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
Mabilioni ya watu maskini duniani kote wanateseka kutokana na magonjwa, majeraha na ulemavu, si kwa sababu teknolojia za kuzuia na huduma hazipatikani, wala kwa sababu rasilimali za kimwili hazikuweza kupatikana, bali kwa sababu ya miundo ya kisiasa na kiuchumi ambayo huendeleza usambazaji usio wa haki na usio wa usawa wa fursa na rasilimali. Vipengele vya afya vya ulimwengu (na hatari za afya za ulimwengu) huundwa na mfumo wa utawala wa ulimwengu unaoungwa mkono na itikadi za neoliberalism. Mfumo huu unatia ndani mashirika ya kimataifa ya udhibiti na ufadhili, pamoja na muundo wa mahusiano ya nguvu kulingana na serikali za nchi tajiri, mashirika ya kimataifa, vikosi vya kijeshi vya hegemonic na mtazamo wa pamoja na maslahi ya kawaida ya tabaka tajiri katika nchi tajiri na maskini. "Kupinga utawala huu kuna vikosi mbalimbali, ikiwa ni pamoja na harakati za watu kuhusu masuala ya uhuru wa kitaifa, kazi, mazingira na afya.""" Harakati hizo zinaweza kuwa za ndani katika lengo lao kuu lakini zina viungo vya kati ya sekta na kimataifa pia. Kuna harakati za kijamii zenye nguvu katika nchi nyingi za Ulimwengu wa Tatu ambazo zina maslahi katika afya au ambazo zinaelekeza sana kwa masuala ya afya na kuna mifano muhimu kutoka miaka ya hivi karibuni ya ushindi mkubwa kuhusiana na masuala ya afya. "Hizi ni pamoja na ""kuondoa haki ya SAP kwa sababu ya athari zao kwa afya,"" ""kuitisha changamoto Big Pharma kuhusiana na upatikanaji wa dawa za UKIMWI"" na ""Matangazo ya Doha juu ya Afya ya Umma.""" PHC, kama mfano wa sera kwa ajili ya maendeleo ya programu, inazingatia aina ya mazoezi ya ushirikiano kati ya wataalamu PHC na jamii ambao wao ni kufanya kazi. Wataalamu na wanachama wa jamii hufanya kazi pamoja kutambua na kushughulikia mambo ya juu ya mtiririko wa maji yanayounda afya yao hata wakati wa kushughulikia mahitaji ya haraka ya watu binafsi, familia na jamii. Mfano wa PHC una uwezo mkubwa katika suala la kufanya kazi na harakati za watu kujenga uelewa na utetezi; kuzalisha shinikizo la kisiasa kitaifa na kimataifa linalohitajika kurekebisha sababu za afya za kimataifa. PHC pia ni mfano wa kushughulikia mahitaji ya afya ya haraka ya familia na jamii na uwezo wake wa kuchangia mabadiliko ya kisiasa haitakuwa na maana yoyote ikiwa haitoi huduma ya hali ya juu na kuzuia, na msaada wa nyuma wa taasisi za tatu na programu. Mfumo wa IPHC umeweka kati ya malengo yake kuu, kuimarisha huduma za afya za msingi na utoaji wa huduma za afya kulingana na mfano wa PHC na utafiti, utetezi na kuhamasisha kuhusiana na sababu za kisiasa na kiuchumi za afya ulimwenguni. Zaidi kuhusu jukumu la IPH