Manifesto of the PSI Human Right to Health Global Campaign

The campaign was launched at PSI's Health and Social Care Services Task Force meeting held in Geneva on 12-13 December.

A BETTER FUTURE WITH PUBLIC HEALTH FOR ALL
Manifesto of the PSI Human Right to Health Global Campaign

Whereas "the enjoyment of the highest attainable standard of health," is universally considered a fundamental human right, as recognised in international human rights treaties and the constitutions of over 150 countries, this right has not been fulfilled for the immense majority across the world;

Realising that this is intricately tied to a situation where 2.6 billion people have no access to sanitation, 1 billion people live in poverty and have no access to potable water, and, wars, internal conflicts and climate change worsen the social-determinants of health for millions of people;

Noting that this situation is worsened by policies and actions which put profit over people, such as privatisation, PPPs, commercialisation of health, liberalisation of health services, and implementation of austerity measures, resulting in 150 million people being pushed into poverty annually, due to expenditure on healthcare;

Observing the negative and damaging effects of budgetary cuts in funding public healthcare and the promotion of user fees, as well as the inefficiency and ineffectiveness of increasing private sector provision of health services;

Bothered by the growing state of precarious employment of the health workforce, violation of trade union rights in the sector and migration of health workers from countries in dire need of more health professionals, as a result of poor working conditions and remuneration in their countries of origin;

Considering the need for reinvigorated concerted efforts within and across countries to build stronger health systems and generalised crisis preparedness cannot be underestimated as demonstrated by the fight against HIV/AIDS and more recently by the epidemic outbreaks of Ebola, SARS and Zika;

Inspired by renewed commitment of the international community to a better future with health for all as expressed in Target 3.8 of the Sustainable Development Goals and recognition of the fact that this requires enhanced employment and improved working conditions for health workers as upheld in the recommendations of the UN High Level Commission on Health Employment and Economic Growth;

Committed to the realisation of the human right to health which of necessity requires the prioritisation of public healthcare to guarantee the availability, accessibility, acceptability and quality of healthcare for all without discrimination and in ways and manners that promote accountability, transparency and the active participation of individuals and communities in decision-making on issues that affect their health,

Public Services International will campaign for the Human Right to Health. Thus, PSI and its affiliates would take action to concretely influence the formulation and implementation of policies leading to Universal Public Health Coverage at the international, regional, national and local levels, worldwide, thus:

• Public Health for All: The human right to health is centered in communities and can only be achieved through universal public health systems that guarantee the quality and the integrality of care. Realising the human right to health requires States taking responsibility for the provision of healthcare. While we recognise the presence of private providers in the sector, it is pertinent to stress that healthcare delivery is a public function, no matter the nature of the provider, requiring the application of equal rules in terms of standards for patients and workers and also in terms of accessibility and quality for both public and private providers. PSI shall thus campaign for stronger governance, best practices and models which harness the full potentials for delivering health services under the overarching responsibility of national, regional and local governments;

• My Health is Not for Sale: as a human right, health is not a commodity. Health and Social Care services globally are estimated at US$5.8 trillion annually. Privatisation and commercialisation including PPPs and outsourcing are expressions of big businesses interest to maximise profit from what otherwise should be an investment in a better future for all. The claim that all these forms of privatization will stimulate competition and enhance quality and efficiency of healthcare is contradicted by the fact that private health care systems are usually more expensive and less accessible than the public ones.

PSI is particularly bothered by the expansion of big business led by multinational health care, pharmaceutical and insurance companies using a variety of marketization strategies to propose private services delivery. This is having devastating impact on universal access to quality health care for patients, on working conditions for health workers and on the financial sustainability of the health systems. The related increase in liberalisation and trade in services gravely undermines guaranteed public health services.

PSI will thus mobilise to provide evidence and raise awareness in the public opinion against the threats of privatisation and commercialisation of health under any guise presented by big businesses

• Fiscal Justice for Funding Health: quality health for all requires adequate funding. Governments often present the argument of Insufficient financial resources as an excuse for inadequate funding of health. PSI considers this as unfounded. The right to health is a most fundamental human right without which it is impossible for people to enjoy all other human rights. Corporations currently avoid paying US$3trillion in tax every year. Overhauling the corporate tax system and prioritisation of governments spending for health would make this available for the implementation of universal public health coverage;

• Strengthening Health Systems Requires Investment and People’s Participation: we live in a global world, epidemics know no borders. Strengthening health systems require concerted investment in epidemic surveillance and response, preventive and primary healthcare, health infrastructure and human resources for health, and a more peaceful world. It equally entails the involvement of patients, health workers and communities with governments in decision-making processes that enhance better health outcomes and accountability in healthcare delivery;

• Safe and Effective Staffing for Health Saves Lives: safe staffing through health professionals-to-patient ratios is a proven method to ensure that the necessary staff are available when needed. Patients are exposed to unnecessary health and vital risks when health professionals-to-patient ratios fall below safe levels. PSI shall thus campaign for mandated staff-to-patient ratios in the health sector, thus setting standards below which healthcare must not fall;

• Decent Work and Decent Working Conditions: Universal health coverage is impossible without health workers. And to deliver quality health services, health workers need decent working conditions, and occupational health and safety. Of importance as well is freedom of association and the right to collective bargaining for health workers. Migration of professionals who leave their countries due to low wages and poor working conditions threatens guaranteed health delivery around the globe.

Decent work also requires that health care workers are able to speak freely and without fear of repercussion about the conditions 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. PSI shall thus advocate for decent work and decent working conditions in all its ramifications;

• Keeping Faith with International Covenants on Health: PSI’s Global Campaign for the Human Right to Health is based on several international instruments ratified by states and governments across the world. The formal recognition of this fundamental right has however not translated into its concrete realisation. PSI would thus vigorously campaign for states to keep faith with these international covenants, including making the human right to health justiciable, thus making governments accountable for providing universal public health coverage;

• Gender Equality and the Empowerment of Women and Girls: ensuring the empowerment of women and girls and combating gender inequality requires that health systems respond to the specific health needs of women and girls. The MDGs programme have shown how improving women’s health can benefit the whole community.  Moreover, women are the majority of the workforce in health and Social care services. The feminization of the sector is part of the reason why wages are dropping continuously contributing to increase the gender pay gap globally.  PSI shall thus advocate health reforms that ensure representation of women, result in better health outcomes for women and the girl-child and will insure pay increase, therefore contributing to the realisation of SDG 5.

PSI will promote the aims and objectives of this campaign with every legitimate means including mass mobilisation of members of its affiliates for days of action, lobbying governments, regional institutions and international organisations, building alliances and forging coalitions, research and affiliates capacity-building and developing proposals for laws, policies and regulations that would bring to birth quality public health for all and guarantee a better future for humankind.

Manifesto available in English - Français - Español - русский (pdf)

 More information:

• Right to Health campaign: www.world-psi.org/PublicHealth4All
• Subscribe to "Right to Health" in English, Français or Español.
• PSI's Health and Social care services page