- V R Raman
Programme Coordinator, State Health Resource Centre Chhattisgarh
First Floor, Health Training Centre Building, Kalibadi, Raipur. 492001.
Tel: 91-771-2236175. Telefax: 91-771-2236104. Mobile. 91-94252-07375Dear Friends,
The PHM is developing an Asian Peoples Health Charter for HIV/AIDS. The draft charter developed by Dr. Prem John and Unnikrishnan is attached for your comments which may be sent directly to HIV@... with a copy to CHC. The charter is being widely discussed by net workers and community groups in different parts of the world. Though it is called Asian Charter it is universal in its reach. It aims to make people’s voices heard at high levels. It will be discussed by a small group of the PHM /Poverty AIDS Circle during the World Health Assembly in May 2004. After modifications following this participatory process the final charter will be launched at the HIV/AIDS Conference in Bangkok in July 2004. Issues such as the need for financial and social audit of money and efforts that have poured in to HIV/AIDS and their impact for health systems are some of the issues that also need to be raised. Addressing the basic determinants that promote the transmission of HIV/AIDS is also important. This includes impoverishment, indebtedness, migration , post conflict social disruption etc.Do send us your critical comments and also discuss the charter with your groups and send in your feedback.
Asian PEOPLE’S CHARTER ON HIV/AIDS:
Consensus charter that
amplifies the voices of the people affected, infected, living with and suffering from HIV/AIDS.
This charter calls for immediate action.
The charter will be officially released to the international community during the
International AIDS conference at Bangkok (July 11-16, 2004).
(For communication on this charter, please contact : hiv@... )
What is it: It is a consensus charter (campaign document) that amplifies the voices of the people affected, infected, living with and suffering from HIV/AIDS. This charter calls for immediate action.
Objective: To provide a people's perspective on HIV/ AIDS and related issues like access, rights and trade issues. It is also to amplify people’s voices.
Why is it called ‘Asian’ ? It is universal. However, in the context of the International AIDS conference that will be held in Asia (Bangkok , Thailand) in July 2004, naming it ‘Asian’ will have strategic campaign and advocacy value. To reiterate, the charter will cover the whole world.
Who is leading this ? The process is initiated and facilitated by the Peoples Health Movement (PHM) (www.phmovemnt.org) - a mass movement that has presence in over 100 countries. PHM was born out of the People’s Health Assembly 2000, a historic summit that was held in Bangladesh in December 2000. (For details read annexure-1).
Several grassroots groups, mass movements, organisations of people living with HIV/AIDS, NGOs, INGOs , media and others are ensuring synergy.
Peoples Health Charter, the guiding spirit of PHM and the largest consensus document on health is the model.
How is it being developed: The charter is being developed through a dynamic interactive and consultative process, spread across the world. Consultations at the grass roots and with people infected, affected, living (with) and suffering (from) HIV/AIDS will be the key highlight.
Starting from April 2004 onwards, the draft charter will be presented and discussed at various meetings, conferences, people’s summits, workshops etc. These consultations will be held at various levels- like local, provincial, national, regional and international levels.
In addition to the above, the draft charter will be discussed, debated and fine tuned through a dynamic and inclusive Internet based discussion as well.
At the International level, PHM will use the following meetings, conferences and meetings to discuss, fine tune, endorse and promote the charter:
1) Several meetings and discussions in April first week (World Health Day) – all over the world.
2) XVIIIth World Conference on Health Promotion and Health Education
(Australia- April 26th – 30)
3) The Public Health Association of South Africa & International Association of Health Policy Conference 2004 (06 to 08 June- Durban)
4) International Conference on Primary Health Care (June 23-25 , Iran)
5) Dialogue of WHO with NGOs in Asia on Commission on Macroeconomics and Health (?????SriLanka)
6) World Health Assembly (17- 22 May 2004, Geneva)
The Charter will be finalised by May third week. It will be ready for circulation and endorsement from May 17th onwards (WHA). A press conference at Geneva during WHA will announce the formulation of the charter.
However, the charter will be officially launched at the International AIDS conferences in July. It will be submitted to the organsiations of people living with HIV/AIDS, media, international community, governments, NGOs, Academicians, INGOs, donors, bilateral and multilateral agencies, WHO, UNAIDS and other UN agencies.
Join the process ! What you can do ?
One: Please hold discussions and consultations on the proposed charter in your community, family, schools, colleges, universities, during conferences, workshops, e-groups, bulletin boards, organizations, clinics, Primary health centres, hospitals and others. Please forward this to others.
