[MUSIC].
I'm Renzo Guinto, a doctor from the Philippines
[]
and an alumnus of the Summer School
in Global Health Challenges
at the Copenhagen School of Global Health.
Actually, I'm right now in front of the main building
of the World Health Organization headquarters in Geneva, Switzerland.
I'm sure we all know that WHO is a leading technical
agency of the United Nations System that is dealing with health matters.
But even before WHO began functioning in 1948, there has already
been an increasing recognition of the international nature
of health. For example, in 1902, the Pan American
Sanitary Bureau was created in order to coordinate health efforts
in North and South America. This bureau will later become the Pan
American Health Organization or PAHO, which is one of the 6 regional offices
of the WHO.
Moreover, the League of Nations, which is the precursor to the United
Nations also created a health organization in 1923, which is the
direct predecessor of what we call the World Health Organization.
And then came 1946, when the constitution of the WHO was created.
The constitution
laid out a very broad, holistic and visionary definition of health,
which is, a state of complete physical, mental and social well-being
and not merely the absence of disease or infirmity.
It also emphasize that health is a fundamental right that should be
enjoyed by every human being. Two years later in 1948,
the Universal Declaration of Human Rights will again mention the right to health.
In article 25, it's stated that everyone has the right to a standard
of living adequate for the health and well-being of himself and of his family.
Including food, clothing, housing and
medical care and necessary social services.
As well as the right to
security in the event of unemployment, sickness, disability, widowhood,
old age or other lack of livelihood in circumstances beyond his control.
It is important to note that even if the WHO Constitution and
the Universal Declaration are the first documents to mention the right to health.
Other documents would follow where the right
to health will be further explained and clarified but
I will not mention them for the purpose of this lecture.
However, in the next 30 years WHO would focus its
efforts on addressing specific diseases through vertical programs,
such as the TB immunization, malaria eradication,
onchocerciasis control. And most importantly
the eradication of small pox, which is a disease that
has been a scourge in many developing countries for centuries.
Despite numerous efforts to eradicate disease in many developing countries
health iniquities still remain. Therefore, under the leadership of then
WHO director General doctor Halfdan Mahler who by the
way is also an alumnus of the University of Copenhagen
and inspired by various community-based health efforts in many
countries, such as the Philippines, China and Latin America.
WHO called for a global conference on primary healthcare in 1978.
It was
held in the city of Alma-Ata, USSR, now called Almaty, Kazakhstan.
This conference gave birth to a visionary document,
which we now know as the Alma Ata Declaration.
This declaration reaffirmed that health is a fundamental human right.
It also emphasized that existing gross inequalities in health particularly
between developed and developing countries, as well as within countries is
politically, socially and economically unacceptable.
The Alma Ata Declaration also called for the vision of
health for all by the year 2000. And it
also laid down the principles of what we call primary healthcare.
Primary healthcare is not just a level of care.
It prefers to essential healthcare that is based
on practical, scientifically sound and socially acceptable methods
and technology made university accessible to individuals and
families in the community through their full participation
and at a cost that their community and country can afford
to maintain at every stage of their development
in the spirit of self-reliance and self-determination.
Primary healthcare also espouses some key principles such
as equity, the social understanding of health, the leadership
role of governments in providing healthcare to people
intersectoral action for health, the importance of community participation.
Emphasis on health promotion and disease prevention instead of just looking
at managing and treating diseases, global cooperation and peace.
And a call for a new international
economic order because social economic development is
perceived as a key driver for improving
health outcomes and achieving health equity worldwide.
[SOUND].
Unfortunately, right after Alma-Atta, some key actors in
global health found the vision of primary healthcare and health for
all as ambitious, immeasurable and even impossible.
Hence governments and even UN agencies resorted
to what we call selective primary healthcare.
Key interventions
that address specific health needs especially of women
and children were applied in many developing countries.
The most prominent of them is what we call GOBI-FFF
which refers to growth monitoring, oral rehydration, breast feeding, immunization.
And the triple f's stand for family planning, female education and
food supplementation. This moment
in global health serve as a continuation of the
verticalization of provision of healthcare across the world.
However, there are still people and actors that remain
faithful to the vision of Alma Ata calling for more
horizontal approaches in keeping our people healthy.
In 1986 they all gathered in Ottawa, Canada, to discuss
health promotion. And they emphasis through the well
known Ottawa Charter, that health is a resource for everyday
life and not just the objective of living. It is a positive concept emphasizing
social and personal resources as well as physical capacities.
The Ottawa Charter also laid out five key action areas
such as building healthy public policy, creating supportive
environments, strengthening community actions, developing personal skills
and reorienting health services. The focus on reducing
health inequalities and promoting healthy lifestyles.
[MUSIC]