There are 4 thematic axes are as follows:
Axis 1: The political and economic landscape of development and health
Political and economic policies and trends determine whether people are able to lead healthy lives. Insecure conditions of living and consequent negative impact on health are also engendered by conflicts and forced migration.
This axis will address issues ranging from the examination of the dominant economic model of development, power relations between and within countries, trade agreements, and the role of powerful actors such as the Bretton Wood Institutions, multinational corporations, private foundations and global partnerships and religious fundamentalist forces. It will also address the underlying factors, global and regional, which are driving forced migrations and precipitating a humanitarian crisis in many regions of the world. Deeply embedded in these contexts and worsening as a result, is gender inequality with its intersections with race, caste, ethnicity, disability, sexuality, religion, etc., that determines the development and health of a majority of the people globally. The axis will also critically examine the gendered implications of macroeconomic and policies and the current developmental paradigm, that in conflation with domestic policies and laws, are discriminatory and unjust and continue to acutely impede the realisation of health and development.
The axis will also interrogate the promises of the SDGs and will explore some of their key contradictions in an attempt to fashion progressive alternatives that civil society can promote. Concerns about reinforcement of dominant development paradigms and indicators that are barriers to gender and social justice, will be discussed.
Axis 2: Social and physical environments that destroy or promote health
Superimposed on existing layering of society through differences in power dynamics related to class, gender, ethnicity, caste, etc. are global trends of rising xenophobia, war-mongering and intolerance. These, perhaps more than ever before, contribute to inequity in access to healthcare services and to a worsening of many social determinants such as food security and sovereignty, secure employment and decent housing. Forced migration, conflict, gender violence, climate change and environmental degradation are increasingly responsible for their profound impact on health outcomes. The axis will examine a range of issues related to these trends, including their gendered impact on people’s ability to lead healthy lives.
Issues related to these trends will be examined, especially their impact on people’s ability to lead healthy lives.
Axis 3: Strengthening health systems to make them just, accountable, comprehensive, integrated and networked
Universal health coverage (UHC) is the slogan du jour in global health systems policy, but its meaning is highly contested. The differences in emphasis between the Primary Health Care (PHC) and UHC approaches are significant. The former involves a focus on building and supporting the primary healthcare sector and envisages a prominent role for community health workers and community involvement in planning, accountability and prevention, as well as attention to the social determinants of health. In contrast, the UHC discourse starts with a focus on financial protection and essentially argues for care that is ‘purchased’ from a range of private and public providers. In many parts of the world, this has legitimized the dismantling of public services and the increased participation of private providers in the delivery of healthcare. Forty years after the Alma Ata declaration the visionary approach of PHC is a reminder of an alternative approach that should not be allowed a silent burial.
While public systems are under threat, compromised access to medicines leads to the unnecessary loss of millions of lives. The way research on new products is organised, the dominance of a few Northern corporations over the global medicines market and the perverse incentives of the Intellectual Property regime contribute to a situation where political and economic decisions override health and welfare.
Health systems are deeply gendered institutions that reinforce inequalities. The costs of health care are increasingly impoverishing the people that need them the most. Discriminatory policies and practices by the health system remain huge barriers to access to health information and care globally. Gender plays a critical role in the health workforce and determines the location and experiences of women and men as health workers.
Within this context, the Assembly will debate alternative models of healthcare delivery that are better suited to promote equity in access, that are fair, and that promote accountable systems built around popular participation, particularly women and others who are socio-economically and politically marginalised.
Axis 4: Organizing and mobilizing for Health for All
While the struggle for Health has myriad dimensions, a key aspect is related to the numerous examples of struggles and actions by groups, peoples, movements, NGOs, community based organizations. PHA4 will provide space for the stories of these actions and struggles to be told, as sources of inspiration and as a platform for sharing experiences, mutual learning and strategizing for future action.