XIV Thessaloniki Conference 2005

Theme of the Conference: Health policy in Europe: contemporary dilemmas and challenges subthemes: Health policy reports from the different European Countries Main characteristics of the national health policies and the ongoing reforms. The dominant Health policies in EU and the other european countries. Are there similar or different? Are the dominant policies within Europe still enhancing profit making and privatisation of health services? Under the threat of the Bokenstein directive and GATS. The crisis of the dominant paradigm. Alternatives and challenges The movement against privitasation Are public, free from charge, health services a realistic goal nowadays? Promoting a European alternative in defence of health as a social right.

invited key note speakers H. U. Deppe, Frankfurt, Ida Hillander, PNHP-USA

Final Programme

Wednesday, 25 May 2005

17:00 – 18:30

  • Conference Registration

18:30 – 20:30

Thursday, 26 May 2005

Panel sessions, papers & posters at the Hall of the University Library 09:00 – 11:00

  • Actual health politics in Germany
    Moderator: H. U. Deppe
    Speakers:

    1. Privatization – Liberalization – Re-Regulation: Recent Trends in German Health Policy Thomas Gerlinger , Johann Wolfgang Goethe-University Frankfurt
    2. A new prevention law in Germany: A change of paradigm, increased bureaucracy or both? Rolf Rosenbrock, Social Science Research Center, Berlin
    3. Regulating pharmaceuticals in Germany: The change of market authorisation Dr. Rolf Schmucker, Goethe-Universitδt, Frankfurt
    4. The health reform model of the social democratic and the Christian Democratic Party H.U. Deppe, Johann Wolfgang Goethe-University, Frankfurt

11:00 – 11:30
Coffee Break

11:30 – 13:30

      Chair person:

G. Stathopoulos

10th Conference “Poverty and Health”, Berlin, December 3-4, 2004

Health and Globalisation

For the first time the German conference Poverty and Health internationalizes with 4 workshops held by medico international. We want to discuss with speakers from the People’s Health Movement from India (Thelma Narayan), South Africa (David Sanders) and Nicaragua (Maria Hamlin Zuñiga) and the Netherlands (Jose Utrera) political strategies in dealing with the current neoliberal health politics all over the world and how Health for All and Access to Health can be realized. Other speakers come from international institutions and Networks as Health Action International (Collen Daniels), the Global Fund to Fight AIDS, TB and Malaria (Kingsley Moghalu) and ILO (Michael Cichon). We are proud that Halfdan Mahler, the former Director General of WHO and one of the “fathers” of the Alma Ata Declaration 1978 will attend our conference as well and participate in the debates.

10th Annual Conference on Poverty and Health , Berlin, Germany,
December 3-4, 2004
New Movements for Health – Networks and Structures for Healthy Environments
Organiser: Landesarbeitsgemeinschaft Gesundheit Berlin e.V.
Contribution of medico international: 4 workshops:

Health and Globalisation
Debates, Concepts, Options of an International Health Movement

Friday, December 3

9.30 � 11.00 h General Opening Session of the Conference Poverty and Health
Among others: Welcoming adress by
Dr. Halfdan Mahler, (WHO Director General 1973 � 88, Geneva)

11.30 � 13.00 h Workshop I
Health is Politics!
Strategies to Confront Neoliberal Health Policies

Maria Hamlin Zuniga (International People�s Health Council Managua, Nicaragua)
Health is Politics. People´s resistance to privatisation in the health sector.

Dr. José Utrera (WEMOS, People´s Health Movement (PHM) Europe, Amsterdam),
Public Private Partnership for Health � chance or danger for health care systems?

Dr. Dr. Jens Holst, (Physician and Journalist, Berlin)
What are the lessons to learn from the failure of neoliberal financing models in Latin America?

Moderation: Prof. Dr. Klaus Stegmüller, University of Applied Sciences of Fulda

14.15 � 15.45 h Workshop II
A global Movement for Health
The People´s Health Movement

Dr. Thelma Narayan (Secretariat People�s Health Movement, Bangalore, India)
Maria Zuniga (International People�s Health Council Managua, Nicaragua)
Prof. Dr. David Sanders (School of Public Health – Western Cape, People´s Health Movement South Africa)
Perspectives of Health Movements in a globalized world

Dr. Halfdan Mahler, (WHO Director General 1973 � 88, Geneva)
Comments and Reflections: Health for All � a failed decision of the WHO?

Moderation: Dr. Andreas Wulf, medico international

16.15 � 17.45 h Workshop III
Treating for AIDS but Starving for Hunger?
Facing a Globalised Epidemic: the Example HIV/AIDS

Kingsley Chiedu Moghalu (The Global Fund to Fight HIV/AIDS, TB and Malaria, Head of Global Partnerships, Geneva)
A new financing mechanism for the Treatment of (not only) HIV/AIDS: A review of the first years of the GFATM.

Dr. David Sanders (People�s Health Movement South Africa, Cape Town)
Challenges for Public Health Care Systems confronting the AIDS epidemic � a view from Southern Africa

Colleen Daniels (Health Action International Europe, Amsterdam)
Who gets the benefits of the treatment initiatives? The necessity of public control of global treatment initiatives

Moderation: Dr. Arnd Hofmeister, University of Magdeburg-Stendal

Saturday December 4

9.30 � 11.00 h Workshop IV
Health for All instead of Access for a Few.
A round table session on social security in global dimensions

Michael Cichon (International Labor Organisation, Social Protection Dep., Geneva)
Dr. Andreas Wulf (medico international, Frankfurt, Germany)
Dr. Thelma Narayan (People�s Health Movement India, Bangalore)
Prof. Dr. Ilona Kickbusch (Yale University, International Health Division, New Haven, USA)
Moderation: N.N.

