. For example.
following the overview chapter. I would start with vital is currently in chapter A6, i.e. TNCs and their
growth over the past 3 or 4 decades, situating ibis wiuiin trends in the global economy.
1 would ihen order the chapters as you have and include in A2 an account of the experience of
Structural Adjustment p
■ '
. ^v
e
*
examples of countries whose social policies have beer
pro-poor and where real advances have occurred.
.After the chapter on Globa’ Economic Governance I flunk we need a chapter on "Politics and power
globally". We obviously need to rekne die changes in the global economy to those in. global politics.
The sectoral chapters A3-AW are fine but we need also to fit in education and possibly housing.
h: section B I would siiift up the chapter on “The PHC approach" :o after El. 1 would also expand ufo
to give an overview of inteoiational health policy’s evohnic-n from the 1960s. \ve n-;ed -hen io have
quite 2 .w,. : crialonh
... j (including 1 ■ lease Jtudies) and I would say tha
fohaj
on ’’’hcTAh personnel-' needs io be linked io ibis or come soon alter d..
Obvious?, there is a lol more detail Lo iv added in each chapter. Xoiabiy howe'.cr we need ic> say
someiinng about educator and draining vfheruh personnel in that chapter and of the hx'us within
health research in that .biaptcr.
I hope mis h,.E>'. I will cc?v;r uc :c ihink about the structure.
In terms of me hndge? : rm mn:
research ?;V\ r'. -■»f erheads.
Bes.: regards.
David Sanders
you should include more for oonrrnlssioned chapters and .also for
From.
To:.
Co:
-Sent:
Subject:
Davis McCoy <David. McCoy@lshtm.ac.uk
*
David McCoy <David.McCoy@lshtm.ac.uk>; <phmsec@touchteiindia.net >,
<! mart! n@uwc.ac.za>
<!exi@hst.org.za>: <mikerowson@medact.org>, <abaysema@pn3.vsnl.rjet.in >
Sunday, June 08, 2003 1:34 AM
Re: Gr-.S'vV
Dear all,
I have received feedback now from Ravi. David and Mike. I will re-work this info a second draft early
next week and send back.
In terms of funding:
Mike has agreed to approach the Dag Hammarskjold Foundation.
I will pass tids by Christina Zarowsky al IDRC and Tim Evans at Rockefeller.
I would Eke to raise small amounts of money from some of the larger development NGOs such as
World Dv vbonww Movement. Christian Aid and Oxfam.
Any other suggestions?
ft H
Many thanks again, for all the feedback
dave
• ■ Tyne^e Martin" lmartin@uwc.ac.za 06/06/03 12:28 F?G
Dear Dave.
Thanks for this. li is a very good first stab and quite comprehensive.
Since I am in a rush this will be a brief first comment. I can give more later when I have thought about
it more.
1) The background is generally fine but needs some tweaking. For example. I do not think we can say
that there lias been "no development". We need for example to be able to explain the success of the
'.Asian tigers'’.
2) Suggested siruciure:
Most of the necessary chapters are then.:, however i would rearrange (hem somewhat. For example.
following the ovei \ M. chapter, I would start with what is currently in chapter A6. i.e. TNCs and their
growth over rhe past 3 or 4 decades, situating this within trends in the global economy.
I would iheti ord-r die chapters as you have and include in A2 an account of the experience ol
Si-itdunb Adjus'ment programmes and give examples oi countries whose social policies Hr.? b-en
g
•the chap r <
>balEc lomii I emanc
flunk we need a chaptei >n "I titles-and p
-A\. obviously need 10 relate die changes in ine global economy to those in globin politics.
he sccioic- chapters \S-Ai J are fine but wc need also to fit in education and possibly housing.
In section B I would shiK up the chapter on ’’The PIIC approach” to after Bl. I would also expand this
io give an overview- of international ncallh policy's evolution (tom the 1960s. We need then to have
quite a lol of max-rial on health systems (including local case studies) and I would say that the chapter
on "health personnel” needs to be linked io this or come soon after it.
Obvioush T.-w is a lot more detail to be added in each chapter. Notably however wo need to say
something about education and training of health personnel in that chapter and of the focus within
healih research in that chapter.
I hope this helps. I will continue to think about the structure.
in terms ot the budge? I am sure that you should include more for commissioned chapters and also for
••■•jscawh. navel and overheads.
B ?>-. regards,
David Sanders
Prof David Sanders/Lynette Martin
School of Public Health
University of the Western Cape
Private Bag Xi 7
Bellville. 7535
Cape. South Africa
Tel: 27-21-959 2132'2402
Fax: 27-21-959 2872
Cell: 082 202 3316
a ”Dr;\ id McCoy" •David.McCoy@1shtm.ac.uk- to-29/03 04:59PM '
Dear Ravi and David.
Crreeiings and I hope you boil; had sale trips back home.
lease find
■ ei .
1
*
dob
hei 1th (equity
atchidea we
i
ingerieva
I’ve written rhe document so as to help ensure that we arc all operating from the siric u-idersu.iv 'mg
it can also be used as a template fo; sharing with oilier organisations and as a funding proposal.
. hav . ...
din fl
:um it whatlcc n ide .. ■. .
.., for the next six . o, and.
would be grateful for your quick feedback (you can .skip the first two pages of introductory comments)
Note:
i. I he document is headlined by Pi Di. GEGA and Heath Counts (which is Medacl
Wk nios)
6,/Q 03
Secretariat
F-om:
To:
Sent:
Subjsct:
Alexandra Bambas <iexi@hstorg.za>
:xav< Narayan <secretariat@phmovement.org>: Abhay Shukla <abaysema@pn3.vsnl.nerin>
Tuesday, June 10, 2003 2:20 PM
GEGA'tquinet project on parliamentary alliances in Southern Africa
Dear Abaay.
I a; sure you know about GEGA’s project, in coordination with Equinet, to put
together a project to work with parliamentarians to support pro-equity
Agi-hdon ir. countlies in Southern Africa. working both at the national
level and at the regional level through SADC. the regional governance body.
^ A; are looking for a case study of a successful struggle by parliamentarians
to influence national policies that affect health equity, with a view to
Inspiring the participants as to the possibilities. If you have any ideas of
countries from the Asian region that might provide a good case study, and
•..I .; v. :■ might contact. it vrruld he
J/-. hdpful in our planning.
rbou’ halfway through my first y w ■ al your draft of the Advocacy
r—h peto bedbnea
of this week, including Gauge references.
In any case will send by Sunday.
I
fhanks. and best to you.
Lexi
=;•
<’
'? '-3
-S
J?5?
Alexandra Bambas, PhD, MPH
b oordinator of the Global Equity Gauge Alliance
Health Systems Trust
PO Box 808
Durban. KwaZulu-Natal
South Africa 4000
eniail: lexi@gega.org.za
(-\/i
PHM Secrete Hi:
From:
-ac: )ayscema@vsnl.ccm >
To:
David McCoy <David. McCoy@ishtm.ac.uk>
C~:
?eri@hst.org.za :phmsec@touchtelindia.net <lexi@hst org.zaphmsec@touchtelindia.net>
Sent:
Wednesday, June 11, 2003 10:03 AM
Subject: . Re: GHEW
Dear Dave.
Sony for the delayed response. overall the structure looks good, though it has definitely come a long
way from our initial idea of a 'Global Gauge’!
Seme general comments and suggestions:
• Section A is well conceptualised o verall but Section B (Health sector) seems to- trail off and has
cc-ilr-in. gaps
2. Li Section A9. there should be mention of Public distribution systems for food security (c.g. various
terms of rationing and food subsidies) and how these have been weakened under neo-liberai regimes
3. There is mention of‘World Bank in Section A (general Critique of WB governance)-but no mention
•?. section 13. We should critique 1’ic specific 'Health sector reform’ agenda being promoted by WB
round the v-.orid. Tliis should be added in section B3.
i flu j shot deal M
rm >f pri tisa i( n o ' h s* 1th ervices incl. c< tri
i < c isn
user fees arid subconireichng of services to NGOs. and wc should critique targeting of services as
opposed to strong universal care systems
5. A section on Private medical care may be relevant, since this is the major, often unregulated fc-r• of
h care ini m
jpingcoi
>; also t
.
.
... . insure
6. .WiOtlivr area of concern is the ’Population control agenda' wliich remains a strong .focus for much
hcul>h uid irc-m id.: Xorih - where does this figure?
7. Would I. be good to have a section on ’Women's access to health care and Reproductive rights'1.'
Vv'GNRk could do thfe,8. A section on fronds in public health budgets and health care j.xpendilure’ may be rlevant since
declini jpubl lealth 1
i
ise in outkpenditure are a majo
>ncen
conn tries
. ’
it be relevan
:RciioTi B4 couid include (1AVI.
■ ■
t Decline in Immunisati
age’
Ihc Rixm should conclude on a positive .4oi? with, soinething like 'Ch'assroois a.- an .
, • . ■ vision ■ Public H 1th' whic talks ab<>ut various alte •• •
...
can provide many examples) and lays om the vision cnWegyf is ;i .j People’s Hcshb
1
. . \J.
'i-. !<:;■
;•• .NmsNra. India
fr.onc: 020-546 5: .?4
rune 411052
■.••■.-•nail: abhayseema@vwl.com '
Join the ’’HoaW Ibr all. NOW" campaign r;> the 25th aimiv,;!.\s<uy year of :hc Alma Ata
occkiraboj vKi; vv^vw.TheK/fillionSignatureCainpaign.org
6 ‘12 03
.ASeers
•car.
. o:
Send
Subject:
xk-l Sacrecadat <phmsec@touchtelindia.net>
u2.-c; .^.oCoy <david.mccoy@lshtm:ac.uk>; mikerowson <mikerowson@medact org>:
<aoaysema@pn3.vsrl net.in>: <ant@fiealthlink.org.za>: David Sanders <lmartin@uwc.ac.za>;
A *exa n ~ E?a m bas < Iexi@ h st. c rg. za.>
Friday, June 20, 2003 5:32 PM
OcnsukaWe process for GHEW
Dear Dave Mike, Ahhay. Antoinette. David, Lexi.
dresL.-.c.s r.c .. -eopie’s Health Maven;ent Secretariat (Globa!) atCHC, Bangalore!
’ hc'/e 'ead W the cur
*ent
mail end exchange of ideas on GHEW. I am in the middle of a detailed 3 year
project prcpcsa:and log frame exercise, so my reply will be brief.
i endorse Aohay and Antoinette’s idea for a GHEW committee.
•t's
ckay to have MEDACT as secretariat and logistical coordinator including receipt of
fu.-.ds ar,ci its disbursal.
ore foci
report and or a larger canvas, 1
"
wiue as you, can get enc mis GHEW publication wiii be a sort of back up .evidence for it.
/
thought ou asrgemonter'l ne Charter
We cou'd '
a section A. which is focused ;x.d exhaustive on certain chapters. And another section B
which has some e/ds/cs on ai!. the remaining issues (cr as much as we can collect in the time constraint).
Year tc year we can shift these chapters into section A and B.
An editorial board which includes expert on science / lay communication would be help? •. .c
prevent !: hern becoming too heavy reading, it must be 'Reader .“rienciy
David as PHM member is okay ! have enough 'osponsibiiity as coordinator cd w-W
Secretariat to gr/e c dey w-ie hr as process, evolves. So someone else ca • -epressi'it PHM
I shall c? on the e-group and will send ideas from t;me to :;me.
Bes
Narayan
Ccc dvrcv.cr Peo.W’s Health Movent
Secretariat(global)
•r-u’c-.’ S:‘inrvasa .xiava’
•jchskasanc-; a 1st *,.■•. 8in. ? oiock Koramangala
Ban o a; o re - 5*3 0 03
*he “Health for ar. 1 bDW" campaign -n the 25th anniversary year of the Alma Ata
dec’ ?; ratio v visit WvW/. TheM i' Iion Signatu reCam pa ig n. orq
pt
u
WWSSfW■ ■ sat
-■
To:
Cc:
Son;;
Subject:
A
s;i:c;r;ec'3 \W.; <ant@heaithlink.org.za >
■.Z:Ke fxov.sc:i <mikerowson@medact.org>: <!exi@hst.org.za>; AbhaySeema
<aoaysema@pn3 v$n!.nei.in>
David McCoy <david.rr,ccoy@lshtm.ac.uk>; LYNETTE MARTIN <LMARTIN@uwc.a
< p h .r.sec@to uchtelindia. n et>
Thursday, June 19, 2003 12:40 AM
Re: Consultative process for GHEW
Ls grwa
this initiative is going forward and that such a dynamic
group of organisations is coming together to work on it. I third-; that
e.idca! ihai .. j pay careful attention to inter-organisational
process and responsibilities from the outset to ensure that we
■
is the
cuuomcs or the work rather creating distractions. To do so is
n^earb ohal-enging given the geograpfiic spread and complexity of
iadvidiwl orxiwusatioris.
,7
y a principle I think we need to be fostering genuine shared
/i
LW and I wduld s
’w//
*/
• - -
g sti<o •: Ste
\ work which ha
lit . .• for the
>fthe
/
it
J................. --■•••.
■ Mfedac .• ft................ he secret
-he work is managed by a c?w that ’• represent alive.
e is agree
0
_
-
yi&
t witjithi
-p.
I -^.y
organij dons should1 be ••.
> loinina two ps tsap so
' uU
'
C:n Siarl
w.
. vTlUjlll'diC
• > !i Juv 2
T .\bhav S
roi
z1
~
A like
.)•?<' io kiicv; tint Medaci weak; be able io .facilitate initial
raising and fonnvilation of the concept for the <Ti n \V. and is
dr this. Howas far as coordinating die actual
>alioa and publication ufibe report ;s conceited,
a mutually agreed on, collective process is
■on''
^e/ C~W
V r(T
j'b) '■-■
Coun-s (e.iedaevin J<•.>:»<• ph.w ib
1
■
■
' be both a sour<
'■■■■.■■■
f PHM■ would
.i■.J.ji;■„uiip >rr Oj. • ?> .• iw. w:, .■ P\ ;jI
* venture i rind, i
be prefe
. eat naun
amsark-ns nenvorks involved /Wiv rA luD. i • walth Vouuts) io
vq pers xis each for a 'GUI’ -V committee’ which wov’d b
r v-muit aboi.ll the.landing piopawks.
:md progress of work regarding th
<y
Page 1 of 3
SscretaJat
From:
Ta:
Cc:
Sent
3
' JJ
Da\:c; :/oOoy < David.McCoy@lshtrn.ac.uk>
<art@nst.ofg.za>, <iexi@hst.org.za>; <mikerowson@medact.org>;
<aba vsema@pn3.vsn!. net. in>
...ch~?=c@;:oi!chtelindia.net-'; <LMARTIN@uwo ac.za>
‘■•hursaay, June 19, 2003 3.31 PM
GHeW
Mike for raising the issue of institutional relationships and coordination.
‘vh; ■
‘ v'ou’d 'ike to add a couple of thoughts from my perspective (which includes sitting with a
foot in Medact and a foot in GEGA) - some background.
^jThe need for one organisation to coordinate fundraising is primarily logistical - to avoid t
jlbility of different organisations approaching the same funder with the same proposal.
In cerms of other things to coordinate under one roof: a) if we are going to commission
--ork from other organ Isations and individuals it would be good to ensure some
stands; disation of contracts; b) financial management for the purpose of donor reporting.
Presently, in addition to Medact being prepared to put some money into supporting my
time to do this work, GEGA has also done likewise. But the firm intent! >n i
>EGA PHf
*
I
and medact to be producing the report, jointly and in concert with a range of other
contributing and endorsing MGOs.
In terms ?f
itic
tech licaland intellectual work for the final
publication of the report:, >' would envisage that if Medact is to act as a the fulcrum for the
logistical :o 'di
ofGHEW itwould
>rk through and with an editorial committee that
is inclusive of GEGA, PHM (and Wernos?)
w~.-tech lical / intellectual persp sctr
the ke
■ is to come to some agreement
and
consensus about the scope, purpose, structure, size and style of the document as this may
influence the kind of organisational approach to publishing GHEW.
Mike is concerned that the suggested format is too bulky and bitty, and would prefer a
•note slimmed ioi
andtignter irsi
or maybe‘t-o chapters, covering a nar
tw
end building fch<a rs-part around a k-sy thj©rn^«
j
I on the other hand would prefer te see GHEW as a broader amalgam of different chapters
\
g the
je oi
stand-aione chapters.
ternational health issues - and where some I the
Tne sections are <te wctured tc allow the report to < ■ incorporate political and economic
e
i.e, to nake he clear point that the politics of global g vernan
gio!
economic order are public health issues and centra; to globai health inequities); r>) raise ine
r
6/20/0?
Page 2 or 3
' T c' .W
sec;o;3i Wuences un health (e.g. ersvu
militarism; rroucTg;
j&tion: ■. ?atei and electricity etc ); and c) raise the key issues around the global health
;jor and health policy.
his is undoubtedly
. . , broad 'ange of issues and topi<^ to raise In a single document,
and some • k me chapters would inevitably be relatively superficial.
However. par;
the rationale for this is to make the point that the problems of
TtarnctTnai ?;ea!± and global health inequities need to be tackled at al! three levels politics aneconomics: non-health sector impacts on health; and hearth policy and
programmes and that WHO and health associations and health professionals all over the
wend reed to engage much more with this comprehensive agenda rather than on disease
based, techncc ;
end health service solutions.
The }e:./ ;..TmisT fo; deliberate!/ broad scope is so that GHEW can support coalition
buiid'ng arc linkages between progressive health NGOs with those NGOs that dee! more
»pscifica y with the pollu’cal economy of deveioment (eg. the bretton woods ins iitutoins)
gP,-, yCj-p prqef sectors .‘arms trade: environment etc). I think this is one of the ends to
which GHEW is a means.
The
. e . ' o cpj .. ip wit a report . . . c i isec
d fe ... e
0-0 roues for different purpose-. ir becomes akin to a yeariy reference document
... .an :e . •.. .
help bi th ?■■•. - .• . . ente . . campaign on a ...nge • issi
.nd n -.
repoT mat»s too centred on one. theme (I have the annual south african heaith review as
a template in
mind}
The found otionate is to see this -?.s an annual report where several of the same chapter
ladings
•, . ted < sry y.
ce...
nt to
tor /hat is 1 .
.. g a
-eport which is centred around a core theme th-/ changes each year wouH. 'ose some or
he potential f annual monito
...
■
ange of public
ssi ..
i '. ....
for the report to
ed
it j titutio ial w ate . ng ar d a< k :a :y.
.... ..
.
side of ..
0
. . .... ti
'
iaunch of the report.
. 3ach is that the report could become‘bitty a
.
jger .. and that t e .. .
. ce ...... k..
. ...
•
The former approach wou!d require a mijch more slimmed down set of wdtem and liters
or
■
st th»la let . >uld requir
e write .. .... riz /or! nd coordii atior .
I ■....
. ca ... . . . -. ciri
.;... a . . ....... ............ ■. . II num . ................. GH5W coes not fee5 disjointed, but 1 think we reed to keep the r.rigjnai conceprhn of
or a -Hc/.fo/.'i. /or muu.oiiidyscs d.rd perspecLive^-
Nc •.
h . :
t there !s an infc tall :c.. iti ad gn
(
t.
’
>ande
exi, Anl
>hay ai <
y Hi vh< I - ve been discussing he co
■W
■ ..■ \ . if they route!
be part of this .
. .
/
■I
Page 3 of
i
J
6/20/0
,.i
■
-■
... . .
'
in a few otl si headsai d perspectives t< help us think
■■.?■'■ ■, scope ' u pose struct
*
re, she and style of the document which is a very
.jiTT wrvi.sg'r de.Aw
v:ak.-j sw.
■Ar A AC A
AT A'.' AND ANTS RESPONSES
□w ’ w .■ w.wgri Av. AN?' vT.g:
;cc 0ST.V - r'sdaci:
■S T V i ■■■ /.:- :=:;
: avi -ro'-i PHM)
cGmrnifes ■■ (Two from iexi. ant, abhsy, pauia)
myself + fWemos
(n?ik>e) + (davw and
GrEw Reference groups - a group of people we can bounce ideas off to get additional
perspectives and views
Thanks ' >r tf is and sc
y for the is, j e-mail
'lisve
6/20/02
From:
To:
Cc:
Sent:
Subject.
Abh’ay Seema <abhayseerna@vsnI. comMike Rowson <mikerowson@medact.org>: <lexi@hstorg.za>; <ant@hst.org.za>
David McCoy -david mccoy@lshtm.ac.uk>; LYNETTE MARTIN <LMART?N@uwc.ac.za>;
■- p h m sec@to u ch tel i n d ia. r ■ et>
"hursday, June 19, 2003 9:22 AM
Consultative process for GHEW
Dear Mike.
:s good to know that Medact would be able to facilitate initial fund-raising and formulation of the concept fcr
the GHEW, and is supporting Dave for this. However, as far as coordinating the actual preparation,
■•a'iwdw; and publication of the report is concerned, it is important that a mutually agreed on, collective
process is adopted. it is not necessary io mention that besides the definite contributor) of Health Counts
uZedact 5 VVemos) in developing the idea, rhe initial concept of a GHEW has originated in GEGA, and that
“r~ international network of PHM would be both a source of ideas and ^formation, and a key forum for
k Tssemin.ation o’: the report. You have already mentioned the importance of ’ownership' by all the
cckabomhng organisations.
•keeping the collaborative nature of this entire venture in mind, it would be pieferable for each of the
organisations / networks involved (GEGA / PHM / Healtr. Counts) to nominate say two persons each for a
GHEW committee' which would be in regular correspondence over e-mail about the funding proposals,
structvre, contributors, and progress of work regarding tne report. This group may also form the editorial
ardforthe
t. With such a cc
Itati
g
I
j
s.pi oces s, ps
onally feel it would be fin
fo
Meciact to act as a ’Secretariat’ for GHEvV, and for Dave to work as a key facilitator for the entire process.
would be a good idea for people from all me networks involved to make suggestions about what kind of
collective frameworK would oe cesi. r.o support tne process. My compliments to in? Medact group for carrying
forward this key initiative.
Regards,
Abhay
^bnay Shukla
5-1 Niigiri Apartments, Kan-onagar. Pune 411.052
Maharashtra, India
P-wne. 020-546 5936
e . r.a;i. abhayseema@vsnl.com
Join tne ’’Health for all, NOW” campaign in the 25th anniversary year of the Aims Ata
declaration visit wvw/.TheMillionS.ignatureCampaign.org
A:-,i
i-wA-.. A •> A-.. V , A -
j
Original Message
■
Mike Rowson
j ~c: 'exi@hst.orq.za ant@hst org.za LYNETTE MARTIN ; phnTsec@touchtelindia.net
;
p’av^HMeCav .
: Slen-VerheUI. I'viaqan-Stoffecs
i -2»cnv. Wacin^sday. Juno »8 2303 IO.30 Pm
* Subject: GHB/7 ’
Deaf r’iends
• • ■■ ■
'
. -■ ■ ■ ■
sing
..
: Dave has oeen working on the proposal here, and although we are having some dc?bate about tne kiwi ;orm
. of the ouoiication, > think, we are getting nearer to sending it out to funders. As you know, wis nas been
I deposed as a joint GEGA/PHPVMedact/?V’/emos publication, but we haven': yet bean wew anou: where
: Me actual nitty-gritty of putting the publication, together wci.jp be carried out
• k it is acceptable to you, would like to propose mat the co-ordination, both of fundraising, and eventual^,
5.Ho , i
*
_ ] c.f
F' PP Secrets; P.:
Page J. of J
PHiV
Ter :
To:
Sent:
teubiecu
-Mika Rowson -r Merowson@medactorg>
-w.wnette Mun <ant@healthiink.org.za>; <lexi@hstorg.za>; Abhay Seems
'2.bayserna@pn3.vsnl. net. in>
David McCoy <david. mccoy@lshtm.ac.uk'-: LYN ETTE MARTIN <LMART!N@uwc.ac.za>;
<phmsec@touchteHndia.net >
Thursday, June 19, 2003 2:4'2 PM
Re: Consultative process for GHEW
•
■
-
'r‘hanx's for your comments and 1 do agree ’hat a committee is essential, to
.. ; is '• a pi iper coll
..’.
. .. ... rther
co?mnems from Others and. then tbink about its composition.
mike
----- Original Message —
i re./.: LMmineile Niuli” "ant@lie^ilthlink.org.zat
to: '..like Rowson” mikerowson@medact.org- : lexi@hst.org. za ; LAbhay Seerria’*
'abaysema @pn3. vsnl. net, in
Cc: 'David McCoy1 • -davidsmccoy@lshim.ac.uk ; ’’I.YNETlk7 MARTIN
*
’
LM.ARTTN@uwc.ac.za ; phmsec@touchtelindia.netSent: A cune^Guy. June 18, 200-3 8:10 R.X-i
Subject: Re: Consultative process for G1TEW
Dear Colleagues,
- hs great ihai ibis initiative is going forward and that such a dynamic
’
)tg
it.
it is mtica that we pa^ ci ul atienti n ro inter■ pi•■■..■• ■ ai......... oi ■ - " - ■ '
i th© ou set ■ ■ • ir ■ tha . •
promow an efructivo woddng rclaiionship that strengthens ihc
- ouicf>m©s ofohe work rather creating distractions. To do so is
clearh halleng ygive]
geographic spr land
lexit )f
the iwdviduai OHymLaikms.
• as z ynodpu; ! mni. v.-e ncwi 'o
rostering genuine snamu
... h
ndrespoi
foi he r
and . ..
y.
i ..
'
^h of tlie organisations.
•- LAe AhhiA. I am iiappy ior Medaci to function as ihn secretariat so
■ ■ long as the wci’k is managed hg’ r otte that is represenM’ive.
if L% / ; is agi /cment wit h the suggersion of such a cue., lien 1 lhi;:C
the organisations should h-.
* ashed io nominate, two reps asap so
that ihe group can start fimcimning.
O \
JxS
PpHr
'
z
( wH G“)H(AbJ
:Ake Ro.\-scn <rrnkerowscn@rnedact.org>
'
ist.c•’u z<z 'cmtjd:• ist erg 4cP- LYNEFTE MARTIN
Tzv
-■.
Gc:
Subject:
MART!N(Suwc ac.za*\
SrCt^LCt’Ci' 3?) in di 3 netR
McCoy <david.mccoy@ishtm.ac.uk>; <abaysema@pn3.vsni.net.in>; Eiien Verheui
•me n • / ? r be;@we m os. n!>; Ma ?■. n Stoffers < m.arj a n. stoffers@we mos. n I>
V7.?dnesdav. June 18 2003 10:39 PiV
GHEW
rust •■.'•mr.te-d to touch base wrth you al! about now GHEW is progressing, and some institutional issues Dave
has been crW-g or. the proposal here, and although we are having some debate about the final form cf the
; ubBcadcr. . ;;■• n.\ vre are getting nearer to sending it out to funders As you know, this has been proposed as
h
it GEGA/PHWMedactZ?Wemos pu blication, but we haven’t yet been clear about where
actu< .
ty-
grt-?/ of putting me publication together would be earned out
if Y is socepisbie to you. ! would 'ike to propose '.hw lhe co-ordination, both of fundraising, and eventually, of
imp A me ma dm; are carried cut at MedacU 0; course this would stiii mean lots of partnership working, and in
panwUar. if we proceed with toe report, a sense of combined ownership being present I don't want it io
seem -ike Medact <s running away with this ^eporJ And in truth, our capacity to do it alone will be limited. We
Ws?e mar most of the document wHi Ye written b^ people outside of Medact, and that we will play a tying
to gather re'e. Both Dave and ’ are eiso conscious of the fact that we need to work closely with Southern
■
. rorks to get the thing written, and to support capacity there.
As we have Dave here at the moment, we ha-w decided to oay him a day a week for the next three months to
-.he Amuraising, end further Arm’..uation of the concept i nope this is OK. But if you nave any
obiec’O? to :e.c:ao: as an organisw:ion wkirg the lead role in future implementation, please !e: me 'mow. We
■3.e
to step
T“!'.’c
Best wishes
Mike
Medact is a UK charity for gbba’ neaitir working on issues related to conflict pc /erty amd the envYc nmerr
Wed r.ct
C01 Hohcway Read
Lcrdcn N19 ADJ
United K;,-.g:io/;
7 -?44 (U) 20 7272 2020
F ~4.o ,Q; 20 726’• 5717
^AW/..megact_org
Registered Charity 1081097
CompmwReg f’c. 2267125
wa'cn 2003 Redacts work on 'raq, including report on likeiy health and environment?.! consequences of
cordic; mailable ?.:
medact.org
Ppiu). (nCfJ
U)
• -• ■
-c:
So--::
Subject
Abr.ay Seoma <abhayseerna@vsnl.corn>
David kicCoy <David. McCoy@lshtm.ac. uk>
or~.zc~- <phmsec@touchteiindi©.net>
Wednesday, June’ 11, 2003 12:10 AM
Re. GHEVV
Dear David.
J. ■./_■- G.-rme JGaywd 7cspoti.se. overall the structure looks good, though ii
dei’D-dy come a tong way from our initial idea of a ’Global Gause'!
3 general comm
gestions:
•. ->cv.< is well co;rje-piua'iiscd overall but Sec,ion B (Health sector}
m trail off and has certain gaps
2. In
1AMi
o ild be me nti mi of Put lie c stri jution systems br
b
ious form
- ■icr-e is mention of Gorki Bank m Section A (general Critique of WB
0bu
iti
sectioi ' Ve si 1 critique the sj ific
11salih ecu i re form age
eir g j
i 3 bj 7B rounc le wc .Th
Would be added in section B.<
In thif
hould
I withfor
privatisati
i
jiid. cost recovery mechanisn
.
**
">.er «J /•: and subcontracting o- services io
« 1 we should critiq
a
strong
?.i \ c! s< < i c;< s c s \ sieins
5. A
i Private medical c
3rel
t. si
2................................................ ............: i.
..
:?isn something on friveze medisa: ivsimmct;?
