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An update on the right to health campaign in Egypt

16 Dec 2007

It is important to celebrate small victories, no matter how partial or temporary they may be. As you all know, the government of Egypt had declared its intention and insistence to introduce a new law under the banner of "health reform". In reality, this amounted to the privatization of the majority of the health care facilities in Egypt as well as running the whole system on market for profit basis. In addition, a multi-tier system is developed in which a basic package for the poor is provided while higher packages of health services are provided for those who can afford it.

Well, reacting to the rising opposition waged by the Coalition for the Right to Health in Egypt and with your solidarity actions, this move was at least temporarily thwarted. At last the government has declared that it will delay this action for at least a year. In fact not only has the action been delayed, but many representatives of the Minister of Health have, in public confrontations with representatives of the coalition, declared that they are rethinking some of the essential points raised by the opposition, such as the articles related to the "contribution of the patients of 1/3 of the costs as well as the multiplicity of insurance packages according to peoples means."

Although we know that this setback for the privatization scheme in the area of health services is only temporary, we feel that it is important to celebrate it, as it shows that despite the fact that the balance of forces is very much tipped in the benefit of the forces of privatization, change can take place when people have the will to do so. It shows that we can make a difference despite the odds.

I would like to take this opportunity to share some of the important lessons learned from this battle and to look at the prospects for the coming stage of our struggle for the right of all people to health and to health care.

Some lessons learned

Strength of the campaign:

  1. One of the most important characteristic of this campaign was and is its strong evidence base. A huge amount of knowledge and relevant materials were made available through many of the colleagues. This reflected the achievements of civil society organizations' previous work in monitoring and studying the health care system in Egypt, such as the work of the Association for Health and Environmental Development (AHED). This strong evidence base gave much weight to the coalition member's argument and their ability to confront the arguments of the ministry and other international and multilateral stakeholders such as the World Bank and the USAID. This was very clear in the confrontations that took place between the government officials and the representatives of the movement whether in conferences, seminars or in the media.
  2. The success in widening the ownership of the campaign. Although the campaign started through AHED members which is a health oriented NGO, it was soon taken on and carried out by a wide coalition whose member organizations were very diversified and included workers organizations, political parties (nearly all opposition political parties), women organizations, community development, human rights …etc. These are organizations which are not necessarily engaged in health related issues. However, the campaign was successful in showing that health is every body's' business. This new phenomena show that a wide based and diversified movement around right to health can develop and is developing.
  3. The wide coverage and the success in attracting the media played a decisive role in making the arguments of the right to health coalition heard and able to reach a wide mass base all over Egypt and isolated the arguments of the other side.
  4. The way that the public in Egypt in most cases responded positively and rapidly to the campaign and was able to see through the "bright camouflaged slogans" raised by the government and the other stakeholders , shows us that people have learned much from the negative experience and the negative impact of the policies of privatization carried out in many other sectors during the past two decades. Dissatisfaction with this dominant neo-liberal policies is increasing. This was true despite people's dissatisfaction with the current state of the health care system in Egypt.
  5. International solidarity was very important despite the fact that it was approached quite late in the process. However, this is a component which we should build upon more for the future stage and confrontation as it can and does carry an important weight particularly in reaching other extremely important and decisive stakeholders such as the World Bank, the European Union and the USAID.

This success is only a small step in the confrontation of a huge global trend which puts market relations and profits before people. It is also a trend whose stakeholders are powerful and insistent. We know that this move towards privatization of the health care system, will not stop and we have a long and hard confrontation ahead.

In order to succeed against this trend we have to address some salient issues from the experience of the past stages of the campaign, among which stands:

  • the need to develop clear and practical alternatives to the current failing and badly functioning health care system both in the public and the private health institutions. We have to move from the vision to the practical alternatives and to make it clear that we are for reform and change, yet, we differ with the forces of privatization in diagnosing the causes of the failure and definitely in the solutions they put forth.
  • The need to widen and strengthen the confrontation on the international arena. The move towards privatization of health care services as part of the move towards privatization of all basic services in Egypt is part of an international dominant trend which is taking place nearly everywhere else. Its advocates are huge international organizations and corporations. It can not be confronted locally only but needs to be confronted internationally both on theoretical as well as the practical levels.
  • In addition, there is a strong need in the coming stage to work very strongly to increasingly widen the base of opposition to privatization of health services in Egypt and to make it a much more popular movement. The original successes in this direction should be strongly built upon and further developed.
Alaa Shukrallah
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