Conference Details
Place: Rathaus Schöneberg, John-F.-Kennedy Platz, 10820 Berlin, Germany
Time: Fri, 03. December 9.30 � 18.00 h; Sat, 04. December 9.30 � 13.00
All medico workshops with English-German simultaneous translation.
Registration fee for the whole Conference: 50 Euro ( 5 Euro for participants without income)
Information about medico workshops and registration for conference:
http://www.medico-international.de/en/projects/health/index.asp
further information about the conference (in german) www.armut-und-gesundheit.de

Contact:
medico international e.V.
Obermainanlage 7
60314 Frankfurt am Main
Germany
Tel: +49 (0)69 � 944 38 0
Fax: +49 (0)69 � 43 60 02
info@medico.de , www.medico.de
Medico site
mail to medico

Call for action by ESF: To defend Health and fight privatisation [english / french / italian / spanish]

Call for action to defend the right to health and
fight the privatisation of health services
European Social Forum

London, 15 october 2005

The participants of the health seminars at the ESF in London propose that the Assembly of Social Movements embrace, as a priority, a campaign for the right to health and against privatisation of health services in Europe. The denial of the right to health, which is an outcome of neoliberal policies, has dramatic consequences for people in Europe.

Neoliberal health policy has transformed people’s health into a profit making commodity. The attack on public health systems and the privatisation of health services throughout Europe prevents many citizens accessing health care.

Privatised services are more expensive and less accessible. Furthermore, independent research is obstructed by market philosophy as funding is dominated by corporate interests.

The Treaty of the European Constitution excludes the right to health which exists in many State constitutions.

The participants of the seminars declare their absolute opposition to this treaty. They consider it to be the product of collusion between banks and economic power and does not take the people of Europe into account.

This is why we urge you to vote against the Treaty in State referendums.

We also reject all similar agreements especially the Bolkestein Directive which makes GATS worse.

The networks that organised the health seminars were the People’s Health Movement and the European Network for the Right to Health supported by the Global Health Watch. PHM, GHW, ENRH are fighting for the right to free access to public health services without discrimination.

They are strugling to establish public health services in all countries, without any charge, that respond to the health care needs of the population.

The participants struggle against fortress Europe which denies the rights of immigrants to access healthcare and their right to live in dignity. This is why the networks propose to build a specific space for health at the Mediterranean Social Forum, 16-19 June 2005.

In addition, we are working with Latin American, African and Asian networks in preparation for the International Health Forum on the 23-25 January 2005 before the World Social Forum in Porto Alegre. We are also participating in the Second People’s Health Assembly in Cuenca, Ecuador, July 2005.

We propose a campaign against the privatisation of health services. We will launch the campaign by supporting the struggle of Hungarian citizens who have organised a referendum against privatisation of hospitals.

We call on all organisations present here at the Assembly of Social Movements to participate in the days of action against the privatisation of health services in Europe.

3 December 2004 – Day against the privatisation of public health in support of the referendum in Hungary

18 February 2005 – Day against the European constitution and the Bolkestein Directive to coincide with the referendum on the European constitutional treaty in Spain

10 to 16 April 2005 global week of action

***

Londres, le 15 octobre 2004

Les participants au séminaire sur le droit à la santé lors du FORUM SOCIAL EUROPEEN de Londres proposent à l’assemblée des mouvements sociaux de retenir comme objectif prioritaire de mobilisation la privatisation des services publics et la défense du droit à la santé pour tous.

En Europe la remise en cause de ce droit, fruit d’une politique néolibérale, prend une dimension dramatique. La politique sanitaire néolibérale a transformé la santé en une marchandise source de profit.

L’attaque des systèmes de santé publics dans toute l’Europe et leurs privatisations excluent un nombre croissant de citoyens de l’accès aux soins.

Les services privatisés sont plus chers et donc moins accessibles à la population. Au même titre la logique de privatisation empêche une recherche indépendante puisque assujettie aux intérêts des multinationales.

Le traité sur la Constitution européenne remet en cause le droit à la santé qui était pourtant déjà contenu dans la Constitution de nombreux pays.

Les participants au séminaire déclarent leur totale opposition à ce traité résultant d’un accord entre banques et pouvoir financier qui ne prend pas en considération les intérêts de la population européenne. Pour toutes ces raisons ils invitent à voter contre ce traité lors des référendums nationaux. Ils réfutent également l’ensemble des accords qui vont dans le même sens et en particulier la Directive Bolkestein qui rend l’Accord Général sur le Commerce des services (AGCS) encore plus dur.

PHM (People’s Health Movement), GHW (Global Health Watch) et le REDS (Réseau Européen pour le Droit à la Santé) se battent contre l’exclusion et pour le droit à l’accès aux services sanitaires publics sans discrimination aucune.

Ils se mobilisent pour obtenir dans tous les pays des services de santé publics et gratuits capables de satisfaire les besoins de la population.

Les réseaux se battent contre l’Europe Forteresse qui nie les droit aux migrants et les empêchent d’accéder aux soins et de vivre dans des conditions dignes.

Pour ces raisons les réseaux se proposent de donner une place spécifique aux problèmes de la santé au prochain Forum Social Méditerranéen en juin 2005. De plus, PHM, GHW et REDS conjointement avec les réseaux d’Amérique latine, d’Asie et d’Afrique, organisent le Forum Mondial de la Santé qui se tiendra à Porto Alegre du 23 au 25 janvier 2005 en amont du FSM et l’Assemblée Mondiale pour la Santé des Peuples qui aura lieu à Cuenca (Eq) en juillet 2005.