. jiol
fc
i is 11
|
ion control i
'
. tron
idfron
1
jre does this figured
VAh:ld ii • e
io
?.
c-: 'Women's access ■: < hedf: care asG
RcOnxlucjicv dghA'j WGXiUl •..c/u-u de t?Js.
h. .
ipcnditure’ may
k
t since dec
m c healtl
m oti’-oi’-pockel expenditure are a major concern in mens' countries
ABiik! i. ' •. .vie’ :;?i !•:? -v ■. ' : case siudy on
:.•■.• A
r;': if..i
overagt om here? S
>ould indue
IVI.
10. Tt
iort should co
ide on a
itr ■
ing lil
'Grassroots ic Global .ihcncdives - an emerging new vision ol PuGk
i ’e.-'Jr' which talks .about various ai'crnauws yhr ,;?f' ;. wi" wt w vr'-' w •
nany e:
,
) an la? put the visio
ivi
.
e.haner.
.■-.(■•bay Shukin
PAM S Al.'Ay
•' rc:.;:
To:
Co:
Ss
Subject
Daw d McCoy < Davia. McCoy@ishtm.ac. j k>
< ab h a ysee nia@vsfi I. com>
'4exi@hst.org.za>: <phmsec@touchtelindia.net >
■'A'ednesday, June 11.. 2003 3:57 PM
Re: GHEW
Ihcnks Abhay
.'•JP-
GudjUSl Gi'i iuiie’
abhayseema@vsnl.com 96 IL03 05:33am >-•
Dear Dave,
Sor-y for rhe delayed response, overall ihe structure looks good, though it has definitely come a long
•7. a\ from gw initial idea o’ a ’Globa! Gauge’:
Some general comments and suggestions:
1. Section .A is well conceptualised overall but Section B (Health .sector.) seems io trail off and has
certain gaps
2. In Sectio
•. fi ati.
/there shoul
2 andfood 1
. •
s) and 1
...
... :> fo food se:urib e. .
hese haw been weakened u ler
li
■ :
■ ••
■
; ■
general Critiqi
in se :t on i. < e ho ... c ritique . ie speci ic ...
seen refom
•reunti th-5 world, i fib; should be added in sccG'on B3
'
nda being-piom I
yW
L Ir
should leal with forms of privatisation of health services incl. cost recovery mechanisms
»‘ fo > 1 ' sub >ontra
srvicc
.and
ould
ique targeting of j
ices <
cj./.oscd io strong umvwsa; care .wd-ems
i sect
Private medic
ay be ielevai
unregulated foimu
fivA’h. care in many dewdoping coun’r-es: aBo somcihing on rrivar... medical insurance’.
kA
u a of concern is the "Population consol agenda’which i
health ■ id from the North - where docs this figure?
<
ng
WGXRR could do this.
' ■
cAUining pubiic
countries
health budget ind healtl
end
’
1
1
‘
budget . nd rise in oui-Qi-poGkci .xpemiikne ;;vc a major ccmcum m wwa
/. \Voukl h he rciexaril io have a. case study on Decline in Immunisation emw.igc >ome\\herc?
cf-?ri 134
mckidc GAVE
■
a...
Ffo.'s':
Sc-j
a- <arjftayseema@vsni.com>
etariat <
oi - i tel.
■ .
. let
i
I; So} -I )a d.McCc
.
n.ac
<
Ao.ac.za>
•
--hre. ;5;:X'ghst.org z-• -• ■ m’kerov/son <mik«3rowson@medact.org>
vonday, jR-ne 30. 2003 1058 PM
P:-/ S - S ma nag?.Ajrv
technical advisory committee
Or:
San?:
Derr Ravi.
It is |
....
.
.. c
...... ■
i !
vv>rv} =,-.v«vre -.-jp’.-:; -p.tavon brom the PH.\ - secret an’nf. Nov; I can escape
ft
_.•; d.Dug •
rcpi’eseiualion .rov. ihei^ain colniborai.iiig
>r la ii salic n
k, Medact a
However ic I ecl r ical ad is ry
□uld include
litec
giving te
calinput
<
; Dr
v reyn.>
<?£•.< t. X
.'. t. )'■ »R ! or nt»i.
Inn.!:
R j T. N ■ A
\j.R..- by
hvv’ .va
* » ■<. A gaN: A.
ve
thei
idi viduals. >o
ette
elect
.............
EGA
....... . . vl networks) bi
i each
.
...... . ...,-..
a;: organic-.iron.
Regard <
\bhay
..
.
E-i
. .pr-'NVxR >. Iv .-.. Pllw
\ iaharashim India
h
c-niaik abhayseerna &vsnl. com
in the ‘
”
JkijiK', Ata
a? ''-: • •. wyy^ThcvljnionSknali^^^^
gJ
A
['o: j
id mc
J
.
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Cb.nay Tee
<abnayse$ma@vsnl.com>
Davie ./.cOov <Davia i;lcCoy@lshtm.sc.uk>; <phmsec@touchteiindia.net><mani?@uvvc ac za>
A’sxancra 5?.rw?as '<;3Xi@hst.org.za>; Mike Rowson <mikerowson@rnedact.org>
Su'.da\. Ju v? 29. 2003 1 T:54 AM
Re. GHEJV management and technical advisory committee
Frcru:
To:
*Gc
Sent:
Cucjgcu
■ )ear FMk’s.
■ agree
D:-w> c.coil conceptualisation of a Management committee and
a • echn’c-v. wMory group However I have ?. few comments and
MMtion?:
Al’ wrsce .?;■ th.? ?• management committee belong, io one or more networks
orgaJMc-us. Wcuki'm it be appropriate for each person io be formally
'cwforM by foe organisation which > he primarily represents in ihis
vOmintUcc. Mew the names ar; finalised1? This is significant because GHEW
i>
ore a nF ,woM ooihtberntion between < rEGA. Mdact and PHM. Individual
'
•'
' ’
• .’ tec . Inch •
.
ional/t
agerial
nut jas; tM-foM bc-uy; represent particufor organisations. besides of
course their personal interest in the activity. (Correct me ifTm
misuMfo.
Uy fi
. ticipate i w Managemet
committee Mausc of serious time constraints on my skF. I am now managing
il secretariat
HM-I
i and
■ ■
vedin
MMpM asikmu; umipaigu on .Rip:, io Lferifor. Cu.cm India, besides
varic?rs ongoing r-c?1.-iw;s ar local and state ?Gvew ■Howwc-.-". \ might bo
able :•■• p-.-c
on me Technical a.h-sory group it apprepriaw. r
defrwteiy foel tins w an imporham ndiiafoe wnich reeds to be carried
head,
1
II
been giving and >ul
mti.ni
suggestions u/.d mpuis as ume permits.
3. The spe
c
I Management
imittee IC) and
5 cchrL-m'- udvisow' group ?"f.wG) need io be to.aue a bit more- clear. Dir.-cs
sed a similar role
scription (
MC.
m
4.
mall j
■
cmnmcui uboiu M sinici.ure of M report is that ii worn; io
■ ■
■ ■ :
■
a
’ ■
sn
.
idconlribun
. .
’
..»•> siagc -wmg
. . ’ King sigr
?ni.
’
itl
the idea recei
■ .
nd p ■ ig >i < ?ti<
•
'
id , an<
ui» areas, c-x-n ;hoiwh we recognise -iwm
'* hh rewTd
.-■.bb **
zWnay Shukk
• > 1 ’ihw . y-y .wver■1 ainc
H - • 5?
62 m 5 46 5936
.-mah: abha\>seema@vsntxom
Join me ' •. GG.r.
my X(wr■ xGm in ihu 25 di amir-,cr.-ary year of the
Alma
■
VAVvv.Thc?vIiIlionSignatureCa mpaigii.org
...... Gr’glnG. Message -----■'
‘ ■ —G6 ? GC’oy David.McCoy@lshtm.ac.uk
• • ’ phmsec@touchtclhidia.net- : lmailin@uwc. ac.za.
ie.xi@hst.org. za
mikerowspn@medact.org-: ••abaysema@pn3.vsnl.net.in
■ : Friday. ’ le 27 20 )3 11 :29 ' '
Saoicw G?IEVd management and iccimical advisory committee
k vuGd like io jhiiovv i.-p on some oi me cariicr doscussions G/oui
"
.
■
> are agreed that tliere will
.<■... GvlEVf Manageraeni Cc-rnr.Jim. .. wm »ikc ?:; also propose lhai we sei up
rr Gcrnkai ad'-isoiy 'xwniiicc io r.:@
c<?nocpmoh$:vion and
prociu ;?<■?,. g f the docmne n..
i-i..; ninttagcmcm ccmm-ttcc
Mia 'GV f A< A '■ J <o >
....... . p . . .
.
.ctud
heve:
LC L.-■. 1’ T. I'1 'd S (‘<J L'^ < L i i
Abhn’- Shukla (GEGA
j
' " ’
ffi
t
' • •
• ■
■ ' ‘
' . ••.■■■'■■•■
xVtnmhUe? \vc are unsure joog. nvnus parlidpaiioc .v. mis presem :•
.•■■.. ...
. '
.
•.
•■ ■ ■
ions: ox
■ •
months to j>rc■
■■■ e on the
■. •:. ■: ' i c er.-.' hr. -m.i
;.k?c?•nmV' b'v;.- on ]msvGy '.o help v. jth
m'secuous and edmog of Ide ivpor;
1 /at t.a broadr
fskifl&an
ipertise
i
iplimentd
.
.
.
■
.....
nuinmmnH-ni commG •
•• ■ ’r'i yy--.,;y .jr./pre
numes may also sucH-tth-m a <H :»?. ■ V mmilng proposal
- no
ihriri rr- people?
.he'- comr jj-f - on die ubemy’
ofprcpL? f.? spym-vh
I’GiA, c:m -.\.j :’ttng.-v. sn;-.?..
a<»\ i <.<> s.
hi
j
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1 ivecf..». .mvish fra-m y hke and IGG
oj
' • ■
...............
ig
a
ision
me wee vk;e
■ • ••
PHM SuC.'C
•iasaa•-..asrsr?.■ ■?.
From;
To:
e ■
•: ■ e r. ; -3rig;err.@eth, ne>
<r-■• :_Stee
*
ing_Group_02-03@yahoogroups com>
Saturday. June28, 2003 7:40 AM
Re
V_S:e?r:i'!g>_G;‘ci!;j_02”03] Evolving a plan of action and overall strategy for PHM ■
Comnx?n;c2t o.i - i
.-..a.-;
Sub Det:
Dear Ravi
Dr
arare' •’3c
under study!
Regards
p-rem
.....C'!g-:-a: Yassage -.....
■ a : PHM Secretariat
PH.M Steering Group
, Sent: Fridav. June 27. 2003 7:01 PM
: Subject: r0!-iV__Steering_Group_02-03j Evoh;rj > phr otaction and overs}! strategy-or PHM ' Commur.icatic:'- -''
•
COMMUNICATION - II
DATE:
PHfd Secretariat
From.
' Gave .VoCoy <Davc; iVIcCoy@lshtm.3ic.uk>
~ o:
phmsec@rouchteiindia.net>; <lmaain@uwc.ac.za>
Cc:
dey.;@hst or? za>: <mikerowson@medact org>, <abaysema@pn3.vsnl netin>
S?w:
GcAy, Jiwe 27, 2903 11:29 PM
iubjcu-: GHEW management and technical adv.sory committee
!>ar alt
‘ would Hke io foHow up or? some of Hie earlier doscussions about institutional arrangements. .As •
j-Kkrsumd il
r!i,:greed that there will be a GHEW Management Committee. I would like to
awo pro.
vw scr up an technical advisory committee to help with the conceptualisation and
•''di ’: do; • )1 ‘: p do: u • nend.
As far A? management committee is concerned we have:
D.-.id McCoy G Sedact - GEGA)
1 u w Rows
*
•n v v 1 edaci ■ PI IM)
Bamb::s(GEGA)
I.
Aohay SmJda :’Gi GA . PI IM;
Da rid Senders fGEGA ■ PHM.)
Is mis sohkLm and agreed-upon representation ol the management committee0 We are unsure
out ■•• <•■.■:<:•■'. porL-ipi liu.i ai this present moment.
As far -T-. a leuhni ;al advisory group is concerned. I would like to suggest:
•■ maii; nmc..Gnv o\cr the
dircc months -o provide auvice on the structure and lay-ucJ of die
?/•• co:eno oner on possibly io help with v iiting c.? sections and editing o' the report
- wain a fro.K: r; ng-;. <;f sldlls ;;i?J expertise, espeda'ly to comphment ihv public health and heahh
.■•c-.-cv vXixriisc that already exis-s in the management committee
geowapbicsi
wswAutkm
- ihdr names may also so cagthcn a GHEW funding proposal
- r •■ mor-? man ter r eoplc?
A-.; conn-V'A on the above
*?
?. nc-L car. we ^’.'ggest some wnw of people to approach as technical ad' Acrs?
m me '■?-;. 'urre. f rcc-.'r'/?xl fA.
*db:ick
i’Om A like and Ravi on the discussion about the suveiurv o'
f: - ?vpon. I air: vvwAw.gv t. r:\AA;!. ;.:id gw thA oui to you soon on M ?nJa\ (hupoim'y .'x.
oc’ j. urc wib now be in a shape that we are all happy to begin to share with potential funded -p-.u
others)
P/Vr7-6A/
PH^Secrstangt
Frorc:
To:
Sec -m ct •pr.-.sec^tO’jchteondia.nebTa-.- ■ •>■ .-Coy <Cavid.McCoy@lshtm.ac.uk>: <abaysehia@pn3.vsnl.netin>;
■ a rt! n@vwc. ac. za >
*■
<A-:>A)hst orc.zs.r rniKero-.vson <rr!ikerowson@medact.org>
SuCjecL
Re: GHEvV r'anage.nent and technical advisory committee
. h iy, ? li
; Da
On iTwher reading through .hi ihe evolving organizational and technical
. econsider my sug
i and would ag
■
on the
manrgemeni iwbiw. hich will perhaps be strengthened by the hat, which i
rcsprrsTTp by ? .-■ ?.g on -he Technical advisory group (TAG). For other
ol : L‘. X: 1 sm-gesi c moic gov..T.-.uk-Gioi' keeping geudur and
; >gi ihical repress
•
id. I woul<
'
is DHF) adi ?
’ '■
Vietm
I
ped the
PrlA-I backg-ot-nd papers ami -he ihird person luw . strong health lights
approach. These .-re T< suggestions. others may have dews.
i heve
-2r; a:r»-?-inc.?m?nt about G’dbA cvob ?v‘g pvo^.;<s :n our last
■
■
; . .
it a j
• : nas reached a stage tor wider disiTibulionh
Test V'.The:'
Rew FAray w
rdinator. eopl
•■ T iC -Aangaio \*
1
menf
ariatfglolx
A
^iAasandra A; Maia, it acw.-. KaramaugMa
Barsg:dore-560034
Join the :Tija-ih ioi ;.L ?<( TV,fe campaign in the 25ih annivusaiy year of ihc
<bna A’a
hc..\
..ri: •AWfTv\Tl^e\fillionSignatiireCampaign.org
----- Original hmssagc-----•o ': T' :\ i ? Th: 'oy Dayrl'y[(^CpW
'■■■-' •abaysema@pn3.vsnl.net.in . phinsecYytouchieRndia.net .
imamn@uwc.ac. za
- ■•■• le\i@ hst.org. za : mikeiw^.^
<0^.; . 2b-\- 6;s- PM
. T
I
lie
tvi
■
j hciTs Mr Jos
.
' fmk. i-w Ki\-. T’iT. /• k:C mrci::.-. ’s io m:wc the key yoiw-A..:
• •• ■
■••••
— (parti
................... - ...
.. ....................... .
.. ;
’
py The Secretariat
■ - ■
.
nuiomcrmw
irn •«.-•?•■>•.p jjm- - mauiiiAv is ..here I wouio
srr • . g1-.- J. crwo •.•. •••..■ ■
L-,
GtCj'eUi'iai
1. a . .. . Jc-C: y -Dav-d. .dcCoy@lshrn.ac.uk >
<abaysema@pn3.vsni.net.in>: < phmsec@toucht$li nd ia net>; <lmartin@uwc.ao.za >
org ~z>-' < m5korcwson@iTfedact.org>
Surday June 29, 2003 6:34 PM ’
C-.-Zv/ management and teonr.ical advisory committee
; .'.s:
To:
"/
Sent:
Innnk’- ter irv’ \hn;-y
of me Management Conmn-is to make the ke> strategic and financial decisions
n the 1 ' . ' advice
/
■ ■
Ms
group) Ph Se •
. . d
o.-ny
:gcs? G the management iiinciGis bm fire Management Coin milice is where- i
would
key strategic decisions a.v
• -A wk
s’rvy.Son that i‘. vvou'H
Joni tee with
j organ
orga^rSPik'n.
impoi'cnf I or nidr kiur.is :x? he on the Management
indi idu 1
h e he ms lah .
1
73
k) eve z
J iKi'dore. .a/; 1 stigges!:
. . .
. ...
,’vii.ke Kowson (Aiedaoyj
1 cxi Rmibas
Go)
.
. '
' '
Abhay Shukia (PFE\ A
■
•- ■■ .
1 j
an 11 ■ ■
..
G ^-1'1 /k-C.
•■•
■
••• ■
■ i ■ „•• .....
e to the PI IM
|
i
it ■ •••
india
kS
ic/ms A .
j,ihatithas b
f,o;.c '.iJilcOi
A
oi
iheix seems io be a Giukc:ic;:i process gom:/
imbersome, and will pa
i
• agrcu
iiw
?
k vhi
abhayscemaGvsnLcom : J :V '..’ •'
1 ocnos
s .-'\0'uU cc>GCupo.K’lis..-7ion
a Monagymont cominG
{ h*iv,; a mw .g-mmijuis and —
Zoui d r C. k.
/•? fcht
vi
ay
©racCs1.
-; ■••••
■ ■■.-ji,d.&.nev■ : Prnartin@uvVG.ac.za-<D.sv d McCoy@tehtrn.3C.iik>
o:
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if) if)
ent:
ubjact:
'G’u." -7 ■:■:>. <Ietd@hst.org za> <nikerov/son@rr ;-?dact org>:
■■'-aysei3 /•/•■:.net.in>
c c.s., ■;•.:/14. GJ03 5:: 1 PM
Re; G:- :G vO
viks '
nevif the <
101
a coupk
*
of suggestions:
en section!
. .
. .
it;rjye.
ps
............ ■ •■
•
idea
David McCoy
.......
sc
■.
■
•
.............
policy
flowing seed
■■
drawin
ti’e a bit repetitive
■................ ■
i section E
'
his report, I
.
A .
global
j;\:iKv.
'
r-- r-v1-.’?4
hc;‘-' ;.■•■"•■ 'hci’gbc.
■
■
—...— Original
ssage........ —------- ------------------ ——
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. r.'. ■■:i Da\M.McCoyg'?sht:n.ac.uk
i.S;12:4s
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•
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iuai.al auih’-fs. aoaCi....a.a a- aaGc
a- :■■:
• ' .
o! draf: chapters
u
- .■
'
p<‘‘i
,1SO‘V pfOUp '’• jir •
....
■-
' •
i*j ■< •' .
PHM Secretariat
■■ ■ - .
.v.-
To:
Cr:
S-3
Atta on:
Subject:
to uchte;• • • oia.nei>, <imardn@uwc.ac.za>
-r; err; za>:>:@~st.org.za>; <rnikerowson@medact.org>;
<abays^ma@pn' 3.vsa!. aet. h '■
>■.■;-• ■ . ;•.■ 22 ?0C3 5 42 PbZ
ReportStrucrure.doc
Re: GH-r'vv
•-r,-
[ere i he rexised versioi
2 H
)p
tn ire. A
icnti i le li i! hat h
uiuuip; :c- be /r.orw
and siirrnued deevn. • iiava also separated oui a section at ihe end
ij............
■ ■ ;•■ th
•............... U .■ it iin < ur ’instituti< nal wat h
ith this
vould like l eg in t
ire this more fom
*. 1
;..’v<c->/..>
ihebsi of polynia; uch?<kal advisow group nteuibers ii;at . <
to get
' '
•
ng on t
t
f the p
ai
sk again f<
air.’:
■ .*>1:^2 es.L.gu:
~
-yj-oeopk:
- poividial i'.r.i'icn
?.:• -/.ohj chapd r;
- pok
•
iivi na
roi sw< van to ndoi
nd
>port the final product and be fa
act r< revhv
of draft c-ar^ers
PpM r C-jT-O/3 /
l/Lo
W
.... .....
Preface
Introduction
SECTION A: INTRODUCTION TO GLOBAL HEALTH INEQUITIES
•;
seo ?' m ? ?.-. c cd World (Socio-economic, health and health systems inequities)
rOLITiCAL ECONOMY OF HEALTH, DEVELOPMENT POLICY AND HEALTH
AxOTOa
SYSTEMS
?
~ • PciHos end Economics or Poverty - Adobe;-’ Public Health Priority
3 J. ~3;-: Yg Prescriptions - Socio. -Sector Policy and Ideology
£:• Hearth Policy: The PWatisaiion Agenda
P- Where are ov- doctors? The Globa! Emin Drain of Health Personne
*
3ig Pharma and the Fuure of Accessis;? Merficnes
£6. Glooai Heath Leadership
SECTCW C: DEYOYDT'-T; HEAL"Y SECTOR
C . AgrouLure ano food security (long;
C2 Water (short/medium)
D3 VAfrr.om and health (medium)
34. Er:, :rcia.nar.t {rn-jGiu:p.)
Co. Gender ano ; Worn e ns Access Y Heaith Care and Reproductive R;ghts (med
.
D:
■ ...'.
II consist oi
nun
' .
■
....
. • •
..
■.
...-,
.
ey institute
case studies (we want a report that is monitoring the performance of key actors) ?no ooHcy
recommendations remred to rhe sarlier chapters The puroose "/ these sosechons v ’ h..- to "‘"•■m the
noron account" o Ct / to ci"il cocr/cy, -vd Y. mo £?nv>
z ::Yo-f-; -:-c
O' .global progress^
numLir of sect Gr.s. .nr example:
Trade and WTO
•
HIPC initiative
Gicb?' r.mano economic governance
AB
:'-.r other international health agencies
GA~S and Health Watch
G.ocA medicines -jatch
Giooa< hearth research watch
Done' '•'•■•atch
Suggested individual or MGOs to co-author or
endorse chapie.
Nelson Manrieia /
Desmond Ttriu /Graca
, Machei
P ;-"f ?.ce
Introduction
.■..••■ ■
er
■
...■■•
■ ■
: '
i -
-
• ; .1: f-!v‘c ;:h in a Divjdoo V\fy: j (Socio econ unde,health and health
srejnd purpose of i
. ■
■ . . II ALT
'
' . - =
inequities}
■ Inlroc’ .cthe •iootoeoc. >c: me and political determinants of health and how socio -economic inequities; aftect health inequities
: WDM
I
.
I Oxfam
Overview r<.hi-: ri:s'.nbUion of woaiib (poverty) ■ hearth (ill health ana mortality) / rieslh < -lie lesoumes. Provide *r. ; ericai oveiview
. of socio-economic deve-ooment and equly since WW2 and describe the cirrc-r.: cocce-ii-. /lion of economic ■.■caiih monspl rich i i»’
nations and fcwei and fewer . h’Cs «.n-I ihe existing level > end distribution of povariy
' GEGA/Equitap
■ Describe trend of growing In-quAies within rich countries as well as within in poor countries.
i
Describe health inequities globally, inier-recioiial and m country - emphasise HIV/AIDS. TB mwl malaria, but jleo :i clvidi ood
cik-s, tr&urns end violence
heaith.
■' here are r rany reasons for tiiis picture, but Ibis section of ihe repoit will highlight the pofticsl and economic
■• /itn ihe unde si^ndng that r.-werty wi-l neb.- addreseedwi’i-iout inequities beincifeduccd
at c- ylohal .
• i )t.. - crib. Il >c s! xtc of I'teafth care >n n laticn to t >• ^tate of health, and the *. a v iieaith sysh.-ms can determine i; :a!th im-q« -ities
t
. •
•
of >Jrican hc?.8h systems
/stems inequities glob? Ily ihtei < •
Ian
.■
■ ■
te a case stud
I I n iCAL ECONOMY OF HEALTH J I
B h The Po’lirics and Economics of
- A Global Public Health Priority
rxp.^n ?!.d -i...:s . • ..,
i: r-. ?, tti.-st a:w rcl-'w ni to >i ; cuu-xrii pHuit- of gia.-'.iig inccwithw and rh..inany poor cciir/iies arc ic.. i-iighl>- »Jniuimess ■]■• • i r. /i-.-c- ?.i fl.; yc.
ay-tom (inducing doitole standards io tariffs and subsides)
(i;;?
Norecna Huri<
George Monbiot
Naomi Kl< in
z
>
>■•
of pooiec1 oniwn and subsideemcncsi ion coujiifies
«
; Relining levels o; ODA. incgu-tebl.. r stribMbn o; ain amongst developing ccuGrics and poor quality ODA Hying of aid: donor !
•;-x cord’ftioii: appropyiak^ss c? z. I 'ir.;:age ic prive.isstic- policies)
Burden of debt and inadequacy of debt reuef
Ffcct global financial systs-m on mac;c-sconomic stability and development ir px r c-WiCS
• «
Cnaiure a the wealth of ne’wal: cso’zees by snlall i;,mbws of people
Pair-ks v.h.ch h-:n.de;- eis Iron, sox-w.cm cel: to; s tointcrrwticr.a! creditor
ir; )'•>•<: ofYG?xh-ngr;cn Consensus pc Cer- on development anti equity.
Susan George > staff
and fellows of
Trans; lational
Institute
Martin Khor and
Cliakravarthi
Raghavw.ri <( • ervi
World Network)
•kx’l?? the political processes rtei underpin die cwvoiii global economic structure and sysi.-.m and highlight issues about global >
ecb
andpolitic
jov
iccouhtability <
ince. These is
*
ob< I <
ternance iristiti tons to < ivil
-
.
riemocrGw. dtfr.-ir he;; ot tovspwmxy and x>?oun ability: corporate control and influent?4 • ■ wk of power of develop-)!ng couhrix in ■
the lu.ee C;
casing economic x/< financial giobalisaiior. and concentration of palithxl and economic powei .nerx; rich nations :
.-: an x iGxcdcr tne eie whon of hi? nc?.tc of foreign cred
*,
to s over those of dhzehs
ba- htn ti ic.e
s to (each as a sub-sihvma'ionai thane al system.
R?rcjhtc.;y y.r.h :jw.s vr.d';ysrems fot tra-Je ■ ■ VTO
Regulatory structures and systems of TMCs
■e IM» UN
'
Ih-.jtectu-ii property nghh regime
■ >
■
j
ij-i-pin--we. ■■!-:•. !. «;•■ bhv ••:•;•?. jH o; ihs vwh Gwhh and tlhrt unless the underlying 'ZKio-ucjncmh ddrumiiinriic of swvwrh ^re •
/.de-;-5--ed <;‘;c h-.-ss ■'ou--.1-•■.?•. c/e adequatciy resourced tc cm.-uiw GGctive IiCcMi syhems we t.H .co deal Jt'n th? 'b ' CCO j
pmvevGibw - '’V•/;•'c .5 dv...'i .s r doy.th.- H’Y
: E 4.iu.-mic.- etc.
Con ‘v’ch: ma: I;:?- - a nucri k;i.
Eelfww of globo1 ecc wmx ?;nd pG'ilx-h insiihihor .
> i-.'i: !<;h gieater <rx-siG• ■ • h r-?c--•>'• -x~ < r.v- •: ’W.im from rich to poor
z
R-G-’i
•-;• T'u;■.<. h/;.roJ'w.c .s '<• ■j'.
I
jh as WHO and other h h assoch
health as a pix he h w-::cg<;o: ;ry
BZ-hhhu F.i .erhvows w -r;.!:./ r <!- -y ;v d kkolcgy
Descril
the a
n
r
n<
orie<
•
ie<
y that unt
sattons to elevate t
tomyo
>oliti
i
ns th
■
vJal
ve
meat is
rse.
ar.;, -he 'wl’.v-'! ,c >f V/R. i’/T -:• G GIT R... x. e Li>. growing puv-Jr. .non agendo c.v; ihe -licp ■ ■.mvc----': vi v among WR. I. '; 1 C'lLens I'Hwo; ?.oi.
i. W’.lTi'iif.. b
W.i /: ■■;U , '•;! .-, --cJ-i if-. It • --X'WY ‘-W. .b.:'.jif’l the t,i< boi IV-li'icG. C -Ci.C’-lV
Essertij) jwvice-; (Ncncy
Alexcnarid Tim
’Gi .iiaini tb.c- effects of Such po-iicie f '.< ■ ow y oHvdstion and inequity.
: Kessler j
with .<w:p.. sof cc-ur^nA-s’vbosv soc^i policies hnvc I' renj•;o-pGor and ••.'here real advances have occurred.
■
indude sub-sections:
• Critique of the current WoriS Development Report
0 Critique of selected PRSPs
* Extent ci and the effects of the privatisation of •.-asr. s: v;
, WEED - German NGO
working on privatization of
’.vater
i
I
1 Bretton Woods Project
: and BIC
•
i Public Services
I
' International Research
I Unit (PSiRU)
.
. ■.•..> >.er and A.-. strictly) on health. poverty and ineqtrtic ■
.
,
_____
. .........................
I
Patrick BondfSouih
! Africa)
_____
, Policy: Rui! Privatisation Aganda
i
• Mike Rowson
• rrun Esum
| Ravi Narayan
David -Sanders
:
< )v.*» view of development of international heath systems pc^cy since the 1960s.
’
De.teiib' Ice helerogc y of health systems, bu. ire :r iwmn w-j.ridv- ide trend of a shrinking public ~ a.’.o:. fte^edix. the demise oi
he rrimuples of the PHC Approach and ho
*./ it is misunderstood and misapplied. Report on (he growing emergence c- selective .
a
ima
I
ar
icalisatio of
dnietvenfion
h otic
c
■
oocte
systems devebp.neni
1 Andrew Green / Charles
I Co'>i: ns
Describe the t<
• ■
.
on ihv nivatisciicn of hedA care Describe trends in piibiic head) budget? nmi n-caith cam ../pent lure'.
n
ic health I
.
