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The struggle for health

Billions of poor people around the globe suffer from a heavy burden of disease, injury and disability; not because the technologies of prevention and care are not available and not because the material resources could not be made available but because of the political and economic structures which promote a grossly unfair and unequal distribution of opportunities and resources.

The global determinants of health (and the global risks to health) are shaped by a regime of global governance supported by the ideologies of neoliberalism. This regime includes international regulatory and funding bodies as well as a configuration of power relations based on rich world governments, global corporations, hegemonic military forces and the shared perspectives and common interests of richer classes in both rich and poor countries.

Against this regime are arrayed a range of forces including popular movements around issues of national sovereignty, jobs, environment and health. Such movements may be local in their principal focus but they have intersectoral and international links also.

There are powerful social movements in many Third World countries with interests in health or which are centrally focused on health issues and there are important examples from recent years of significant victories in relation to health issues. These include delegitimating SAPs because of their impact on health, challenging Big Pharma in relation to the access to AIDS drugs and the Doha Statement on Public Health.

PHC, as a policy model for program development, envisages forms of practice involving partnerships between PHC practitioners and the communities with whom they are working. Practitioners and community members work together to identify and address the upstream factors shaping their health even while dealing with the immediate needs of individuals, families and communities.

The PHC model has huge potential in terms of working with popular movements to build understanding and advocacy; to generate the political pressure nationally and internationally needed to reshape the global determinants of health. PHC is also a model for addressing the immediate health needs of families and communities and its potential for contributing to political change will mean nothing if it is not delivering high quality care and prevention, with the back up support of tertiary institutions and programs.

The IPHC has established among its central purposes, the strengthening of PHC and health care delivery in accordance with the PHC model and the study, advocacy and mobilisation in relation to the political and economic determinants of health globally. More about the role of IPHU