Declaration by the Peoples’ Health Movement of Latin America and the Caribbean

23 Dec 2013

We, the participants in the first Latin American Peoples’ Health Assembly, from 19 countries in Latin America and the Caribbean and 13 in other regions, gathered in Cuenca, Ecuador on 7-11 October 2013, in an ambience of fraternity and commitment, to debate our struggle for the right to health in the midst of the crisis in capitalist civilisation.

A dispute between two major directions for the future of humanity and the planet marked the context of the Assembly.

On the one hand, the dominant trend in the world is seeking to restore the model of accumulation in a few hands, with dire social and environmental costs, further dispossessing people through irrational hyper-consumption, extractivism and the commoditisation of health, violently imposed while criminalising social protest and resistance.

On the other hand, there is the emerging trend toward Living Well and guaranteeing the essential preconditions for health, defending it as a fundamental human right.

Neoliberal prescriptions cannot stanch this sweeping crisis. Instead, we must build grassroots and country-level alternatives that tackle the roots of the capitalist system and its manifestations in the economy and labour, forced migration, contamination and climate change, ethics and health services.

Latin America and the Caribbean are contributing concretely to this emancipatory trend, with its history of resiliency and of fighting for social justice, with alternatives and ideas that include the furtherance of indigenous wisdom, which teaches us that we must seek a balance with nature and live in harmony; with the admirable example of the Cuban people, who have been dealing with a criminal blockade for over half a century; and in general, with the extensive solidarity and hope in our region, from which spring alternative models to rebuild our utopian ideals.

In light of the current discussions over the post-2015 development agenda, we reaffirm the principles of the Peoples’ Health Movement in the Declaration of Alma Ata, reclaimed, updated and enriched in our Peoples’ Charter for Health adopted in Bangladesh at our First Peoples’ Health Assembly in 2000, in the Declaration of Cuenca at the Second PHA in 2005 and in the Cape Town Call to Action at the Third PHA in 2012.

We question the way international agencies are proposing universal health coverage, centring on basic packages and services limited by ability to pay. This reduces the problem to one of access to health care services; although these are of course necessary, they produce inequities if they are not comprehensive and are also insufficient if they do not address the social determinants of health that are in the same development model. Protection of people and of the environment should be at the centre of public policies and international policy, and we should distance ourselves from development focused on hyper-consumption and unsustainable, untenable economic growth.

We demand mechanisms for environmental justice alongside social justice, including recognition of the ecological debt and the differential liability of developed countries in climate change and in the many other ways nature has been harmed.

We question the move by several governments in the region to criminalise and prosecute the legitimate social mobilisation of the region’s peoples. We are also against their plans to ramp up extractivist projects.

We make a special call to the government of Ecuador to desist in its plans to open the Yasuni Amazon reserve to oil drilling and expand the extractive model, ignoring the cries of Ecuadorans and the other peoples of the world who are following the path of Sumak Kawsay—Living Well, a movement that begin in Ecuador itself. We also call on Ecuador to not criminalise the social protest movement, but instead to devise democratic mechanisms to deal with the differences between the government and social movements.

Together, we commit ourselves to restoring the health of ecosystems and combating new threats to commoditise life. With urgency, we express our opposition to technological solutions that attempt to gloss over social problems:
• The use of genetically modified seeds and species, because their genetic modifications have unpredictable results, they bankrupt peasant farmers, take over large swaths of land without consulting the people who live there, and turn communities into laboratories at the service of transnational corporations that are encroaching on national sovereignty.
• The production of biofuels that increase pollution in order to power vehicles while millions starve.
• Pesticide use by large-scale agribusiness.
• The focus on surgical and technical procedures that are palliatives, yet mask the underlying structural causes of disease, differential exposure and preventable premature death.
• A pharmaceutical industry that puts profits before human rights, patents life to appropriate it and is one of the main driving forces of the medical-industrial complex, which exploits the results of collaborative research, with the complicity of a large number of universities and governments.

These so-called solutions are creating more problems than the ones they claim to fight, upsetting the balance in the ecosystem and causing disease, death, bacterial resistance and social and health exclusion and inequity.

In response, we call for:
• A different model of society that rises above capitalism to found a new, truly human civilisation based on solidarity and harmony with the environment, conditions for Living Well.
• The embodiment of sovereignty in health, by building together the conditions that enable a dignified life for human communities and the environment in which they live. We want health to be in the hands of communities and the people, thus reclaiming and appreciating the enormous wealth of knowledge, practices and experience that the peoples of Latin America and the Caribbean have in protecting and caring for health.
• Public, universal, equitable health systems with social justice that are multicultural and include promotion, prevention, treatment and supportive care, returning to the original meaning of these terms, which go beyond lifestyle and refer to the integrality of people and their context.
• Health worker training institutions that break with the forced commoditisation of the way they practice and educate from the perspective of the social determinants of health and inequalities, social responsibility and direct engagement with their communities.
• Public policy and governance to lead these necessary changes.
• Broad social participation based on strengthening social movements and building alliances that enable communities to seize their rights and mobilise to develop and defend fair policies that put the right to health and a balanced ecosystem before the interests of the market, responding to this historic moment of generalised crisis around us.
• Research, information and communications systems free from spying, framed in personal and collective rights, that allow for the flow of ideas to develop alternatives and make knowledge freely available to society.

We know that the ancient wisdom of Living Well can save the planet. The emancipatory worldviews of indigenous peoples are being revitalised and reconstituted and can provide the foundation for the political intentions of the people, after 521 years of resistance. We are moving towards peoples’ self-determination and autonomy, and along this path the Peoples’ Health Movement seeks to contribute to building the health sovereignty of our peoples.

With our alegremia[1] high, we call on ourselves to continue along the road to human emancipation, to build health with dignity for the people and for our Mother Earth.

Cuenca de Guapondelig
October 2013

[1] Alegremia: joy + -emia (blood concentration) = the level of joy in the blood; a social construct, based on hope, water, food, air, shelter, education, art and love, that involves a profound social transformation towards a more dignified, freer and united world.

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