Les réseaux qui ont organisé les séminaires sur la santé – PHM, GHW et REDS – proposent une campagne de mobilisation contre la privatisation des services de santé avec comme point de départ le soutien à la lutte des citoyens hongrois qui ont imposé la tenue d’un référendum contre la privatisation des hôpitaux publics.

Les Réseaux appellent toutes les participants à l’Assemblée des Mouvements Sociaux à contribuer activement aux journées de mobilisation contre la privatisation des services de santé.

3 DECEMBRE 2004: Journée contre la privatisation de la santé en soutien au référendum hongrois.

18 FEVRIER 2005: Journée contre la Constitution Européenne et la Directive Bolkestein en lien avec le premier référendum sur le Traité qui a lieu en Espagne

10-16 AVRIL 2005: La Semaine d’Action Globale

***

Londra 15 ottobre 2004

I partecipanti ai seminari sul diritto alla salute, svoltisi nel FORUM SOCIALE EUROPEO di Londra, propongono all’Assemblea dei Movimenti Sociali di assumere come obiettivo prioritario, nelle mobilitazioni contro le privatizzazioni dei servizi sociali, la difesa del diritto alla salute della popolazione.

In Europa, la negazione di questo diritto che è il frutto delle politiche neoliberiste, sta assumendo per donne e uomini aspetti drammatici. Le politiche sanitarie neoliberiste hanno trasformato la salute della gente in merce da cui trarre profitto.

L’attacco ai sistemi sanitari pubblici in tutta Europa e le politiche di privatizzazione dei servizi stanno di fatto impedendo a molti cittadini l’accesso all’assistenza sanitaria.

I servizi privatizzati sono piu’ costosi e meno accessibili per la gente. Questa logica di privatizzazione impedisce una ricerca indipendente perche’ assoggettata agli interessi delle multinazionali.

Il Trattato sulla Costituzione Europea sta cancellando il diritto alla salute che in molti casi esisteva nelle Costituzioni Nazionali.

I partecipanti al seminario dichiarano la loro totale opposizione a questo Trattato, frutto di accordi tra banche e potere economico, che non ha tenuto in considerazione il soggetto piu’ importante rispetto a queste scelte: le popolazioni europee. Per questo motivo invitano a votare contro I referendum nazionali sul Trattato.

Rifiutano altresì gli accordi che vanno in questa direzione ed in particolare la Direttiva Bolkestein che rende ancora piu’ duro l’accordo generale sul commercio dei servizi (GATS).

PHM (People’s Health Movement), GHW (Global Health Watch), REDS (Rete Europea per il Diritto alla Salute) si battono contro l’esclusione e per il diritto all’accesso ai servizi sanitari pubblici senza discriminazioni.

Si mobilitano altresi’ per ottenere in tutti i paesi servizi sanitari pubblici gratuiti in grado di soddisfare i bisogni della popolazione.

Le reti si battono contro l’Europa “Fortezza” che nega i diritti ai migranti impedendo loro di accedere alle strutture sanitarie e di vivere in condizioni dignitose.

Per questo motivo le reti si propongono di costruire uno spazio specifico sulla salute nel Forum Sociale Mediterraneo nel giugno 2005. Inoltre PHM, GHW e REDS stanno collaborando all’organizzazione, insieme alle reti latino amercicane e afro asiatiche del Forum Mondiale sulla Salute che si terra’ a Porto Alegre dal 23 al 25 gennaio 2005 prima del Forum Sociale Mondiale e dell’Assemblea Mondiale per la Salute dei Popoli che si terra’ a Cuenca (Eq) nel luglio 2005.

Le reti che hanno organizzato I seminari sulla salute – PHM, GHW e REDS – propongono una campagna di mobilitazione contro la privatizzazione dei servizi sanitari a partire dal sostegno alla lotta dei cittadini ungheresi, che stanno organizzando un referendum nazionale contro la privatizzazione degli ospedali pubblici.

Fanno appello a tutti i presenti all’Assemblea dei Movimenti Sociali per contribuire attivamente alla realizzazione delle giornate di mobilitazione contro la privatizzazione dei servizi sanitari.

3 DICEMBRE 2004 giornata contro la privatizzazione della salute in appoggio al referendum in Ungheria
18 FEBBRAIO 2005 giornata contro la Costituzione Europea e la Direttiva Bolkestein in coincidenza con il Referendum sul trattato di Costituzione Europea che si svolgerà nello stato Spagnolo.


10-16 APRILE 2005 settimana di mobilitazione contro gli accordi sul Commercio

***

Londra 15 ottobre 2004

I partecipanti ai seminari sul diritto alla salute, svoltisi nel FORUM SOCIALE EUROPEO di Londra, propongono all’Assemblea dei Movimenti Sociali di assumere come obiettivo prioritario, nelle mobilitazioni contro le privatizzazioni dei servizi sociali, la difesa del diritto alla salute della popolazione.

In Europa, la negazione di questo diritto che è il frutto delle politiche neoliberiste, sta assumendo per donne e uomini aspetti drammatici. Le politiche sanitarie neoliberiste hanno trasformato la salute della gente in merce da cui trarre profitto.

L’attacco ai sistemi sanitari pubblici in tutta Europa e le politiche di privatizzazione dei servizi stanno di fatto impedendo a molti cittadini l’accesso all’assistenza sanitaria.

I servizi privatizzati sono piu’ costosi e meno accessibili per la gente. Questa logica di privatizzazione impedisce una ricerca indipendente perche’ assoggettata agli interessi delle multinazionali.

Il Trattato sulla Costituzione Europea sta cancellando il diritto alla salute che in molti casi esisteva nelle Costituzioni Nazionali.

