Rosa Pavanelli, PSI General Secretary says: “Instead of moving closer to the implementation of the Sustainable Development Goals, we remain very far from ensuring the human right to health for all. More than 1 billion people live in poverty and have no access to drinking water, while 2.6 billion have no access to sanitation. Wars, internal conflicts and climate change continue to claim tens of thousands of victims and cause the refugee crisis. Health workers pay with their lives for being on the forefront of the fight against natural, man-made and epidemiological disasters such as Ebola, Zika and MERS, working without adequate protection or when providing much needed humanitarian aid in hospitals.”
Unfortunately the recent Ebola and Zika Virus epidemics are totemic of the lessons we are failing to learn on a global level. These lessons talk of the need for adequate numbers of well-trained healthcare workers who are appropriately resourced. They talk of the need for regulation, and more importantly accountability and enforcement of these regulations, within healthcare systems and they speak of the need for a whole government / societal approach in both preventative and reactive situations; the need for robust and coordinated services at the primary, acute and post acute service levels.
Questions of healthcare, whether they are funding, resource allocation or accessibility questions all become political issues. We therefore challenge the excuses of “how much the global forces are shaping favourable conditions”. The global forces are a result of political decisions; the decision to bail out the banks, the decision to implement austerity measures, the decision to cut revenue sources and the decision not to close tax avoidance loopholes. These forces are not out of human control.
In too many countries, the Millennium Development Goals have left unfinished business, including on reducing child and maternal mortality due to austerity and structural adjustment programmes. The domination of the global pharma-industry on national health delivery has only increased, while investment in public research and development is generally declining. And now the insurance industry wants to use patients as a commodity to trade, moving people to other countries where healthcare is cheaper.
“We need to keep health, social and other public services out of trade agreements like CETA, TTIP, TPP, RCEP and TISA, which will otherwise lead to cut-throat competition over the backs of patients and workers. On World Health Day we reaffirm our goal of building a public health system that guarantees universal, free, comprehensive and quality healthcare for all!” adds Rosa Pavanelli.
Decent salaries and safe working conditions for health workers are key to the delivery of those services as well as the respect of their labour rights. Migration of professionals who leave the public system due to low wages and poor working conditions threatens guaranteed health delivery around the globe, including in paediatric services. Cuts in public funding make these systems more fragile and work more precarious, whereas investments in healthcare delivers growth and quality of life. Home carers, those delivering elderly care, health care assistants, nurses, junior and other doctors, cleaners are standing up for better pay and recognition of skills, qualifications and their labour rights.
Decent work has many parameters; a living wage, the right to belong to a trade union and participate in the actions of the union, the right to a safe work place, access to ongoing education and support, sufficient down time and safe length of shifts, opportunities for professional development and advancement are a few these. Importantly for healthcare workers decent work also requires that they are able to speak freely and without fear of repercussion about the healthcare system in which they work. Indeed, when they speak about their working environment, they are primarily advocating for the rights of patients to effective, safe and quality care, irrespective of government policies.
Public healthcare is more effective and efficient than private systems. Evidence from countries with universal healthcare access systems, such as France and Italy were for many years considered the most effective, the NHS, or the Australian universal insurance system (Medicare), show that they are far more efficient than the privateer based systems such as in the US whilst costing less. It is not the absolute percentage of GDP that determines health outcomes; it is how the healthcare is provided.
World Health Day is a day of action against health commercialization, bringing together health users and workers, citizens, trade unions, NGOs and international networks calling for adequately staffed and well-funded public health systems. Policy prescriptions of the World Bank, IMF and regional development banks continue to favour the commercialization of care, although more expensive and proved to fail as it excludes many people from having access.
The lesson from Ebola is clear. In a globalised world no disease remains confined to a country and this is why we need strong global governance and effective, well-resourced national public health systems to ensure universal access for all.
Actions and demonstrations are planned in several European cities : Madrid, Barcelona, Zarogosa, Paris, Lille and Brussels. A call was launched to the population to support the action hanging a white sheet at the windows to defend health away from commercialization drifts. Hashtags #Health4All #SantePourTous #GezondheidVoorIedereen #SaludParaTodos will be used on social medias.