The document discusses challenges to achieving universal healthcare and addresses social determinants of health. It references statements from public health advocates calling for comprehensive primary healthcare as a fundamental human right, irrespective of ability to pay. Evidence is presented showing how social factors like poverty prevent access to health interventions. The document advocates strengthening public health systems and inclusive global cooperation to tackle health inequities and the social roots of poor health.

1. Health for All? or Health for those who can pay? The Equity Challenge before US! Ravi Narayan Community Health Advisor, Society for Community Health Awareness, Research and Action (SOCHARA) India. Conference - “From Alma Ata to the Millennium Declaration” 15th August 2007, Buenos Aires

2. What are the people saying? “ From Alma Ata to the Millennium Declaration” Less Food No Jobs No water Source: Community Health Cell, Bangalore (www.sochara.org)

3. “ From Alma Ata to the Millennium Declaration” What evidence? Whose evidence? WHO decides? Source: Community Health Cell, Bangalore (www.sochara.org)

4. “ From Alma Ata to the Millennium Declaration”

5. “ From Alma Ata to the Millennium Declaration” Source: Community Health Cell, Bangalore (www.sochara.org)

6. “ From Alma Ata to the Millennium Declaration” Source: Community Health Cell, Bangalore (www.sochara.org)

7. “ From Alma Ata to the Millennium Declaration” Source: Community Health Cell, Bangalore (www.sochara.org)

9. Case study Use of bednets among indigenous people in Mandla, India Source: Singh N., et al MRC (ICMR) 1993 “ From Alma Ata to the Millennium Declaration”

12. Evidence What? Whose? Who decides? The people are sharing evidence with the malaria programme bednet researchers about poverty, survival, marginalisation and other social determinants. “ From Alma Ata to the Millennium Declaration”

14. Collecting evidence on social determinants in all its complexity “ From Alma Ata to the Millennium Declaration”

15. The People’s Charter for Health “ Health is a social, economic and political issue and above all a fundamental human right. Inequality, poverty, exploitation, violence and injustice are at the root of ill health and the deaths of the poor and marginalized people”. “ From Alma Ata to the Millennium Declaration” Source: www.phmovement.org

16. The People’s Charter for Health “ Health and human rights should prevail over economical and political concerns…… … ..Calls for provision of Universal and Comprehensive PHC irrespective of People’s ability to pay”. “ From Alma Ata to the Millennium Declaration” Source: www.phmovement.org

17. The People’s Charter for Health “ Strong people’s organizations and movements are fundamental to more democratic, transparent and accountable decision making processes…. … .They have an important role in policy development and monitoring of its implementation”. “ From Alma Ata to the Millennium Declaration” Source: www.phmovement.org

18. “ Strengthen health systems in the context of access, quality and equity” “ Establish Comprehensive PHC based on Alma Ata and updated to address gender, environment, disability, mental health, traditional systems and other issues”. “ From Alma Ata to the Millennium Declaration” The Mumbai Declaration 2004 Source: www.phmovement.org

19. People’s Charter on HIV/AIDS 2004 “ HIV and AIDS is a development issue that calls for social and political action. It is also a public health issue that requires people-oriented health and medical interventions. Such responses require democracy, pro-people inter-sectoral policies, good governance, people’s participation and effective communication. They should be rooted in internationally accepted human rights and humanitarian norms.” “ From Alma Ata to the Millennium Declaration” Source: www.phmovement.org

20. The Cuenca Declaration 2005 “ Implement comprehensive community-based PHC (with a Rights Perspective) supported by legislation…. … .Provide healthy environments to respect and guarantee the health rights of all…. … .Address the crisis of human resources for health by code of practice on ethical recruitment and financial compensation to exporting countries”…. “ From Alma Ata to the Millennium Declaration” Source: www.phmovement.org

21. The Cuenca Declaration 2005 “ Establish and fully implement universal health care financing mechanisms at national level in all countries to provide protection for the whole population. … … .WHO to support and promote the above by advocating for removal of economic and political obstacles at global, regional and national levels that adversely affects government social policies”…. “ From Alma Ata to the Millennium Declaration” Source: www.phmovement.org

26. “ From Alma Ata to the Millennium Declaration” PAHO “PHC” Document - 2007 Why Renew PHC? For many in the region there is a feeling that, “health is a social, economic and political issue and, above all, a fundamental right, and inequality, poverty, exploitation, violence, and injustice are at the root ill-health and the death of poor and marginalized people” pp: (Quoting People’s Charter for Health from “Alma Ata Anniversary Pack”, PHM, 2003.)

27. “ From Alma Ata to the Millennium Declaration” PAHO “PHC” Document - 2007 Approach to PHC “ Social and political focus of PHC should be inclusive, dynamic, transparent and supported by legislation and financial commitments if they are to achieve equitable health improvements”. (Quoting People’s Health Assembly background paper, PHM 2000.)

29. Health for All, Now ! Let us all make it HAPPEN! Thank You! “ From Alma Ata to the Millennium Declaration”