The People’s Health Movement’s Position on a Framework Convention for Global Health

The idea of a Framework Convention for Global Health (FCGH)has been promoted as an opportunity to advance global health equity and the right to health. The idea has promise but needs more thought regarding its risks, obstacles, and strategy. 

PHM takes the following position on a FCGH:

I.   Current analysis does not adequately address the social, political, and economic determinants of global health.

The FCGH calls for obligatory heath care financing, but it does not challenge the current political and economic order which prevents economic development in many countries and drives the transfer of value from the South to the North. Increases in official development assistance that do not challenge the prevailing order will function to legitimize it.The idea that aid is a sufficient solution to health problems arising from an inequitable and unstable global economy is flawed. A FCGH should be developed and campaigned for in a way that highlightsorcorrects the underlying structural problems of the current system. 

II.   A campaign toward a FCGH is not practicable given the current situation inWHO.

The proposition that WHO might adopt a FCGH overlooks the significant power some donors exert over WHO. Assessed contributions (obligatory payments required from all member states) remain frozen. WHO has not been able to implement various resolutions adopted by the Assembly because the donors have not agreed to support such programs. Two areas where this has been a critical constraint on WHO effectiveness are in implementing effective national medicines regulation and promoting policy coherence across trade and health. Moreover, if there ever were sufficient pressure for adopting a FCGH, it would be convenient for powerful countries to fall back on a FCGH focused only on aid.Finally, the proposed FCGH would likely be so watered down through negotiations to suit the interests of powerful countries that it would not be as effective as it was initially intended to be.

III.   Social mobilization around a Framework Convention on Global Health should link local problems to global response.

PHM’s experience has shown that campaign initiatives structured around abstract and distant reforms, such as an FCGH, have limited potential to build a movement. Campaign initiatives that inspire community activists to focus on the priorities of their communities have more success. They promise a direct response to problems. They offer real access to the levers of change. Such campaigns must be guided by strong analyses that links local problems to global structures. They should not be distanced from the wrongs that people are actually facing. PHM envisions a global movement in which many different actions come together in the struggle for the right to health. We are not persuaded that a campaign for a FCGH will have enough practical or inspirational power to build and sustain a mass social movement. 

IV.   Campaigning around regulatory strategies for global healthis a more effective method for movement building around a FCGH.

A campaign for a FCGH must ensure that concerns with reform at the global level do not overshadow the conditions needed for progressive social mobilization. It must inspire enthusiasm and put forth proposals that actually challenge power relations. Campaigning for effective regulation in global health, for example in the areas of noncommunicable diseases or quality use of medicines, would enable stakeholders to see the regulations as connected to their own struggles. Additionally, campaigning for global health regulation in areas beyond the power of WHO, such as for integrating health indicators into future Framework Convention on Climate Change legislation, would also frame local struggles within the global context.Although these types of campaigns seem disconnected from each other, they can be related to all other campaigns that fall under the right to health. This type of strategy would best serve movement building around a FCGH.

PHM acknowledges the need for stronger regulation around global health. However, focus on mandatory health care financing,as proposed by some FCGH supporters is too narrow. Also, supporters of a FCGH should carefully consider the likelihood that powerful countries will adopt an effective, transformative convention.Any campaign for a FCGH must be anchored instrong global social movement that is built from the bottom up and connects the local to the global.

For more FCGHand PHM resources:

Joint Action and Learning Initiative on National and Global Responsibilities for Health

http://www.jalihealth.org/take-action.html

Will the struggle for health equity and social justice be best served by a Framework Convention on Global Health?

Health and Human Rights Journal, Vol. 15, No. 1, June 2013

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