I partecipanti al seminario dichiarano la loro totale opposizione a questo Trattato, frutto di accordi tra banche e potere economico, che non ha tenuto in considerazione il soggetto piu’ importante rispetto a queste scelte: le popolazioni europee. Per questo motivo invitano a votare contro I referendum nazionali sul Trattato.

Rifiutano altresì gli accordi che vanno in questa direzione ed in particolare la Direttiva Bolkestein che rende ancora piu’ duro l’accordo generale sul commercio dei servizi (GATS).

PHM (People’s Health Movement), GHW (Global Health Watch), REDS (Rete Europea per il Diritto alla Salute) si battono contro l’esclusione e per il diritto all’accesso ai servizi sanitari pubblici senza discriminazioni.

Si mobilitano altresi’ per ottenere in tutti i paesi servizi sanitari pubblici gratuiti in grado di soddisfare i bisogni della popolazione.

Le reti si battono contro l’Europa “Fortezza” che nega i diritti ai migranti impedendo loro di accedere alle strutture sanitarie e di vivere in condizioni dignitose.

Per questo motivo le reti si propongono di costruire uno spazio specifico sulla salute nel Forum Sociale Mediterraneo nel giugno 2005. Inoltre PHM, GHW e REDS stanno collaborando all’organizzazione, insieme alle reti latino amercicane e afro asiatiche del Forum Mondiale sulla Salute che si terra’ a Porto Alegre dal 23 al 25 gennaio 2005 prima del Forum Sociale Mondiale e dell’Assemblea Mondiale per la Salute dei Popoli che si terra’ a Cuenca (Eq) nel luglio 2005.

Le reti che hanno organizzato I seminari sulla salute – PHM, GHW e REDS – propongono una campagna di mobilitazione contro la privatizzazione dei servizi sanitari a partire dal sostegno alla lotta dei cittadini ungheresi, che stanno organizzando un referendum nazionale contro la privatizzazione degli ospedali pubblici.

Fanno appello a tutti i presenti all’Assemblea dei Movimenti Sociali per contribuire attivamente alla realizzazione delle giornate di mobilitazione contro la privatizzazione dei servizi sanitari.

3 DICEMBRE 2004 giornata contro la privatizzazione della salute in appoggio al referendum in Ungheria
18 FEBBRAIO 2005 giornata contro la Costituzione Europea e la Direttiva Bolkestein in coincidenza con il Referendum sul trattato di Costituzione Europea che si svolgerà nello stato Spagnolo.
10-16 APRILE 2005 settimana di mobilitazione contro gli accordi sul Commercio

Declaration for Venezuela – Pronunciamento por Venezuela

PRONOUNCEMENT OF THE INTERNATIONAL ASSOCIATION FOR HEALTH POLICY (IAHP) AND THE LATINOAMERICAN ASSOCIATION OF SOCIAL MEDICINE (ALAMES) FOR VENEZUELA, IN THE WAKE OF THE REFERENDUM OF AUGUST 15TH

September 27th, 2004

The IAHP and the ALAMES wish to express publicly their congratulations to the Venezuelan people and would like to share this important moment of the results of the referendum of August 15th, which has confirmed Hugo Chávez Frías, in the post of President of the Republic.

This fact represents the consolidation of his legitimacy, which has been confirmed by the people in seven other electoral processes in the last five years, and which is a consequence of the changes currently underway in Venezuelan society and its government:

  • During this period, a further 1.5 million Venezuelans have access to drinking water, and the electricity companies continue to build power stations throughout the country.
  • The Social Security system has not been privatized: pension have been linked to the minimum wage.
  • National spending on health and education has doubled to 8% and 7% of GDP respectively. Doctors and teachers are now the highest-paid professionals, and the salaries of other health professionals are catching up.
  • The most remote villages of the country now have a doctor, thanks to the support and solidarity of Cuba.
  • The Venezuelan Constitution is probably the only one in the world to include, in article 88, that “the State recognizes housework as an economic activity that generates added value and creates wealth and social wellbeing”, and that “housewives have the right to social security, in accordance with the law”.
  • There are no political prisoners in Venezuela.

These facts, among others, constitute a small, but enormously significant testimony to the fact that, in the fields of health and social policy, alternative, non-hegemonic social processes that aim to progressively ensure that effective guarantees of the right to health are possible today.

With this pronouncement, which coincides with the commemoration of the 30th anniversary of the death of Salvador Allende, we would like to share in the collective hope of the popular classes of Venezuela, Latinoamerica and the world our questioning of the neoliberal fraud, not merely without breaking the rules of democracy, but by developing them. In an age in which we are losing our sense of democracy, a democracy without a people, the Venezuelans are managing to build a reactivated, renewed democracy. Their democracy currently constitutes a benchmark reference and also obliges us to reflect on the sense of democracy today, on the real participation of the people in social processes and on the role of health in the construction of citizenship and on the alternatives to neoliberalism.

We believe that the next stage will not be easy, despite the people’s support. The political, social and ethical challenges facing the government and the people of Venezuela involve us all. Negotiation, together with the censure of those who opt for subversion will continue to be necessary strategies, and we trust that they will bear fruit and contribute both to the reduction in inequality in the population and to the consolidation of the areas of power which have been conquered for the construction of the new society.

***

PRONUNCIAMIENTO POR VENEZUELA DE LA ASOCIACIÓN INTERNACIONAL DE POLÍTICAS DE SALUD (IAHP) Y DE LA ASOCIACIÓN LATINOAMERICANA DE MEDICINA SOCIAL (ALAMES), TRAS EL REFERÉNDUM REVOCATORIO DEL 15 DE AGOSTO

27 de Septiembre de 2004

La IAHP desea expresar públicamente su felicitación al pueblo venezolano y quiere compartir este importante momento de los resultados del referéndum revocatorio del pasado 15 de Agosto, que confirma a su Presidente Hugo Chávez Frías en la Presidencia de la República.