■■
j
D
ribe the lack<
gulatio
th
•
|
’ AbhayShukla
■ .
rtevelopiiig countries and the grovrih of the private medical insurance industry
•'
in Hilary
' (Jessica Woodrpffe and
I Claire .?oy) ? S* nah Sexion ’
•jcscob . the /urious fonris of 0: Ar■■■-.on ind ?/-.d recover’/.•Liuchanisins. userfees /.nd subcontracting t ’ ’//V)
to i■••■G<and j
critique the temein.u 0; ser-/xes ap- loach -./ s c^o :d to strong univem/il care sysitm:;). Emphasis- also he”-' public sortor bucjei M-1 >:cn m;.< kmb ? 1
. .
• ■
. in rdi--' poji.,..-, ?dx-f.reforms r.n/- foi •?-. that are contributing to this and raise the issue of inc.'.-ased inequities,
inefficiencies sen iVrmation ci tteahh systems and '.-.eakth-g public health capacity. Make reference to WB md WHO positions in '
this i^gard.
eyiew evidence 3
he perl
•
encV in<
^vei
te^
irnpict on equity In contras-. CiEcjss the ■:■■. d-mm w-.: exists io suggest that universal public sos-toi state somices are mhererrily ,
iretldenr and ine;;jif.b!o - ..-JI need to Jackie •- ■ >c of the WE papers and xfiews on this ckeuly.
Buts on case studies - for -’xample,
Ai tafia, Malays
.$
of Eas in
vhai ?s happe .ling in a number of countries (for example. India, Mexico, South Africa. j
n courtry), and then propose an a{
date health sect
* >r reform pack -
Describe Free Frac? Agreembni.s and GATS. -and tlvrii :r .pads for likely impacts) on increasing privutisalion. increasing health i
sysfcrns ii equities and weakening qc •<-. •«.<.. re fj'aiory capacity
;
WWxW Bslkl-iJ’dS nagenjtW
fricMier increasingly dominar
n development ant
-. .
I
.:■■■■.
ublic manag
-
. ■
i
pronotion of market-based. private "oiuthns io public sector management, [/escribe extent io which this is being promoted and ■
entifue its .^pprenriateness fdr rhe rteWe’y of social gooch and services such as hc-iaith ct-rc (develop a box summarising the j
reasons why health- an-J h?alth chu/ reqJm th - y,.;e and are foiled by Hie nW and mortebbrisai reforms W -he public sector).
I
i
Bl. Where are cur doctors? The Global crax? Own of H^i-h Personnel
; Equinet-HRH netwoik
monitor ths
•.. ■
. le c
■.. .
,.
’
|
I Rockeiellr. ■ - WHO:cc/ti
Ce^rib .- the •:.. nlr1? importance c ' he': ’ >.-rson-.!-.-I :c functioning hcaiih systems, sed the detur-/ of Gohai heaiih pei sonne! ; members
Describe tne aggressive mcruitment of health personnel ircm the. couth. In short, the political economy of health '
persx in-el ava-Wriiny and '• W ring.
Osvibe efforts under-.vay io aedress this crobtem indudirig tiv- Rockefeller / WHO initialive Describe v/hai 'WHO. ILO and othor
Magenc
•
.
be s
ok
ther
<
Ider positions. M<
.’ritn-rte
the q’obW br.iir.
drniu .
•
....
i
rental
.....
BSiBig Phamnu and the i-uhj <? cd-Accessible fwmc; us
■ *
'
Ctesdbe the mvriti-bifcon dw-jr ^armaceuticsl industry- in reinticn to globs! health and '..odd p;; r/.rty
!
Repprt on progress • vii i resj. •• ■ .1 to:
<i f RiPs and the impiementaiion of the Doha agreement
« Accelerated access initiative
© Regutetion of::in ph?i.r '-. ’ >y
« Progress tdwards EDP imhlernert
De$<1l i the efforts of ti
i
?
lit
/ to remain non-trai
;
nt, to infl
ieir: reseai
and dex
wetbs to promote a <k .-r:-r Uo.’. ■?<! .•?; maA-/ v.-. -st -Veixyh.:ning their - ./jacii/io proWrt ('.•‘■J?/. ;..nd io fix pno-s.
ipment
■■
MSF, < iAi and TAC
C\...c:O? progess re. dev
c- pharmaceutical manufacturing capacity in developing countries
I
Set cut an E7..L-3 cf cation fc- WHO. m---distancing itself from the influence of the pharmaceutics industry and calling for a
■ international fantowork for the tiansparent regulation of the pharmaceutical industry as cell as the development of generic
n>:-.nufacti5in<?j-ipaciby in deve oping, countries
B6. Gioho’ ttatfh Leadership
. The whole concept of $0
1
*
heeith governance needs to be described and explained in relation to many 4 the earlier chapters. II '
should point to- a lack. of g?oo:;i public health leadership in addressing -he undeiiyi.g detei mi Hants of poverty and disease: 1
ijiadocuede ht^ha.iisms for c:v! society enaauement -and participation: dancx rs of GPPIs etc
■ Tn:s chapter di include a cmique of some of the key health sector sp< dfic multi iaterJ agenck-.
*.
® Wortd Health Organisation
;
UNAIDS
c. UNICEF
.
'
.•
I
'. •.•••di look at iveml: performance; the extent to which a broad public agenda is acknowledged anc> supported; the extent to which ;
■ \hc.e hes bom adequate civil s...-..kry engagement especially v/idi developing country civil w.J- y, tnc extent to which they have
been comprorijsed Ly cor porate intererts c-.c
I
ii su.Mci build jnsome contra: o case studies including:
invokerne/; ;md influence of pharrnacei.tical industry within WHO
e '. .i . jsbeejinr. the state of p'..y re. ini ;«rf. feeding co; :c and the influence of baby food indjsiry on health policy agencies
the tcoacco control initiative ■■ WHOs desire to shod up Io the sugar and food industry .. positive examples of h-:ai‘h
leadership
.
!
SECTION C: BEYOND THE HEALTH SECTOR ’
I• --■•• • — -----— •-• — — * — ~
■ ■ —- •■ - • -.........
•
■ ■■ -• ■- ■ . • ■ ■ •
■
■
- •
i
. C1. A.jricuilt:;p ar•<? ?cod secut ity ('o;>g/
i
•
...............
Tim Lang is Prote ssor of
Describe siatc- of hunger and malnutrition, and growing inecfjities in food consumption
c- i F‘ 'il: -.y at Ti'-tn *.e y
Increasingofigoopolisation of f4od mdustty
i V. .,-y University.
CnLque: o’ ag: i-business. GMOs: and TRIPS- related developments
Comnir iti'i ii:e vv:-aker-.pg of public <:;«st»ibution systems fcr food security (e g. various forms of; rticnin i ’-id food sg- jic■•-'.<
1 1 ■•'''’:e r ,? ;Ti' '
under neo-hbera! regimes
; Action-in Nutrition
•
onunfair nori ::i-L^I subsicies ar.d dumping
j
•
‘
■'
VandanaShiva
Criti que o' ;j> / o’enor / i'A<? apprerch in household food security Critique WHO s approach, and performance rol -ted io food
-xv-curity. cpiici.;:ufe. nutrition. Rep -n on WHOs recent Laities -rith the sugar and food iivJurrtiy. Make mct: ic-n of U;<- mtifeivnijr ■
development project's background pap^-.r.
*<■
■:
• «
Propose alternative strategies
i
f-mr-lkrAe ike importance of this ?s m:-akh is-vue. Detenriine som? key recomm -.;.drier;:, that \v? can ask health associations
iwwih-i L-’r-icd NGOs. wei, - :i-e global health instiiulions such as > JNiCdF and VC; IO i: advocate- for. and which GHEW can ’
monitor on an annual basis.
_
I
Z 2. VJiZ er (short/rnediurn)
I
’.. /piam importance of basic uw s :rze .•--•> w.aiw. sanitation and electricity services) to heanii, emph< vising aguin the importance of
address ng the broader determinants of health.
; A y7.ee: • >•<■• globed situation in terms of coverage. access and utilisation (i’ocludiiKi inequities in consumption). Review. assess vnd .'
~s
re.••’ state of international treakes and ccmW.ons related to wider and energy.
c& fiffiitari
i t
Rcpoil on trends related to military expendture and ik. direct and indirect effec.s on development and health (describe Medact / IPPNW
itable disinbuticn of the consequences of
end conflict)
Report on trend.:. related to the effect of war, violence and conflict on health
; Centre for Humanitarian
Describ ‘ on-going thieats of nu Dear.capons and its impact on health
Dialog ie (H:iman Sect •• ity
. and small arms project)
•
■
i Bosnia, Sri!
Kfghat
Ira
ierre
>ne,
i
Odum
nd Pe
srael)
What is happening from a heaith perspective
. Safeiworl l •• independent
V'. x1h'jvc i -esn the post-yy: responses to rc-constructing the health system
; k^ign 'iffaits think tank
,
“
i has two research
buof surr? ■■. of wha^ :'i hsppenino m the UN and the various other weapons control treaties and conventions: Construe', this as a ■ !-uor;i
.e . ?vv-: .1..
report cMd of p> c:imis and f',uire - naming and shaming of perpetrators and problem c/uiitries
■ Cecuiii ;. vnd Conflict
| Prevention
k-’nphesis'c •’>? in?.: p.-v.-.a of tb/s .? a health issue Deien'nme vvin? key recommendations that w . can a--A heall i . sso .iaiions
n health-i
'' • •
.
lobal health instil
h as UNICE
.'
/
' for. s I which <
f can H
monitor on an annual basis.
; Scientists- Aims wo-e..
= Monitorii'.tj Projeei w-. d?’
' fo< trdnspwc-ncy,
I account ability am! deep
I reductions in global
I conventional weapons
i production and trade.
j Case studies.
I The Region/.i Centre for
| Strategic Studies in Sri
t Lanka
I Regional I iuman Secu nry
Center in jordan
h ■ .:• f
Studies r, South Africa
C4. Environ^?.;;- (medium
*
J ... ..
(BIC) has been working
. . . - •
development tanks from
an enviiowTienOi
perspective.
CTepcit on tn? wo.-rw and givy-.-iiig u-'
to hoeith from en.konmtnms der.adation and pcdurion:
* global •;/-. nTiinc
« ozone depiction
* water pWJor. Grom pesticides. sewage etc
de for
The Cerie'- for
ini ^-national
Sumi nary of
-s happening ;-n the UN and through the Commission for Sustainc-’oe Development. Describe the sfiortcomings of Environmental i.vv the cun ent sysrern w global economic governance in protesting the emironment as -.Ml «•> the •.■.w.-.ko ?<s of the interm'Jbor.al • NGO that provides
environmental teual
latory system to identify and punish environmental offenders Construct ? si
port card of progress ai
se. v'icev. as /C! as ’ •o' c.
various bestros a? •_ :on••-.>••.t:or.3 - naming and shaming of prrpetratui’s ./id probz-m countries
Moke link between .-»< veriy. environment^ dwodation and health. htu;di:ce conc-cp of ecological debt.
esearch
Delateinis b-ick to th ? ■•-.;j.ih community. What shoNd they i?e ciouig? Wiiat sboud WHO b■? doing? For ixampk' has it spekun on?
against ths failure of the Kyc?o protocol from a public heallfi perspective?
.••■••; • ‘vVore'in’s Access to Heyidi Cam *nd r’eprac.ucuva v-h-c ...'i vdium)
C't.
education and irai-iing.
i
■■■ .
I
' ■ >re . •::
I
Hiudiight the specific needs and challenges io eddressing women ;■ hoalth [> /scribe ihe preon^
has b- ■•;■>. made since : :airo. ■ Womens GkC>!> • Av.•,■■!
-■ : :
a<' ■
■-. th
■ : Ion ■ on
'.'■■■
I declarationsJt is short < changing th
■ .
mii’icri cA v/omei who sufr r from ciscnminaGon and a lack of adequate
ewe. Prouip; wihri.
j ;t n; i> v. demonstrate the.
he-;-tn if.e^jriy1 ■'•; /emn nv.n end ■< omen.
m j i.rT. oelv..-•en the oCianse cf heaiih systems tovvomen’s WaiTi.
Make ih.. 'ink to h. wier sond <nd culfami issue- • nddascnL/ attempt4 io err:, '/.ver and ferrnc \svi-.-,n faroi
'■r'-g-,.;-
h•
cam
wu v i .’.W•■ ■■■■\-.u".'-s g.‘ Wwr/ilonaj J 'd rnui.j-lat^r::•.?.<«<-»jcjc• io address this issim.
SECTIC NJ : MDNll ■
; . ANE /. /O< .
iE STK
>
porttt
r a nut
■,
-
•.
..
■
hlight a few .■ in ti S
commend tic is related to the e
..'
.
.
f key actors) at
•
.•
n I case
■
udies i ■
n a
■
urposeo
these sub-scctions .Xi: bu to Win the notion accountability io civil society. and at the same time inform the advocacy and lobbying
actions of •;
■
hesriih movement committed to a just ..c. ici and health for ali. There would be a number of sections.
example-
• 1 rade and Vv fO
Ir
-
■
•
..
■
te issues tor a
lude I
i
•
and si ■ t<
i
ndthe en
• .
i ol
pre
d
-.\zd- of I he fairness of (he Cjncun talks.
c.o-.- rnance and a<xc;.inhihility.
picfe^iori’c: te-jr <.■: .■ ;:i ncor coiinkics. This might
in terms o:
? ?•
the need for reform of
•j ODA
.i ' Provide det^ji ot good and bad performers
■
Develop donor counhy case studes (possibly u mix o: good performers and bad performers) - to look at quantity. quality.
conditicr-y r-.r. • poetic->?;icn of aid
.♦ G<? report card
1
*
Describe the
p.owess reHmd to dvhl cancellation
-.-. z ns .he in.epprcp.-iate 7unfair curdihoiAlDus.
Development Initiative- they compile ar. ■ nnua'.
review of -.T ODA
■» Kee's B:ekxhc\h. TNI
l-e'lc'. ' working on aid
impact
o David S'ocJ’.?. Woi ks
on devf !oj.; neru < .d
and aid po'icy in
Southern Africa.
o North-South Institute independent institute
that conducts
research on Canada’s
relations with
developing countries
.ir .: its foreign aid
programs. •
Anno Pettifor • works on
: debt relief and HIPC
'yrf./ P-TXcH
’T1.:'.,'T CrA-i-’ TH;x<:.
Regulation oi gcbsl iirpnciai...:• ic-ipital marked
* Recommend and mcivior pro gms-: towards poiicy prop>.;ii' such os foDn hu;.
«
An effective global tax system
' '•'?'r:.??iy.‘2El£L !-:' ■ ’•X'iPJ.?1 JxlxP'L-d"
Assess their p./5'i.cns and actions o.- Ji .> political nd economic issuos i.v.ed abG ze (include scseace of such issues :n innero
>cmk: commissic-. on health).
vVH Wfrfch
i
a aXiigue of ir.j World P<i>A which .:rt»» be used to make- ••oecriic •.Jtx'Vfi-.! ? of the '?
xn<; r.o mo;; er .he Pair: ■••
. e.
k-d :n ‘~i Lsxus-ji i .'J•!-?indud-: i-zues re’ Acd !o govzm nrc. h&ri-iparenm zrl pc!:?.•?.y <ix;. • iv; ■ ii;[?•
. :
ti
.
•• ?’€ sysre:
:
.
.
ised In G1 and C2J
;
■■ mticuc .••.•’ l A n,u.Aic:i a.:d policies with regard io GAI S c.jA FTAs.
<3.?j’5_«nd H :.-s Al:.‘A k? '•
VI
.
•
'
■
,r
Global mediene.swaich
Global health research .•. alch
Progress on the widely publicised 10.90 mismatch between the allocation of research funds and the burden of disease.
29;jPXy'.atch
< A'-houg?! the 773 A probab’.v the biggest influence on health systems policy / health sector reform, bilateral donors can be influential
me counirv ;
rhe::fore important forthc/e to be a greater donor assessment within the health cafe Sector to determine how
c:; " c' i’.:' being u$?d to support appropriate health systems development and equity. Also how are donor countries choosing
i-ci'.ve m ri/krerf: countries? l-lcw much aid is recycled back to home country consultants? Tc what extent are trade objectives and
idigious agendas dewg promoted through donor programmes?
APPENDICES : VOICES FROM THE GROUND
LM v.'ih son
* wth’ng positive thci talks about various allcrna-- vea rih-i PHM network can provid; many er.inples) and which
' illustrates the vision envisaged in the People's Health Charter.
id- ijfy ■.•n < promote good models end counirics which have cordinuxl to strengthen uni ■ers;-' health care systems
. .. _|
! PHM
w-orw.
To:
Sent:
•- .’ ’ S2:'.^:ar;a,
,Yi33G@toucht3'inai&.nec>
_ .
<■ :•■
. ■■ i ■ ■ net i •■
We resets y
02 2003 4:39 PM
Ee: Z r:f cation -ro:n Ravi
Abhay.
■
vwm
■. Secretariat-
■ ?vu' t .ipciogr?- /or perhaps a careless note that caused some confusion. I
Awf, w.
•?.>: w info my
-han was imcaded. I dmikyou arc a
cXcGKwi <-.;w r.uuW cf the 2 AG, wHUihcr you represent GEGA or PEM is your
ft
Ou! m ;• 6 camber group presently in GHEW. we have i woman and 5 males so
• r.,
v.;^-.oibcu gender balance.
i. •' <. are baG.Ely ironi South .-Africa. UK. and India. So we need
gwwmr-'mE bah’ice.
w. ?. <;<.;« i r.w .lienee earGlt seiccTion. i /.a.-;
mal we ail were
r >y:
: ;bcted. bm onh mcc-m that fron^ a larger number of
seggesdeur, , ... :y. uiake to awKG pcopK oilih;m those already hi the
C(n.
_ •., v)ee(j i0 y.;Cp genucf and yeog-aphy in mind.
1i’ yci. were upset wiin an\; impzicali’-a ?Z the ieto. h was not
at all intended.
■YpiEogies aJ the same. I hopcthis note nu'.s ali in contc’rr
3e>i wishes.
Ravi Xapiyaa
Coordinatcr. ?eop-e;s I wakh Movement Secretariat(globa.l)
CIIC-Bangalore
“367 Snniwha yilayif'
Block Koram;
A;.ngak>rc-5ov034
alth foi L N(
gn in the 25th n
.
.-Ja
'■-’ .• ••.■' ,f •:'• ' ’• :■■ wwvjhcMdiioBSigmimrc(’amr>;ngti.org
-— Oiigima
----w•••<■•.: i.;.:. ;.
nbl)avsy?emay^
•
i plimsec@touchtelindia.net
I'uesuay. .:Gv i?L 2303 i2:u-v AM
Subje. =: • ’ rwi • :cadon trr.m Rrvi
y.y^
)
PHM Secretariat
. ...
To:
Sent:
Ac nay Seema <abhayseema@vsnl.com>
■ i'•/’ S s: retanat < pn msec@touchteI i nd; a. net>
Tuesday, Jury 01 2003 12:04 AM
Tom Ravi
Dear Ravi.
r’v - mail :<iiy to you. unlike th ?, other one which is addressed
■ •/ ;;d me . EILW core group'. This is because 1 warned a clariiieatioa
suuement -
c?!» si)a.re the PHM responsibility by being on the Technical advisor.
w ?. ; ■; TAG;. Fo- other ■rembcrs of the TAG I suggest a more careful selection
mind.’
A ... you A.;' Aui kn; Hing on ih^ TAG is not a careful selection. Gliis is
.hirdied by the above statement but I am not sure it you mean this) please
?: n.c know.
1. s ou < r ( not mean this, then this should be clarified by you to the
; v.y. explicitly
mien .
. da
ince nearly a yeai back ron
. ;
m is issue in
Global (
^e' in Sept
er last year in the GEG A
rdi
g on mitt .
S?-c>: -hen. iAvc and mysc.n were nominated by die GEGA CO to work on
'wdng dds. Doth of us ''cr.v consider:!/pushed for such a Global Gauge
.
i idG_\ < sgai.r.-.; signiiicaoi i’u-siaiic<; and to some exiom h is as a
itinuat
■
arli
GHEW is mate
ins io
I Axe- puhiicd out in my oth-r mail my opinion, iha: unlike the Managing
commr.Wc. v:bi;;b is an organisadonai body,
f echnical advisory group
?ed n
mb
rgani
. . .
i
.
..............
.................
yrwidmica- myws for GJ • AW.
m
.siiuaikm, ifis deciduc. thm the *1. \G wouid consifd of
...
,.;r:r -.u.Th ,• v^r’iy drfmhcly no
* .?xy ?ct s"
m:
an
ng.keepingavvay fron
’. ’Hr 'V ,■-v- •..
y- J v-jyy
corr-f.U'.r.; OUi h i‘ is dudcAd by
......
....
darby ihc issues 1 huvc raised a;
Cczrnkec$(
(S
earliest.
'.eg
...
...
I'kcl
::;ws'r.;u. I.nu?.
il: abhavseema^
t)H 5
sgLcOTn
V
iaigi n th
f .... I
if
p^cT) -
PH?;1 S2c:-tar;.-.?:
,__________ .__ _______ _ __
~.::. -.z.-.-z___
• .■ CL-Cy ‘'jj2v:cjviCC'Oy^isnirr^sc.t'k^’
Davie? McCoy <David.MGCov@lshtm.ac.uk>; <phmsec@touchte1india.nep-;
-- !manin@t;wc. ac.Z'r--crnyyis" om.z?>; ••iex:@hst.orc.z8>: mTkerov/son@medact.org>■
ysema@pn3.vsnl.net in>
Tuesday, July 08, 2003 5:47 PM
,-U-. GHdvV
i
To:
Sent
dix.cc;;
rv ’?• vll
• nly oi ■ ■ ti ■
■'
mtent f th ■ ■ ■
■ revised •
idual
■ .
n toinvi
collaborator
a
a wai
styy.'wr- and ad<IRions - 1 also want io generate some more southern names - especially ivom
A
ur :rv ikradon <>i Jk
In tern
chamer?
. mu
s;v.R.mrc.
ic
;s - are you suggest!
msive i
nakin
k
. ' .
to!’ advisory group - have you any pari icualr people y<?n have in mind?
........ R". i. *■>..; i’-." i.f.i J-. I UXl tils'
13V'v.
•. ;•••:.’■■ \s for
'.'-I. ..Iciv > :.• Si.-1 ” '■. L.
. '.'vv 171 '• xi'. .,'-...7 10 ‘.JLiV x-SS •r.;i,w
! ■. '
< u: jor:.;V
iiii ''.'C
ai ig
rtin
:
■ I
5<
■
!y in g
ucture but still 1
t.u . uu.ikv;to./. ;rvc tRCtt
<.uil
?T.yxu’i;.>v
v-'V'-'.vt v:h-fh.:r yen; received my earlier email on this?
......y. Ssclvu J -.., 1
.ViySt ' -. PukKU on
-c.-:1
servmes. Seciion D Ren Labonte on DD -. walci)
neml
..■■■
I
1
resentation
\ i
.- •.••• •; • j pr •
<- Gy>t(r)d ((pHtd
secti !
th
J
RV5
are
'■
i
tot just I
ing
/ ■'
.’.>Ctl4\.‘.. i'
J?.’?!}
Univsf:-iU . ■ f 1' ?s V.’. . sicni (’a0c
p
icli
snsivc
amples
W SsoreXaria’;
r3ri~-_r.;3a_____
creta
t<phmsec@toi
fcelindia.net
Da ■■•: a . • • ■ c Goy < davia. i n ccoy@ is htm. ac. u
□??. ;c San~?rs <imart’n@uwc.ac.za>
PM
Fw. GHEW
< rlobal PcrigdcrG
’’ lA’y erdo’.v: :.A id's suggestion about' PrimaA Iba'th Care and integrated
A.2a..A ni:?d;A bin asg goce ..xadiyks of Raiding Ar health action and
. . ..
.
.. -•. . ■ • • . .
• ■■■ ..
.•■■•, nt nit old mode
... . '
..
35 ■
Asngy-' ?•iGkani • i amii Nadu; ano AtOgya Saini GxAdhva Pradesh) which are
“•
rati
; •.
1
■
A ,-,k.Awe
'
aid <cLon. Aa .GA modeA
.
.
I
■ ...... .
nd C
. .
nodels not on just •■• .
’
'
retari
aulAa'i Aa« par.
GG coiAi
a sepacaic swiion o;
e-'cr.
. a •>. he:; ?..r.7.: ;n vAny ci'de-? Gb.er C’n•piers. 1 Aid; A'on ;.hould
-.i.d
re}..,.: w .... /.ALr a:GA1'cc
Ac
L; Ac
.g
■
lAirac. x.c...;
'v.e.r.jiACr.;; ■■
. emlS:
< g
..
-A; .hi.y 2Ajo;
papei
.
4 • GEG?
DACT J
>?7..Aa i;'7vi;;\- Aa^ch lA.pori AAA wA become
. ■: ;A •;,7iSic.d A 2k
Pi A - Id
-’•’•/.•■■■p/v •»»’ ji-7 ■:
:(/; ' :-.. Gad •
’ '.
:
' ■
.
■
icpod a- die G'cenrA. gi'oup sgota
:
OuSt V’- f.'
.In .■'..•A\i s iLi
■rv:?r'hv-;.'c.“ ;<-? •-.••7) ?,A ‘ ’ Aid
.
. .
- >..^ .i>
.y//,
AGvA
T
i'.t ■
v i‘A .
’A- A.--
.:A.'rnieni Secrete A AbbA)
?rs.:- .7 J
j-
Ai.r.o.y.u;.
i\i ..■ -
‘.•e-y- ?. ■- A
ctaa'a’ in tbc
.:w Av< .,.-.y ,•.;••;• A y?.;
PHV S’• v-- L-X-.-7- ; -
•_
’/.c'Cr. <.ma»lm@u?/c.ac.za>
-D3Vic?.;'4cCoy@lshtrn.ac.uk>: <phmsec@touchteiindia.net>
i O,
e/i@ Hst.org za>; • mikerowson@medact.org’
Sent?
.esc.a
;3 2:31 .-.C
i agre. .... ...................... . 3U still I: si ■'' • ./ m •
uhui s •iavc been !Gi out from :mcoriant sections. I
er von received my earlier email on ibis?
1 Ally
Pollock i privatisati
,.’i ... kon Labonte on D1JA watch.
■
ip n s
■is. V/.;- clcany need some representation
a section, chapier on inoi c panicipaiory comprehensive
are v.ofking. This should no7, just be an appendix. Exampit;
a, Thai
' )
a 'io. Sanders
•■■. ,
. . .
2,;C:h
aoc
:r
:
j .
..
?2pe. South
2402
Cea: Gn.2 202 3316
D
■
■•
3 C....... .. . ,-
- 2.'. liMct
k rhe revised mrsion of the GHEv repoit structm
'
I
i have also separated out a section ai the
.
.
a ;»wiu«.I Lvoup
people? Peii^ps u? »'•• J»s. -
i.g on me sn u
t ; ( n:
D
9
4
- pOte.'W'h '• ?■;< •
pw;pk
- poten.-»a«
,. w...:i,js -Q v..
- pole
r-jp..- \
liiia... ;.w .
chapters
endorse and support the
of'chT.i; chapters
Thanks
:ind i-s ccn c;;?.. ,'5x subject tc our email
HC'dce which can be vkwed at :
lYttp:7wvw.uwc.ac.za/-ic&/defaulttasp?webPageIDi=85
• ■■■
■
■ . . ■
s the link provided,
... . ..
.... ■ a
. .
:
cv ±.-? '-a.-.-: noi'ce.
.
...
:w(;WC.AC.ZA-
*5mn:
7o:
vxi.swa? • .tun sant@r eaithlink.org.za>
•; ase-••.i-Lcuc^esndia.;■)£’>, ■ jmartin@uwc.ac.za >: Davie McCoy
■-’D-:.
HcCcy^isntm ac.uk>; <mikerowsor’@medactorg>
---j./3>; <mikercwson@rnedact.or^: <abaysema@pri3.vsnl.net :n>
?z~' j's ? j■/. Ju:. 1C. 2003 6:11 AH
Sub/ici: Re. G’
Greetings Friends,
■- y much .o
lor ihc work that has gone into the initial
m;ui-.‘ne re the structure and content for the GHE\V.
h w, ■ umdw.w.Gy ceding. I suspect that the lime needed to raise
fuHH. o-«tnamission. review. edit and pritu a publication of this
I I think vye wdll need
nake *
iDmmug Hi.J <mj,u. re .rmdincs before we are able io finalise
•he suggested contents.
• ■
ntini o produce *
nj . ■
• •
tjiicjue from planning io publication.
■ • e.G
' A annual i
vv.; ;oukl produce the • bril, .V anniiufy widi some tore
covered evenr year and -her? some issues that we nmhJ
!:• ec-ver more bdcrmiticntly?
io produce a once oD:’ '••.ry cm • ynd: huDc tHIEV.'
/.mcL wmdd L<
•..< smwvqi4em years’:
I
••s'juld like to mink ol ihc Oni;AV
a/; ruHUa:
puffwiiiou
\\ouid suggest imv for m^mhwmAiy v<-.-
iry
comers aboui what \vu leave oui of tins sd.mukhi'ag outline.
•Ad'ui do others think?
JuiiOincttc
<>•1 4- Jul 2003. ai 7:4 l inikcrowson vroie:
• i.j^ar. ■..... jus
Thuik< Dwg. b),r .;i-c iiC\\ stHKlurc. Ji-sl r cci:pk of sugg
\ aiii not sure about site ox-wiaps
scriiou Bl-Bd. 1 ihmk Ih-. v
itive. and Fd get fi
■ podw. as vv., wm go; r;u;;i ofwika wu j-wU into a broader ’ oJid-.m
.
■
ion on heal
(:<« 1 cm also unsure about whether
iadd • <o many subject in
riHle'cid NGt ).-• orc. into this report, i feel it will also make it ait
nwk
just focus on <
'hv
cruci
P(-iIxa. (nRl^u. [ (nlrGfl
SjW
-iU
.
