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[MUSIC].

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I'm Renzo Guinto, a doctor from the Philippines 

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[]

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and an alumnus of the Summer School

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in Global Health Challenges

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at the Copenhagen School of Global Health.

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Actually, I'm right now in front of the main
building

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of the World Health Organization
headquarters in Geneva, Switzerland.

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I'm sure we all know that WHO is a leading
technical

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agency of the United Nations System that
is dealing with health matters.

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But even before WHO began functioning in
1948, there has already

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been an increasing recognition of the
international nature

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of health.
For example, in 1902, the Pan American

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Sanitary Bureau was created in order to
coordinate health efforts

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in North and South America.
This bureau will later become the Pan

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American Health Organization or PAHO,
which is one of the 6 regional offices

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of the WHO.

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Moreover, the League of Nations, which is
the precursor to the United

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Nations also created a health organization
in 1923, which is the

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direct predecessor of what we call the
World Health Organization.

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And then came 1946, when the constitution
of the WHO was created.

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The constitution

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laid out a very broad, holistic and
visionary definition of health,

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which is, a state of complete physical,
mental and social well-being

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and not merely the absence of disease or
infirmity.

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It also emphasize that health is a
fundamental right that should be

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enjoyed by every human being.
Two years later in 1948,

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the Universal Declaration of Human Rights
will again mention the right to health.

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In article 25, it's stated that everyone has
the right to a standard

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of living adequate for the health and
well-being of himself and of his family.

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Including food, clothing, housing and

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medical care and necessary social
services.

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As well as the right to

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security in the event of unemployment,
sickness, disability, widowhood,

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old age or other lack of livelihood in
circumstances beyond his control.

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It is important to note that even if the
WHO Constitution and

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the Universal Declaration are the first
documents to mention the right to health.

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Other documents would follow where the
right

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to health will be further explained and
clarified but

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I will not mention them for the purpose of
this lecture.

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However, in the next 30 years WHO would
focus its

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efforts on addressing specific diseases
through vertical programs,

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such as the TB immunization, malaria
eradication,

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onchocerciasis control.
And most importantly

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the eradication of small pox, which is a
disease that

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has been a scourge in many developing
countries for centuries.

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Despite numerous efforts to eradicate
disease in many developing countries

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health iniquities still remain.
Therefore, under the leadership of then

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WHO director General doctor Halfdan Mahler
who by the

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way is also an alumnus of the University
of Copenhagen

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and inspired by various community-based
health efforts in many

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countries, such as the Philippines, China
and Latin America.

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WHO called for a global conference on
primary healthcare in 1978.

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It was

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held in the city of Alma-Ata, USSR, now
called Almaty, Kazakhstan.

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This conference gave birth to a visionary
document,

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which we now know as the Alma Ata
Declaration.

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This declaration reaffirmed that health is
a fundamental human right.

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It also emphasized that existing gross
inequalities in health particularly

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between developed and developing
countries, as well as within countries is

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politically, socially and economically
unacceptable.

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The Alma Ata Declaration also called for
the vision of

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health for all by the year 2000.
And it

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also laid down the principles of what we
call primary healthcare.

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Primary healthcare is not just a level of
care.

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It prefers to essential healthcare that is
based

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on practical, scientifically sound and
socially acceptable methods

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and technology made university accessible
to individuals and

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families in the community through their
full participation

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and at a cost that their community and
country can afford

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to maintain at every stage of their
development

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in the spirit of self-reliance and
self-determination.

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Primary healthcare also espouses some key
principles such

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as equity, the social understanding of
health, the leadership

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role of governments in providing
healthcare to people

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intersectoral action for health, the
importance of community participation.

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Emphasis on health promotion and disease
prevention instead of just looking

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at managing and treating diseases, global
cooperation and peace.

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And a call for a new international

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economic order because social economic
development is

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perceived as a key driver for improving

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health outcomes and achieving health
equity worldwide.

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[SOUND].

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Unfortunately, right after Alma-Atta, some
key actors in

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global health found the vision of primary
healthcare and health for

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all as ambitious, immeasurable and even
impossible.

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Hence governments and even UN agencies
resorted

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to what we call selective primary
healthcare.

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Key interventions

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that address specific health needs
especially of women

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and children were applied in many
developing countries.

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The most prominent of them is what we call
GOBI-FFF

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which refers to growth monitoring, oral
rehydration, breast feeding, immunization.

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And the triple f's stand for family
planning, female education and

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food supplementation.
This moment

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in global health serve as a
continuation of the

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verticalization of provision of healthcare
across the world.

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However, there are still people and actors
that remain

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faithful to the vision of Alma Ata calling
for more

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horizontal approaches in keeping our
people healthy.

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In 1986 they all gathered in Ottawa,
Canada, to discuss

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health promotion.
And they emphasis through the well

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known Ottawa Charter, that health is a
resource for everyday

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life and not just the objective of living.
It is a positive concept emphasizing

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social and personal resources as well as
physical capacities.

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The Ottawa Charter also laid out five key
action areas

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such as building healthy public policy,
creating supportive

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environments, strengthening community
actions, developing personal skills

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and reorienting health services.
The focus on reducing

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health inequalities and promoting healthy
lifestyles.

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[MUSIC]