Este hecho supone un afianzamiento de su legitimidad, que ha sido refrendada por su pueblo en otros siete procesos electorales en los últimos cinco años y que es, además, consecuencia de los cambios que está realizando la sociedad venezolana y su Gobierno:

  • Se ha conseguido que se incorporen más de 1,5 millones de venezolanos al agua potable y las empresas eléctricas siguen desarrollando plantas a lo largo y ancho del territorio nacional.
  • Se ha evitado la privatización de la Seguridad Social y homologado las pensiones al sueldo básico.
  • Se ha duplicado el presupuesto nacional en salud y educación, hasta el 8% y el 7% del PIB, a tal punto que ahora médicos y profesores son los profesionales mejor pagados y homologando los sueldos de otros profesionales de la salud, como las enfermeras y los bioanalistas.
  • Los pueblos y aldeas más recónditas del país ahora cuentan con un médico, con el apoyo solidario de Cuba .
  • Es probablemente la única Constitución que reconoce, en su artículo 88, que “el Estado reconocerá el trabajo del hogar como actividad económica que crea valor agregado y produce riquezas y bienestar social” y que “ las amas de casa tienen derecho a la seguridad social de conformidad con la ley.”
  • Venezuela no tiene un solo preso político.

Entre otros, estos hechos constatados constituyen una pequeña, pero a la vez enorme, manifestación de que en la salud y en las políticas sociales, hoy es posible el desarrollo de procesos organizativos-sociales alternativos al modelo hegemónico que buscan avanzar por un camino de garantía efectiva del derecho a la salud.

Con este pronunciamiento, cuando se conmemora el 30 aniversario de la muerte de Salvador Allende, deseamos también compartir la esperanza colectiva de las clases populares de Venezuela, y también de América Latina y del mundo, que cuestionamos la estafa neoliberal, no solo sin romper el juego democrático, sino desarrollándolo. En una época en que estamos perdiendo el sentido de la democracia, una democracia sin el pueblo, los venezolanos están consiguiendo construir una democracia reactivada y renovada, constituyendo, en estos momentos, un referente y una fuerte motivación para intensificar la reflexión individual y colectiva sobre el sentido de la democracia hoy, sobre la participación popular real en los procesos sociales, sobre el puesto de la salud en la construcción de la ciudadanía y sobre la vía alterna al neoliberalismo.

Creemos que el escenario próximo no va a ser fácil, a pesar del respaldo recibido por el pueblo. El desafío político y social, pero también ético que tiene el gobierno y el pueblo venezolano nos envuelve a todos. La negociación, pero también la denuncia de quienes optan por la subversión, seguirán siendo estrategias necesarias que deseamos sean fructíferas y contribuyan a reducir las desigualdades en su población y a consolidar los espacios de poder conquistados para la construcción de esa nueva sociedad.

X Congreso de Medicina Social, Lima 11-15 Agosto 2004

DECLARACIÓN POLÍTICA

Hoy más que nunca, 20 años después de creada ALAMES, ha mostrado su vigencia, compromiso y militancia contrahegemónica.

roducto de diversas debates, exposiciones y trabajos presentados en el marco del IX Congreso Latinoamericano de Medicina Social, podemos concluir que las condiciones sociosanitarias en América Latina han empeorado y se constituyen en expresión de los efectos del conjunto de políticas sociales y económicas hegemónicas que han puesto el énfasis en el mercado, implantando prácticas excluyentes frente al acceso a la salud, llevando con ello a un grave deterioro de las condiciones de vida y la pérdida de la dignidad humana producto de la mercantilización de la salud, hoy asumida como bien de consumo individual.

En medio de una nueva ola de reformas que profundizan la propuesta neoliberal para generar un gran mercado monopólico multinacional a partir de las propuestas de acuerdos comerciales impulsados fundamentalmente por Estados Unidos (ALCA y TLC para el caso de América Latina), con miras a privatizar lo que aún no han logrado privatizar y robustecer el papel de los Estados en la transnacionalización del capital. A su vez, privatizar por completo el conjunto de los servicios de salud, fortalecer el negocio del aseguramiento y avanzar con el monopolio transnacional de la tecnología médica y los medicamentos.

Estas políticas por supuesto impactan negativamente la realización del derecho a la salud al excluir a amplios sectores de la población a bienes, servicios y programas de salud, produciendo mayores inequidades con sus efectos devastadores de deterioro de condiciones de vida, enfermedad, incapacidad y muerte.

El IX Congreso evidencio también el conjunto de coaliciones y movimientos sociales que tienen vida en el continente Americano, que se resisten a las políticas de privatización de la salud y que demandan y buscan hacer realidad la salud como derecho humano fundamental y como bien público garantizado por el Estado. Dejó percibir un espíritu continental por generar procesos de integración donde prime la solidaridad y la realización de los derechos humanos y no la liberalización de la economía que aumenta el empobrecimiento de los pueblos.
En este sentido se destaca la presencia de experiencias organizativas sociales como las de Venezuela, Colombia y Perú y experiencias alternativas al modelo hegemónico de salud que buscan desde gobiernos locales (como los casos de México Distrito Federal, Bogotá, Montevideo, Rosario entre otros) y nacionales (como los casos de Cuba, Brasil y Venezuela) avanzar por un camino de garantía efectiva del derecho a la salud.

La II Conferencia Nacional de Salud realizada en Lima conexa al IX Congreso, logró evidenciar los profundos problemas sanitarios que se viven en Perú, producto del impulso de políticas que no tienen en cuenta el conjunto de necesidades sociosanitarias y la diversidad cultural propia del país. A su vez, visibilizó el esfuerzo ciudadano y la voluntad política de base regional en la lucha por exigir la garantía del derecho a la salud en el Perú, desde el espacio organizativo denominado Foro Salud, proceso que valora y respalda ALAMES.

