Some recent economic programmes have endangered people's health, especially the health of poor people, and are one of the most significant barriers to 'Health For All'. This is what civil society speakers said at a symposium organized on 20 May 2003 - the second day of the 56th World Health Assembly in Geneva. The symposium was jointly organized by the World Council of Churches (WCC) and the "NGO Forum for Health". The WCC and other NGOs facilitated civil society participation in the Assembly by bringing members of the world-wide Peoples Health Movement to Geneva to share their grassroots experiences and insights on the goal of 'Health For All' and primary health care (PHC) with governments. Among the economic programmes identified as dangerous for people's health, symposium speakers mentioned bilateral free trade agreements in Latin America, and the World Trade Organization's TRIPS (trade-related aspects of intellectual property rights) agreements.

25 years ago, an international conference at Alma Ata, USSR, said that the way to achieve 'Health for all' was through primary health care. The Alma Ata Declaration then became the cornerstone of WHO's and of many governments' health care policies.

In a 20 May Assembly discussion of the Alma Ata anniversary, several states reiterated their commitment to the ideals of 'Health for All' and PHC, and moved to further strengthen Assembly resolutions in this respect. The WCC and the Peoples Health Movement were also invited by WHO to address the topic in plenary. "It is encouraging to see WHO's and member states' openness to the voices from the grassroots on an issue that is of vital importance to the poor and the marginalized," says Dr Manoj Kurian of the WCC's Mission & Ecumenical Formation team.

Voices from civil society Later in the day, presentations by practitioners of primary health care in different parts of the world at the well-attended symposium co-organized by the WCC and the "NGO Forum for Health" brought the issues into stark relief.

Speakers from Nicaragua, Kenya, India, Philippines, Bangladesh, Iran, Moldova and the Democratic Republic of Congo described the health situation in their countries, and unanimously reiterated their commitment to the vision and vital importance of community participation in health care.

They reported that preoccupation with health care methods often leads to losing sight of goals. By endangering people's health, some recent economic programmes constitute important barriers to 'Health for All'. And trends towards vertical, disease-specific programmes are damaging the functioning of public health systems in developing countries, they stressed.

These civil society voices expressed a shared conviction that the vision of Alma Ata is as relevant today as it ever was, but that international events like war and trade need to be factored into the analysis. Yet overall, there is adequate evidence that primary health care brings significant improvements in the health status of individuals and communities, the PHC practitioners said.

By WCC