Xw ■ 1:
■ Du-c: '
'
’’ less.■--------- —-—-------------- --■
' David..McCov@lshtm. ac.uk 02 «•'. ;-ui3 i 5:; .2:4o-~0100
' ; Dear ah.
on of the GI
repo
.
.■
werX,^.. e -dicr k has changed in an attempt io be more coherent
<•2 s':.xdown. I hex.- also separated out a section at the end for
Wx mW-ring and advocacy - ibc section that will contain our
" 'tww'wd
-he/’ and "demands'.
?-.? ww:w::bi\ wm;w with this, I woutd like to begin to share
ww\
wd; .. broadw group of people? Perhaps to thd.isi
• ?. pwcmwi itcnnical a<i.\isoiy group members that we need to
iddition to
a- rep
w
.
ting on the sU
■
. )
j-divcbjiiLs grc.uu s we want to endorse and
supno/i j ‘/.h-s product and be invited to act as revieww-- of draft
- “ chcptWS
•
-• • Ranks
• ’ ■ Rave
• > dike Rowstm
Execuf' C Dirccirr
Moihway Road
London N19 4DJ
I nhed Kingdom
T:
/0)^) 7272 2920 F: 44 (0)20 72?1 577 7
■ .
yAvw.nicdact.org
Chadenging baiiier:< to hcalih
I- egisivrCbanh.’ ;. 981()9'/
vudnenc Xmli..
.. ..-. th
(.rEs 7,-\ t, G'onlin:<m?> (.‘ommiilee
1 i i.G
Pave 1 of 3
'...... /'.a : .
'
Alexandra Sambas <lexi@hst.org.za>
Da .-..-cCoy < David. McCoy@lshtm.ac.uk>; <ant@healthlinK.ofg.za>:
<>^::cerowso?'.@fmedaotorg--- <abaysema@pn3.vsnl nei.ii'.>
?•; seo@to i ; chte •i n d;a. net> < ’ rna rti n@> iwc. ac.za>
rscc/ ^Sy
2093 2:17 Pi/i '
From:
7o:
*'? c:
r<V. oHhVV
ID to ;-D
but my
;> ;h;u UP.; croud preclude'.................. t tt
’ .
:
. .
'
a ? fed.Ac? ■’• . -fios combin;Don for 2 representatives on the management group.
yet.
\ '•<••;•.'
agree ••-those Abo Lru. •Jed to phs?? :a ;mphasis on ’‘hearing
the unhea*
.
...
r,,
TWpl
<p.:g’2V>-'i’’'P.
-rwch
:cp-u;/ i ■:.’..;a^. .
;.S\ u.; ah.i,
/.O.
*
.
'/'i-icb-
’id .rJuuh fCpQi'i IS
J;
vdiLh
.?rc bei'ip promoted v imki them. 5 >r
jo.;
'
J.SI
.
ablyi
. .
•• . '
iocs sector?
.vif-.m-a a’BNh ihem.
''jh...-
. .
for the
Das ?
.
■ .'
Jdind scope of the report
ou:Hj'-ed r.-.i!ifo'.? fK 'opi GH?..-'V -ss a pimibn-, i'^r soopor/ing ?: bo\D
'
.... .<7, .-.3.;....;. u/i
. ■•. '•vO' ;.Lt gr;:aic/ dup-.L vauio- than Oil b:-.uc
?.o<- V. : :• \-.z. ■:
S !•• It.
..<u
.
- OlLi.ri.: iO’--’ •
.. .. .... -
Ou; 2
D:’
OiiC.
. ■ p.
A'/ ,.
proA
‘ it-- O'
,p ( ;,:--p;;r A
\ ‘ i.: -iLi’s I--.,- 1
:H. h.
■'ubi
■ -poo:
ppLOr
nV-: ■' ;
•ays :s-i; some of :M other sector; addressed
. ? ■/,• -.1 d :nailow us iu highlight much of the work different
been doit
tich was pa
f he
•
r
'
HEW.
r •
ivc
'
.
I be
. s ty, bu
GevSopmem'’ and ’meqiniy-inequality W i realise ihal they are lied
•
.
. t
.
•
• o-Mi v.v
■:..
-g •
lapter, but
■
kplici
5
loba
d strongly <
!
ini
ublic I lealt.
ri<
:
■ ies.
ng explicit in th
*
by an 7>e<gdiv. mdvdmg
operational dvfiniden. ii
.■
and Sy d. u-Wskid du’c.'ghoiit. I
t • the
...... .
■
...
or ”pc
ty” For it tanc
.;.
tl
.
...
aiiilws. reviewers. de. so mai ihu.v can im.orporcic the language usage, in
Mr chapters •. ••••' edirs.
Lexi
—r
! Mu s >:... -1 • v: ■ :maiIto:Da\dd.McCoy@lshlnLac.uk;
Sent: Wednesday. July 16t
7:03 PM
healthlinkorg.za; texi@hst.drg.za; mikerowson@tnedact.org;
.i 3.•_ vs ?d JieLi n
': . i '«'■ ’
: phms‘ic@tpiicbu]m
Subject: Re: i;v\: GREW
Dear all
. . m keen <o
or. nev,
■; sj.in'.'nan’ o: ib.-..- '
r,>.
sn-tK ?ur.'
bk: concepiuaJ Mage, i a;n nuppx volh.
v ' management and rdv;-nry siai<rm> .-
fiv:
■ MO
c :: :ra? WJ
C ..
’........:. d.x .a:., i.
■
-j./i .•; i rl no more a;n.< 5 ..n:,micr> \Uncb
mij!
WMh •- ib y-^v, ■.■■■ ;•? dexsdop a co?nmon mom v- hh M
_■ ...;.■ ■.■•/?. .■■•. < ;■■■■;
the ■ iro\. ocnl
pec
:/ • .-•
. ■ .a-';- y.or
-■ .
■
.
\ ; W } vG;;
; , J.
O.i } ,-SlrJS dim • .■■- caa muiHiO; CdL?
and r.'<' a;- R/.i-W-'-W nro-jr.s n.v.1 •••■?
• ;/y
c ? s:
.
jchtc
-wr-ma McCoy -asvk; mccoy^’pontm.ao.Mr.- . >■ >■-:wn? cxsrr.bas
m’kesowson <miKerowson@mev<w •■'?;■'.'■■ :r:K orr
De
>............. '
' ■■ i
c.zs
abayse
.
S;<7:
Thursday, July 17. 2003 3:33 PM
S u b ■ a ct:
G H 7'jV
:rorn:
To:
<: ..u-j -^z-
Dwr Mi.
Gieetnps rrcrr; People's Heaith Movement Secretariat f'GiouM, at C.-iC £a .^lore
Daye’s / Mik
1 re
£
unications on GHEW 5
year one (15u- July 2003).. : am Stiii caking efforts to s-.mj yoj some
Health .Watch initiative (id<
■
■■
larity an<
:ipated
sibilift
sund
je c
2
cr. s 3:w:..
ps...
1998-2000 .
Eric Rarr
Gene
you receive them.
! cm crscent'y
PH?
with DHM - 2 \'?cr y-oiect icg
^dia and a tentative South Asi
^wpoint, in addition to ir
’
la’s
r
■
• iphc@cab!enet.com.ni>
Pc'-'e :bala@haiap.org;. C::r - 'oHe.nordberq@dhf.u.se
(aviva@netnam.vn) lews tc sta 'ith te lative!
SMc.'/cg group
j ..c;, ciu.; recu.. e iks: :r:ree S' eng .. ere
'
7 •
! X • •■' t I v r' fci '/c11' I
Coorchnwor f^eopw's -:errh rkrmm
CWC-BnnceMro
-7 "Srhcwsa MMr ?”
•. -s;x '\£ y ;■] -J ■£'. • s: ■ •’) ri i i; i 2;ock Kc :c.c -; ?, c.: a
c.j a. 1 vi ^1 j. <■■ -v x-j v- •> ■• >■
" r
www.TheMiIIionSianatureCampaign.org
p wn
7P
* 51
?'< J Secretariat
From:
Cc,
Sent:
-a sorcwson <mikerowson@nyedact0jj0>
mikerowson <miKerov-/son@meciactorg>: Alexandra Barpbas dexi@hst.org.za>:
<ab3ysem?@on3.vsn!.netJn>: <ant@healthiink.org.za>; PHiVl Secretariat
<onms-?-c@tc!Jchteiina?a net>; Antoinette Ntuli <3nt@healthlink.org.za>
j dd.r
:
t
xuk
■
^telindia.nei
r
guwaac
Wednesday. July 13. 2003 W P.Vi
r<e: rw: GHtzW
Dear Ant and others
............... . ■................................
y
•.
i
.
.
.
get
tlie
draising
sup-pon from mysW AledacL. but ifa-wt.mc has any osdiu. contacts Vve couin utilise. dense do V
ihepr
'
ted
'
ie next week
./.. j.'. iu . .om-rm, 1 util send
more mmigms io him.
(
I
i
.
.
nds
.....
.
enthusiastic ail
I it,
. .
.......
i
.
.
... ■
’
point a physi : . tin •
' .
I
veil need to n
money for ihai. m the meantime. i mink v c should tweak ihe proposal sligauy to emphasise Jk-.
.
\
I
'
.
■
j '‘voices’* and
yand
cowd abo cemre on this (heme, partct’hrly as any knmeh v-.-mfjd n-ob;f.Py oe hnkvA with ihe
■..'.■ \
.
objccti?
aboiu nhs?
.,.'•.....
. ..
.
.
•
ige clean
'
tould A
;:rov/.;Ld. Maybe a)ou. you : odd siar: o bud V-mail ckbmc on m.L‘?
- . u: "Arfobcu,; W“
aniVheaiihlink.org.za
J... J, :.z ' iO ,-ili.
• . .
thoughts or
- -.
- .
rHl
...
:
..
■
ov. ?]
■
.T .
.
:.-iW
iv; ,u
' .
id
i ........
?-•! •rtUv-v •••.< mow '•■••
"inx’.‘.u oov.
.....O'
*
>•, d.-i.-iiOf o- -.:-v
'•
.
■ ■ •■
■> m ;j’iv ii.b-L
;•!. m-Vm Aomd.
■ •
•................. • •■■
............. 7
:
r•'
• ,•< r
’i t
• '
•f
■
‘ : '.)(• ‘.MOK ‘.’ i
{•...i.;-..
(n G in
H u
(?.• '03
PH?;’ Secretariat
7_7."~■ “Cr,?"”rz.'.'.''.~.r
~~-~77
-7 r:k
Antoinette Ntuii <ant@healthlink.Gfg.za>
mtovowson <mikerov
*
3on@rnedact.org>; Alexandra Bambas <lexi@hstorg.za>.
<abaysema@pn3.vsnl.net.in>: <ant@healthlink.crg.za>: PHM Secretariat
<pnmsec@touchtelindia. net>
-to.- U mccoy@!shtrr. ac.-to ; ••phmsec@touchtolindia.net>; <lmaton@uwc.ac.za>
Vvednesday, -July 16, 2003 12:57 AM
Re: rw. GHEW
Trcni:
To:
’
Sent
Subject
Greetings to AIL
, \ tow more thoughts on GtoLAV vvliich stern from my experience of
to’to, toe South .African Itonith Review. and are an attempt to
*
ldn<
with ths project.
re going to need
hoi
2
Hordinator ’.the
prqto - nresmntoiv tois tol be tovc.- Wave will sil in an <x officio
pacit
■
'
I the Advisory B
. '
flu manag j.iwv.
wxxpjis;;?: aw; wps Irons MedactAVemotk
:to.1, ;to Ito? to’ he -ortohh to stoatcgic decision making.
A.i-draiskig, publictom;. —to ;'f,w; A.;a.tom
Advisory Board will prevkic technical support and may be a
• co w fluid body than Lhe managen w.v tearm pulling in indtolduals as
necessary. ; he tovison Board wifi pto an important role in
emmtossiontog and editor of eomdbiuions. Il may to necessary :o
to /c on jindA tonal toio tow.> a lead3: .vorakg withDave :c coorctomc circh of toe four s'-xiions.
s going
•
■
li
...._/.
■
■;
.
atance
■ '■...................................................... •....:.
. ■■ ..m;,-
•
fex. mialto corkfoL
■
reby eat
i.
j.,\-ed
by c.\ icas; one
is todLtoi io insntoew of i’u
. tovkory Board. When we request contributions we need to have a
t which gi
and indicates dia< to->:-:.--ca deadlines .ire not nici then this
:vay dsl; work being excluded.
<. ’.A
>• • aoniciHs. 6scA-h AW .:cd me s-.’-x. cud we will
rerhaps want to exercise to?mer e toori:’j cotortf man in Section C. I
. .
•.:• 'nstortov horn year to V'X?v. anti ncriiaps we shoukl aim io have
'
n that section each yeai
. lilil’iix iiLCi'C i.S
.xi'iV.C Ji'gvAC'. LC
1 Ci'C-S iviX:.-. /.J
C uli:-' ..
Atobig gropes?’ and to star! to raise funds, ih..- ticitos .vahead;
ugnL
'
.•
.
'
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Subject
So w I'.’.cCoy <David.r7lcC0y@lshtm.ac uk>
<om.2Ae3!tnlink.org za~: dexi@hst.org.za>. <mikerowson@rnedact.org>;
<abaysema@pn3.vsnl.netin>
;d AcCoy <D<“v.d.K;!cCoy@!shtm ac.uk>; <phinsec@touchteiindia.net>:
<lmartin@.uwc.acza>
Wednesday. July 16, 2003 10:32 PM
Re: rw. GHEVv
Dear all,
:
kcor tc move or. now beyond the conceptual stage. I am happy with Antoinette's summary of
GKIAV mcnagcmcnt and advisory structures.
of tl
11 ta
t that we are agreed on:
; ■.•■.; four Broad Sections ofGI’fW (SHcAms .A B. Cand D)
. . . . .
. itcl
: ch \
. d winch . ill
j'i’O'v
io ckwdop a common from with RGBs from mhcr sectors such as the environment and
peace groups
A that seciion B is j'oeussed on neaiih • miky, and the chapters may also change from year io year.
4; that Sectioo I? wd! consisi o’’ /: set
issues
w< can monitor each year aod use as
hi.ick, narks of pro own. and fb; :.d\ Gw/wy
....
...
.
. .
C .'.
wgucdaA having some mamkiw io now move on w’ih engaging Conors and pohmtial advismy
i'.b',•/:•:
. am a little I i
al
.
dea of a n
■LIiirLl
Wabo
his necessarj’.-ie. counter
inging realib
)li
■
io tW v..uwhcd anu hek; uccocuwow:. dw need 4; make ilw pAiiicw cconc-iuy -c.itih .;
•
ie
vitalise t
•
prc-pr-vaic sec-or conscwcG
key glob-u! players v;c.
s?.u
- - ■ ..
. ■■ '
•
• ■
he rm cmpAAs «.•; 'he o. ■ kuh Ay/easoi- . fur
xnjd
.
•
n Health R
ortan
v;\- arc dok1
_■
ucti
nm for supporting
>ntext be t
w.'u.wp
jater depth
.
■
*
an issi
v;mc i;k\ v
'A'I'--
A rilmiu the Routh African lieiuih KwavV. is that it pt<.v\<. :. iw a* ot arJereni issu
’PA ■:<(
-.hoo <•
C.'ld /u:d ■ : •’/ ".?:» ;. « A .
i c ck
• .
(there’s
;
ddrU- lacked off!
•
t to target the pr<
:
From:
To:
. - .
Subject
.Use ;hc
J- : -..‘cOo/ -Da7:Jk'1cCoy@roedaccurg;csec^rouch-c-Hf-Gia.^ev•osrt? r:.‘<s/
au>; <mH<?&medact.org>
Wcdoesday: „k::\ 23, 2003 10:29 PM
0 >2;. repose, coc; Dear
Steer ng Ccrri;i
*kt&6./.oc
GHEvV
> a len
md out: to the PHM Steen
inc . isyouaugj
.Attached i
1213 int-dllicd s-rdon cf the coixcpi nCc (shuiler it has the PrD.k med act arid
GEGA logos etc.)
•■ •
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.
.
mdcrs
ii.
?vk ncn .she
'•
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[ii<e 1
ttee houkh
i oni contac
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luiiic '.'Ocn on. wuni <<• avoid a;?;.
- • ■
.
h: hjpkng ?ne ..-r hrs - so h<v
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............ S<
ippi
i
itly
him about G1
ing in g
I?
•■uin.u,.^ak(/n wi.h .tenners ;hai
•
v, ‘11 be popping up.
il
PlA m r (nk fr u
name
S-oer/n-g Committee.
Cue:
... r.-,:c. vvo!’-?. r—3‘tn assembly. the Peoples Health Movement endorsed an idea put forward by
GSGA <'•■■:■ ? Gcact o o'oduce :w ?'tcrna:im .vor'd health report'. After so:v e weeks of discussion
,?y ■- st?.” group ?■•; .ncVduais representing the organ.cation we have developed a ccncepr note
:
t w use w begw a piccess of wider consultation with other NGQs and with funders.
• am attacmrg th? concept note and i wOuM value your input and thoughts, in particular i would
•••/? ■ e ? s-. ;;•? - ors about peopl ?• who would be able to contribute either as chapter authors. or
ss ? p•-.£.•
.••:■;•/- V/e are looking for two types o' auinors - authors who will be able to provide
a rwcrsus <wo / /....-.. wc-based una.ysis c- the themes and topics, and second?/, authors wno w.v
be uGe ./- pw.w c case studies an-u be expressions of jw /o.’c&s of trie unrieaid Ahese wm jo
boxes emoeaded witmH Me various chapters as ouWec at tne present moment).
< e■
; <•-•■ the chapters to be cc-aulhomd h r more than one authcr with the /ntention of
■ . .
.
sons
cc .'.ci icficcto norths;/:
"rriwefwe :;id;v.a<w:s. aoederrncs and NGOs <rom the South
,^c CL .-ee,.
some expertise Mat could contribute to s particular chapter would be especially
•. TZ .
.g
'r :c ?■
.;•> S<wwm C ./• .■■?
j........................ sre fore locking foi
i/wi. wc i/c v.i? outside of the health ce/ior.
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.
................. ...........
reiateu wd -e environment. agricmiUie. food seccrny. gender etc.
i ?./? ■•: p?'.g
.
'^/.e ? !ist of aumors and c-_ w-.th-u-s oy m:d-Se<xembe..
fc; ,.ar;_ ;?■ //carinc f; w. you
‘mar w. ver/ rruwi
Da--, e. G 'cOow
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Introducing the Global Health Equity Watch - an alternative
World Health Report for the future
c^ackGround
E^.y day 30,000 children die of pre ve.nt.?, die causes. The HIV/Alto endemic continues to
Z-. CTcH. “ th
j- <?».,r—/7oryr /'•'><
-O'-ZC'C, 5 nd forge
rf A/g fAm. '
j
j-..!;’. 7/or’d/y; de.. ro--ir :■. ci 'if__ t-jr.f:•’••/. iccc. -J household !•.•;•.•'■/ remains Ac b r-.mm
jrAeHAnq cause of morbidly a?; ci premature death. 1.2 ciilior people, most-y v/orner -.r:
dAdren, live on iess c>JS$i a day".
corsu’r-ijr.-g more. The wcridA 25 : ich-z^ people 'rc.-t income mA csscrc -/or r> AS/4~<
more •;••»<•»'» vhe errhre (TAP of 5ub-5<marc-.n A'ray.
Li
: -
or trie eccnorr„c y oo to aorj Te;.'-hco.'>..gicG.' advances ci ; ;-.c. iasv fo. ty , ec.'.-;.. •.: a cc; <
e asion tiger econom
abl
settle ebuntrie
have
e
k
tent, for
ec
indards of h
'■‘/erst still, the sacici crc ?.cor'Omic ■“■c. Hoprrc<? cf some has com:. ■:" ‘'-le
•.■■i.'.v.c-c'ishj’cr:(■ :f fhc-■$.
frat
o’ the
C
:.. Ljcbs:
' 0 GC'CC;
:' • / . 1 <.
been me- virn barely o. vhimper •yiparr from the effcrt$ of -?ne Peon:?.s --AdTri <7 .• ••.:. :•• ro
T
■’ •.gcj A' th-: L.:a\ •:. be■ A. •
' 5s c.’iba.'
■ •
..
...................
I
•vek
r
...
th
i
(which is dominat
national Moi
u
.
.
’■
.
■
Fund .hav
tent tally
icon
■
'■ ooiic/ p-c/ers by virtue of *he impacts of Trade policies and brooder x’bhc
se<-wholes or. hec :h ere health care.
. .
idaratio u
:l
st
e<
.
-J-W ___
cij
of eqi
----- J
social r
•
,.
.yur-ent that the conceptual meaning of the “PrIC Approach" is no ion-ger
owe wood b.
wk? freqaenby confuses w w«th primary level care. Instead, WHO has
become increasingly tied up with vertical disuse-based approaches and questionable
occwnwHc, numbs •'••crunching
Obers have pc: rived to its supper;' of the -ckv."ej
t i sis an
rnmendations
£ Com
or Mac
s
.
jc Ith a
.••ww?siug inf
zs the corporate and private sector.
. w:: Swrk or. tne other hand has cow.-wed to foist discredited, r.eo-liberal solutions to
new and pover.y dii/ilwy. Icirbcr Than supper; ing Tire development of public
svs’-ems, vriey have promored the fragmentation c;; health s*/s terns and increasing
.rwetisetioh. Hea;th sectorci;.on .vwh an increasingly under-funaed public .wwi c
for tne ooor remains the stock sobwion - in spite oy its glaring failures. On top of
reforms of
'
s to
rat
■ eff cienc.es r:w<;■ r&sc.t from oerncr. under-skiiied and under -paid civi. servants.
y.ww
tear after year, the worid
trectec -c a new set of commitments, goals and targets for
development and health - the lew
*
being *he millennium development goals. -Vr■';••■? making grand
•>• c-wu..cerrwwic cr. deb. iw.e;, ;.wc.u /worm, c.;J anc
'.^e WYvn s that overseas
Tr-'/c’io&rre,'!r oscicTc’nce r-’- reebn'id..
rc ...ar ■>.
■•:• es hrepr ?.rr/!ror--menT
bemme
even more
f
dfy
ppc
J rhe
arclal imperatives of riel
end mob i-nationai corporation^ ho-^. consis’eri; ly taKen precedence over social deve’e.-ome-w.
cme’/iahoc, equity end ccc--.- wc zc.;r :.ess.
.•.,7?K,joh corfrct/ ccrrLp"-on, i^eff'cier;, unethica' and urdemocraf-ic gcver-iimenT ruthin
cc\.ntc.os arc a ciriciorence <o r>qa;?able deveiopn;e/'.T ■.hcv requires iocai v.ctiur. d-.v.
establishmentsuch go\.mmrents often hav--; c.<tcrn-j| g'aba’ con? dbutory and causal factors.
to tnc-slYmticn 'escr oc-? abover more and mo-'c health workww -■.’or;?. ■‘•h::u
idarc
• - .
oprnenf. M
■-vr'e commonf+ioc and academics are aware of hc-w the internr-rjO'-al '.aooorric S‘v:-rm end
g ocw wcvwn -;s perpe-ua' .sg govw■;y and is.creasing inoquitjes; end -! he
c- c- sj <- '- ..-.:
e^fecsi75 giobai
health wa-:krsh:p has become ;rare:-smqi-- c/i:. ■..:<■
:.n
re>uon<2 to rhis si ■ uatiou. The Peop.es meadh a-oveme: '. together : •t-i i=\-..\cc: ?. r.
Eqi,
< Milam
jposec h le\ Uop lent on ar It
'
‘Id s dth
Ar-ipor-.be k/iciun as 7 he buobu. Hecith dqur.w V.'utcnj.
r-rd jee ''Ynr’t.v’ worid rep'jrrs on pfwticuiar ’•’ed'i'n too;cs. ’'’ae ;-;oriri sm's p'-od
*we.:
a ''''cmo
..
•?e•/eiormeru report every -ear. In addition, academic-:' -md
produce many dccurner'iYs
nd discussin
.
f of global health
*
Hou
■ . i’
■
•jcg
vg Tais ,<«•;;;■•:??•■ L.-<>r.--- of
■/'••‘hai' ■.•'■;\,lci be •! '■ charccT‘-’-:s. ws aw ■. -. :.-cs of
' ' ■ .
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.
.. . .
'
.
'
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:■ iiCT'C’ describes the ?:j^pose; characterist'cs ahd need '■:r' c'-r.
’■ :
r'.rs <mci need for cm alternative'world health report.
■<•.
’ -.e ■-'
eb.vj'-y
o.Tch wouid represent an ‘alternative world health report' rhot;
>: i.-.aes equ'W ano net poverty at vne centre of its analysis - this stands in contrast to the
co-:hor -i'arcx/t w the poor and the marginalised c.'h'hoiri
*
^e fating them to
\v.c
uf:o
A beheve That any significant improvement in
hemih of Tne poor
'•
-y
-.j*1 only be Possible trough an explicit commitment to reducing the
. tor;lies ce-;
: :e. rich and trie poor-: and betv/esn the powerful and he
* a; ria Used.
c?.
«s
.•’•••?:?■'v-7 'vo’ces of the unheard - tn is ends in conTras'r to reports that are proa-uceo
WiW
:c W.gucgv arc ?ucctc>; e’e for mats. V/c. wan
*
;u produce a ^eport
r r:
access; die •:
.bed in reaiity and which reflects rhe voices of the poor and trie
mc’rg.na-ised.
<
?.?■?/ perspe; r\> - r<h: ’-•'tands ir cctrti\ist to th? jomirent devu'opn’rnt
ihioj
he null ate
e jpme
icies
. :
:oun
.
;lieve
“-..f g •■err.iref'ts and the p,<■':•: sretor
ion r a r.--> able, to provide bus’s
remote eq
and e
s effecth
id.efficienc
imar
■
i
rez -er inequities
ve ie...............
■’'•.a?
supper;
ws.au.rsrwer t of pubho seai-cr bcreairjracie? •ifr .
ano ef ficienTlv. rather tnan dirrrnishma "heir roie.
«■
Arcrnores rhe PHc Approach -
tr? *
awards explaining ths
si
relieve that rhe principles of
.
I
<
iportanz
he 1978 Alma Ata
y Watch v/il| work
i
:ipk
Pro notes hearih systems development m cor.;rcst ?o .-orticah disease-cased i at er veer ions in reern? veers.
has beer c c^c.'.-f-c tendency to
’rartictm;" disiXGes
ir Than ac
?sing the core fi
intai c<
fu
.
health
squarely
r b
.
. -
i -
s stands in
cvmrcst To rhe Tendency for'- g<rba| Hedtr problem; to be cescrm^d in ->;?• r.nor? u.; The
ui'/uirr-iss of ■■'•-/•.. ghbJ po’./ c-.: ec:ro:r./. '
rhev ?' :' d dr
srcncrAv vf
hecuth shciiid be a ceniroi c-ubix heai?h prioni'/ of rii iieahv ,? vrkers concer.'vd abou - 7;-e
pccrt s ta re c f gio ba I hea .
>
Places health end the reduction of hecitr irequi^ies ■■.>•.( xy vithir c multi-rrrtora!
spectb
adsiitio
- ing heal
jn< lealt!
ss t
.■;•■■■:•~T0; rccromv. tn? Siohci ■--?? -..-rr. Fzp.;;-v Watch wii: prcrncTe. a r- ;cr'^hr ?f --ne . r
i teall
evt roc;.- scT.- r-.r.'.
< ‘f
r >7
is
environ
, interne
hoL'S!^;, ‘mb rights, c-:^f'’CT anc er-:
-r ••
• rl
scie
fc
' ,
. healtl
.. ubhcct’cn cf.reports by UN and other multi-laterai instituticns and a’so c'Jows ww
;o'-r>•:?, of cjch iryjtirut-Tr? -0 be the subject of afrwo; monitoring and reporting. ?•'.'•
< 3
(press the views
1 St
■
rcseartf. •/. c./clysis :c- advocacy - the Global i-’>c:th equity Watch v/T de more mr
aescr-ce. The $iv..-g of heairn and inequity. It wiii aroVide recommender ions and
C'-.:c
advocacy cci :o;.c tpct w: .’ heip ens..re thai real change in favour cf justice and
• edistrjbir'ii/O rakes piece and tnat governruents ano the relevant international ir uttirtons
j: •? he'd ms-re accountable to th?se who arc. marginalised and impoverished.
L
t/i’ :!c the report w!;
rrrih be an ara’yhc cre evidence-based document grounded v. ‘"h rar.c
:..sc vc; ?/-•; elements of reauiy 0 the ground, .7 will also be explicitly based on a sound
-cation of r^e. nr/'-m-st’vs
desc^’h^.r abeve.
3. M anagement
of:7 coc 'dirated by " he
organisations hc^cd
<idv;sary rechniaa; committee. Because The three sponsoring
trod,;c-;-ion
aoove. They wii; be guioea c-/
j
I
ithin the health sector, r
g
iee
nuIti-sectore appr
ilop par
7hut ir.e regert adequately reflects a
orgcnisahons from rcc -jc-rcai:h sucrors to
node ..to make
I
srt
possible.
Structure and Lay-Out of the Report
4
■.. .
h sub-secti
0
t
i
;
bal hec
s
ground and vr.e voices of peoaie .-/ho
cade
vtd
h. Many N6<
rieaith Equity
cS;.' provide an an per ?i
cac a
,O
_ • ■■
i v;1
t
testimonies, f
7rad> .-ior.miv u.-.;eGrci. The '.:iea is <•;•:
e the
lave c
sear
1 some ng
co.. -•?.-■
:
Global
aqpu arisation.
d
ic
be comslimentod vv^^-
■ for tr? cro'yvis
.
■
.
ue
as
it be
scessai
t1-?
x cc
a"
sio some primary
reseerco
•’he ioea -s that rhe chopiers would be wrrrten by an ec'ectic
p
intati
?f al
.
of
i world. Far e
' . .'
Th
exnerT- cino .’x’£Os,
ujt
vill be id(
g in the f ie
i
chapter,
cop.'m-j to rizo -/'■ ■ .T-. repor.c 15C,9OO wo rd:.