Este balance del deterioro sanitario continental a la par de la presencia de organización y movilización social expresada en el IX Congreso, ratifica en los 20 años de ALAMES su pertinencia y la necesidad de ubicar como elemento central de su agenda política el impulso a la lucha por conquistar y concretar la salud como derecho humano y como bien público, concretado a través de modelos de salud universales y equitativos.

La Asamblea de ALAMES ratifica el papel político y social de la Asociación en el rol del impulso a la corriente de pensamiento medico social y de su ejercicio organizativo y de acción por generar procesos que fortalezcan los mecanismos de exigibilidad del derecho a la salud en cada uno de los países del continente. Por tal razón seguiremos impulsando la organización en los ámbitos nacional, el desarrollo de redes temáticas, las alianzas estratégicas con organizaciones hermanas y el impulso a la Campaña Continental por la Garantía del Derecho a la Salud.

El IX Congreso Latinoamericano de Medicina Social toma partido y hace explícito su respaldo a los gobiernos locales de México Distrito Federal y Bogotá, que en el marco de gobiernos nacionales neoliberales realizan acciones por hacer realidad el derecho a la salud, que evidencian claramente que desde posiciones alternativas se puede gobernar adecuadamente con la gente, para hacer realidad los derechos.

A su vez, el IX Congreso se pronuncia con un respaldo explícito al proceso Venezolano que evidencia claramente su independencia y autodeterminación, lo cual les ha posibilitado hacer apuestas con políticas explícitas que avanzan en la realización del derecho a la salud. En este sentido deseamos la mejor de las suertes en el round del referendo, para que puedan continuar y consolidar este proceso evolucionario.

Por último, la Asamblea de ALAMES en relación con la situación de agresión a los trabajadores colombianos del sector salud y a su dirigencia sindical, que a la fecha han producido 101 homicidios, 350 amenazados, 198 desplazados, 12 desaparecidos, 35 retenciones arbitrarias, 30 allanamientos, 17 atentados, 23 detenidos, 15 refugiados y exiliados, para un total de 793 infracciones contra la misión médica; respalda la realización del campamento humanitario por la vida, la salud, la dignidad de los colombianos y el derecho a existir como sindicato en este país a realizarse a partir del 14 de septiembre de 2004 en la ciudad de Bogotá.

Finalmente quedamos convocados y convocadas a seguir organizándonos y luchando por la salud y nos vemos en Salvador de Bahía en el año 2006, para realizar nuestro X Congreso Latinoamericano de Medicina Social, esperando tener allí más y diversas expresiones de organización social, de gobiernos locales y nacionales para poder decir que hemos avanzado en conquistar la salud como derecho humano.

Lima, Agosto 14 de 2004

Allyson M Pollock, NHS plc: the privatisation of our health care

Allyson M Pollock

NHS plc: the privatisation of our health care. London: Verso 2004. £15;
ISBN: 1 84467 011 2

“This is a shocking story, brilliantly told, by one of the leading thinkers in the field of public health policy. Here you will learn how Labour politicians, with their cronies from the private sector, are turning this magnificent institution into one of the greatest pork barrels of all time. No one who cares about the health of the nation should ignore NHS plc.”
Prof Raymond Tallis, author of Hippocratic Oaths. Medicine and its Discontents

Whether or not the public has a ‘right to choose’, it seems likely that the basic right to free care that the creation of the NHS sought to enshrine will continue to suffer at the hands of a succession of politicians more interested in media presence than in the realities of public health policy. Now, more than ever, it is vital to understand what has happened to our health service, and to ask whether it is in the public interest for matters to continue in this way.

NHS plc tells the story of how the ideal of universal, comprehensive health care, equally available to all and disconnected from income and the ability to pay, has been progressively eroded, and how the clock is being turned back to pre-NHS days. Now even the shrinking core of free NHS hospital services is being handed over to private providers at the taxpayers’ expense. Allyson Pollock deconstructs slogans like ‘care in the community’, ‘diversity’ and ‘local ownership’, to present a clear and powerful analysis of the transition from a comprehensive and universal service to New Labour’s ‘mixed economy of health care’.

“This book is a stimulating overview of a shift over time that has taken the NHS away from a public health system toward a consumerist approach more concerned with healthcare delivery.”
James Johnson, Chairman of Council, British Medical Association

Allyson Pollock’s criticism of those who have promoted healthcare as a commodity, to be sold for private profit, is based partly on the moral importance of social solidarity and shared risk in providing for health care. But it is also based on economic analyses that lay bare the gross inefficiencies of markets in health and social care. If “what matters is what works”, this book makes clear that healthcare markets can not serve the British people well.
Sir Iain Chalmers, Editor, James Lind Library

It should be required reading for everyone who works in the biggest industry in the country and everyone who uses it. Claire Rayner OBE

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Public risk for private gain?, by D. Price & A. Pollock

Price D, Pollock AM.

Public risk for private gain? The public audit implications of risk transfer and private finance.

London: UNISON 07 July 2004.

The key claim by government that private finance deals in the public sector are value for money has still not been evaluated, according to a report published today by public sector union UNISON.

The report shows that although 563 private finance initiative (PFI) deals worth £35.5 billion had been signed by April 2004, the National Audit Office (NAO) has carried out only one inquiry into the profits earned by private financiers. This inquiry found that shareholder profits were 61% higher than agreed in the PFI contract and that the increase had not been earned.

