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Nicklaus Borthwick

	-----Original Message----- 
	From: Health Promotion on the Internet on behalf of Alison Stirling 
	Sent: Wed 8/3/2005 9:17 AM 
	To: [log in to unmask] 
	Cc: 
	Subject: [Fwd: People's Health Movement Response on Bangkok Health Charter]
	
	

	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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