. ■
n
;
:
at ion:
J5
•
[NTRC
EALT14 1 EQUS TIES
FC
odd (.5oc:c--. .xcol'c, Health and health systems inequities)
'?'■ ./•?.<
r
h Equity
I He
CONOMY OF HEALTH, DEVELOPMENT
.
Li. ” •
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‘
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Social Secto
53. ’ 'cf.’-1 •• "o .
;T-iG"
icy and ‘
5L.: ;n /-.ger- d :
3' doctors? The Glob:/ Lrair u)ra ‘ : f' :■•■..-th Personnel
BL y~
p,,-! r? of Accessible 3'-.ed-c:■■/'.'•
--
■“. Si- be: r- :;? ’■:• - •:?. cr Lender::1':-- - S niece
•
di. Aar:cc:'-^'e end
v-sEf^ecrive anc; ^roerosive
-j
SecuriTy
LL. v'/Q-er
53. ?A. i'"cies-n,or ur.d Conf i ict
C4. E-’L •on.rc.-- ■
CL. Gender anc ’ V,>\\ - Access ?c -^eprodua: Le ^igrrrs
'
.
TM:
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nu-S/ir oi: aib-scctbns each of ---C’1 vr;!' h'gh/Srrr - <;
; a report that is - icnrror rg de:
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Funding Proposal for an annual
Global Health Equity Watch
.
i
.
ues io
es
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:o
, local and hoi
j
e bigges
■ .1T / err pre mat :"'O death. 1.2 b: Ilion people. mn.s?;v ••/om-v an-::
fric
jridwic
cause of
l-dre--7:!'.r<
\.* ecu; :
he healthy
Acdcc rc '•" s ere
.
The poor are getting pco;
and the
’’-T
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're eHvi< <•? &Nr of Sub-Saharan Africa.
ivore
pea-. v.'.-r-a yvcr.e •:
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People’s Health Movement
The People’s Health Movement (PHM) is a growing coalition of health activists and health
professionals, NGO s and civil society organizations, academics and researchers and networks,
associations and people’s organizations that endorse the (People’s Charter for Health — a consensus
document that arose out of the People’s Health Assembly in December 2000 when 1453 participants
from 92 countries met to discuss the Health for All Challenge.
Objectives
The objectives of the Assembly and the Movement, which evolved beyond it are:
•
•
•
•
•
•
Promote Health for All as an equitable, participatory and inter-sectoral movement and as a
Rights Issue
Promote government and other health agencies to ensure universal access to quality health
care, education, social services according to people’s needs and not people’s ability to pay |
Promote the participation of people and people’s organization in the formulation,
implementation and evaluation of all the health and social policies and programs
Promote health along with equity and sustainable development as top priorities in local,
national and international policymaking. |
Encourage people to develop their own solution to their local health problems.
To hold accountable local authorities, national governments, international
organizations and corporations to the health for all commitment |
The People’s Health Movement is coordinated by a global secretariat now located in Bangalore, India
which is supported by a steering group consisting of the representatives of
•
8 organizations and Networks that cosponsored the first Assembly: Asian Community Health
Action Network (ACHAN); Consumers International (CI); Dag Hammarskjold Foundation
(DHF); Gonoshasthaya Kendra (GK); Health Action International - Asia Pacific (HAI - AP);
International People’s Health Council (IPHC); Third World Network (TWN); Women’s
Global Network for Reproductive Rights (WGNRR) and thirteen regional focal points
representing members in the regions of South Asia; India; South East Asia; China; Middle East|
and North Africa; East and central Africa; Southern Africa; West Africa; Europe; North America;
Central America; Mexico and Caribbean; South America; Pacific; Australia and New Zealand
and the past and present coordinators.
The movement] is operationalized through Geographical circles at country and regional level
and jlssue based dialogue circles that are linked though local and country level campaigns.
PHM secretariat facilitates communication between members through advocacy and campaigns;
website; a discussion group called PHA Exchange; Media releases; publications including a News
Brief; and through the PHM participation in various conferences, policy dialogues and other
events supported by PHM volunteers all over the world.
Presently Dr. Ravi Narayan is the full time coordinator of the People’s Health Movement
Secretariat (Global) and can be reached at the following address. '
PHM Secretariat,
C/o CHC,
# 367, “Srinivasa Nilaya”, Jakkasandra I Main, I Block Koramangala, Bangalore - 560034.
INDIA. Tel: 00 91 (0) 80 5128009 (Direct): Fax: 00 91 (0) 80 5525372
Email: secretariat@phmovement.org
For more details visit our website www.phmovement.org
16July: 1(21)
Application to Sida for grants for the period July 2003 to December 2004
for continuation of two linked projects
Free software for visualisation of development statistics
Applicant: Gapminder AB
and
2. World Development Chart (WDC) & World Health Chart (WHC)
Provision of free time series of digital data on world development powered by Trendalyzer
Applicant: A Swedish University network in collaboration with WHO and UN
co-ordinated by the Division of International Health, Karolinska Institutet.
Compiled by Hans Rosling July 16, 20031
Internet:
Data
Server
Software
The six main functions of Trendalyzer ®
Presentations
www.gapminder.com
Figure 1. Conceptual model of the six main functions of the free Trendalyzer software
1 This application is a reconstruction of a former version lost due to computer theft on June 7.
16July: 2(21)
CONTENTS
1. Background................................................................................................................................ 5
1.1 Millennium Development Goals (MDG)......................................................................... 5
1.1.1 United Nations Development Group, UNDG.......................................................... 5
1.2 New IT resources.................................................................................................................6
1.3 Contemporary provision of global development statistics................................................ 7
1.3.1 Yearbook tradition.....................................................................................................8
1.3.2 Software for professionals.........................................................................................8
1.3.3 Untapped new IT resources...................................................................................... 8
1.3.4 Data ownership......................................................................................................... 8
1.4 The Vision.........................................................................................................................9
2. Project Milestones.................................................................................................................. 9
2.1 Phase one, World Health Chart 2001 ............................................................................ 10
2.2 Phase two, Trendalyzer 2003.........................................................................................10
2.2.1 Project collaborations with UN in 2003..................................................................12
2.2.2 Project extension to Education and Economy in 2003 ..........................................12
3. Aim........................................................................................................................................ 13
3.1 Users groups.................................................................................................................... 13
4. Plans for July 2003 to December 2003................................................................................ 13
4.1 Effect of Macromedias software for program compilation........................................... 13
4.2 Project team at Gapminder in the fall of 2003.............................................................. 14
4.2 Main collaborations in the fall of 2003..........................................................................15
4.4 Project team at KI in the fall of 2003 ............................................................................ 15
4.5 Output by December 2003:............................................................................................ 15
5. Plans for January 2004 to December 2004.......................................................................... 16
5.1 Output by June 2004:...................................................................................................... 16
5.2 Output by December 2004:............................................................................................16
5.3 Output in Coming Years:............................................................................................... 16
6. About Gapminder................................................................................................................. 17
6.1 Why a company?............................................................................................................ 17
6.2 Gapminder owners and board........................................................................................ 18
7. Budget for July 2003 to Dec 2004....................................................................................... 18
7.1 Budget for Gapminder....................................................................................................18
7.2 Budget for KI July 2003 to Dec 2004............................................................................ 20
7.3 Budget for other partners for July 2003 to Dec 2004................................................... 20
7.4 Budget for continuation in 2005 and beyond................................................................ 20
Annexes:
1. Travel report by Martin Ejerfeldt from project teams visit to UN in NY on March 10-13 2003.
2. Mail from Jan Vandermoortele UNDP/UNDG & report from UNDG Re-Cap meeting with
project team during UN tour March 10-14, 2003
3. Invitation from Michael Marmot on collaboration with Amartya Sen and Emma Rothscild
at Trinity Collage, Cambridge University.
4. Annual report from Gapminder AB 2002.
5. Report from Gapminder Share holder meeting April 28, 2003; with annexes.
6. Economical report from KI for World Health Chart grant for Jan-June 2003.
7. “Improving Statistics for Measuring Development Outcomes” at WB June 4-5, 2003.
a
16July: 3(21)
EXECUTIVE SUMMARY_____________________________________________________________
BACKGROUND: UN has defined 8 Millennium Development Goals (MDGs) and 48 indicators for
monitoring of goal achievements at national and global level. The MDG initiative requires increased
use and improved understanding of development statistics to guide global and national governance.
Annual data for most development indicators are available for almost all countries for the past
decades. Each year UN Statistic Division, World Bank Development Data Group, UNDP, WHO,
UNICEF and other UN-organisations add the last years free national statistics to their growing time
series of development indicators. In spite of a similar basic structure (Country/Indicator/Year) the
numerical data sets are provided by several agencies in many different digital formats.
“World Development Indicators” from World Bank and “UN Common Data Base” are the main
global data sets with long time series in standardized formats for hundreds of variables from all
countries. These data sets are sold at prices of 100 to 275 USD, but only attracts a few thousand
buyers in spite of the co-existence of (1) data sets with long time series, (2) free yearly updates from
countries, (3) UN’s focus on MDG and (4) an ongoing "IT revolution". We think this can be changed!
The key to successful sharing of digital information is free software for user-friendly
visualisation. Prominent examples are Explorer, Netscape, Acrobat Reader and Google. An explosion
of free sharing of genetic information among scientists is based on the free software on the Gene
Bank servers. The same can be done for development statistics whose use will explode when a click
of the mouse automatically turn selected information from free data servers into understandable
animations on the users computer screen! The software solution for this should be freely provided.
Our Vision is to improve the understanding of development by providing a free software system
that makes the number of users of development statistics increase from thousands to millions!
Project phase one (Nov 1999 to June 2001) We developed a software with WHO that turned built-in
time series of health data into easily understandable moving graphics. A beta-version (300 A4 pages
of code) called World Health Chart (WHC) 2001 (www.whc.ki.se) got positive comments from
10,000 testers, but they also requested additional functions. With WHO we concluded that a stand
alone computer program was needed with the following six functions:
1. Interactive visual display of time series as animated graphics with options to split national averages
into data for provinces, gender, and other sub-units, access to data sources and uncertainty estimates,
as well as several additional interactive user “goodies”.
2. Export of created images to Power Point and other common image software.
3. Export of created animations to Flash and other major animation software.
4. Import of data frdm Excel and Access for comparison with the built-in data set.
5. Production of National and Topic “Charts” for distribution of special data sets to identified user
groups by adding new built-in data sets and customisation of languages, settings, and interfaces.
6. Browsing the Net for data and downloading & uploading of datasets in standardized format.
Project phase two (July 2001 to June 2003). We developed the free software Trendalyzer® with
above listed functions 1 to 5 and used it to make animations in Flash for the Human Development
Report 2003 (www.undp.org/hdr2003/). Trendalyzer2003 (1,500 A4 pages of code) is now available
for testing (www.trendalyzer.com ). It will be provided as World Development Chart (WDC) 2003
with a built in data set from the UN common database. Collaboration with UN and the new MXversion of the Flash has expanded the concepts for the Trendalyzer software system
THE AIM is to convert boring development statistics into enjoyable interactive moving graphics by
1. Trendalyzer software for download (.exe), with built in data sets as regularly updated World
Development Chart, World Health Chart, World Education Chart etc.
2. Trendalyzer software for interactive web display (.swf) of development statistics in moving
graphics from UN and other Data Providing Agencies.
3. Trendalyzer software system in Flash components (.fla) with open source code for use by
others interested in composing software systems for visualisation of time series statistics.
4. Search of time series of development statistics for visualisation on a web site linked to a “Civil
Society Server” with possibility to download and upload documented time series.
16July: 4(21)
EXECUTIVE SUMMARY continued_______________________________
Target users are:
Various groups concerned with global and national development, public officials researchers, policy
makers, students, politicians, activists, journalists, other professionals and user groups in the civil
society that formerly did not access global, national and local digital development statistics.
PLANS FOR JULY 2003 TO DECEMBER 2004:
Software development will continue as "extreme programming" (as games are made). This means
stepwise definition of requirement specification by continuous interactions between software
developers at Gapminder and test pilots at Universities, UN and the Web. Pragmatic changes from
Director to Flash programming with intention to eventually provide the whole Trendalyzer software
system in Flash components with open source code.
Networking with UN and universities will facilitate improved provision of free development statistics
with documentation of collection and editing methods as well as systematic provision of uncertainty
estimates.
Output by December 2003:
WDC2003 with tested, revised, and debugged Trendalyzer2003 and UNCDB data, promoted.
Specialised Charts with Trendalyzer2003 done with WHO, UNAIDS, UNESCO & selected countries.
TrendaIyzer2004 (.swf) tested for web based visualisation of UN Common DataBase.
Development of Trendalyzer2004 in Flash (.fla) for providing both executable (.exe) and web based
(.swf) versions.
Planning of a Civil Society Server (CS-server) with an international university network.
Examples of documentations of collection & editing methods, and estimations of uncertainty ranges.
Output by June 2004:
WDC2004 with tested, revised, and debugged executable version of Trendalyzer2004(.exe).
UN Common DataBase visualised on the web using Trendalyzer2004(.swf).
Specialised Chart versions promoted with UN-organisations and a few countries.
Start of a Civil Society Server with an international university network.
Documentation of collection & editing and display of uncertainty ranges for variables on CS-server.
Output by December 2004:
Debugged and revised Trendalyzer2004 (open code components in .fla) for promotion.
Expanded Trendalyzer use as downloadable Chart versions (.exe) and as visualised databases(.swf).
Further development of CS-server and linking to some other servers.
Plans for systematic quality certification and uncertainty estimates with UN and university networks.
Output in Coming Years:
A 100 to 1000-fold increase of the number of interactive web- and computer users of free digital
development statistics compared to the present thousands that buy commercially provided data sets.
Increased use of national digital development statistics in a number of countries and by a number of
international organisations for monitoring of development and MDG and for policy analysis.
Facilitation of evidence-based research on global development issues.
Contribute to a growing system for quality certification of time series of development statistics
resulting in provision of understandable and well-defined uncertainty intervals to users.
16July: 5(21)
1- Background
United Nations has defined 8 Millennium Development Goals (MDG's) as well as 48
development indicators for national and global monitoring of the fulfilment of these goals.
This set of goals reflects the contemporary view that favourable development is composed of
different dimensions that reciprocally reinforce each other. The multidimensional concept is
only useful for policy if specific indicators are used to monitor each dimension of
development. Time series data for the 48 MDG indicators and for other relevant development
variables are available for most countries for the last 20 to 40 years. The success of UN's
MDG focus will depend on increased access, use and understanding of development statistics.
We do not think this will be achieved by “business as usual”, i.e. by selling major data sets of
development statistics at a high price to a small group of professionals. Almost none of the
world’s students use these digital data sets during their university training. The available
digital development statistics of countries and the world need to be in the hands of many and
to be displayed in ways that many can understand. Fortunately the Internet and new IT tools
now enable us to make development statistics as understandable and enjoyable as the daily
weather forecasts on TV.
Students, activists, politicians, journalists, planners, researchers and decision
makers need to view and understand time series of development statistics, especially those
assessing past trends and future options for national and world development. Many millions
of those sharing the need to view development have access to TV and computer screens, but
the data is only available in the databases of a few professionals. We think the time is ripe for
the development of a free software system that enables the development data on the servers of
the few to interactively move in understandable ways on the screens of the many! We call our
attempt Trendalyzer®, a free software system composed from Flash components with open
source codes.
1.1 Millennium Development Goals (MDG)
In September 2000, a total of 191 nations adopted the Millennium Declaration of the United
Nations. It sets the agenda for the 21st Century for peace, security and general development
concerns in the areas of human rights, environment, and governance. The Declaration
mainstreams a set of inter-connected development goals into a global agenda. The goals
contained in the Millennium Declaration have been merged into the eight "Millennium
Development Goals" (MDGs).
1.1.1 United Nations Development Group, UNDG
The UNDG has been assigned the responsibility to support UN Country Teams in
their efforts to assist national governments to implement and report on the Millennium
Declaration, especially with regard to the MDGs. UNDG is chaired by the Administrator of
the United Nations Development Programme (UNDP). The Executive Committee that leads
UNDG is comprised of the heads of UNDP, UNICEF, UNFPA, and WFP. UNDG also
includes: the Department of Economic and Social Affairs (DESA), United Nations Drug
Control Programme (UNDCP), United Nations Human Settlements Programme (UN
HABITAT), United Nations Office for Project Services (UNOPS), United Nations Fund for
Women (UNIFEM), Joint United Nations Programme on HIV/AIDS (UNAIDS), United
Nations Conference on Trade and Development (UNCTAD), World Health Organization
(WHO), International Fund for Agricultural Development (IFAD), United Nations
Educational, Scientific and Cultural Organization (UNESCO), the Food and Agriculture
Organization (FAO), the regional commissions, the High Commissioner for Human Rights
and the Special Representative of the Secretary-General for Children in Armed Conflict. The
UNDG Executive Committee is comprised of: UNDP, UNICEF, UNFPA, WFP, and other
16July: 6(21)
entities participating as warranted by their interests and mandates. The Office of the
Spokesman of the Secretary-General and the United Nations Fund for International
Partnerships (UNFIP) participate in UNDG as observers.
The MDG process offers an opportunity to provide coherent development statistics
from the UN system. Through this process and other initiatives such as the Paris21
programme of OECD and the work by the Development data group of the World Bank it is
recognized that development statistics need and can be better used (Annex 7).
To gain optimal credibility an international collaboration is needed for development
of systematic methods for quality certification of development statistics. Such a system must
be based on documentation of both collection and editing methods used to generate each
number. An uncertainty estimate of each numeric value for each indicator for each country
and year would greatly facilitate a wider use of the data. Christopher Murray at WHO has
started such methodological development for several health indicators and other data
providers can benefit from this development. Eric Swanson at the World Bank has suggested
the formation of one international group for the assessment of each variable (Annex 7). These
are promising initiatives.
1.2 New IT resources
The global flow of information on the Internet has exploded in the last decade. The reasons
are the free provision of software for web browsing. It may have been forgotten how "Internet
Explorer" and "Netscape" rapidly became widely used. They were provided free of charge.
Exchange of documents with combinations of texts and illustrations in pdf format has also
exploded in recent years. The reason is that pdf-files can be read on most computers due to
the free provision of the Acrobat Reader software, which today is installed on new computers.
The provision of free software for visualisation of information was part of commercial
strategies. The exchange of music exploded on the Internet due to the availability of the free
Napster software with which the end user could easily turn MP3 files into music. The e-mail
exchange through hotmail and yahoo are prominent examples of free provision of software on
web servers. Free provision is the rule, rather than an exception, for those that want to reach
the millions via Internet. A late example is the efficient search engine of Google that is freely
provided to all Internet users. In contrast to these global successes based on free provision of
information and software the numerous attempts to sell digital information via the Internet or
on CD became market failures.
The process for successful explosion of information sharing on the Internet is
straightforward: - new user-friendly software is either made available on a web server or as a
downloadable programme. This software attracts increasing numbers of information users, this makes information producers upload more information in the standard format, -which in
turn attracts more users, and so the snowball rolls faster and faster. Trendalyzer, or a similar
attempt, may be the software needed to initiates effective Internet sharing of development
statistics within and between countries.
In molecular sciences a similar explosion of free information exchange of genetic
information from all organisms has been made possible by the Genbank software system. This
system today makes detailed genetic information freely available to all researchers in the
world as a global public good. It expanded rapidly in the last 5 years by linking several
servers for DNA sequences into one system. These were the DataBank of Japan, the European
Molecular Biology Laboratory, and the US GenBank server at NCBI. DNA data for 100,000
species is now daily up- and downloaded freely on these servers as global public goods. The
2002 Nobel Prize in Medicine was awarded for the discovery of the genes that regulate cell
death and organ formation in all species. The Nobel laureate John E. Sulston attributed the
discovery to the free provision of gene information as global public goods through the
Genebank software system.
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Publicly funded statisticians can share information about development in the same
effective way as publicly funded molecular scientists share information about genes! It is in
fact strange that UN and Breton Wood organisations claims ownership of compiled National
Development Statistics and sell the datasets. This correspond to how biotechnology
companies claim ownership and sell genetic information from crops originating from all
continents.
1.3 Contemporary provision of global development statistics.
Discussions about our common global future have not been much based on evidence.
Ideology-generated assumptions appear to be more common regarding the present state of the
world as well as for development trends and determinants. The works of Amartya Sen, the
Global Burden of Disease study by Christopher Murray and Allan Lopez, the study on
Macroeconomics and Health lead by Jeff Sachs and the international collaboration on climatic
change are important parts of a move towards more evidence based assessment of global
development. Another example is the book "The skeptical environmentalist" by Bjorn
Lomborg. It triggered a confusing debate that typically did not differentiate well between the
numeric evidence provided and the conclusions drawn. There are still several objections
against the use of numeric evidence as one component is assessment of world development.
However, we think that the above examples represent an ongoing paradigm shift that is driven
by the very fact that a growing amount of data on global and national development is
becoming available in growing time series with gradually improving quality. This data has
been generated by a number of different collection and editing methods and is unfortunately
still made available in a countless number of different digital formats, mostly without the
“metadata” which describes the source and nature of the data items.
“Improving Statistics for Measuring Development Outcomes” was the title of a
meeting at the World Bank on June 4-5, 2003. The meeting included the major international
stakeholders for development statistics. Several valuable recommendations regarding data
collection and statistical systems emerged from the meeting (Annex 7), but less emphasis was
put on how to increase the use of development statistics. Trendalyzer was presented at the
meeting by UNDP, and it was found that this software is complementary to other international
efforts being made to improve the monitoring of MDG.
The IT revolution has so far only had limited effects on the use of development
statistics. The most comprehensive data sets are still being sold on CDs or as a few numbers
at a time being made accessible on web pages. Sometimes development statistics are made
available free as .pdf files or in free excel files of different formats but it remains cumbersome
for users to merge data sets and compare time series of data from different sources. We
believe this is the main reason why updated social, economic and environmental data still has
a limited impact on how the future of the world is viewed and debated. Digital data is still
used in very limited ways, if at all, when world development is taught in schools and
universities. The explosion of development statistics on the Internet is yet to come!
Time series of the main development indicators are being compiled at country
level by National Statistic Agencies and at international level by several UN organisations
and Breton Wood institutions. A leading provider of comprehensive global development data
sets is the World Bank that sells a CD called World Development Indicators (WDI) with
visualisation software owned by World Bank. Annual updates of the web version and the CD
sell some thousand copies at prices of 100 and 275 USD, respectively. The other main
provider of data sets on world development is UN Statistic Division that provides data from
the UN common database (UNCDB). Web accesses to selected numeric values from this
dataset are sold at a prize of 100 USD. UNCDB does not find more buyers than WDI. UN
population division provide selected numeric values for important variables free, but the
population data is not yet available in user-friendly graphic formats. UNICEF also provides
selected numbers free of charge from www.childinfo.org. UN organisations also provide the
16July: 8(21)
numeric information about MDG fulfilment at both international and national level in
conventional static graphs. Our projects aim to offer more enjoyable, user-friendly ways of
using statistics for improved understanding of the complex dimensions of development.
Specialized UN organizations still mostly distribute data in yearbooks (on paper) or
as pdf-files. At best the data sets can be freely downloaded as excel files from websites.
However, in these excel files the numeric data is organized in different patterns. Using only
Excel, time series data with country/indicator/year can be organized in 3x3x3=27 different
patterns! The different ways data are made available make it cumbersome for the majority of
potential users to compare indicators, countries, and time periods. It takes a dedicated
researcher to make comparisons across data sets. When statistical agencies distribute their
numerical data in digital format they often do so on a CD with special software that works
relatively well for their own data-sets, but the differences in software and data format
complicate combination with data sets from other providers. A powerful free software for
effective exchange and visualization of existing numerical data on national and global
development can change this. Our attempt to provide such software may not be the only one.
Others may provide user-friendlier software. But our aim is to either succeed in providing the
software that can multiply use of development data, or to stimulate others to do so. But why
has this not already been done?
1.3.1 Yearbook tradition
The tradition to publish and sell yearbooks is strong in agencies providing statistics. This
tradition makes agencies keep new IT-tools and data sets secret until special release-date. The
old book concepts as well as sales of data sets as products on CD or via the net do not at all
utilize the effectiveness and the dynamism of free Internet distribution.
1.3.2 Software for professionals
International and National Agencies tend to make software for their own professionals and for
those with similar skills. Such software is often very useful for the intended user group and
constitutes a valuable tool for production of conventional graphic illustrations of new data.
However, across the world most of the computer experience of the young generation that are
interested in Millennium Development Goals comes from playing interactive computer
games. They would be able to use digital development statistics directly from data servers in
interactive and visual ways.
1.3.3 Untapped new IT resources
IT technology and software continues to develop very fast, thereby proving that it always
remains difficult to imagine what we have not yet seen. Existing IT-tools for development
statistics tend to produce digital versions of what already existed on paper or adopt
conventional interfaces from statistical programs. They do not utilize new opportunities to
create automatic digital links from huge data sets to understandable and visual screen
interfaces. Nor do they use new possibilities to display change over time as motion, or to
enable users to select data interactively by mouse clicks in the graphic interface. Those
involved may have limited experience of advanced interactive software environments, i.e. of
computer games. The game sector today leads the interactive software design and
programming and hosts the world elite of programmers and interaction designers.
1.3.4 Data ownership
Most National Statistical Agencies understandably claim "data ownership". The UN and
international agencies receive development statistics free of charge from countries. When they
have copied, compiled and edited the national data in a "global" Excel sheet they also
consider their organisation as "owner" of the global data sets. The income from the sale of the
global data set is often expected to finance the competent statisticians that compiled and
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edited the data sets. These qualified professionals perform data quality assessment during the
editing process, and are making documentation about editing methods more available to users,
but rarely provide full documentation on how each number has been generated. Although the
quality assessment and standardisation of format constitute an added value the cost of doing
the global compilation is marginal compared to the costs for primary data collection and
editing at country level. We are convinced that if global development statistics can be made
available and used by the millions it will be easy to find public funding for the few highly
professional staff that will continue to be needed in the statistical system at national and
global level.
The concept of selling development statistics emerged in many countries and at
international level more than 10 years ago. We claim that it has now been by-passed by the IT
and Net revolutions. The modern visualisation software has increased the potential
effectiveness of digital information sharing so much that the old concept of selling digital
products to end users needs to be reassessed. The core of digital development statistics should
be regarded as a global public good; both for its value in the political and democratic process
as well as for its critical role in creating equal economic and trade opportunities. In relation to
the present emphasis on objective monitoring of development it appears as if the international
and national statistical systems are under funded (Annex 7). Sale of data does not seem to
have solved this problem, whereas a multiplication of the number of users may improve the
public funding.
1.4 The Vision
Contribute to effective sharing of development statistics on the Net by providing free
software for enjoyable interactive visualisation of time series!
Our vision is based on ides generated in discussions with Sida and WHO in 1999 and 2000 as
well as from pilot testing of different software versions at Karolinska Institutet and other
Universities. We also received very valuable inputs from the Development Data Group at the
World Bank during a visit in 2000 and from the Paris 21 Programme at OECD during visits in
2001. We are also influenced by continuous requests from students that the data collection
methods that generated the data in the first place need to be fully documented in ways that are
accessible to all users.
In 2002 and 2003 the Swedish government expressed strong support for our
projects. However, both the government and Sida suggested that the scope should be widened
from world health to world development, including the monitoring of the millennium
development goals. It was suggested that the collaboration should include UNDP and other
UN organisations. This coincided with the thinking of the project team. Following the
finalisation in June 2001 of the first beta version called World Health Chart 2001, the project
has focused on development of a generic stand-alone software called Trendalyzer that has
been programmed using the program compilator Director and the language Lingo. For reasons
given later, the work is now being programmed in Flash MX, a new and excellent
improvement of earlier software.
2. Project Milestones
The idea for this project was generated when teaching global health at Karolinska Institutet
(KI) in 1996. Ola Rosling did the first software prototype in the fall of 1998, and improved it
during 1999. The first year of development with testing in courses at KI and in external
16July: 10(21)
lectures was done without any external funding. Table 1 shows the two project phases since
the first external funding was received in November 1999. The first phase delivered a
multimedia like product called World Health Chart 2001 with a built in (mainly WHO) data
set. The second phase delivered a beta version of a stand-alone “generic software” for
visualisation of time series data as moving graphics called Trendalyzer.
Tabic 1 Project milestones for first two phases and plans for the third phase
Phase one
1999 Nov
2001 June
World Health Chart project starts with WHO and Sida support
Bela version of World Health Chart 2001 provided on www.whc.ki.se ( 10 000 downloads)
2001 July
2003 June
2003 July
Trendalyzer/World Health Chart(WHC) & World Development Chart(WDC) projects start
Beta version of Trendalyzer (25 June) provided on www.trendalyzer.com
Provision of web pages in flash from Trendalyzer for UN Human Development Report
Phase two
2003
2003 July-
Provision of WDC2003 beta version for internal testing
2.1 Phase one, World Health Chart 2001
The first phase resulted in the planed provision of the beta version of World Health Chart
2001 for download and testing from <www.whc.ki.se> in June 2001. Without any active
promotion this has resulted in 9 500 downloads at a gradually increasing rate. The web testers
have provided many useful comments that have been introduced into the development of
Trendalyzer. WHC2001 has been extensively used in training at KI and a number of other
universities. It has proven to be a useful tool for lecturing. It has been presented in the
Swedish Science radio and shown in Swedish Television News in prime time.
With limited information and no funds spent on promotion we got 6 500
downloads in Sweden of the beta version of World Health Chart 2001. Internationally we got
an additional 3000 downloads. Sweden has about 1% of the world's computer users. From this
we estimate that the number of users worldwide can be increased more than 100 times if it is
made known that global development data sets are provided as global public goods with userfriendly software.
In spite of many downloads we have recognised that many potential users
hesitate to download free software. It is now clear to us that the Trendalyzer software system
will get several-fold more users if the visualisation of development statistics can also be made
with full interaction on web sites. This is the main reason why programming is being switched
to the new program compilator Flash MX that presently is revolutionising interactive visual
IT design.