Private finance is much more expensive than traditional public finance. In the London Underground PFI, private finance has added £450 million to the investment bill faced by fare-payers and council taxpayers. The extra costs of private finance have resulted in service cuts across the NHS and education as public budgets are switched to pay shareholders and venture capitalists.

According to the government, the higher cost of using private finance is justified because the private sector assumes risks for project failure or default. But the UNISON study shows that in a number of high profile PFI project failures there have been no systematic efforts to identify whether risk transfer took place and at what cost to the public purse.

The report’s authors reviewed a series of NAO investigations into operational PFIs, to show the way in which the private sector passes risks and costs back to the public purse when problems arise and the projects fails.

For example, when computer company ICL underestimated software development costs in a £184 million PFI deal with the Lord Chancellor’s Department, the government agreed to put in extra money and guarantee shareholders’ profits. Similarly, Siemens’ shareholders were protected when the Passport Agency PFI went disastrously wrong. In this case, an extra £12.6 million had to be spent by the Agency to protect the service to the public.

This study lends support to the Public Accounts Select Committee complaint that Parliament has not been given the facts about the cost of private finance.

Prof Allyson Pollock, co-author of the report, said: ‘It is extraordinary that a policy which has run for 12 years and created £35 billion of new debt still remains unevaluated and that the cost to the public purse is still unknown.

‘The failure by government watchdogs to examine the government’s central justification for PFI is crucial because it means we do not know the purposes for which public money is being spent.’

PFI was established in 1992 by the Conservative government of John Major as part of their privatisation policy. It has steadily increased in importance from £667 million a year in 1995 to £7.6 billion in 2003. Most PFI deals have been signed since New Labour came took office in 1997.

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IX Congreso de Medicina Social, Lima 11 – 15 August 2004

ALAMES 20 AÑOS 1984-2004

IX CONGRESO LATINOAMERICANO DE MEDICINA SOCIAL
II CONFERENCIA NACIONAL DE SALUD DEL PERÚ

SALUD: UN DERECHO A CONQUISTAR

La Agenda de la Medicina Social Latinoamericana

Lima, 11 al 15 de agosto del 2004

Estimad@s amig@s:

Tenemos el gusto de informarles que del 11 al 15 de agosto del 2004 se realizará en Lima el IX Congreso Latinoamericano de Medicina Social, que se desarrollará a renglón seguido de la II Conferencia Nacional de Salud del Perú (9-11 de agosto).

En este IX Congreso estaremos conmemorando los 20 años de existencia de ALAMES y daremos continuidad y desarrollo a la ya larga tradición de la medicina social latinoamericana, cuyos congresos han sido siempre hitos en el debate de la realidad social y sanitaria del continente y el emprendimiento de iniciativas en pro de la salud de nuestros pueblos.

En medio de vertiginosas y profundas transformaciones, se han profundizado viejos problemas y aparecido nuevos en América Latina. Se han hecho más evidentes los problemas para el crecimiento económico y más manifiestos los niveles de desigualdad. Ha aumentado la inestabilidad de nuestros países y generado un profundo malestar de la ciudadanía por este tormentoso comienzo del siglo XXI.

En ese contexto deberemos afrontar en el IX Congreso los complejos problemas de la salud contemporánea y los sistemas de salud. El Congreso deberá responder así al desafío de construir una agenda política para este inicio de siglo, al desafío académico de evaluar y renovar el campo de conocimientos de la medicina social, al desafío social de promover el desarrollo de amplios movimientos nacionales por el derecho a la salud y al desafío de hacer un balance crítico y hacia el futuro de la Asociación Latinoamericana de Medicina Social tras 20 años de existencia.
El IX Congreso de Medicina Social se realizará inmediatamente después de la II Conferencia Nacional de Salud del Perú. Ambos eventos cubrirán la semana que va del lunes 09 al sábado 14 de agosto del 2004. Esta decisión de realización conjunta parte de una valoración de la lucha por el derecho a la salud que se viene dando en el Perú y en el continente y otorga a todos los participantes en el IX Congreso la oportunidad de participar también en la II Conferencia Nacional, al tiempo que a los asistentes a la II Conferencia la posibilidad de participar en el Congreso. Ello podrá permitir el apoyo activo a la construcción de un movimiento social nacional significativo y, a la vez, la ubicación de la lucha peruana en el contexto de las luchas latinoamericanas por la salud.

Invitamos a todos a construir y participar activamente en este IX Congreso. Será una gran oportunidad para analizar nuestras realidades, escuchar y concordar soluciones y buscar respuestas en el marco de la presencia masiva de investigadores, tomadores de decisiones, dirigentes de la sociedad civil, todos motivados e inquietos por mejorar las cosas, como es la tradición de nuestros Congresos. Tengan la seguridad que estaremos haciendo todo lo necesario para que tengan una estancia agradable y fructífera para tod@s.

Coordinación General de ALAMES (2000-2004) .
Débora Tajer, Mario Hernández y Armando de Negri

Comité Directivo de Alames-Perú: Sandra Vallenas (Coordinadora del Comité Organizador del IX Congreso), Julio Castro, Pedro Guerrero y Juan Arroyo (Coordinador Nacional de ForoSalud

Página web del IX Congreso

ALAMES 20 AÑOS 1984-2004

IX CONGRESO LATINOAMERICANO DE MEDICINA SOCIAL

II CONFERENCIA NACIONAL DE SALUD DEL PERU

Lima, 11 al 15 de agosto del 2004

SALUD: UN DERECHO A CONQUISTAR

La Agenda de la Medicina Social Latinoamericana

Comisión Organizadora
Sandra Vallenas (Coordinadora), Julio Castro, Pedro Guerrero, Juan Arroyo, Héctor Pereyra, Elizabeth Aliaga, Santiago Saco, David Tejada Pardo, Carmela Chung, Patricia Mostajo, Juan Pablo Murillo, Pilar Campana, María Antonia Remenyi.