Two: Join us – as an individual or representing your organization/ association/ union.
Three: Use this draft charter as an issue for discussion during the World Health Day (April 7) or during the week.
Four: Send names of persons and organizations to which we can send the final draft for endorsement.
Five: Please give your feedback with comments, suggestions and critique to : HIV@.... Please send your feedback ASAP, latest by 15th May 2004.
Six: Help us to publicize the launch of the charter in July through local media in your province/ country. Kindly send us the contact list of journalists. Kindly let us know whether you can help to distribute the press release in your region.
This charter derives ideas, opinions, strength and synergy from the Peoples Health Charter ( http://www.phmovement.org/charter/index.html) and the Mumbai Declaration.
HIV has gained foothold, destabilizing societies and economies thus threatening millions of lives. The AIDS pandemic is one of the greatest humanitarian crises of all times. It has caused death and misery, destroyed families and communities and ravaged entire populations. HIV/AIDS is already wiping out a generation in Africa. Two decades after it began its onslaught in Sub-Saharan Africa, the disease has been spreading fast and has gained a firm foothold in other places like parts of Asia. Lives of millions of people, in some of the world’s most populous nations, are threatened.
Africa’s experience shows that HIV/AIDS can destroy development gains of several decades and social composition of people in a single stroke. A similar tragedy is unfolding in other parts of the world. Spreading along migration routes related to globalization and to social and economic distress due to war, global trade and economic policies, HIV/AIDS is now associated with the resurgence of other communicable diseases of poverty, such as tuberculosis.
The Alma Ata declaration of 1978 promised Health for All by 2000. HIV/ AIDS was not a key issue in 1978. While HIV/AIDS has contributed in negatively affecting this goal, the total break down of the public health system and primary health care during the 1980s and 1990s have amplified the spread and impact.
Peoples Health Movement considers HIV/AIDS as a public health issue. However, PHM believes that the way to combat HIV/AIDS is not through just a medical approach, but through better politics, care, research, pro-people policies, rights and governance and effective communication.
Access to ARV treatment has increased the life expectancy and quality of life of those who can afford it. The majority of AIDS patients being impoverished are denied access to treatment in violation of the principles of the international covenant on social, economic and cultural rights. Children orphaned by HIV/AIDS and women who are more vulnerable take a heavy toll.
Health is a social, economic and political issue and above all a fundamental human right. Inequality, poverty, exploitation, violence and injustice are at the root of ill-health and the deaths of poor and marginalised people. Health for all means that powerful interests have to be challenged, that globalization has to be opposed, and that political and economic priorities have to be drastically changed.
HIV /AIDS is a public health issue that calls for medical, social and political responses.
This Charter builds on perspectives of people who are affected, infected, suffering from and living with HIV/AIDS. It encourages people to develop their own solutions and to hold accountable local authorities, national governments, international organisations and corporations.
Equity, ecologically-sustainable development and peace are at the heart of our vision of a better world - a world in which a healthy life for all is a reality; a world that respects, appreciates and celebrates all life and diversity; a world that enables the flowering of people's talents and abilities to enrich each other; a world in which people's voices guide the decisions that shape our lives.
There are more than enough resources to achieve this vision.
The HIV/ AIDS crisis- a public health issue:
Poverty, hunger, ill health and its contributing factors are increasing. The process is amplified by neo-liberal economic policies, lack of respect for health and human rights and breakdown of nation states because of conflicts, wars and disasters.
While endorsing concern about the HIV/AIDS epidemic, the need for Primary Health Care oriented and Health Systems strengthening approaches to other communicable and non-communicable diseases in an integrated way is urgently required.
Principles of this charter:
This charter calls for Action at various levels:
Calls for Action by People’s Health Movement and Civil Society to;
- Continue campaigns for the rights of people in poor countries to receive ARV treatment delivered through comprehensive PHC services.
- Facilitate Public Interest Litigations to oppose changes in Patent laws that is expected to escalate the ART prices.
- Make the links between the spread of HIV/AIDS and the underlying societal determinants such as poverty, war, displacement and participate in efforts to redress these injustices
Calls for Action by Governments
· Develop a comprehensive Primary Health Care oriented and health systems’ strengthening approach to address the HIV/AIDS epidemic through interventions, including:
- Peer education that includes sexual and reproductive health and rights information;
- Oppose stigma and promote respect of and care for people living with HIV/AIDS;
- Increased access to basic services by people living with HIV/AIDS;
- Immediate availability of ARV drugs;
- Support those affected by the epidemic through empowerment.
