Our global health advocate, Marco Angelo, recently participated in the 5th People’s Health Assembly (PHA) in Mar del Plata, Argentina. The PHA is the meeting of the People’s Health Movement, a global network advocating for universal access to quality healthcare of which Wemos is a member. The People’s Health Assembly convenes approx. every five years and brings together health rights and human rights activists, indigenous movements, health workers, health policymakers and academics to discuss urgent issues affecting the right to health. In the article below, Marco reflects on his experience at the assembly and the two sessions we co-hosted with our partners Alliance of Women Advocating for Change (AWAC) and N’weti.
Marco Angelo (left) at the session ‘Health Financing and Barriers to Access to Healthcare’
One of the greatest strengths of the People’s Health Assembly is that it fosters the engagement of experts, activists, and movements from more than 70 countries. The 2024 theme was ‘Struggle for Health: Confronting the role of Capitalism and Imperialism’. Under this theme, pressing issues gained the spotlight, including decolonization, sexual and reproductive health and rights, environmental and indigenous rights, corporatization of healthcare and access to medicines.
Attending the assembly was an insightful experience that helped us further sharpen our advocacy. It was a valuable opportunity to connect with different people from all over the world, who shared lived experiences and diverse perspectives on urgent health issues affecting patients, health workers and minoritized groups.
The assembly started with a touching act of solidarity with the many health workers in Palestine who are making grand efforts every day to offer people the healthcare they need. Some health workers participated online and shared the struggles they are enduring in Gaza. Although they could not attend the People’s Health Assembly physically, the memory of their words stayed with us the whole week.
The programme of the assembly was a mix of plenary meetings, working groups to discuss advocacy strategies and self-organized sessions by the members of the People’s Health Movement. Wemos, together with partners, hosted two sessions: one on sexual and reproductive health and rights in oppressive contexts, and another on health financing and barriers to access to healthcare.
In our first session, we discussed the alarming rollback of the rights of minorities, particularly when it comes to sexual and reproductive health and rights, across many countries worldwide. Panelists from the Alliance of Women Advocating for Change (AWAC) opened the session, elaborating on the situation in Uganda, where the Anti-Homosexuality Act of May 2023 forbids any form of same-sex sexual relationships. A clear violation of international law and basic human rights. Among other things, this act criminalizes advocacy organizations working on LGBTQIA+ rights, under the newly created crime of “promoting homosexuality”.
Participants from India, Mozambique, Congo, Bolivia and Cuba joined the session and shared their experiences and struggles with conservative leaders who are eroding civil rights. All of them reported that organizations working on sexual and reproductive health and rights face operational and legal obstacles, as well as increased stigma and discrimination. The Alliance of Women Advocating for Change (AWAC), for example, was forced to relocate one of its largest health centers that provides sexual and reproductive health services to more than 32,000 sex workers, because the landlord refused to have “a health center for sex workers” in his property.
The participants discussed specific strategies that feminist advocacy movements in East and West Africa, South America and Asia use to enhance access to reproductive health and rights in times of backlashes. Among the main strategies, the participants emphasized that seeking support and funding from the community and network members from the services were essential for the continuity of activities. Also, keeping communities and allies engaged and mobilized was necessary to counter discriminatory narratives and prevent further setbacks.
The participants gained valuable insights to secure their mission in difficult political contexts.
Session ‘Sexual and Reproductive Health and Rights in Oppressive Contexts’
Our second session focused on the current challenges in healthcare financing and the question what is needed to promote universal access to healthcare. Public healthcare is central to realizing the right to health (see CESRC, General Comment n. 14). However, many low- and middle-income countries are struggling to provide adequate health services to their population because of a lack of financing.
I had the honor to moderate the session and started by presenting an overview of health financing systems and aid. Panelists from the Alliance of Women Advocating for Change (Uganda) and N’weti (Mozambique) explained the consequences that years of austerity measures and the fragmentation of health financing programmes have had on healthcare accessibility in their respective countries.
First, Michael Ssemakula, sexual and reproductive health activist at the Alliance of Women Advocating for Change, talked about the current barriers to access healthcare and sexual and reproductive healthcare services in Uganda. The closure of key funding programmes in the health sector, like the Global Financing Facility, has made it difficult for people to access tailor-made healthcare services, especially in peripheric communities. Moreover, after the ratification of the Anti-Homosexuality Act, the World Bank announced the suspension of funding to Uganda, leading to the shutdown of essential sexual and reproductive health programmes.
Then, Ilundi Durão de Menezes, from N’weti, took the floor, discussing the many health financing challenges in Mozambique. She pointed out the difficulty of leveraging funding for health from both internal resources (government and private expenditure) and external resources, e.g., from global health initiatives such as the World Bank and the Global Financing Facility. She shared vivid descriptions of how underfunding of healthcare directly affects access to healthcare services for people in Mozambique: long waiting lines, a lack of personnel as well as essential medicines and medical equipment, and health services that are only available for those who can afford the out-of-pocket expenses.
The session concluded highlighting the urgent need for systemic solutions to address the financing challenges. First and foremost, funding programmes should prioritize primary healthcare that is public and accessible for everyone. Also, programmes should support the expansion of fiscal space to create more budget for public health.
Amidst touching moments, fiery political debates, and new friendships, the week of the People’s Health Assembly went by really fast. The conference was a valuable opportunity for exchange, where I found new allies and gained a deeper understanding of the issues and solutions related to the right to health of many people in different contexts.
During the week, I experienced a great sense of solidarity and the feeling that we were all there together, sharing the same vision: “a world in which a healthy life for all is a reality; a world that respects, appreciates and celebrates all life and diversity; a world that enables the flowering of people’s talents and abilities to enrich each other; a world in which people’s voices guide the decisions that shape our lives.” (People’s Charter for Health).
The dire situation in Mozambique that Ilundi illustrated in her presentation, is the reason why N’weti and Wemos started a joint project. Together, we aim to boost awareness raising among government and civil society in Mozambique and international health donors about the alarmingly increasing funding gap in the health sector. Through data-driven advocacy we will promote sustainable and equitable solutions to increase national and international resources for health. So that everyone – including people in remote areas or in vulnerable situations – have access to the health services they need.
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