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More than 1 billion people live in poverty and have no access to drinking water, while 2.6 billion have no access to sanitation. One thousand children die each day from waterborne diseases, which also fill half of the hospital beds in the world. Wars, internal conflicts and climate change continue to claim tens of thousands of lives, leaving millions more in utter misery. Health workers pay with their lives for being at the forefront of the fight against natural, man-made, and epidemiological disasters, often working without adequate protection or remuneration as the Ebola, Zika and MERS outbreaks have recently demonstrated. Overworked, with shortages of staff in proportion to populations, contracting work-related illnesses as hazards, health workers’ sacrifices have been too heavy and are no longer acceptable.
We have seen enormous efforts of privatisation, liberalisation and cuts in the funding of health and social services, driven by an ideological construct, using the tools of ‘free trade’ and conditions for ‘aid’ and loan facilities from international financial institutions. All of them are backed with promises that ‘markets’ can do better than states because they are supposed to be more efficient and less bureaucratic. The policy space for maintaining the modest level or improving health services was constrained in the developing world due to the structural adjustment programmes of the 1980s-1990s. However, it is now recognised that these measures have led to increasing inequalities and have worsened the quality of health services. Persisting with this policy will overturn the significant improvements in health conditions and life expectancy registered in the past decades, particularly for much of the population in developing countries.
Due to the underfunding of public health services, hundreds of millions of poor people must pay out of their pocket for health services. According to the WHO: “about 100 million people globally are pushed below the poverty line as a result of health care expenditure every year”. In short: a lack of basic provision of health care contributes to higher inequality and extreme poverty in society.
This is a clear pointer to the critical need for universal public health coverage, for health as a human right to be realisable. However, what we have seen is quite the contrary. Over the past few decades, the health and social care sector has been one of the main targets in significant restructuring, with increasing for-profit private interests’ involvement in the provision of health services, with explicit support of governments formulated as health reforms.
Such support often takes different forms of privatisation, including Public-Private Partnerships (PPPs) as well as policies that foster transnational corporations’ expansion into health services insurance delivery and pharmaceutical production. These health reforms are part of three-dimensional fiscal reforms: involving tighter systemic fiscal controls, new priorities for the allocation of governments’ resources spurred by a limited sense of growth, and improvement in the use of resources, leading to the creation of the ‘lean state’
There are windows of opportunity for bringing back the narrative of health policy to one that places people over profit. These include the Sustainable Development Goals and the Five-Year Implementation Plan for Health Employment and Economic Growth. But for these institutional footholds to be effective, trade unions, civic organisations and our communities have to actively engage the process and unite behind an agenda for universal public health.
This is the contextual background for the PSI Human Right to Health global campaign, which was launched at the PSI Health and Social Services Task Force meeting at Geneva in December 2016. Our affiliates in different regions of the world have started taking action, moving the campaign forward. The Right to Health newsletter is our voice, bringing to you news and perspectives on the campaign and struggles around the world to realise health as a fundamental human right.
I encourage you to subscribe to the newsletter and send your stories to us. Now is the time for us to unite and fight for health for all, as a significant domain of our struggle for people over profit. And this means sharing our experiences and ideas. United and determined, we will win.
PSI General Secretary