Most users expressed the need for a stand-alone software or a web display rather
than a download of a multimedia like product such as WHC2001. It also became clear that the
project would benefit from a widening of the focus from health to all forms of development
data. The aim of the second phase was thus to produce the software Trendalyzer based on the
extensive user testing of the version from phase one.
2.2 Phase two, Trendalyzer 2003
The discussions with Chris Murray and his group at WHO in 2000 and 2001 as
well as our wide testing of the beta version indicated that our way to present development
statistics in moving graphics is something genuinely new. From the feedback of the users of
the phase one World Health Chart, we believed that what was needed was a stand-alone
program with the functions summarised in Table 2:
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Tabic 2. The main 6 functions of the Trendalyzer software system shown in Figure 1.
1. Interactive visual display of time series on the screen interface. IN the default display one
country will be a bubble that simultaneous can display name of the bubble and time as
movement and four development indicators as size of bubble, colour of bubble, position on x
and y axis’s. This chart interface can display the wanted indicators and changes over time
through clicking user-friendly buttons on the screen__________ ________________________
2. Export of images into PowerPoint or other image software. In these software the
generated graphs can de further edited for display or other forms of distribution and
publication._______________________________________________ ____ _______________
3. Export of animation to Flash files that are the dominating animation tool on the Internet.
The graphics generated by Trendalyzer in Flash files can be further edited or directly
displayed on WebPages or sent to other computers.
________________________
4. Import and export of data from Access and Excel files in addition to the built - in data
files that are distributed with the Trendalyzer software in customised format______________
5. Customisation of the software into National and Topic Charts with other data-sets,
default settings and language. This will be done for distribution of National or Topical
development charts powered by Trendalyzer.
_____________________________________
6. Browsing for time series on Internet servers for visualisation or download of the data. It
will also be possible to search for data and to upload data on a Civil Society Server that can
complement data servers of International and National data providing agencies. In other
words to provide a Google/Napster like function for development statistics.
Trendalyzer2003 was produced with the compilator programme Director from Macromedia.
Code was written in the programming language Lingo. Functions 1 to 5 in Table 2 are
included in the Trendalyzer2003 version that is now uploaded on www.trandalyzer.com for
the first period of testing. These five functions will be debugged and interfaces improved
based on gradually expanded testing and use during the fall of 2003. A data set compiled at
Karolinska Instituted will be built in to turn the version into a World Development Chart 2003
during this testing period. The second phase implies a considerable change in aim of the
project. The volume of the software best explains the increased ambitions. WHC2001
contained about 300 A4 pages of code, whereas the present Trendalyzer version contain about
1500 A4 pages of code.
Table 3 Major project presentations, discussions & meetings in the first half of 2003
January 8
February 6
February 13
March 3-4
March 10-13
March 14
Mach 17-19
March 28
April 3
April 11
May 15
May 19
June 5
June 8
June 12
June 25
July 2
Inauguration lecture at the course of International Health at Helsinki University
Presentation at regional meeting for Ministers of Health, Khartoum, Sudan
Presentation at ICT day at DESO/Sida
Project presentation & discussions with the Swedish Prime Minster and the Minister of
Education & Research at meeting for researchers at Harpsund.
UN tour in New York hosted by Jan Vandermoortele, UNDP/UNDG
Closing key-note speech at the Swedish Conference in Public Health
Visit to UNAIDS for joint planning of Trendalyzer usefulness
Planning meeting at Centre for International education, Stockholm University
Discussions with Marcus Storch, vice chairman of Nobel Foundation
Project team onc-day meeting at Gapminder in Malmo
Key note lecture at the Swedish Conference in nursing science
Meeting with Dept of Epidemiology & Historic Demographic database, UmeS
Meeting with Sakiko Furruda at KI on Trendalyzer for Human Dev. Rep. 2003
Presentation at workshop on Mobility Regimes at Institute for Future Studies
Key note lecture at Nordic Conference on Sustainable Development, Min Educ.
Key note lecture al World Technology Summit, San Fransisco
Presentation at UN/ECOSOC meeting in Geneva
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2.2.1 Project collaborations with UN in 2003
During the spring of 2003 the advancement of Trendalyzer 2003 enabled extensive contacts to
be made for future promotion of the software system. Both Sida and the Swedish government
suggested in 2002 that the scope of the project should be widened from monitoring of world
health to include all millennium development goals and general monitoring of development.
To achieve this it was suggested that the collaboration also should include UNDP. At
meetings in Copenhagen and Stockholm in the fall of 2002 UNDP expressed great interest in
collaborating with the project. This was confirmed when Jan Vandermoortele at
UNDP/UNDG hosted a one-week tour by the project team and the Sida desk officer Martin
Ejerfeldt (Annex 1) at UN organisations in New York in March 10-13, 2003. We received
especially valuable inputs from Garret Jones and Howard Dale at UNICEF, from Saikiko
Furuda and Haishan Fu at Human Development Report and by Robert Johnston and Zoltan
Nagy at UN Statistic Division. These professionals and the Administrator of UNDP, Mark
Malloch Brown, shared our vision.
They all emphasised that Trendalyzer will be complementary to the IT
developments at these UN organisations, especially by its capacity to provide digital
development statistics to a wide range of user groups. UNDP represented the project and
showed a version of World Development Chart at a June meeting at the World Bank (Annex
7). As requested by the Human development report editor Sakiko Furuda Gapminder made
animations of this years report messages for the launch on July 8. They are available at
http://www.undp.org/hdr20Q3/flash.html The files were used around the world, including
Stockholm, for the launch of the report.
2.2.2 Project extension to Education and Economy in 2003
Through initiative from Anders Frankenberg at the Education Unit in DESO/Sida the project
has extended collaborations to the Institute of International Education at Stockholm
University regarding data sets for Education. This turned out to be an excellent idea as Prof
Albert Tuijnman had extensive international experience of development of data sets for
Education. He is also adviser on MDG goals in Education to UN and had a highly skilled
group of researchers that are motivated to develop a World Education Chart with UNESCO.
Unfortunately the planning of this component has been delayed as Prof. Tuijnman has taken a
position in Luxembourg but he continues to lead a research group at Stockholm University
that will develop a UNESCO collaboration based on Trendalyzer. The present head of the
Institute for International Education and UNESCO has confirmed their interest to collaborate
with Prof Tuijnmans group.
Prof Christer Gunnarsson at the dept of Economic History at Lund University is
likewise planning for collaboration with UN, World Bank and OECD for provision of
historical data sets from high-income countries with economic indicators together with those
from middle- and low-income countries provided by World Bank.
2.2.3 Interest by Swedish government
At a two-day meeting at Harpsund in March the Trendalyzer and World health Chart project
was thoroughly presented for the Prime Minster and the Minister of Education & Research.
They expressed great interest on behalf of the government and confirmed the usefulness of
viewing time series as moving graphics for policy makers. The suitable organisational form
for developing and providing Trendalyzer software system as global public goods was
discussed. The Prime Minister had no alternative suggestion to software development in a
Company. He kindly invited the project to make a presentation for the whole government in
the fall of 2003 with the aim to discuss wider application of Trendalyzer for public statistics.
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3. Aim
The overall aim is to improve understanding and monitoring of development,
by increased use of development statistics as enjoyable interactive moving graphics,
generated by a free Trendalyzer software system in Flash (.fla open code) that enables:
1. Trendalyzer software for download (.exe), with built in data sets as regularly updated World
Development Chart, World Health Chart, World Education Chart etc.
2. Trendalyzer software for interactive web display (.swf) of development statistics in moving
graphics from UN and other Data Providing Agencies.
3. Trendalyzer software system in Flash components (.fla) with open source code for use by
others interested in composing software systems for visualisation of time series statistics.
4. Search of time series of development statistics for visualisation on a web site linked to a “Civil
Society Server” with possibility to download and upload documented time series.
3.1 Users groups
Those concerned with national and global development; professionals and researchers, policy
makers, students, activists, journalists, other professionals and various user groups in the civil society
that formerly did not access global, national and local digital development statistics.
4. Plans for July 2003 to December 2003
Software development will continue as "extreme programming" (as games are made). This
means stepwise definition of requirement specification by continuous interactions between
software developers at Gapminder and test pilots at Universities, UN and elsewhere.
4.1 Effect of Macromedias software for program compilation
In 1998 Macromedia (
) launched Director 6 and later version 7. This
software from Macromedia made this project possible. The reason was that Director 6 made it
possible to make visualisation software much faster than in conventional C++ programming.
It is estimated that this software increased the productivity 10 times compared to conventional
programming in C++. The reason why one programmer in 2 years could make World Health
Chart 2001 (using Director 6) was this effectiveness. When starting in 1999 and when
continuing to develop Trendalyzer in 2001 all other program compilators available were
considered. Neither in 1999 nor in 2001 was there any software that enabled a production of
moving graphics produced from data sets to be made available interactively on web pages
(this included Flash version 5).
It was never clear if it would at all be possible to make Trendalyzer as a stand-alone
software as fast as planned with Director. It was a high-risk endeavour, but it turned out to be
possible, although more debugging still remain to be done. However, the initial wish to make
development statistics available interactively on web pages through direct reading of data
bases is in 2003 possible to achieve by programming in Flash MX.
In the late fall of 2002 Macromedia launched the Flash MX version. It considerably
increased the speed by which interactive graphics can be programmed. When
Trendalyzer2003 was almost ready in Director in the end of 2002, Gapminder realized that
Flash MX would enable much faster advancement, probably by a factor of five. Flash MX
with its language Action Script constituted a higher level of programming, and contained
more ready-made graphic components. This posed a frustrating challenge to the project team
during some months, (as it seemed the whole system would need to be rewritten in this new
language). However, Director MX version was launched by the turn of the year, and this new
16July: 14(21)
version allows combinations of DirectorMX and FlashMX components in the same software
system. Trendalyzer 2003 will thus be debugged in its Director version,/but all new
programming for Trendalyzer 2004 will be done in Flash MX. The advantages of Flash MX
are given below in table 4.
Software produced in Flash requires a special reader on the users computer if it is used
for visualisation on a web page. The good with Flash is that most modern computers have a
Flash reader installed. In the last year the new Flash version make it possible to make the
Trendalyzer software system available in both an executable (.exe) and web-usable
format(.swf), using programme components made in Flash MX in the open source code
format (.fla). Another growing advantage is that large functional components of Flash code is
becoming available as global public goods on www.flashcomponents.net
Table 4: Comparison of Director MX and Flash MX.
Aspects of the programmes
Director MX_______________ Flash MX
Most have reader on computer
Few have reader on computer
Reader
Smaller but better
Bigger
Size of reader
Action Script
Lingo
Language
> 5 times faster
Fast
Development speed
Fast growing
Constant
Developers community
500 USD
1 500 USD
Annual license cost
The vision of these projects seemed far-reaching some years back, but we are now
sure they will become a reality. It will be through a much less rigid software system than
anyone of us could imagine in 1999. The software components can be recombined by
advanced users or used as an old-fashioned computer program by less advanced users. The
components will also become global public goods in themselves. It should be noted that these
components also could be used as building blocks in software systems that are commercially
produced as well as used for data sets that are sold commercially. The reason is that the
overall aim is to increase use and understanding of development data, be it as global public
good or as a commercial product.
4.2 Project team at Gapminder in the fall of 2003
The basic principle of extreme programming and the fast advances in visualisation software
makes it irrelevant to make detailed hour by hour work plans as done in earlier applications.
For August to December 2003 the composition and division of tasks in the software
developing team is as follows:
Main area of responsibility
Person
Debugging and revisions of Trendalyzer 2003
Mattias Lindberg
Design of colour function in Flash for Trendalyzer 2004
Jakob Malmros
Design of icon function in Flash Trendalyzer 2004
Martin Ohman
*
Jorgen Abrahamsson
Design of calculator & chart functions in Flash for Trendalyzer 2004
Programming to link data bases to Trendalyzer
Johan Nystrand
Co-ordination and innovation of software system structure
Ola Rosling
Anna Ronnlund Rosling Flash output design and Tutorial and Help functions + administration
* Live and works mostly in Stockholm
16July: 15(21)
4.2 Main collaborations in the fall of 2003
Table 4. Meetings planned for the Fall of 2003_________ ___ ________________________
UNDP/UNDG, Human Development Report_________________________________________
WHO and UNAIDS_____________________________________________________ _
The Swedish government, invitation by the Prime Minister_____________________________
The Swedish/French commission for Global Public Goods,
invitation by Minister for International Development__________________________________
UN statistics Division, New York_____________
Institute for Future Studies________________________________________ ________________
Cambridge University__________________________________________
Stanford University______________________________________________ _______________
UNESCO______________________________________________________________________
Inter-American Development Bank (IDB), Washington________________________________
Vanguard conference on new visualisation technology, Phoenix, Arizona 4-5 Dec,
Vanguard Technology Transfer Institute!
The fall will be a very intensive period with gradual spread of the Trendalyzer software system
and maintaining the collaborations started during the first part of the year. A timetable is yet to
be laid. Most important are the connections with UNDP/UNDG, Human development Report
and UN Statistical division that will be given highest priority. Likewise the change of senior
staff in collaborating clusters at WHO make it necessary to start the fall by re-establishing the
collaboration with WHO. Plans for work with UNAIDS were already established in the spring
of 2003. The HIV time series are the most requested by users but data have a considerable
uncertainty range. The time series are also recalculated each time a new value appears so that
HIV variables are optimal for attempts to define collection and editing method in ways that
enable estimation of uncertainty.
4.4 Project team at KI in the fall of 2003
Marie Reilly, who since joining this project has been promoted to Professor of Biostatistics at
KI, provides the statistical expertise. Christian Ahlstedt will continue as research assistant, and
will be assisted by Mattias Strand who joined the project during the summer of 2003 on a KI
fellowship for summer research students. Hans Rosling continues as project co-ordinator and
Asli Kulane, in charge of IHCAR’s course programme will also participate extensively with
planning and monitoring the pilot testing in courses. Several other researchers at IHCAR will
also participate with provision of data sets as part of other ongoing projects.
A special effort to test the Trendalyzer software for local MDG monitoring will be made
by Prof Vinod Diwan during his period as guest professor in India, where he is organising
development monitoring down to village level in a pilot area outside BohpaL As part of a Danida
project, health centres and health administrations have been supplied with new computers and
the use of Trendalyzer visualisation of the time series generated will be implemented in the fall
of2003.
In addition to WDC2003, it is foreseen that an updated health data set and the Trendalyzer
2003 version will be provided as a World Health Chart 2003. It will also be tried to apply the
Trendalyzer 2004 system as first suggested by James L. Duppenthaler, Statistician at WHO and
in charge of the WHOSIS statistical web system.
4.5 Output by December 2003:
One of the major delays in Trednalyzer2003 was due to a bug found in the Excel, from which
Trendalyzer imports data. Numeric data cannot be read by available database readers on the
16July: 16(21)
first row in the excel sheets. This bug also exists in the last Excel version, and several in the
programmer community know it. The bug cannot be solved without access to the source code
of Excel. At the World Technology Summit in San Francisco a high representative of
Microsoft offered assistance to Gapminder in solving this problem. Counting on this
assistance from Microsoft a World Development Chart, WDC2003 with tested, revised, and
debugged Trendalyzer2003 and an expanded UNCDB data set will be ready for promotion
during the early or mid fall 2003.
Specialised Charts with Trendalyzer2003 in a yet to be decided form will be done
with WHO, UNAIDS, UNESCO, either as a separate chart version for each organisation or as
contributions to a joint World development Chart. This depends on the final attitude and
motivation in the different UN organisations /Annex 7).
Development of Trendalyzer2004 in Flash (.fla) for making both .exe and .swf
versions will be done during the fall of 2003. Trendalyzer2004 (.swf) will be first tested for
web-based visualisation of the UN Common DataBase. This will be done during the fall of
2003 to allow for revisions based on comments from the highly professional partners at UN
Statistic Division. If successful, Trendalyzer may perhaps also access the WHOSIS data base
at WHO.
The planning of a Civil Society Server (CS-server) with an international university
network and joint examples of how documentations of collection & editing methods, and
estimations of uncertainty ranges can be done will be an issue of collaboration between
Gapminder and KI teams, and also hopefully teams in Education at Stockholm University and
in economics at Lund University.
5. Plans for January 2004 to December 2004
Before the requisition of funds for the first and second half-year of 2004 detailed work plans
and expected outputs will be submitted to Sida. For the time being it is not meaningful to
make more detailed plans than as specified in the foreseen outputs given below.
5.1 Output by June 2004:
WDC2004 with tested, revised, and debugged Trendalyzcr2004(.exe) for promotion.
UN Common DataBase visualised on the web using Trendalyzer2004(.swf).
Specialised Chart versions promoted with UN-organisations and a few countries.
Start of a Civil Society Server with an international university network.
Documentation of collection & editing and display of uncertainty ranges for variables on CS-server.
5.2 Output by December 2004:
Debugging and revised Trendalyzer2004 (fla) for promotion.
Expanded Trendalyzer use as downloadable Chart versions (.exe) and as visualised databases(.swf).
Further development of CS-server and linking to some other servers.
Plans for systematic quality certification and uncertainty estimates with UN and university networks.
5.3 Output in Coming Years:
A 100 to 1000 fold increase in the number of interactive web- and computer users of free digital
development statistics compared to the present thousands that buy commercial data sets.
Increased use of national digital development statistics in a number of countries.
A growing system for quality certification of time series of development statistics resulting in
provision of understandable and well-defined uncertainty intervals to users.
16July: 17(21)
6. About Gapminder
Gapminder AB (reg nr. 556586-9285), Angelholmsgatan 4, SE 214 22 Malmo, Sweden.
Telephone +46 40 305120.
Bookkeeping: Eva Isgren, Isgrens Bokfdringsbyra AB, Geijersgatan 4A, Se 216 18 Limhamn,
Telephone+46 40 160165.
Auditor Boo Levin, Aktiv Revision och redovisning, Box 89, Se 230 44 Brunkeflostrand,
Telephone +46 40 468 218 (+46 706 468 218).
Gapminder is registered as a limited company, (Aktiebolag in Swedish) for invention,
development and provision of free software that visualise global, national and local
development. The company’s vision is to compensate for market and institutional failures in
providing cutting edge IT solutions for information and education on development in the
public sector and civil society. Software development is done in collaboration with
universities, UN organisations, public agencies and non-governmental organisations. Six
software developers are presently working at Gapminder and one is attached as a consultant,
having his own formal company and being based in Stockholm.
It all started in 1998 from an idea to enhance the understanding of world health.
We developed a prototype software showing time series of health statistics as moving
graphics combined with visualisation of varying human life conditions by 360° photo
panoramas from homes, schools and health facilities. From the prototype software emerged
the Dollar Street project with Save the Children Fund in Sweden and the World Health Chart
project with WHO. Gapminder developed the free software Trendalyzer within the World
Health Chart project. Collaboration with United Nations Division of Statistic and UNDP,
started in 2003 with the aim to visualise fulfilment of millennium development goals with a
World Development Chart powered by Trendalyzer.
The initiators Ola Rosling, Anna Ronnlund Rosling and Flans Rosling own
Gapminder together with the Karolinska Institute!, the medical university in Stockholm. It is
organised as a limited company, but do not pay any dividend on the capital. Ten percent of
the shares were sold to Karolinska Institutet for 1 SEK to mark that the involvement of this
medical university was not for profit but for transparency, stability, and advice. KI benefit
from an early benefit in teaching and research software developed by Gapminder and from the
experience of forming companies for production of global public goods.
The funding for Gapminder is by grants from non-commercial sources such as
Sida, WHO, Save the Children Fund and UNDP. Being a producer of global public goods,
Gapminder benefit from free and creative inputs from pilot-testers and other end-users in
many institutions and organisations. Gapminder trademark product names to prevent others
from claiming ownership. Gapminder will not seek patents, costly processes that impede
intensive external user testing during software development. Patents are also largely irrelevant
and offer no additional advantage for free Gapminder will not bid on tenders to do
commissioned work for delivery of specified products or software adaptations according to
predefined requirements specifications. However, the company will accept non-commercial
funding for joint non-commercial endeavours with external partners with common interest in
developing visualisation software as global public goods.
6.1 Why a company?
The development and provision of Trendalyzer software system has benefited from the
flexibility and effectiveness of being done by a company. The advantage of being organised
as a company is related to the need for fast purchase of hardware, software updates and plug
inn’s as well as flexibility in long and short time employment and affiliation of partners. The
16July: 18(21)
clarity in laws and rules for taxation, bookkeeping and audit are the advantages of being a
company, compared to alternative organisational forms such as foundation, association, or
project within government agency or university.
to consult the most experienced advisers possible we have asked several persons
about the organisational form. The decision to maintain Gapminder as a company is based on
consultations with Hans Wigzell, the president of Karolinska Institute!, Jan Lindsten the
secretary general of the Royal Academy of Science (elect), and Marcus Storch former CEO of
AGA, and now vice chairman of the Nobel Foundation. These experts on interlinks between
public and private sector in Sweden recommended Gapminder to be organised as a company,
as the Swedish law clearly allows companies to operate without generating profit on the
capital and to receive grants from public sources. The Prime Minister also agreed that a
company appeared as a good organisational form and he invited us to continued discussions
about future collaborative mechanisms between the public sector in Sweden and UN
organisations to specify in detail the future tasks and assignments of Gapminder.
Jan Kleerup, the leading expert at Ernest & Young was asked whether a
company can receive a grant from a public institution like Sida without paying VAT(moms)
(http://www.ey.com/GLOBA L/content.nsf/Sweden/VAT_Services_Branscher_Finans).
He said that was no problem, and compared to Almi bolagen (http://stockholm.almi.se) that
receives grants from Nutek without paying VAT(moms). Gapminder will keep the activities
linked to development and provision of the Trendalyzer software system separate in
bookkeeping and in reporting to tax authorities. As an independent grant (oberoende bidrag)
without direct reciprocal product or service being delivered to Sida there will be no need to
pay VAT on this grant. Gapminder will report to Sida as required and specified in contract.
6.2 Gapminder owners and board.
As can be seen from Annex 5 the ownership of Gapminder has been changed based on the
above considerations. Anna and Ola Rosling have sold 10% each of the shares to Hans
Rosling and Karolinska Institutet for 1 SEK, respectively. This is to mark that this is not a
commercial investment but a way to offer Karolinska Institutet full transparency into the
activity and economy of Gapminder as well as to enable Hans Rosling to participate as owner
in the running of the company. Hans Roslings participation in Gapminder thus follow regular
proceedings when a researcher forms a company based on ideas generated at the University. It
now remains for Hans Rosling to report to Karolinska Institutet how he handles university and
company tasks, and the earlier type(???) of conflict of interest disappears.
The present board is lead by Anna Rosling Ronnlund, software designer,
Gapminder. E-mail: anna@gapminder.com and includes Ola Rosling, Software inventor &
designer, Gapminder. E-mail: ola.rosling@gapminder.com, Hans Rosling, professor of
international health at Karolinska Institutet, Folke Meijer, Karolinska Institute Holding AB,
Karolinska Institutet. E-mail: Folke.Meijer@kab.ki.se and from the staff Jorgen
Abrahamsson, Gapminder, jorgen@gapminder.com.
7. Budget for July 2003 to Dec 2004
We apply for the following budgets for the two linked projects and will appreciate if Sida can
sign separate contracts with Gapminder and KI. We are also grateful if funds can be
transferred once every six months period. Economic and activity reports will likewise be
submitted for six month periods from Gapminder and KI, respectively.
7.1 Budget for Gapminder
The budget for Gapminder is calculated for the next 6-month period. It is in a similar range as
the last six month period when 1082 000 SEK were transferred to Gapminder and KI
16July: 19(21)
separately paid for the NY visit and some other travel costs from Gapminder. The end of the
parental leaves for two of the team members explains the slightly higher budget. The
estimates for each cost item is on the same levels as the last half-year. The employed software
developers do not have a fixed number of weekly work hours. This is partly due to
preferences and partly to the character of the project. They are paid for an average of 40
working hours per week at 158 SEK per hour, including compensation for holidays. The
employers’ tax (LKP) for this type of company is only 33%. Software development benefits
from teamwork, but going beyond 7 persons requires costly managerial structures. Therefore
Gapminder continues with the present effective team size.
Presented budget is based on full time work by five software developers during
the half July 2003 to December 2004. This implies that test versions done with partner
organisations like the animations of the Human Development Report 2003 is covered by
additional external grants as well as some of the testing in courses and other events. The
applied budget for the core development and provision of Trendalyzer will be handled
separately from the other smaller activities and grants at Gapminder. The two travels to UN in
New York and to Sida and university partners in Stockholm are also exclusively for the
development of Trendalyzer. The costs for external consultations include highly specialised
programming for linking Trendalyzer to other software’s, this may be solved by free service
from Microsoft. The program license costs correspond to the Macromedia products Director
and Flash that are used to compile and programme Trendalyzer. The plug inns are available
programme scripts written in Lingo and Action script available at low costs from the web.
Careful documentation of payment is needed for inclusion in Gapminder free software.
Equipment is a low estimate for the need for hardware renewal. Overhead includes rent,
security, other office costs, internal and external administrative service. That the application
concerns a grant is supported by the effectiveness that can be assess by recalculating the
budget into cost per hour including all overheads, even for consultant, travel and other non
salary expenditure. The salary cost and overhead is 1 270 770 SEK divided by 4400 hours
gives 289 SEK per hour.
Budget for Gapminder for July to December 2003
Timlon inkl. semester
158
LKP 33%
52
Lonekostnad/timme
210
Arbetade timmar/manad
160
Lonekostnad per manad
33 622
Antal personer
5
Lonekostnad / man
168 112
Arbetade man / halvar
5,5
Total lonekostnad / halvar
924 616
Resor till NY 2
10 000
*
20 000
Resortill Sthlm 10
*2500
25 000
Resor totalt
45 000
Extern konsult 400SEK
200
*
80 000
Program licenser 10x5000, Plug-ins 5 x 2000, utrustning 44 230
104 230
Totalt konsult & utrustning
184 230
Totalt halvarskostnad
1 153 846
Overhead 30%
346 154
Grand total Juli-Dec 2003
1 500 000
ITOTALT 200307- 200412
4 500 000
16July: 20(21)
7.2 Budget for KI July 2003 to Dec 2004
Budget KI for July to December 2003
Salary
months cost
Statistician, 20%
6
12 000
Research assistant, 100%
30 000
6
Total salary
Travel
number cost
Geneva
2
8 000
NY & Washington
2
14 000
Malmo/Lund
4
2 000
Total travel
Consumables and services
Subtotal
overhead 35%
Total
TOTALT 200307- 200412
72 000
180 000
252 000
16 000
28 000
8 000
52 000
21 926
325 926
114 074
440 000
1 320 000
7.3 Budget for other partners for July 2003 to Dec 2004
The Department of Economic History at Lund University and the Institute for International
Education at Stockholm University will apply for separate budgets for implantation of their
components of the network collaboration.
7.4 Budget for continuation in 2005 and beyond.
It is understood that following completion of the third phase in December 2004 Gapminder
will not apply to the Health Unit of Sida for any further funding for continued development
and provision of the Trendalyzer software system. Gapminder defiantly plan to apply for
other public and non-commercial funding for the continued provision of the software, but
given its wide application that funding should come from appropriate sources. This
organisational form for provision of software as global public goods and the sources of
sustainable funding will be the focus of the discussion with the Swedish Government in the
fall of 2003.
The Division of International health at Karolinska Institute may submit an
application for continued support for further development of World Health Chart or the health
component of a World Development Chart.
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9/15/03
4
PHM Secretariat
From:
To:
Cc:
Sent:
Subject:
PHM Secretariat <phmsec@touchtelindia.net>
David McCoy <David.McCoy@lshtm.ac.uk>
mikerowson <mikerowson@medactorg>
Monday, September 15, 2003 9:55 AM
Re: GHEW
Dear Dave,
Greetings from PHM Secretariat (Global)!
Thanks for the response finally.
1. The Teheran meeting is now postponed to 29th / 30th November and 1st
December 2003. Hope one of you can join if I raise the grant, if not we meet
in Geneva, then Mumbai.
2. Its good to have Fran and Maria on the committee. At some later date once
the administrative aspects including funding is well underway. I shall be a
little more low key and suggest Thelma’s more active involvement since as a
Public Health Policy Researchers and activist. She may have more to contaet~!4< h
e
at the compiling and editing levels. She is presently quite pre-occupied
with a Fellowship scheme that CHC has been granted, which means 4
undergraduates and 2 post-graduates spending 6 months -1 year with us
understanding Community Health Theory and praxis. An exciting, but time
consuming new initiative.
.
nope Mike and you receive Han’s proposal on 0HC.
Best wishes,
Ravi Narayan
Coordinator, People’s Health Movement Secrctariat(global)
CHC-Bangalore
#367 ’’Srinivasa Nilaya”
Jakkasandra 1st Main, I Block Koramangala
Bangalore-560034
join me “Health for ail, NOW" campaign in the 25th anniversary year of the
Alma Ata
declaration visit www.TheMillionSignatureCampaign.org
---- Original Message----From: David McCoy <David.McCoy@lshtm.ac.uk>
To: <mikerowson@medact.org>; <phmsec@jouchtelindia.net>
Sant: Friday, September 05, 2003 4:41 PM
Subject: Re: GHEW
> Dear Ravi
4
7^^-Cr^
D&Se-
■
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r 'om:
> o:
David McCoy David.McCoy@lshtnn.ac.uk>
<iphc@cabienet.com.ni>: <oiie.nordberg@dhf.uu.se>: <fran.baum@flinders.edu.au>:
•<e?d@gega.org.za> <ant@hst.org.za>; <maria@iphcgloba!.org>: <pbrave@itsa.ucsf.edu>:
-mi:<ercwson@rnedact.org>; <patriciamorton@jmedact.org>- <arutherford@onev/orldaction org>
<?bays?n-.a@;on3.vsn!.net.in>; Ghassan --afcdafro@scs-net.org>: <phmsec@touchteiindia.r.ef-■' r.?. a rtin @ uwc.ac.za>
Sara:
Sunday. October 26, 2003 5:12 PM
S ’bject: Global Health Watch update
Dea/ friends,
:
uccepc apologies for an update that is long overdue. A few quick notes to keep you abreast of where we
c -j. and what we are doing, mainly through the medact office.
