Post 2015 Development Agenda Consultation, organised by PHM, supported by WHO

Date: 
11 Feb 2013

In September 2012, the WHO and the UNICEF launched a call for proposals for thematic consultations on health in the post-2015 developmental agenda. As part of its engagement with this initiative, the PHM coordinated  country critiques, focusing on selected Asian countries (Thailand, India, Bangladesh, Pakistan, Nepal, Philippines, Sri Lanka, Malaysia, Indonesia and Palestine). This time-limited consultation aimed to engage as far as possible, within the time and resource constraints, different actors including health activists, civil society organizations/networks, academic centers, governments and international intergovernmental institutions.

This consultation process included development of nine short country reports (seven from Asian countries and two  regional reports from Latin America and Sub-Saharan Africa) followed by a one-day meeting which gathered nearly 80 participants who represent different actors and constituencies. The majority of participants were from civil society organizations/networks from 10 Asian countries.

The objectives of the consultation process included:

  • Reviewing and appraising progress towards achieving the health-related MDGs and discussing lessons learned;
  • Initiating a civil society dialogue on a post-2015 health-related developmental agenda and the role of civil society in its implementation; and
  • Initiating a multi-actor policy dialogue at country, regional and global levels on goals and targets of a post-2015 health-related developmental agenda focusing on the roles of different actors and mechanisms of accountability.

 

CLICK HERE for the full report as submitted to WHO

 

PHM country reports:

India, Philippines, Indonesia, Malaysia, Pakistan, Sri Lanka, Nepal, Palestine, Latin America

 

CLICK HERE for the agenda of the one day consultation meeting which took place 29 January 2013, Bangkok, Thailand (List of participants)

 

PHM country presentations:

Key-Note Address, India, Latin America, Palestine, SSA Ghana, Thailand

 

Over the last decade, the road towards the achievement of the Millennium Development goals (MDGs) witnessed success stories as well as failures. The concept of MDGs, since its inception, has been a subject of considerable debate.. On one hand it has been welcomed as a vehicle for securing measurable commitments from countries, while on the other, it has been  critiqued for its attempt to enforce a top-down global developmental and national agenda that does not adequately reflect and emphasize the differential needs and priorities of regions and communities within countries and across countries. As the deadline for the achievement of the Millennium Development Goals (MDGs) approaches, the UN is driving a global consultation around a new global development agenda post 2015. The People’s Health Movement (PHM) welcomes the prospect of a global compact which commits to sustainable and equitable development.

 

Conclusion of the report:

 

There are important lessons to be learned from the experience of the MDGs.  The first lesson is that focused energy and resources can result from such a global initiative. Another key lesson is the need to address the equity dimension, within and between countries. The gap between poor and rich globally has increased with a negative impact on access to social determinants of health and to quality health and health care for the majority of people. The new development agenda should include, as a top priority, the achievement of equity within countries and between countries.

It is clear that the instabilities, imbalances and incapacities of contemporary neo-liberal globalised capitalism carry significant barriers to development. The crises of finance, equity, food and climate can all be traced in large degree to the dysfunctions of this economic regime. Unfair trade was emphasized repeatedly as impacting negatively on both social determinants of health and health systems.The new development agenda needs to engage with the crisis of contemporary capitalism and the power relations which sustain it, including the political domination by the global corporations and banks and rich world elites. It should be based on an analysis which understands how global injustice, poor governance and sociopathic insecurity hold back ‘development’.

We need to work towards a different model of development which supports humans living in harmony with their environment (rather than growth as the only pathway to development), and which creates societies in which people can ‘Live Well’ without the extreme materialism and consumerism currently prevalent. We need to work towards a process of development which is driven by social mobilisation and peoples’ participation based on people’s needs and experiences rather than simply (inadequate) financial transfers.

The current health crisis highlights the need to set health priorities which address the structural determinants of health including the root causes of ill health such as poverty and inequity and the determinants which shape health system development (the ‘causes of causes’ as correctly denoted by the Commission on Social Determinants of Health). A new global development initiative should have a structure that addresses the interrelations between health and other aspects of development.

During the consultation, the following determinants were emphasised:  Environment, water and sanitation, mental well-being, gender, occupation, military presence and conflict and nutrition and food sovereignty. Nutrition and food sovereignty were stressed as key determinants that needs to be monitored and addressed as they are central causes of both communicable and non-communicable diseases: many countries during the consultation identified NCDs as putting a growing burden on people’s health.  Therefore research has to be undertaken in order to develop a comprehensive set of indicators that address these multiple linkages and complexities.

The majority of participants during the consultation agree with universal health coverage (UHC) as a health priority but emphasised that it should be clearly defined as including access to quality care, strengthening public health systems including public financing and provision and should not focus solely on an entitlement to limited benefits within a narrow package of care when in many cases the service delivery infrastructure is simply not present.

The new development paradigm should go beyond charity and security to rights and solidarity. This is only possible by deploying leadership, reconciliation, consensus building and participatory policy development and not just ‘international financial assistance’.

The majority of participants in the consultation stressed on several occasions the importance of social mobilisation as a vehicle for social change. Civil society participation in the development, implementation and evaluation of policies and programs is essential in making the new development agenda work for all. The new development agenda should ensure that mechanisms and resources are put in place that will empower civil society to build solidarity and security which entail democracy, accountability, probity, justice and equity. The new development and health agenda must recognise and harness people’s legitimate outrage constructively rather than negate it by obfuscating and palliating a world order that reproduce inequality, including health.

 


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