INTERNATIONAL ASSOCIATION OF HEALTH POLICY
ASOCIACION LATIONOAMERICANA DE MEDICINA SOCIAL
Open Letter to the World Health Organisation
The participants of the VIIIth Latinoamerican Confernece of Social Medicine and of the XIth Conference of the International Association of Health Policy, held in Habana, Cuba between the 3th and the 7th of July 2000 express our complete disagreement with the Assessment of the World’s Health Systems carried out by the World Health Organisation and presented recently in the World Health Report 2000.
This report, that results in a ranking classification of the countries, through its extensive diffusion from the mass media, generated protesting reactions from researchers in the field of health services and from local, regional and national health authorities in several countries.
Supported by a controversial methodology, cover with a superficial sophistication, based on reduced and questionable sources of information, its results conceal very distinct realities and produce unacceptable distortions in the comparison among countries.
Upon classifying each country by a reductionist and market oriented criterion of equity, that keeps in mind barely what the persons spend in health of their own pocket (known as “out of pocket”), abandons other more relevant criteria to evaluate the equity from the point of view of the equality of opportunities and the universal access to the health services in all the levels of complexity, that offer an integral care and of good quality.
It cannot be admitted that in Latin America, Cuba occupy the 25th place, while Colombia is located in the first place in equity.
We, the professionals of health of ALAMES and IAHP know that this does not correspond to the health reality of our countries, which is much more complex than that presented in the World Health Report 2000 of the WHO.
Finally, we feel repulsed with the implicit agenda in that type of evaluations, falsely neutrals, for the implementation of the alternative of health insurances, which are in their great majority private and with for profit goals, although they are directly or indirectly subsidised by public funds.
According to our criteria, that are based on the defense of the public and universal health systems, we consider that Cuba continue occupying the first place in Latin America and one of the leading positions worldwide, in everything that refers to health and social justice.
La Habana, 7th of July 2000
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ASOCIACIÓN LATINOAMERICANA DE MEDICINA SOCIAL
INTERNATIONAL ASSOCIATION OF HEALTH POLICY
Carta abierta a la Organización Mundial de Salud
Los participantes del VIII Congreso Latinoamericano de Medicina Social y del XI Congreso de la Asociaci?n Internacional de Pol?ticas de Salud, reunidos en La Habana, Cuba, entre el 3 y el 7 de julio de 2000, manifestamos nuestro total desacuerdo con el ?ltimo Informe de la OMS que hace una evaluaci?n de los sistemas de salud en el mundo.
Este Informe, que result? en una clasificaci?n de los pa?ses, ampliamente divulgada por los medios de comunicaci?n, ha provocado reacciones de protesta por parte de estudiosos en salud y autoridades sanitarias locales, regionales y nacionales en muchos pa?ses.
Respaldado por una metodolog?a controvertida, revestida de una supuesta sofisticaci?n, basada en fuentes de informaci?n reducidas y cuestionables, sus resultados encubren realidades muy distintas y generan distorciones inaceptables en la comparaci?n entre los pa?ses.
Al clasificar cada pa?s por un criterio de equidad reduccionista y mercantilista, que tiene en cuenta apenas lo que las personas gastan en salud de su bolsillo (el llamado �out of pocket�), abandona otros criterios m?s relevantes para evaluar la equidad desde el punto de vista de la igualdad de oportunidades y del acceso universal a los servicios de salud en todos los niveles de complejidad, que brinden una asistencia integral y de buena calidad.
No se puede admitir que en Am?rica Latina, Cuba ocupe un 25? puesto, mientras que Colombia se ubica en primer lugar en equidad.
Nosotros, los profesionales de salud de ALAMES sabemos que esto no corresponde a la realidad sanitaria de nuestros pa?ses, mucho m?s compleja de lo que pretende el Informe de la OMS.
Finalmente, repudiamos la agenda impl?cita en ese tipo de evaluaciones, falsamente neutrales, de implantar la alternativa de los seguros de salud, en su gran mayor?a privados y con fines de lucro, aunque tales seguros est?n directa o indirectamente subsidados por recursos p?blicos.
Seg?n nuestros criterios, que se basan en la defensa de sistemas p?blicos y universales de salud, consideramos que Cuba sigue ocupando el primer lugar en Am?rica Latina en todo lo que se refiere a la salud y a la justicia social.
International Association of Health Policy 