In April, Argentina is set to host the 5th People’s Health Assembly (PHA 5), a crucial meeting on the right to health, drawing participants from social movements across every continent. The PHA 5 is a forum dedicated to sharing experiences, reflecting, seeking alternatives, and coordinating collective actions. This will be the second occasion Latin America has hosted the event, with Mar del Plata being the host this time around. The 2nd People’s Health Assembly was held in Cuenca, Ecuador, in 2005, while the most recent edition in 2018 took place in Bangladesh, the country where the first Assembly was convened.
The PHA 5 represents the culmination and convergence of the efforts of organizations within the People’s Health Movement, which describes itself as a “network of networks” comprising social movements, predominantly from the Global South, engaged globally in the struggle for health for all. The PHM was born out of revolt at the fact that the world was moving away from the paradigms established at the 1978 meeting of the World Health Organization (WHO), and set forth in the Alma-Ata Declaration. That year, in what was then Soviet Kazakhstan, it was decided that Primary Health Care should be prioritized by all countries as the key to universal health promotion.
As the 20th century concluded, it became evident to social movements that global health priorities were shifting towards a disease and hospital-centric model, increasingly influenced by private sector growth. The inaugural PHA in 2000 rallied over 1,500 activists, scholars, healthcare workers, and representatives from various movements, including those focused on food sovereignty and breaking HIV drug patents, among others. Carmen Baez, regional coordinator for the PHM and PHA 5, highlighted this event as a crucial moment of transformation, where activists shifted from revolt to action against the global health landscape’s direction.
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Baez recounted this story during a launch event for the PHA 5 held in Brazil in the last week of February. She pointed out that the People’s Charter for Health, adopted as a result of the first PHA, was a strategic milestone for the movements involved, steering the PHM’s future direction. Inspired by the Alma-Ata Declaration, the People’s Charter for Health conceptualizes health through its social, economic, political, and ideological dimensions. Baez noted its translation into 50 languages as evidence of the movement’s extensive reach.
PHM activists in Argentina did not foresee the political climate they would face hosting the PHA 5 under President Javier Milei, whose policies are diametrically opposed to the principles of the People’s Health Movement. The president elected at the end of last year is rapidly destroying Argentina’s public services. “The organization committee in Argentina has been very keen to host the assembly, given the turbulent context the country has been going through, and all the attacks on people’s rights in Argentina. That’s why they’re eager to receive our solidarity too,” Leonardo Mattos, an PHM activist and researcher at the Federal University of Rio de Janeiro and Fiocruz, told Outra Saúde.
The rise of the far-right around the world is one of the themes running through the PHA 5. But many other crises will be debated during the event. “The Assembly will have a very strong character of solidarity with the Palestinian people, an issue that has become much more acute in recent months,” Mattos said. “It’s going to be an Assembly very marked by the discussion of this geopolitical moment, in which wars intensify and the climate crisis is a threat to the entire planet.”
There are conflicts that have been going on for decades, since the first PHA. Mattos said, “We’re going to discuss the international context of broken promises regarding health. Countries in the so-called Third World continue to struggle to finance universal public health systems. The pandemic has made this very clear: public systems – strong public health systems – are needed more than ever.”
According to Mattos, the health emergency brought about by COVID-19 is likely to be a central theme in many of the debates during the Assembly. Not just in relation to the pandemic “lessons,” but also in order to “discuss the models of development and relationship with nature that produce precarious living conditions for the people, exacerbated by the climate crisis. The same models also create all the conditions for epidemics and pandemics to spread further and further.” The Pandemic Treaty, debated at the WHO and defended in particular by countries from the Global South, should also be an important topic during the Assembly — which precedes the World Health Assembly. According to Mattos, participants at the PHA 5 are “also going to discuss a necessary reform of global health governance, so that members can really be sovereign.”
The PHA 5 agenda will be structured around five thematic areas: transforming health systems, gender justice in health, ecosystem health, resisting war and forced migration, and ancestral and popular knowledge and practices. The last topic, according to Mattos, is particularly relevant to Latin America, with a history of Indigenous peoples’ knowledge being marginalized. “We are on a continent that was populated by native peoples thousands of years ago, who still keep their knowledge, their health practices, their views of health and disease. These are populations that have been colonized, exploited and had this knowledge erased. It’s a moment to think about alternatives and make this discussion visible.”
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Mattos also commented on the Brazilian delegation’s contributions to the Assembly, emphasizing the importance of Brazil’s health conferences and the social control of the Unified Health System (SUS) as well as the country’s experience navigating the pandemic under a denialist government that was dismissive of the crisis. It is to be expected that Brazilian representatives at the Assembly will also raise debates about “the struggle of the various social movements, the black, Indigenous, feminist, quilombola movements, the movements against the privatization of health, the anti-asylum struggle, health workers’ struggles.”
Lígia Giovanella, a researcher in primary care at the Federal School of Public Health/Fiocruz, celebrated the PHA 5 as an opportunity for dialogue, participation, and solidarity among health-focused social movements worldwide. “It’s a moment of fellowship, dialogue, participation, involvement and solidarity between social movements in health from all continents. It’s an opportunity to learn about the political struggles, activism and issues that mobilize hearts and minds in defense of the universal right to health.”
A new addition in 2024 is the 1st International Conference on Collective Health and Primary Health Care, aiming to foster discussions on the implementation and challenges of primary care in the Global South.
The PHA 5 is important, according to Mattos, because it is “a moment to discuss the various experiences of implementing Primary Health Care in the countries of the Global South. In particular, to discuss strategies, successful experiences, the harms inflicted by privatization, the struggle to expand services and coverage. We will also discuss the setbacks we have seen in relation to comprehensive primary care.”
The People’s Health Assembly is set to take place between April 7 and 11. Mattos concludes: “This is a time to think about how the struggle for the right to health should be articulated in view of finding alternatives, other development models, other paradigms that incorporate not only the workers’ struggles, but also other worldviews, other knowledge and practices.”
The report was written by Gabriela Leite and published in Portuguese on Outra Saúde.
People’s Health Dispatch is a fortnightly bulletin published by the People’s Health Movement and Peoples Dispatch. For more articles and to subscribe to People’s Health Dispatch, click here.