Consejo Asesor

Débora Tajer, Mario Hernández, Armando De Negri, Celia Almeida, Naomar Almeida Filho, Leticia Artiles, Madel T. Luz, Susana Belmartino, Giovanni Berlinguer, José Blanco Gil, Carlos Bloch, Fernando Borgia, Jaime Breilh, Paulo Buss, Rutilia Calderón, Pedro Luis Castellanos, Alcira Castillo, María Consuelo Castrillón, Amelia Cohn, Catalina Eibenschutz, Sara Escorel, José Carlos Escudero, Sonia Fleury, Saúl Franco, Edmundo Granda, Jacques Girard, María Elena Jaén, Asa Cristina Laurell, Sebastiao Loureiro, Eduardo Menéndez, María Cecilia Minayo, Francisco Rojas Ochoa, Víctor Penchaszadeh, Tirsis Quesada, Mario Róvere, Juan Samaja, Giorgio Solimano, Barbara Starfield, Alicia Stolkiner, Silvia Tamez, Mario Testa, Javier Torres Goitia, María Urbaneja, José León Uzcátegui, Howard Waitzkin, Carlos Zamora.

Presentaciones de Resúmenes
y aceptación de Ponencias

Los resúmenes de Ponencias deben ser enviadas a la Comisión Organizadora del IX Congreso antes del 30 de abril del 2004.

Los Resúmenes deberán enviarse en formato electrónico e impreso con las siguientes características: un máximo de 400 palabras; contener título, autor(es), institución, dirección y correo electrónico, objetivos, metodología y resultados. Se adjuntará una Hoja de Vida del autor principal en no más de 100 palabras.

La Comisión evaluará los Resúmenes para su asignación a las diversas Comisiones de Trabajo y Sesión de Posters del IX Congreso, lo que comunicará con anticipación a los autores.

Comisiones de Trabajo

Áreas:

1) Políticas en Salud
Globalización, desarrollo y salud
Reformas de sistemas de salud y de la seguridad social en salud
Descentralización y municipalización en salud
Formación y gestión de Recursos Humanos en salud
Gestión de sistemas y servicios de salud
Democracia, gobernabilidad y reformas institucionales

2) Género e interculturalidad
Interculturalidad en Salud
Género y salud
Salud sexual y reproductiva

3) Participación social y promoción en Salud
Participación y control social en salud
Promoción de la vida y la salud
Comunicación y Educación para la salud

4) Medicina Social / Salud Pública
Violencia y salud
Salud mental
Medicina tradicional y prácticas populares
Etica y salud
Paradigmas en salud y filosofías sociales
Historia de la Medicina, la Salud Pública y la Medicina Social
Investigación en Salud

5) Epidemiología, Trabajo y poblaciones
Nutrición y alimentación
Salud de poblaciones de grandes ciudades
Salud de poblaciones rurales e indígenas
Salud del Trabajo

6) Nuevos desafíos
Medicamentos
Salud ambiental
VIH-Sida
Nuevas tecnologías y salud
Ciudadanía y derechos en salud

Questioning the claims of Kaiser Permanente

Dr Alison Talbot Smith, Dr Shamini Gnani, Prof Allyson M Pollock, Sir Denis Pereira Gray


Questioning the claims of Kaiser Permanente

British Journal of General Practice 01 June 2004

A key document in UK government policy making for the NHS has been evaluated by Dr Alison Talbot Smith and her co-authors Dr Shamini Gnani and Prof Allyson Pollock of UCL’s School of Public Policy, and Sir Denis Pereira Gray in the British Journal of General Practice published on 01 June 2004. The original paper purports to show that Kaiser Permanente (a US HMO or health maintenance organisation) “achieved better performance at roughly the same costs as the NHS”.

An evaluation will show that the paper has four major areas of error.

Crucially like was not being compared with like. Kaiser covers around eight million people in the US, mainly the working well. In contrast the NHS provides universal coverage to around 60 million citizens including the unemployed, the poor, and older people. Richard Feachem et al, the authors of the original paper, were not able to adjust for the differences in the populations, thereby negating comparisons of bed use and costs.

Similarly Feachem et al also used an unorthodox approach to adjusting for level of service when calculating costs. They did not include the additional charges that Kaiser members incur, currently £28 for each primary care consultation, £56 to attend an accident & emergency centre, and £285 for childbirth, and they omitted the 12% of Kaiser members who take out supplementary cover for services which are not included as part of the plan (‘coinsurance’).

They also wrongly applied a double currency conversion which added no less than 40% to their calculation of the NHS’s costs. They converted pounds into dollars at the general exchange rate, and then took this dollar rate and multiplied it again by the special rate that applies to the health sector. As the chief economist for the Department of Health pointed out, ‘it is simply wrong to adjust for health care prices over and above adjusting for general differences in prices’. In spite of systematically inflating NHS costs and deflating Kaiser’s, the NHS still comes out ahead. Undoing it puts NHS costs at $1,102 per capita compared to Kaiser’s $1,951.Prof Allyson Pollock and Sir Denis Pereira Gray said today:

‘When the Lancet published a paper on MMR, which threatened to undermine public health programmes, the DH and other major medical journals lost no time in entering into the scientific debate. Now we have a paper being widely adopted by policy makers, the claims of which concerning Kaiser are not supported by the evidence.’

XIII IAHP 2004 Conference, Durban, South Africa

6, 7 and 8 th June 2004
Conference theme
Challenging health inequalities – forging progressive partnerships for public health

programme

elected executive bodies

Presentations