•.. Name change - after feedback from various quarters, there seems to be a genera! feeling that the title Global
■ c d t e better and mpore catchy than Global Health Equity Watch.
z. Funciing • this is ■ iw main area that is being focussed on. A funding propsal has been developed and sent ou:
to various donors (IDRC, Rockefeller, Rockefeller Brothers, Ford, Soros Foundation, SIDA, Charles Stewat Mort
Foiijnaation. Macarthur Foundation). Rockefeller has turned us down but we are following up on others.
3. Fund?;g from NGOs - we have received some funding from wemos in Holland, which is adding to the
amounts that GEGA has put in thus far. We are planning to approach some of the bigger development and
health NGOs to see if they would be interested in co-fundtng (e.g. oxfam, save the children, Christian aid,
green peace, friend^ of the earth etc.).
he N
)s tl
W/
3&V
will be approached will be UK-based - if you have NGOs in othei parts of the w:
wrcm vol might think would oe sympathetic, there is a ready-made funding rpoposai that you could use to
sd;dt funds etc. Even if it's a small amount of money, the final report will be strengthened if we car. shew that
a iarge number of NGOs nave actively supported its publication.
4. Chapter briefs - we have been working much more slowly on developing the briefs fcr eacn of the proposes
Chapters. This would be followed by a process of identifying authors and formai'y commissioning artcles -oigamsmg a review / advisor/ pane! for eacn chapte .
w»ices “ Thefu
5,
*
ng received from Wemos has been ear-marked primarily to enhance
es from the ground. In order
ipone t of t
• orts
chosen co focus on ewo areas:
- xhe pr ivatisation and commercialisation of health, water, sanitation and electricir/ services
- the struqc-e for heeith amongst indigenous ooop’es
v7e huve already begun sending cut cut information through various networks to alert people to this in: Lath ?.
a ic
3 :olk Jstii >nies. i sfar as the in igenoi
pie's jlth c
ad
a to be
working with and through the indigenous people’s rights networks that include oi m tai ons$
■fntcrnational, Minority Rights Group etc.
orton....
coorc
at 3 th
’ v<Dices
so
.
.
ce c
undraising
efi’crcs. She is based at the medact office and you wiil be hearing much more frorr; ner in the coming we«i<s.
thunks and best wishes from the GHW team in London,
Dave, Mite and Patricia
DGS[S5P
< pa i/ic^rrio; ton.reed act. org>
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r
Secretariat
From:
To:
Sent:
Attach:
subject:
Patricia Monon <patriciamorton@medact.org>
<iphc@.^blenet.com.ni>; <olle. nordberg@dhf.uu.se>-: <frari. baum@flinders.edu.au>:
<iexi@gega.org.za>; <ant@hst.org.za>; <mana@iphcglobai.org >; <pbrave@itsa.ucsf.edu >;
<•mikerowson@medact.org>; <patriciamorton@medact crg>: <a'-;.rtherford@.or.e'woddactkcn.org>
<abaysema@pn3. vsnl.net in>; Ghassan <afodafro@scsm.et.org>, <phmsec@toucrLehndia.net>;
<imartin@uwc.ac.za>; David McCoy <David.McCoy@lsriim.ac.uk>
Wednesday, October 29, 2003 9:17 PM
Global Health Watch Flyer.doc
Re: Global Health Watch update
Dear fvll
j|7e
’
out a call
Watch. Tl . >ll< -v i ig is an e-mail: n i att ched is a
ve been sent oi
va
and organisations who are concerned with privatisation of health systems and utilities.
li would be- appreciated if you-could assist us with this endeavour by sending this information out to
oigauisatioiw networks; individuals you tlrink could contribute.
Mucl \ppi cia sd
Patricia Morton
Dear Friends
,
■ •. . .
? People’s Health A
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on the effects of the market] za! ion of:
»•
i. Health care provision in the developing 'world, issues we- are particularly interested in are:
.
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CJ6F
' oierxiocx’y and geographically and avdiahie for public access on die web. 1 vy will also be
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V, c hope ihai he Global Health Watch will fonn a mechanism to express and amplift
.... .
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society's
concerns abom the increase in marketisalion and commercialisation of key public services
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patriciamorton@medact.org
With many thanks
'alricia Morton
Gr the Global I lealth Watch team
G’cbsd Health Watch
Globai civ.; society has not adequately participated in international health advocacy. Although high*:le
n.-of
success has been achieved with some campaigns, most notably around access to medicines
and breastfeeding and certain diseases, there has been a striking lack of involvement and pressure
torn health campaigners on broader public health and health systems issues. In addition disparities in
be?Jth between the rich and the poor have grown at alarming rates both within and between countries,
leaving society and the public health movement with a large humanitarian and moral challenge.
The increasingly global dimensions of poverty, disease and health policy require a much more vigorous
input from public health experts civil society and non-government organisations. The People’s Health
Movement. me Global Equity Gauge Alliance and Medact therefore propose to mobilise a fragmented
global health community through the publication of an annual Global Health Watch. This publication
wiii be used to shift the health policy agenda away from a technocratic approach to delivering heait:;. to
one that recognises the important political, social and economic barriers which prevent the achievement
of better health.
We want the Watch to strengthen the calls for a broad approach to health amongst policy-makers,
health professionals, campaigners, researchers and others concerned with health ana to act as a
reality-check on those formulating health nolle--- by providing a forum which magnifies the voice of the
poor and vulnerable and those who work with there;.
The Watch will consist of a compilation of chapters on various global health issues written by NGOs
anu academics. Stories, experiences and analysis direct from poor communities will be threaded
through the chapters and enable those who are tradition ally unheard to voice their concerns on globed
health issues.
The Globai Health Watch lean; is now looking both for authors to write chapters and roi stories and
experiences from around the world. For more information on the areas we are covering, go the Medact
v /ebsite www. medact.org
Medact
Th- Grayston Centre
28 Char’es Square
London N
*i 6HT
Unhod Kingdom
Tel: +44 20 7324 4733
rax: +44 20 7324 473 5
vwA7.medact.org
October, 2003
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Page 1 of 4
PHM- Secretariat(Global)
From:
To:
Cc:
Sent:
Subject:
David McCoy <David.McCoy@lshtm.ac.uk>
<mikerowson@medact.org>; <patriciamorton@medactorg>; <phmsec@touchtelindia.net>
<lexi@gega.org.za>; <ant@hst.org.za>
Saturday, November 22, 2003 7:08 PM
Re: PHA-Exchange> Global Health Watch
Dear Ravi
Thanks for this message. I hope the meeting in Iran goes well. I will not be able to attend the meeting due
to work commitments here, but we have resolved that Patricia will represent the GHW secretariat and be
able to report on progress and make useful links and contacts. I am not sure if Lexi is planning to go.
In the meantime we are continuing with out fundraising efforts and identifying organisations and individuals
to write chapters. More later
^st wishes
»> "PHM Secretariat" <phmsec@touchtelindia.net> 11/11/2003 12:36:51 >>>
Dear Mike, Patricia, Dave,
Greetings from PHM Secretariat (Global)!
Further to my recent communication, this is to encourage once again all
three of you to attend the Internationa! Health Forum, 14th - 15th January
2004 and the World Social Forum, 16th - 21st January 2004 (at least till
18th for health events in WSF), since they would be a great opportunity to
listen to testimonies from a wide variety of civil society participants
from
all over the world. You will notice that in the tentative programme
(enclosed) that we have already begin to show testimonies in all the
sessions.
^/ou can raise some travel support and make it to Mumbai, then we will
definitely be able to cover your local accommodation and meals etc. PHM is
trying to raise travel grants, but for now most of the applications are
focused on participants from developing countries / LDCs etc.
Dave may qualify, because of South African passport, but we may have a
little more problems for UK based PHM delegates. Lets all try to explore
alternative sources. Perhaps GEGA could support one travel and GHEW /
MEDACT
project could support one travel and we could cover one.
PHM India has launched a Right to Health Care campaign and as part of this
process, there are case studies and stories of denials of Right to Health
Care being documented in many states.
Prem and Hari John of ACHAN (premjohn9141@hotmail.com and hariprem@eth.net)
have also volunteered to support identification and facilitation of
f
testimonies for the IHF / WSF health events.
The events will also be an opportunity to brainstorm about GHEW and add a
stronger collective planning dimension to the whole initiative. Do give it
serious consideration and let me know your thoughts on this as soon as
possible, so that we can include your names in the tentative participants
list and get on with formalities such as registration in the events, etc,.
Page 1 of 1
PHM - Secretariat
From:
To:
Sent:
Subject:
David McCoy <David.McCoy@lshtm.ac.uk>
<ant@hst.org.za>; <czarowsky@idrac.ca>; <smhatre@idrc.ca>; <patriciamorton@medact.or>;
<mikerowson@medact.org>; <phmsec@touchtelindia.net>
Friday, December 05, 2003 9:36 AM
Global Health Watch
Dear Christina and Sharmila,
It was good seeing you in Johannesburg. This e-mail is a follow-up on the GHW discussions, and I am
copying to .Antoinette (GEGA), Mike Rowson (Medact), Patricia Morton (Medact), Ravi Narayan
(PHM) and .Andy Rutherford (PHM).
First of all, we are really pleased that you are keen on supporting the Global Health Watch, pending
agreement through the proper EDRC channels. This is going to be a really exciting development that will
W-Hy challenge the current neoliberal and dsisease-focussed orthodoxy, and give a rigorous / academic
voice to the progressive social movements through the lens of health and health equity.
.Anyway; following the meeting we had in Johannesburg, I am writing to confirm that we will:
1. Provide you with more detail on the plans for each of the chapters we envisage having, as well as
the authors and institutions we have approached to contribute to the document. We will also
indicate where we would like some advice and suggestions from you (e.g. there may be places
where IDRC-funded research could feed into the report - e.g. MIMAP and MSP).
2. Provide you with a detailed budget, especially for the next few months. As I mentioned the bulk of
the budget in the proposal that we sent to you earlier is made up of printing and publication costs,
and for coordination costs.
3. Let you know what the response has been from other funders.
i^erms of your suggestion that IDRC may also be able to support the GHW through a co-publishing
Wangement, would it be possible for you to provide us with a little more detail? What would be the
implications of such an arrangement in terms of making the document available electronically for free;
providing the document at cost to targeted audiences; copyright etc. We will probably need to discuss this
option in a little more detail.
I hope you are both back home safe and well from your travels. .
Keep well!!
Dave
12/8/03
Page 1 of3
PHM - Secretariat
From:
To:
Sent:
Subject:
PHM - Secretariat <secretariat@phmovement.org >
Mike <mikerowson@medact.org>
Tuesday, December 09, 2003 12:03 PM
Re: [PHM_Steering_Group_02-03] PHM steering committee
Dear Mike,
Greetings from PHM Secretariat (Global)!
We managed charters from all sorts of sources and had a good stall at GFHR, More details in a separate
communication. You and David McCoy have not yet confirmed your participation at the Mumbai Health
Forum and WSF. We have even tentatively show you in the programme as facilitators of sessions. Do reply
as soon as you can. We have registered Patricia and Lexi already.
est wishes,
Ravi Narayan
..... Original Message
From: Mike
To: PHM-Secretariat(Global); parnzinkin
Cc: chetley.a@healthlink.org.uk ; uque@bluemail.ch ; marjan.stoffers@wemos.nl; qksavar@citechco.net;
simb@comset.net; cfischer@bukopharma.de ; woodwarddavid@hQ.tmaiI.com ; sunil.deepak@aifo.it
Sent: Monday, December 01, 2003 1:06 AM
Subject: Re: [PH M_Steering_Group_02-03] PHM steering committee
I'm afraid we only have a handful at Medact
— Original Message
From: parnzinkin
To: PHM-Secretafiat(Global)
Cc: chetiev.a@healthlink.org.uk ; uque@bluemail.ch ; marjan.stoffers@wemos.nl,
HtP
on
mikerowson@medact.orq ; qksavar@citechco.net; simb@comset.net; cfischer@bukopharma.de ;
woodwarddavid@hotmail.com ; sunll.deepak@aifo.lt
Sent: Sunday, November 30, 2003 7:59 PM
Subject: Re: [PHM_Steering_Group_02-03] PHM steering committee
Dear Ravi
Have only just got your email message. Problems with computer, server. Marjan at Wemos was
going to do distribution as I have no resources for this but I don’t think she has many copies. Qasem
was the source of the Charters. Medact and Healthlink may have a few. As I am only email sec-. I
have ven’ few’. David Woodward is the focal point.
The charters in other languages are available on the website of phm. The translators are not likely to
have 50 hard copies or the means of sending them, certainly not by tomorrow. We really have to
budget and plan these things as it will arise again.. (Agenda item in Mumbai).
I have some electronic versions of translations (there are 30 not 40) and I could forward these io
either Allyson or Eugenio if the web site does not lend them. Can whoever has the means of
printing the charters in other languages help?
Pam.
12'9/03
Page 1 of2
PH M - S ec r e ta r i a t( G Io ba I)
From:
To:
Cc:
Sent:
Subject:
Mike <mikerowson@medactorg>
PHM-Secretariat(Global) <secretariat@phmovementorg>; pamzinkin
<pamzinkin@gn.apc.org>
<chetley.a@healthlink.org.uk>; <uque@bluemail.ch>; <marjan.stoffers@wemos.nl>;
<gksavar@citechco.net>; <simb@comset.net>; <cfischer@bukopharma.de>;
<woodwarddavid@hotmail.com>; <sunil.deepak@aifo.it>
Monday, December 01, 2003 2:36 PM
Re: [PHM_Steering_Group_02-03] PHM steering committee
I'm afraid we only have a handful at Medact
mike
— Original Message —
From: pamzinkin
■ Jo: PHM-Secretariat(Global)
Ifcc: chetley.a@healthlink.orq.uk; uque@bluematl.ch ; marjan.stoffers@wemos.nl;
mikerowson@medact.org ; qksavar@citechco.net; simb@comset.net; cfischer@bukopharma.de \
woodwarddavid@hotmail.com ; sunil.deepak@aifo.it
Sent: Sunday, November 30, 2003 7:59 PM
Subject: Re: [PHM_Steering_Group_02-03] PHM steering committee
Dear Ravi
Have only just got your email message. Problems with computer, seiver. Marjan al Wemos was
going to do distribution as I have no resources for this but I don’t think she has many copies.
Qasem was the source of the Charters. Medact and Healthlink may have a few. As I am only
email sec. I have very few. David Woodward is the focal point.
The charters in oilier languages are available on the website of plim. The translators are not likely
to have 50 hard copies or the means of sending them, certainly not by tomorrow. We really have
to budget and plan these tilings as it will arise again.. (Agenda item in Mumbai).
I have some electronic versions of translations (there are 30 not 40) and I could forward these to
either Allyson or Eugenio if the web site does not lend them. Can whoever has the means of
printing' the charters in other languages heir
Pjge I of 1
FHMS - Secretariat
From:
To:
Sent:
ALach:
Subject.
Pamela Monon <patriciamcrton@medact.org>
abay <abaysema@pn3. vsnl.net in>; PHM-Ravi <phmsec@touchtelindia.net>; Rowson
kerowson@medactorg>:
*
<m
McCoy <David.h4cCoy@lshtm.ac.uk>; HST <a nt@hst.org.za>;
Lyn ette M ? •> * n < LMA RTIN@ u wc. ac. za>
Monday, December 22, 2003 7:41 AM
Spending sr.eet for global health watch December 2003.xls
Budget for Global Health Watch
Dear AB
Here is an account of funds recieved and spent (please ignore that in the GHW update).
Best Regards
Patricia
B .
Health
'/edaci. is .?. U:< charity for global health, working on issues related to conflict, poverty and the environment
Medact
The Grayston Centre
28 Chames Square
London Nt 3Ht
united Kingdom
7 +Z4 (C) 2C 7324 4739
F ->4^ Gj 20 7324 4734
yn -y rneosct.prg
Reoisterec CheriC 1C81097
ComeReg. '•Jo. 22G7’’25
At
Global Health Watch project
Activity
Activity cost (US$)
Patricia (project co-ordinator's) salary (Oct - December)
6200
Patricia's salary (Jan - March)
Flight and expenses to World Social Forum
Honoraria for authors
Administrative overheads and support costs for Medact
8900
1700
3500
3500
Honoraria for authors
Administrative overheads and support costs for Medact
4600
1600
30000
Resources committed to
Donor
Amount (US$)
Wemos
6200
Exchange
17600
Wemos
6200
Total
30000
Page i of 2
- Secretariat
From:
To:
Sent:
rHi-.' ■■ Secretariat <secretariat@phmovement.org>
Pavicia Morton <patriciamorton@medQct.org>
Tuesday December 23, 2003 12:52 PM
Re Global Health Watch Update
Subject:
Dear Patucra.
Greetrgs from PHM Secretariat (Global)I
;. > nan^s for me update on GHEW initiative. At the PHM Steering ana Suppot group meeting on 13th
'?rv-ary, there is a slot for the GHEW initiative, which we hope that you will present.
Please note that more man half of your advisory committee - Fran. Maria, Olle, Lexi. Andy. David, possibly
Pnd“eA- . ,;e at Mumbai, 13th to 13th January, if not longer. So the opportunity cost of a detailed
discussion must be explored We are st«i! hoping Dave and or Mike will change their minds and attend.
..c . ec- to strengthen Southern and Asian participation in the Advisory Committee and SHF - WSF will be
a.-: excexer.: opportunity to .dentfy Southern Authors as well.
iv ’ was surprised to rote that your communication for case studies was net mentioned in the update Prerc
just-reoef .
ttoget ier a pe
>f 40 case studies / tes
es
at may be part of
picjwmme. The tentative list is enclosed Perhaps you could help prem coordiante the testimonies and later
get permission from the testimony givers rthose you think are relevant to GHEW) to give persrnission to use •
them).
Rxvj Ncnryan
Coordinaux; People's HcaUh Movement Secruuniai (CHobab
CH<?-Bangalore
r-367 “Srinivasa Nilaya”
b
j’X: GO 9i 80 51280009 (Direct;
m?\: 00 91 GO 5525372
e bsitc: .. \ n.\\p!imo iy j pciitjjfg
Join dvr “Health for ail NOW'’ campaign in the 25th anniy,w.v:Hy y..of th-;
. iln
..
. ■.
.
he? ’”■■■ .
'..... Grigmaf Message —
’ From: rXgch.M-mpn
1 o: Lyne ie ■ a
; ;
:
at ire . • .. • '
i
F i
.
ford
l B.ainbas Baum ; Nordberg
■ Sent: Monday. December 22, 2003 7:34 AM
l Subject: Globa! Health Watch Update
I
: Dear AM
\ Here ;s an update of the progress of the Global Health Watch We welcome your cor.me v on
various
PHM.7" Secretariat
From:
To:
Sent:
Attach:
Subject:
Pamela Morton <patficiam.orton@medact.org>
u/nerte Marun <LMART!N@uwc.ac.za>: Chetley <cheiiey. a@heaithiink.org .uk>; McCoy
' Daid. McCoy@ishrm.ac. uk>: PHM-Ravi <phmsec@touchte!india.net>: abay
abayserna@pn3.vsnLnet.in>; Rutherford <arutherford@oneworldaction.org >: Rowson
<m:xercvvsor:@medact.org>; Braveman <pbrave@ifSa.ucsf.edu >; IPHC
•-maHa@iphcgiobai.org>; HST <ant@hst org.za>; Bambas <lexi@gega.org.za>; Baum
<ran oaum@ninders.edu.au>; Nordberg <oile.nordberg@dhf.uu.se>
Monday. Decemoer 22. 2003 7:34 AM
Global Health Watch Updatel (1).doc
Gleba! Health Watch Update
Dear A»i
rWe ;s an update of the progress of the Global Health Watch. We welcome your comment on the various
activities.
Season's Greetings and Best Wishes for the New Year
Patricia Morton
Global Health Watch
Medact is a UK charity 'z: global health, working on issues ru-crW to conflict poverty and the environment
Medact
The Graystor Centre
28 Charles Square
Lender. N1 oHT
Uniiea Kingdom
7 +44(0; 20 7324 4739
F +44 (0) 20 7324 4734
' '
U
Registered Chaii-.y 1081097
Company Reg. No 2267125
Global Health Watch Update
Chapter briefs and authors
Attached is a table giving a full update on progress with the development of chapter briefs and the
commissioning of authors. Highlights include:
•
Survival International have agreed to take the lead on a chapter on indigenous people’s health
•
The Municipal Services Project have tentatively agreed to take a lead on the water chapter.
There has also been interest shown by Water Aid.
Mickey Chopra from University of Western Cape is discussing the nutrition chapter with Phillip
•
McMichael (Cornell University) and Tim Lang about the nutrition chapter
Public Services International have been approached to write for the chapter on privatisation of
•
health services. In terms of chapters, there has been a decision to include a chapter related to
disabled people and to mainstream gender through the report.
We are still looking for advice and recommendations on other authors - especially people who are
from the South.
Funding
Funding provided and received:
•
HealthLink (UK) - £10,000
•
WEMOS-£10,000
•
GEGA-£3,000
Dag Hammarskjold - has promised us some in-kind support.
IDRC have given a verbal undertaking to fund GHW
Soros Foundation - recent phone conversation indicates a genuine interest. They want more detail
on our post-publication advocacy strategy.
Other organisations are yet to get back to us.
Thus far, funds have been allocated to support the secretariat and the part-employment of Patricia
Morton.
Publication
Zed Books has proposed a very affordable publishing deal. IDRC have also proposed a joint
publication proposal. Both offers are being investigated.
Advocacy
In light of the enthusiasm for the Global Health Watch, we are proposing the idea of launching the
initiative at the International Health Forum in Mumbai in January. Apart from creating anticipation
and demand for the report, we are hoping to recruit southern based authors or at least tap into
networks of southern based CSOs and potential authors. Patricia Morton will be present at that
meeting, but we need to know who else will be able to support her with the launch of the report.
please respond to this item
We are currently in the process of putting together an advocacy plan which will include activities to
create demand for the report as well as how we will use the report to influence global health policy.
Informal discussions with certain allies in WHO suggest that the report could be used to strengthen
the hand of progressive elements within WHO. There is a tentative plan to meet with Tim Evans in
January (this will be brokered by Jeanette Vega).
There is a proposal to hold a meeting with other NGOs in June at the time of the GEGA meeting to
discuss potential advocacy opportunities.
Timeframes
We are setting the date for the final draft of the report at June 30 and we plan to launch the report
in October.
Project management
The organisational management of GHW is as such: Dave and Mike are providing day to day
coordination and leadership, with the support of Patricia who is working almost full-time on this.
There is a steering committee consisting of representation from the three organisations. There is
also a broader advisory group consisting of the following people: Fran Baum (PHM); Maria Zuniga
(IPHC/PHM); Paula Braveman (GEGA); Ollie Nordberg (DAG); Andy Chetley
(Healthlink/Exchange); Lexi Bambas (GEGA); Antionette Ntuli (HST/ GEGA); David Sanders
(PHM); Andy Rutherford (One World Action); Marjan Staffers (Wemos); Paula Braveman (GEGA).
An e-mail discussion list will be set up for the advisory group to ease communication.
Each chapter will have a reference / advisory group set up.
We are proposing a steering committee meeting in February with representatives from Medact,
Gega, PHM and possibly also some of you from the advisory group. There may be some travel
money available for this. Please respond
7
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Resources committed to Global Health Watch project
Donor
Activity
Amount (US$)
Activity cost (US$)
Wemos
6200
Patricia (project co-ordinator's) salary (Oct - December)
6200
Exchange
17600
Patricia's salary (Jan - March)
Flight and expenses to World Social Forum
Honoraria for authors
Administrative overheads and support costs for Medact
8900
1700
3500
3500
Wemos
6200
Honoraria for authors
Administrative overheads and support costs for Medact
4600
1600
GEGA
5000
Fee for initial concept development. Paid directly from GEGA to Dave McCoy
5000
Total
35000
35000
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People's Health Movement
OD©[b®iO IrOsgiO^h Wsiteth
lto£?Wy©®)©0
Global civil society does not participate strongly and consistently in international health
advocacy. Whilst high-profile success has recently been achieved with the campaigns on
access to medicines and the past twenty years have seen positive achievements due to
pressure from civil society (for example, on breastfeeding and smoking), there is a striking
lack of involvement and pressure from health campaigners on broad health and health
systems issues. Where such pressures exist, they are inadequately drawn upon by the
institutions of global health governance - notably the World Health Organisation - whose
legitimacy and accountability to the world’s population would be enhanced by more vigorous
engagement with civil society.
A fragmented, disease- and issue-specific approach to health dominates research, advocacy
and governance agendas. Calls on policy-makers to address fundamental causes of illhealth and failing health systems are weak and uncoordinated: a dangerous situation in a
world where these issues need to be addressed more than ever. In addition, the growing
disparities in health care consumption between the rich and the poor have grown alarmingly
within and between countries, leaving society and the public health movement with a major
ethical and moral challenge.
In response to this, the People’s Health Movement, the Global Equity Gauge Alliance and
Medact - each with excellent technical expertise in research and advocacy - propose to
mobilise a fragmented global health community around values which stress the need to
tackle the fundamental causes of ill-health and inequity in our societies. The vehicle for this
advocacy is the publication of an annual GGoM HeaOB Wafcsh which will combine
outstanding research and policy analysis with a commitment to bringing the views of poor
and vulnerable groups to the attention of international and national policy makers.
The Global Health Watch will be used to shift the health policy agenda away from a
technocratic approach to delivering health, to one that recognises the important political,
social and economic barriers which prevent the achievement of better health. We want the
Watch to be a tool which:
o
Legitimises and strengthens the calls for a broad approach to health amongst policy
makers, health professionals, campaigners, researchers and others concerned with
health;
I
0
Can be used by advocates to strengthen their existing work whilst drawing them into
broader debates about international health and in the process creating a more vibrant
global civil society in health;
o
Acts as a reality-check for those formulating health policy by providing a forum which
magnifies the voice of the poor and vulnerable and those who work with them.
The rationale, values and contents of the Watch are sketched below.
Background
Every day 30,000 children die of preventable causes. The HIV/AIDS epidemic continues to
escalate, with the situation in sub-Saharan Africa already tragic, and large parts of Asia
about to follow suit. Worldwide, poverty remains the most important underlying cause of
morbidity and premature death. Over a billion people, mostly women and children, live on
less than US$1 a day, and this number has grown over the past twenty years.
Perversely, growing poverty exists with growing wealth. The world’s 25 richest people now
have incomes and assets worth US$474 billion - more than the entire GNP of Sub-Saharan
Africa, in both developing and developed countries we have witnessed increasing
inequalities in income over the past two decades, coupled with the persistence of other types
of disparity and social division such as gender and ethnic inequalities.
The failure of the global community to achieve “Health for Ail by the Year 2000” is the result
of this situation. New targets - such as the Millennium Development Goals - have come to
the fore more recently. However, whilst overseas development assistance declines, and the
trade and investment environment becomes even more unfriendly to poor countries, there is
a great danger that these objectives too will not be met, increasing cynicism and discontent
in the world.
The global health institutions of the UN system have become increasingly weak. The
influence of the World Health Organisation has declined in a global policy arena which is
now dominated by the World Bank, International Monetary Fund and World Trade
Organisation. As a result, international health policy is dominated by a market-led
development paradigm which is leading to fragmentation of health systems, privatisation and
a gross lack of emphasis on the underlying causes of ill-health.
To counter these trends, the People’s Health Movement, Medact and the Giobai Equity
Gauge Alliance, have proposed the development of an annual global health report to be
known as the Global Health Equity Watch. The following section describes its objectives and
values.
2
sumd) vaOmies ©ff ft® G0©fc>ai Healft Wsrtch
°
We want to invigorate the international health policy agenda by capturing the
perspectives and spirit of civil society, and bringing in the ‘voices of the unheard
*
. We
aim to re-connect global civil society with the institutions of global health governance and
offer a contrast to the technocratic and dry nature of many other assessments of the
global health situation.
0
We
promote human rights as the basis for health policy, as a corrective to the
market-led policy agenda which tends to fragment and exclude.
°
We wiB place health and health inequities within a broader political economy perspective.
There is a tendency for global health problems to be described in isolation from the
unfairness of the global political economy. The Watch will promote the idea that the
political economy of health should be a central public health priority of all health workers.
o
We will Place health and health inequities within a multi-sectoral perspective. The Watch
will explicitly link health to other sectors such as the environment, international finance,
agriculture and food security, war, housing, land rights, conflict and education.
o
We will link research and analysis to advocacy. The Watch will provide
recommendations and encourage advocacy actions that will help ensure that real
change in favour of justice and redistribution takes place and that governments and
international institutions are held more accountable to those who are marginalised and
impoverished.
Sfewftre Mdl
©ff ft® R®|p©irft
The Global Health Watch aims to promote substantial participation of civil society (and
others concerned with international health) within the constraints of producing a coherent
and well written report.
The intention is for the Global Health Watch to consist of a compilation of chapters (some
with discrete with sub-sections) on various global health issues, supplemented with
testimonies from the ground and the voices of people who are traditionally unheard. The
idea is not to commission new research. Many NGOs and academics have done the
research and analysis: the Global Health Watch will provide a platform for the further
dissemination and popularisation of this work.
Chapters wilt be written by different authors, and a special effort will ba made for the authors
to be representative of all regions of the world. Each chapter would also have designated
reviewers. The approximate size of the report will be 100,000 words. The suggested
structure and chapter headings of the report are shown below, it is envisaged that the
precise scope and size of the report will change slightly from year to year.
