As CLICK4HP listserv does not allow attachments to be posted to the list
(a virus prevention measure, and consideration of size of attachments
affecting accessibility of the list), I asked for a copy of the message
that Rick Edwards tried to post yesterday. The full text of the response
from the People's Health Movement to the draft of the Bangkok 'charter' is
contained below.
- Click4hp co-facilitator

---------------------------- Original Message ----------------------------
From:    "Kumanan Rasanathan" <[log in to unmask]>
--------------------------------------------------------------------------

Please find below the submission. Please note it is the submission from
the People's Health Movement, and not from New Zealand per se.

Kind regards
Kumanan

------------------------------------

Cuenca, Ecuador

21 July 2005

Submission from the People’s Health Movement on The Fifth Draft, 24 June
2005, of the Bangkok Charter for Health Promotion

Thank you for the opportunity to comment on the draft Bangkok Charter.
This submission comes from the People's Health Movement (PHM) and is based
on email discussions between PHM members and supporters worldwide and
discussions held at the People´s Health Assembly 2 in Cuenca,
Ecuador. The People´s Health Movement is a worldwide coalition of
people's organisations, civil society organisations, NGOs, social
activists, health professionals, academics and researchers that endorse
the People´s Charter for Health
(http://www.phmovement.org/charter/pch-index.html).

The PHM is strongly focused on the interests of the poor and the
marginalized and their struggle for health. The People´s Charter for
Health summarises our basic ethos about the struggle to achieve ¨health
for all¨ as envisioned by the Declaration at Alma Ata. Our comments
overall reflect the discrepancies in focus and intent between the draft
Bangkok Charter and the People´s Charter for Health

We appreciate the work and expertise that has gone into developing the
draft Charter. We are supportive of the intent to address global issues
that have arisen since the Ottawa Charter was drafted in 1986. However, we
have concerns about many aspects of the draft and hope that our comments
will be taken constructively to inform the final draft to represent the
interests of those currently marginalised by the global obstacles to
¨health for all¨. We would thus like to make the following points:

1.	We agree that health is a human right but would like to see this firmly
grounded by reference to Article 12 of the International
Covenant on Economic, Social and Cultural Rights, and more clearly
articulated throughout the document.

2.	We see the reduction of inequalities between and within countries as a
fundamental aspect of health promotion and would like to see this
re-instated explicitly as a principle in the draft (in addition to
referring to social justice and health equity).

3.	We believe that the increase in poverty and health inequalities since
the Ottawa Charter was drafted should be clearly identified.

4.	We believe that the Ottawa Charter has been very important in the
development of health promotion and that it remains relevant today. We
would like to see a stronger endorsement of the Ottawa Charter and more
explicit identification that the Bangkok Charter will operate alongside
it, as opposed to replacing the Ottawa Charter.

5.	We believe that the draft should explicitly identify the serious
negative forms and impacts of the processes that may be collectively
termed ¨globalisation¨. Key elements of current globalisation such as
transnational property and land tenure concentration; large-scale
social exclusion, privatisation of public resources; and the loss of human
rights resulting from commodification should be identified due to the
challenges they pose to health.

6.	We believe the draft should also identify that the current processes of
globalisation have reduced social and economic development
prospects, particularly for marginalised and impoverished peoples, and
that they have exacerbated health inequalities. Whilst some members of
developing countries have benefited from globalisation, it is important
that the overall negative effect of current modes of globalisation on
health is noted.

7.	We argue that any potential positive health effects of a
¨globalising world¨ lie in adherence by all nations to
internationalised rights and obligations. The draft should therefore
clearly endorse and align with existing international human rights and
environmental treaties, and agreements such as the Framework Convention on
Tobacco Control and the Millennium Development Goals (MDGs). These
treaties offer health promotion potentially powerful frameworks which have
the backing of international law.

8.	We are concerned that the draft charter is weaker than
aforementioned existing international human rights and environmental
treaties, the MDGs and other international agreements that promote health.
If the draft is not clearly aligned as above, there is the risk that it
could be cynically used by corporations, states and
international finance institutions to claim that their actions were
“health promoting in accordance with the Bangkok Charter” and thus avoid
complying with stronger health promoting standards set by the
international treaties, agreements and MDGs. If this happened, the Charter
would facilitate the equivalent of “greenwash” and have a
negative effect.