- To allocate more resources for primary health care in general and communicable diseases in particular
- To reduce budget for factors that amplify public health and HIV/AIDS crisis like military expenditure.
- To place people above profits and politics and thus take control of policies that affect people’s lives in general and people infected, affected, suffering (from) and living with HIV/AIDS.
- To develop a transparent, scientific and human way to conduct clinical trails through an informed consent approach.
Calls to WHO
· To evolve a comprehensive approach emphasizing Primary Health care and health systems’ strengthening approaches including preventive information and services and ARV treatment;
· Work towards reduction of high drug costs;
· Enhance involvement of people, affected communities and civil society in its planning and initiatives through proactive dialogue.
· WHO’s 3 X 5 initiative (that promises 3 million persons with AIDS receiving Anti-retroviral Treatment (ARV) treatment by 2005) requires contextual solutions. The 3 x 5 initiative at present focuses on treatment alone, ignoring the complexity of the epidemic. A paradigm shift is called for.
· High drug costs can lead to long-term dependency on donors;
· There is inadequate involvement of persons living with and affected by HIV/AIDS and civil society in planning, implementation and evaluation
· There are inadequate budgetary and related commitments on improving health systems, particularly Primary health Care to provide drugs and general health services and information in the long term.
· There is inadequate attention to life skill education, women’s health empowerment and utilization of traditional systems of medicine.
About the organizers:- Annexure-1
People's Health Movement
People's Health Movement (www.phmovement.org) (PHM) is a mass movement that has presence in over 100 countries. PHM was born out of the People’s Health Assembly 2000, a historic summit that was held in Bangladesh in December 2000.
The goal of the People’s Health Movement is to re-establish health and equitable development as top priorities in local, national and international policy-making, with primary health care being the strategy to achieve these priorities.
The Movement aims to draw on and support people’s movements in their struggles to build long-term and sustainable solutions to health problems.
The People's Health Movement (PHM) is a growing coalition of grassroots organisations dedicated to changing the prevailing health care delivery system. This system is considered to be failing to serve the deteriorating health of most of the poor worldwide
The PHM process began with a series of networking and discussion activities worldwide to consider key issues in preparation for an international gathering - the first People’s Health Assembly, held in Bangladesh in December 2000.
The PHM is a long-term process with important preparatory and follow-up phases in addition to the Assembly event.
The PHM is a collective effort in opening up opportunities for communities and civil society organisations that believe that the current health situation is unacceptable and therefore want to have a more significant voice in determining the direction of the future.
The following objectives will guide the People’s Health Movement :
To hear the unheard. The assembly will present people’s concerns and initiatives for better health, including traditional and indigenous approaches. Their direct experiences of ill-health, its causes and possible solutions will also be presented, discussed and analysed. Action plans will be worked out and refined;
To reinforce the principle of health as a broad cross-cutting issue. There will be emphasis on the intersectoral dimensions of primary health care and focus on health development, rather than health services. The problematic aspects of vertical, non-integrated programmes will be highlighted;
To develop co-operation between concerned actors in the health field. The importance of strengthening the links between the different institutions and actors in the health field should not be underestimated. Such revived and/or new partnerships will be built on the principle of equity and accountability between the parties;
To formulate a People’s Health Charter. Based on thorough analyses of world health problems as well as existing policies and programmes, a People’s Health Charter will be formulated. Concrete recommendations regarding policy and practice will be made to governments, international organisations, the business sector, non-governmental organisations and people’s movements;
To improve the communication between concerned groups, institutions and actors. Communication and networking among individuals, groups, organisations and institutions will be developed during the Assembly and sustained and strengthened thereafter;
To share and increase knowledge, skills, motivation and advocacy for change. During and after the Assembly opportunities will be provided for in-depth exchange of experiences and development of skills to participants in the on-going PHA process. The People’s Health Charter will provide a base for advocacy, policy-formulation and campaigns at the local, national and international levels.
To use the Internet and Telehealth technology in innovative ways to supplement existing modes of global communication.
Asian Community Health Action Network ACHAN
Consumers International CI
Dag Hammarskjöld Foundation DHF
Gonoshasthaya Kendra GK
Health Action International - Asia Pacific (HAIAP)
International People’s Health Council IPHC
Third World Network TWN
Women's Global Network for Reproductive Rights WGNRR
The movement is picking up energy and it gets involved in actions and campaigns mainly from the strength and synergy it galvanises from volunteers- grass root health workers to well known academicians, campaigners, activists, INGOs etc. It also joins with International campaigns on a case- to- case basis.