3
IHl^sidlBiJT)^ ©ft th®
IntesMtlh WfaMh
Foreword] by eminent global personality
by the co-ordinating organisations
Secfttoro A: rtrmMcw to GD©teS ta® Drae^Motes
A1: Introduction
See^omi B: Tte IPoOoftilcaD Eeocwmy off IHMto amid HeaOto Programs
B1: Politics and economics of poverty and inequity- a global public health priority
B2: Health policy: the privatisation agenda (including JPPls)
B3: The global brain drain of health personnel
B4: Big Pharma and the Future of Accessible Medicines
B5: Responding to treatment access and beyond
Sectoomi ©: Beyort Tfoe iHesiOto Sector
01: Nutrition and the right to food
C2: Water and Sanitation
C3: Violent conflict
C4: Environment
05: Education
C6: Disabilities
07: indigenous People
Secffoomi 0: Ffcmtormg Aodl AdJvoeaey Seeffoom
This section will consist of a number of sub-sections which will highlight a few key
institutional case studies (we want a report that is monitoring the performance of key actors)
and policy recommendations related to the earlier chapters. The purpose of these sub
sections will be to affirm the notion accountability to civil society, and inform the advocacy of
a global progressive health movement committed to a just world and health for all. There
would be a number of sections, that may include:
° Trends in financial 'flows to developing countries
° Trends in health and key health-related expenditures in tow-income countries
° Assessment of actions of
WHO and other international health agencies
World Trade Organisation
International Monetary Fund and World Bank
Private Sector (e.g. pharmaceutical industry
Note: Gender issues will be mainstreamed through the report.
4
The production of the report will be managed and coordinated by the People’s Health
Movement, the Global Equity Gauge Alliance and Medact, with Medact acting as the
secretariat. An editorial committee will be established to help shape and review each chapter
and make sure that they are adequately reflective of the 'voices of the unheard’ from
different parts of the world.
To achieve its greatest impact, the co-ordinating organisations are proposing an advocacy
strategy with three primary goals:
o
o
o
To increase the accountability and responsiveness of the World Health Organisation
(WHO) and other global health institutions to the opinions and ideas of global civil
society;
To legitimise and strengthen our core message: that equity, the centrality of effective and
inclusive public health systems and broad public health issues need greater recognition
in the health policy arena at both the global and national level
To encourage greater involvement of CSOs in the determination of international health
policy, with a particular emphasis on strengthening representation of the poor
The activities planned to realise these goals are as follows and combine a mixture of
activities at national and global ievei.
T’jw process ©IF [pmdlycmg Uh® Waftsth will in itself be a part of the advocacy strategy. We
aim to involve a diverse range of NGOs, CSOs and individuals from both developed and
developing world in the writing the report (emphasising the fact that health is a broad cross
cutting issue). The Watch will also be ‘pre-launched’ at the World Social Forum in Mumbai in
January 2004, and it will be further promoted to attract attention and involvement before the
report is published. A notice about the report has already been published on many different
listserves, websites and e-lists. Post-publication, we will encourage CSOs to use the Watch
to strengthen their own positions in the particular areas of health and development that they
work in.
S6miutoini®OMS (jaweh ©IF lite Wafteh in as many countries as possible. We will be asking
local NGOs, CSOs, academics and others to help organise a simultaneous launch of the
published report in as many countries as possible. Both GEGA and the Peoples Health
Movement are already networks of country-based individuals and organizations that are
capable of covering a large number of countries. The aim will be to get strong media
coverage, putting pressure on WHO and other global health and development institutions to
respond to the report. The precise timing of the launch of the report has not been finalised,
but it may be linked to a particular event, possibly around the time of ths publication of
WHO’s World Health Report.
5
Camspaogtn) aroimdi ©emtati recommeinidations. Apart from encouraging advocacy around
the recommendations made in specific chapters of the Watch, the co-ordinating
organisations will also develop a campaign around a number of cross-cutting
recommendations related to the goals above and recurring themes. The campaign will aim to
exert influence on WHO and other global health institutions through national governments
and a broad coalition of CSOs. Organisations at the national level will be encouraged to take
the report to representatives of their national governments.
wifth
maters. It is hoped that the Watch will be used as the basis for
CSOs and NGOs to initiate and stimulate dialogue and discussion with international and
country-level decision-makers whenever they have the opportunity. For this reason, an
underlying strategy will be to seek formal and explicit endorsement of the report or specific
chapters from as many individuals and NGOs as possible so that there will be a broad sense
of ownership of the report.
Fromo^om) amd) dWntaCoom In collaboration with a leading publisher with good distribution
networks in the developing world (Zed Books), we will subsidise the publication of the Watch
in poorer countries at a cheaper price. The Watch will also be available for free on the World
Wide Web.
tagjMgje gjfjWips will be a challenge, and we are planning to develop
shortened versions of the report in languages other than English for dissemination to
grassroots organisations and other civil society groupings.
6
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Prasanna - PHM Communications
——agga—w—gga”'MIXMW,TirTri[giinT»lTiirnB»t
From:
To:
Sent:
Subject:
"Prasanna - PHM Communications" <prasanna@phmovement.org>
"Patricia Morton" <patriciamorton@medact.org>
Saturday, February 21, 2004 9:20 AM
Re: Photos of IHF
Hi Patricia,
Just y'day I recd. some of the IHF/WSF photos in the digital form from Andreas. Will put it up shortly
on the web. I am yet to optimise the size of the photographs as they are very huge and it took me ages to
download with my dial-up connection. Will get back to you with the photos soon. Any deadlines?
Best Wishes
Prasanna Saligram
Communications Officer, People’s Health Movement Secretariat(Global)
CHC-Bangalore
#367 "Srinivasa Nilaya"
Jakkasandra 1st Main, I Block Koramangala
Bangalore-560034
| Tel: 00 91 (0) 80 51280009 (Direct) Fax: 00 91 (0) 80 25525372
F Website: www.phmovement.org
Join the "Health for all, NOW!" campaign in the 25th anniversaiy year of the Alma Ata
declaration visit www.TheMillionSignatureCampaign.org
— Original Message —
From: Patricia Morton
To: Prasanna - PHM Communications
Sent: Monday, March 01, 2004 3:55 PM
Subject: Photos of IHF
Dear Prasanna
I wondered if you had any photos of the International Health Forum which we could use for our medact
newsletter. If you do we need them asap.
Thankyou very much.
Patricia Morton
Global Health Watch
PS: did you recieve my bits for the webpage??
Medact is a UK charity for global health, working on issues related to conflict, poverty and the environment
Meaact
The Grayston Centre
28 Charles Square
21/02/04
Page 1 of 1
Main Identity
From:
To:
Sent:
Subject:
Patricia Morton <patriciamorton@medactorg>
<secretariat@phmovement.org>
Monday, March 01, 2004 7:52 PM
photos of IHF and WSF
Dear Ravi/PHM staff
I wondered if by any chance you had some photos of the IHF and WSF that would be available digitally, for
our medact newsletter. I took some, but they were not great.
Thankyou very very much
Regards
Patricia
Patricia Morton
Global Health Watch
Medact is a UK charity for global health, working on issues related to conflict, poverty and the environment
Medact
The Grayston Centre
28 Charles Square
London N1 6HT
United Kingdom
T +44 (0) 20 7324 4739
F +44 (0) 20 7324 4734
vvww. medact. arg
Registered Charity 1081097
Company Reg. No. 2267125
3/2/04
Prsp. 1 Af 2
j-
Page 1 of?
Main Identity
From:
To:
Sent:
Subject
Patricia Morton <patriciamorton@medactorg>
GHW mailing list <ghw@hst.org.za>
Wednesday, February 25, 2004 7:45 PM
Re: [ghw] Concept document- Latest Version
Dear All
In light of Amifs very useful comments, it would be good to have the
steering committee’s opinion on the following letter, prepared to go on to
PHA-Exchange as a start to some regular discussion on the GHW on this
e-list. Dave has suggested that it come from the steering group itself. If
possible, could you please make your comments in the next couple of days so
we could send it out asap.
Thanks
Patricia
Dear Friends,
At the World Health Assembly in May 2003, the Peoples Health Movement, GEGA
and Medact discussed the need for civil society to produce its own
’Alternative’ World Health Report. It was felt that the WHO reports were
inadequate, and furthermore, that there is a report that monitors the
performance of the global health institutions themselves. It was also felt
that the dominant neo-liberal discourse in public health policy also needed
to be challenged by a more people-centred approach that highlights social
justice.
An ’Alternative World Health Report’ based on rigorous analysis would also
form a useful platform for the strengthening of advocacy and campaigns to
promote equitable health for all. In this sense the report should be seen as
a means to an end.
This idea of an alternative world health reoort has since develoopcj into an
initiative called the ’Global Health Watch’. In January 2004, the initiative
was presented at the International Health Forum in Mumbai and we are now
attaching for your consideration, the latest concept document. We plan to
launch the Global Health Watch in May 2005.
Till now the Global Health Watch has been supported by the Peoples Health
Movement, Medact and GEGA. However, we now need to widen the network of
collaborators and supporters to this initiative.
We are looking to members of this list to:
- Comment on the concept document: link
- Stimulate discussion about what key messages should be contained in the
2/26/04
Page 2 of 2
report
- Develop local platforms for the use of the report in 2005 when it is
> published
We look forward to hearing some of your views and comments.
Yours Sincerely
Global Health Watch Steering Committee
2/26/04
Page 1 of 1
Main Identity
From:
To:
Sent
Subject
McCoy Dave <Dave.McCoy@haringey.nhs.uk>
<ghw@hstorg.za>
Wednesday, February 25, 2004 7:05 PM
RE: [ghw] Concept document- Latest Version
Dear Amit
Thanks for this message. You make some excellent points and timely as
well We have just been drafting a message to put out onto the PHA mailing
list where we want to invite comment about the Global Health Watch, as well
as about some of the topics that will be covered in the Watch. In this way.
we hope to catalyse much greater ownership of the Watch and allow tha Watch
to act as a platform for a more vibrant discussion about key issues for
civil society and NGOs in the health sector to engage with.
For example, in the run up to the publication of the report, it would be
great if the PHM network could facilitate some discussion and debate about
how we position ourselves vis a vis the new orientation of the WHO. Or to
discuss how we strengthen to good bits about the WHO and how we target its
weaknesses for advocacy.
We will circulate the message for the PHA mailing list to the GHW steering
group first, and then send it out from all of us, if there are no
objections.
Best wishes
David
2/26/04
-Page 1 of3
Main Identity
From:
To:
Sent:
Subject
<ctddsf©vsnl.com>
<ghw@hstorg.za>; GHW mailing list <ghw@hstorg.za>
Wednesday, February 25, 2004 6:23 PM
Re: [ghw] Concept document- Latest Version
Dear All,
Just a brief reaction to the GHW concept document that has been circulated.
I think it reads vety well, and captures the key concerns. If I may add a
few small suggestions:
1) When we refer to CSOs, NGOs, etc. it would be appropriate to also
specifically mention "movements”. The PHM, while being a network of CSOs,
NGOs and other organisations, is above all a movement. I understand that the
distinction between movements and NGOs/CSOs is not always clear, and may not
exist in many contexts. But going by our experience in India, it would be
useful to specifically talk of movements as part of the PHM process and the
process of putting together the Global Health watch report
<——
2) Two small specific suggestions on the note:
1°
a) When we say ” ...the diminished capacity and role of national
governments..." can we also add "and the erosion of sovereign decision
making space”
b) Instead of saying "...as a corrective to the market-led policy agenda...”
can we say "as an alternative to market-led policy agenda..."
3) A suggestion for the proposed structure of the Watch:
Two special chapters are proposed on Indigenous people and Disabled people’s
right to health. Can we, instead, have a section that talks about the
"marginalised and the right to health care". To elaborate: imperialist
globalisation today is leading to the accelerated marginalisation of those
vrfio arv alrvady margMtnlievd, tiw must vultivroMv are
attacks on their health rights. this includes the indigenous people and the
disabled, but also in many settings: women, children, the aged, and other
traditionally marginalised sections like ethnic or religious minorities,
dalits (in India and other parts of S. Asia), etc. It might be useful,
especially when we focus die report on health inequities to have a section
with substantive focus on this aspect.
y.
£14^
Finally some reactions to the issue raised by friends in this discussion
list, regarding the long-term view of the Global Health watch and its
relation to the PHM (this is not necessarily in the context of the concept
note).
^4
2/26/04
Page 2 of3
I think we need to take note of the veiy loose organisational structure that
the PHM has and which we have consciously promoted. In such a situation it
would be veiy difficult for the PHM as an ’’organisation” to administer the
* Global Health Watch. So it makes sense for organisations like Medact and
GEGA to play the co-ordinating role that it is playing at the moment. The
PHM can add value to the enterprise by bringing in perspectives and insights
that are truly global and also by using its extensive network to publicise
the report, and by making its impact felt at regional, country and local levels.
In order to facilitate this process, it would be necessary over time to
consciously bring in concerns of the PHM — which would means concerns of
the large number of organisations, which form the PHM. This is not going to
happen overnight (possibly much of this will not happen for the first report
in 2005), and would require a process where PHM constituents discuss the
concept of the Global Health Watch and also suggest ways in which they can
enrich the report. This will, I presume, involve a discussion within the PHM
— maybe also the activation of a separate ’’circle" in PHM to initiate this
process. Even relatively minor things like discussions within country PHM
constituents about suggested authors/editors/issues from that country/region
would be useful in enhancing a sense of involvement with the Report by PHM
constituents. If this can be ensured the PHM can be better placed to "own"
the Report.
I think that in some way there may be a concern that the Global Health Watch
should not be "institutionalised" and thereby loose its vitality. These are
early days and such a danger, is at best, just a theoretical possibility —
but a possibility nonetheless that we would need to guard against. The best
safeguard in this regard would, of course, lie in the ability of the PHM to
play a proactive role in the preparation of the Report.
Hope the above adds some substance to our discussions.
With warm regards to all,
Amit Sen Gupta
Jana Swasthya Abhiyan (PHM - India
At 05:22 PM 2/24/04 +0000, Patricia Morton wrote:
>Dear All
>
>See, attached, the latest version of the GHW concept document This version
has incorporated comments from some of you and from IDRC (who are looking
like they will fund the GHW). Changes have been to emphasise the role of the
PHM and to spell out the advocacy strategy a bit more.
>
>Please let us know what you think.
>
>Regards
>Patricia
2/26/04
Page 3 of3
>Patricia Morton
,
Page 1 nf 1
Main Identity
From:
To:
Sent:
Subject
PHM Secretariat <secretariat@phmovement.org>
<ghw@hst.org.za>
Wednesday, February 25, 2004 4:48 PM
Re: [ghw] Concept document- Latest Version
Dear Patricia,
Greetings from PHM Secretariat (Global)!
Just out of interest. Could you send me the latest GHW mailing list, so that we can identify all those
who have PHM linkages already even if they are wearing other hats and send you names, for regions not
adequately representated.1 think the latest version is evolving well in an interactive way. Specific
comments follows after I do a more relaxed review.
Best wishes to you, Dave and Mike
Ravi Narayan
Coordinator, People’s Health Movement Secretariat(global)
CHC-Bangalore
#367 ’’Srinivasa Nilaya"
Jakkasandra 1st Main, I Block Koramangala
Bangalore-560034
Tel: 00 91 (0) 80 51280009 (Direct) Fax: 00 91 (0) 80 25525372
Website: www.phmovement.org
Join the "Health for all, NOW!" campaign in the 25th anniversary year of the Alma Ata
declaration visit www.TheMillionSignatureCampaign.org
2/25/04
Pogft j of 1
Main Identity
From:
To:
Sent:
Attach:
Subject
Patricia Morton <patriciamorton@medact.org>
GHW mailing list <ghw@hstorg.za>
Tuesday, February 24, 2004 10:52 PM
Concept document-Feb 27 2004.doc
[ghw] Concept document- Latest Version
Dear All
See, attached, the latest version of the GHW concept document. This version has incorporated comments
from some of you and from IDRC (who are looking like they will fund the GHW). Changes have been to
emphasise the role of the PHM and to spell out the advocacy strategy a bit more.
Please let us know what you think.
Regards
Patricia
Patricia Morton
Global Health Watch
Medact is a UK charity for global health, working on issues related to conflict, poverty and the environment
Medact
The Grayston Centre
28 Charles Square
London N1 6HT
United Kingdom
T +44 (0) 20 7324 4739
F +44 (0) 20 7324 4734
www.medact.org
Registered Charity 1081097
Company Reg. No. 2267125
Global Health Watch discussion list
List address: ghw@hst.org.za
List information page including list archives:
http ://akima. hst. org. za/mailman/listinfo/ghw
This list is hosted by the Health Systems Trust: http://www.hst.oig.za
Global Equity Gauce Alliance
GBoM Wt W^itdfB
^©billsmg Site g)D©fc)®0 h©all® aoud) s©©oaO psfti©© mwemert
aswsrDdl afrs altem&tllv® World Hoalth [R©ip©^
Introduction
Global civil society dees not participate strongly and consistently in international health
advocacy. Whilst there have been some high-profile successes due to pressure from civil
society, (for example with campaigns to improve access to medicines and to regulate the
promotion of infant formula), there is a striking lack of involvement and pressure from civil
society on broad health and health systems issues.
With the failure of the global community to achieve “Health for Al! by the Year 2000”, new
targets - such as the Millennium Development Goals - have come to the fore. However,
whilst overseas development assistance declines, and the trade and investment
environment become even more unfriendly to poor countries, there is a great danger that
these objectives too will not be met, increasing cynicism and discontent in the world.
A fragmented, disease- and issue-specific approach to health dominates advocacy as well
as research and governance agendas, under-emphasising the underlying causes of illhealth. Meanwhile, disparities in health care consumption between the rich and the poor are
growing alarmingly within and between countries, leaving society with a major political, social
and moral challenge.
The values that underpin the goal of health equity and the PHC Approach are often
undermined by development policies emphasising efficiency at the expense of fairness;
market forces at the expense of planning based on population needs; and selective
approaches to disease-eradication at the expense of more comprehensive strategies for
achieving health. In addition, the diminished capacity and role of national governments,
particularly of poor countries, has further undermined the notion of social solidarity and
inclusive health systems.
1
Although there has been a recent and welcome shift by the World Health Organisation to
highlight global inequity and reassert the principles of the Primary Health Care Approach,
constant pressure from civil society is needed to hold national policy-makers and
international organizations accountable to declared values and to address the fundamental
causes of ill-health and failing health systems. To be effective, civil society voices must be
well informed, evidence-based, and united on fundamental issues.
In response to this, the People's Health Movement, with the support of the Global Equity
Gauge Alliance and Medact, propose to mobilise a fragmented global health community
around values which stress the need to tackle more effectively the fundamental causes of illhealth and health inequity in our societies. The vehicle for this is the Glbtell UtaiOfth Watch,
an initiative that will combine outstanding research and policy analysis, a commitment to
bringing the views of poor and vulnerable groups to the attention of international and
national policy makers and a more effective civil society advocacy movement.
We want the Watch to be an initiative that:
o
Amplifies the calls for a broad, multi-sectoral approach to health by explicitly and
concretely linking health concerns to the environment, international finance,
agriculture and food security, war, housing, land rights, conflict and education.
o
Strengthens the capacity and accountability of the world’s global health institutions to
provide technical and value-based leadership in the struggle to attain adequate
health for all.
o
Creates a more vibrant global civil society in health by strengthening the links
between socially conscious non-govemment and civil society organisations across all
regions of the world, based on shared values. ■
o
Provides a forum for magnifying the voice of the poor and vulnerable and those who
advocate for them;
o
Shifts the health policy agenda away from technocratic approaches, to one that also
recognises the political, social and economic barriers to better and more equitable
health; and
o
Promotes human rights as the basis for health policy, as a corrective to the marketled policy agenda which tends to fragment and exclude.
BoustitattomiaiD tarn ©woirik ©ff ta Wefclh
t he People’s Health Movement (PHM) is an organised network of civil society and
grassroots organisations that developed out of the international gathering of the first
2
People’s Health Assembly in Bangladesh in December 2000. At that meeting, delegates
from all ever the world reaffirmed their commitment to the strengthening of health care
systems that are equitable, sustainable and locally appropriate, as well as to the view that
health is a human right. This has since been encapsulated in a People’s Health Charter,
which has been translated into several different languages.
As a global network, with its base firmly rooted in developing countries, the PHM is a vehicle
that can act as a unifying umbrella for a wide range of individuals, organisations and
community-based organisations engaged in struggles and efforts to improve health and
social justice globally.
Medact is a UK-based charity with a health professional membership that has been active in
highlighting the harmful effects of globalisation, poverty, environmental degradation and war
on health and equity. GEGA, a network of projects mainly in the South that primarily
addresses in-country health inequities, has committed itself to tackling the global
determinants of health disparities within and between countries. Together with PHM, they
have helped to provide the impetus around the development of the Globa! Health Watch.
In keeping with the organisational philosophy of the People’s Health Movement, the aim is
now to promote the involvement of as many NGOs and individuals as possible in the
development and use of the Watch as an advocacy tool. The efforts to ensure this
widespread involvement and the shared ownership of all those who participate in the
development of the Watch and I or endorse its contents will strengthen global civil society’s
engagement with global health policy, and are as important as the actual production of the
report.
A central feature of the workplan to produce the Watch is therefore the process of forging
and strengthening linkages between CBOs, NGOs and academics; between constituencies
in the South and the North; and between the progressive health sector and other progressive
social and environmental movements and organisations.
1)
I he regular production of an alternative world health report
The Global Health Watch will regularly be produced as an alternative world health report that
is coherent, rigorous and written to support civil society’s capacity to promote a more socially
conscious and equitable health agenda. To be effective, the report’s credibility as a reliable
source of sound evidence is crucial. At the same time, the report will serve as a forum for
civil society perspectives, testimonies from the ground and the voices of people who are
traditionally unheard. The report will consist of a compilation of chapters on various health
issues. Generally, the Watch will not commission new research but will rely on research and
analysis already done by NGOs and academics, providing a platform for the further
dissemination and popularisation of this work.
3
Chapters will be written by different authors from various regions of the world. Each chapter
would also have designated reviewers, thus expanding the network of contributors to the
text. An editorial committee will oversee the report production, ensuring the overall quality of
the material, the coherence of the report as a whole, and that it reflects the ‘voices of the
*
unheard
from different parts of the world. There will be a set of recommendations at the end
of each chapter and the opening chapter will draw' out the main themes of the report and put
forward over-arching recommendations. A dedicated editor will be hired to support individual
contributors in producing material of adequate quality, and finalising and copy editing the
report.
The approximate size of the report will be 100,000 words and the suggested structure and
chapter headings of the report are shown below. It is envisaged that the scope and size of
the report will change somewhat each time to accommodate emerging issues while
preserving a critical core that remains consistent over time
2) Advocacy
In addition to the production of a report, the Watch incorporates an advocacy strategy that
aims to:
o
Increase the responsiveness of global health institutions to the opinions and ideas of
global civil society;
o
Legitimise and strengthen our core message: that equity, the centrality of effective and
inclusive public health systems and broad public health issues need greater recognition
in both global and national health and development policy agendas; and
o
Encourage greater involvement of civil society organisations in the determination of
international health policy, with a particular emphasis on strengthening representation of
the poor and their advocates.
The activities planned to realise these goals combine a mixture of activities at national and
global level.
Tte
©ftpriming} fth® WqMh. By involving a diverse range of NGOs, CSOs and
individuals from both developed and developing worlds in the writing the report, the core
messages of the Watch will be filtered and communicated through a wide range of formal
and informal networks and information channels.
report. In order to raise the level of expectation and demand for the
Watch, it will be ‘pre-launched
*.
The Watch was presented and discussed at the World Social
Forum in Mumbai in January 2004, and will be presented to a broad group of health,
development ?MGOs, CSOs and trade unions as well as the press at a meeting in London in
March 2004. In addition various notices about the report have already been disseminated
through different list-serves, websites and e-lists.
4
SSmManeous Ssimch cffth® Watch. \Nq plan to launch the published report at the time of
the World Health Assembly in May 2005. We will also be asking local NGOs, CSOs,
academics and others to help organise a simultaneous launch of the report in as many
countries as possible. Both GEGA and the People’s Health Movement are already networks
of country-based individuals and organizations that are capable of covering a large number
of countries.
Campaign ammd c®mttr3i0 r®®Mm®m)dlatocini^. Apart from encouraging advocacy around
the recommendations made in specific chapters of the Watch, a campaign around a number
of the cross-cutting recommendations will aim to exert influence on global and national
health institutions through national governments and a broad coalition of MGOs/CSOs.
Organisations at the national level will be encouraged to take the report to representatives of
their national governments and to use it to strengthen their own positions in advocating for
equity in the areas of health and development that they work in. A key global health
institution that the Watch will engage with is the World Health Organisation, and participating
organisations will be encouraged to raise the main and chapter recommendations from the
Watch with WHO.
In addition to hard copy distribution of the report, the Watch will also be
available without charge on the World Wide Web. The report as a whole and individual
chapters will be available in easily downloadable format to facilitate advocacy .
^achHimgj dJoffl®ir®inft Bmgjiuiaig}® gjiroupg. We will develop shortened versions of the report
initially in Portuguese and Spanish for dissemination to grassroots organisations and other
civil society groupings. We will explore avenues for the translation of the document into other
languages.
Proposed] stacW® aimfl O^oiufi of a®
art
_________________________________________________________________
A summary of the report, linking the chapters, drawing out the main themes and ending with major
recommendations.
S&stoiro fa
anno)ofi (nte^OtHh_________________________________________
AD: Polctacs and sconomocs of poverty - a gOolbali pMbScc heaOfh prtoiroty
Describes the mechanics of the global political economy that keeps people and countries poor; covers
trade, global financial systems, debt and their linkages io health._____________________________
A2: Approaches to heaOfth car®
An overview of the relevance of the PHC approach today, and how health policies are influencing the
shape of health care in ways that diverge from the principles of Alma Ata. This includes some
commentary on the role and effects of GPPPs.__________________________________________
5
A3: Hea'to PoSicy: to® privatisation agenda
Describes the processes of commercialisation and privatisation of health care, the resulting problems and
the appropriate government and non-government responses. Describes the weaknesses and
shortcomings of the marketisation and commercialisation of health care.__________________________
A4: Tfcs gtoM ibrain drain off hsaiito parsonnei
Describes the effect of migration of health personnel, the underlying forces of economic and political
globalisation and suggests ways to address the problem. Critiques the lack of effective action to tackle
this urgent health priority.______ ______________________________________________________
AS: Big Pharma and to® founding off TOD ffor medocmss
Describes the multi-billion dollar pharmaceutical industry in relation to global health and world poverty
and the influences of this industry on health policy. Sets out an argument about the need for more
fundamental reform of R&D and the need for excessive profit-making from medical care to be regulated.
AS. Responding to treatment access and fesyond
A critique of 3x5, the Global Fund and the World Bank's treatment programmes, in the context of the
overall progress towards combating the HIV/AIDS epidemic.__________________________________
A7: Genomes and health
The unravelling and exploitation of the human genome leads to important questions in the health sector
from an ethical and equity perspective. This chapter further explores the unclear inter-face between
commercial health care and public health, and for accountable governance of the future development of
this industry at the international and national level.
Sitton 1; Boywd to© H©aOto
BU. Nutrition and to® right to ffood
_________________
Focus of this chapter is still to be defined________________________________________________
B2: Water and Sanitation
Covers the commodification of water and control of water rights by private companies, looks at case
studies from around the globe, discusses responses from UN and recommendations from water NG Os.
B3: War, toe new militarism and prtc heaith
Focus of this chapter is still to be defined________________________________________________
B4: Environment
Focus of this chapter will be on making the connections between health and global warming; and thereby
between politics, economics, development paradigms and environmental justice with health.__________
BS: Education
Focus of this chapter is still to be defined1
Describes the relationship of indigenous people to land and discusses the underlying health effects of
displacement of these communities.
p@©p(l®g® irfigfote and teaOto
Focus of this chapter is still to be defined
This section will highlight a few key advocacy targets and institutions} case studies, so that the Watch
evolves overtime into a tool that monitors the performance of key actors, institutions and policy
processes._____________________________________
'___________________
Debt cancellation / HIPC process
___________________________________________________
ODA quantity and quality - include an in-depth case study of one bilateral donor___________________
World Bank monitor - what are the strengths and weaknesses of the World Bank and the key
recommendations for change._________________________________________________________
IMF monitor - what are the strengths and weaknesses of the IMF and the key recommendations for
change.________________________________________ ___ ______________________________
WTO monitor - what are the strengths and weaknesses of the IMF and the key recommendations for
change.__________________________________________________________________________
WHO monitor - what are the strengths and weaknesses of the WHO and the key recommendations for
change._______________________________________ __________________________________
UNICEF monitor - what are the strengths and weaknesses of UNICEF and the key recommendations for
change.________ _________________________________________________________________
FAO monitor - what are the strengths and weaknesses of FAO and the key recommendations for
6
change._____ ___ ______
Foundation monitor -private philanthropic foundations have been playing a greater role in the
development of health policies and programmes in recent years, in order to develop some assessment of
_the-r role and effects, it is proposed that an in-depth case study of one Foundation be developed.______
Cross-cutting
° it is expected that the ‘voices of the unheard’ will be incorporated throughout the report in the form of
short case studies and testimonies.
° It is expected that the issue of gender will be mainstreamed throughout the report.
7
Page 1 of 1
Main Identity
From:
To:
Sent:
Subject:
_
________________ ____________________________
Maria Hamlin Zuniga <maria@iphcglobal.org>
<ghw@hst.org.za>
Thursday, February 26, 2004 10:29 PM
RE: [ghw] Concept document- Latest Version
Hi friends,
I have been following the discussion and want to make my contribution.
However it is impossible at this moment. I hope to send my ideas and
comments early next week. I hope that will be ok.
I am swamped right now and under pressure to get some items finished before
Monday.
Hope you all understand.
Cheers,
Maria
---- Original Message---From: ghw-bounces@hst. org. za [mailto :ghw-bounces@hst.org. za] On Behalf Of
McCoy Dave
Sent: miercoles, 25 de febrero de 2004 7:36
To: ,ghw@hst.org.zat
Subject: RE: [ghw] Concept document- Latest Version
Dear Amit
Thanks for this message. You make some excellent points
and timely as
well. We have just been drafting a message to put out onto the PHA mailing
list where we want to invite comment about the Global Health Watch, as well
as about some of the topics that will be covered in the Watch. In this way
we hope to catalyse much © eater ownership of the Watch and allow tha Watch
to act as a platform for a more vibrant discussion about key issues for
civil society and NGOs in the health
- Media
PHM _21_GHW_1_SUDHA.pdf
Position: 16 (92 views)