9.	We argue that the potential negative impacts on health of
international trade agreements should be identified and that rights which
improve health should be asserted as superordinate to the
provisions of any such agreements and incorporated as such within all
bilateral, regional and multilateral trade agreements.

10.	We would like to see the endorsement of equity-focused health
impact assessment of trade agreements during their negotiation and the
endorsement of assistance from global bodies for poorer countries to
undertake this.

11.	We reject that the importance of health is for poverty reduction.
Rather, the relationship is in the opposite direction whereby the
importance of poverty reduction is for health.

12.	We suggest several other strategies to make globalisation less
negative for health:
•	Trade agreements should be reformed to discriminate positively in favour
of economic development of low- and middle-income countries. •	Debt owed
by developing countries should be cancelled due to the negative impact
this transfer of wealth has on the health of the poor. •	Economic
conditionalities should be removed from debt cancellation, development
assistance or loans/grants from the international financial institutions
and other development banks.
•	Financial markets and international taxation systems should be
reorganised to ensure equitable cost-sharing of public programs and
infrastructures amongst all citizens and corporations.
•	All nations should immediately ratify, and agree on enforcement
measures for, the United Nations Convention on Corruption to reduce the
negative health effects of bribery and other forms of illegal or
unethical practices involving multinational corporations and
governments.

13.	We strongly advocate the re-instatement of the need to support
governments to work for peace in areas of conflict and minimise the health
impacts of war on peoples, given the enormous effect that war continues to
have on health.

14.	We reject the encouragement given to public-private partnerships
throughout the draft. Such partnerships do not improve health,
particularly for the poor and marginalised peoples that are our focus.
Instead they contribute to the commodification of health. We do not
believe that advocacy of such partnerships is therefore consistent with
health promotion. All references to facilitation of such partnerships
should be removed.

15.	We would add that a core responsibility of all governments is to
develop appropriate legal and regulatory frameworks to protect health from
commercial activity and promote appropriate, sustainable and
health promoting intersectoral collaborations

16.	We strongly advocate the consideration of the health of indigenous
peoples in the draft. Currently, this is a serious omission. The
Bangkok Charter should aim to be of particular benefit to indigenous
peoples given the specific and grave health problems they face.

17.	We believe that the draft could achieve this by aligning itself with
the 1999 World Health Organisation Declaration on the Health and Survival
of Indigenous Peoples, which called for action on the
following:
•	Respect for all the rights of indigenous peoples as described in
international instruments and other treaties and agreements between
governments and indigenous peoples.
•	Recognition for indigenous peoples' concept of health and survival and
expressions of culture and knowledge.
•	Policies and programmes in capacity building, research, education,
rectifying the inequities and imbalances in globalisation; increased
resources; co-ordination between United Nations bodies; the
participation of indigenous peoples at all stages of policy development
and implementation; and constitutional, legislative and monitoring
mechanisms.
•	Action on the broad determinants of the health and wellbeing of
indigenous peoples which include the effects of the loss of identity due
to removal from family and community, displacement and
dispossession of lands, resources and waters, and the destruction of
languages and cultures; the impact of environmental degradation; the need
for sustainable development; the need for participatory community
development; and the effects of war and conflict.

18.	We believe that there should be consideration of labour rights in the
draft, and support for the need for governments and corporations to
respect such rights globally and nationally, including the ratification of
International Labour Organisation conventions.

Once more, thank you for the opportunity to make this submission and
contribute to the drafting process for the Bangkok Charter. We look
forward to the discussions at the 6th Global Conference on Health
Promotion and the final document.

The People´s Health Movement


People's Health Movement Secretariat (Global)
C/o Community Health Cell
# 367, "Srinivasa Nilaya", Jakkasandra I Main
I Block, Koramangala,
Bangalore- 560 034
India
Email: [log in to unmask]
Telephone:   + 91-80 - 51280009 (Direct) or + 91-80 - 25531518 (CHC)  Fax:
             + 91-80 - 25525372

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