JAN SAWASTHAYA ABHIYAN

Jan Swasthya Abhiyan
In 1978 at Alma Ata, the governments of the world came together to sign the
Alma Ata Declaration that promised "Health for All by 2000". However this
promise was never taken very seriously and was subsequently marginalised in
health policy discussions.
As the year 2000 approached it appeared that "Health for All by 2000"
was quietly being forgotten by governments around the world. To remind
people of this forgotten commitment the First People's Health Assembly
was organised in Savar, Bangladesh in December 2000 . The People's Health
Assembly was a coming together of people's movements and other nongovernment
civil society organisations all over the world to reiterate the pledge
for Health for All and to make governments take this promise seriously. The
assembly also aimed to build global solidarity, and to bring together people's
movements and organisations working to advance the people's health in the
context of policies of globalisation.
The national networks and organisations that had come together to
organize the National Health Assembly, decided to continue and develop this
movement in the form of the Jan Swasthya Abhiyan (People's Health
Movement). Jan Swasthya Abhiyan forms the Indian regional circle of the
global People's Health Movement..
Despite medical advances and increasing average life expectancy, there is
disturbing evidence of rising disparities in health status among people
worldwide. Enduring poverty with all its facets and in addition, resurgence of
communicable diseases including the HIV/AIDS epidemic, and weakening
of public health systems is leading to reversal of previous health gains. This
development is associated with widening gaps in income and shrinking access
to social services, as well as persistent racial and gender imbalances. Traditional
systems of knowledge and health are under threat.
These trends are to a large extent the result of the inequitable structure
of the world economy, which has been further skewed by structural adjustment
policies, the persistent indebtedness of the South, unfair world trade
arrangements and uncontrolled financial speculation - all part of the rapid
movement towards inequitable globalisation. In many countries, these
problems are compounded by lack of coordination between governments
and international agencies, and stagnant or declining public health budgets.
Within the health sector, failure to implement primary health care policies as
originally conceived has significantly aggravated the global health crisis. These
deficiencies include:
• A retreat from the goal of comprehensive national health and drug polices as
part of overall social policy.
• A lack of insight into the inter-sectoral nature of health problems and the
failure to make health a priority in all sectors of society.
• A failure to promote participation and genuine involvement of communities
in their own health development.
• Reduced state responsibility at all levels as a consequence of widespread and
usually inequitable policies of privatisation of health services.
• A narrow, top-down, technology-oriented view of health and increasingly
viewing health care as a commodity rather than as a human right.
• It is with this perspective that the organisations constituting the Jan Swasthya
Abhiyan have come together to launch a movement, emerging from the
Peoples Health Assembly process. Some objectives that this coalition set for
itself (which are set out in detail in the Peoples Health Charter) can be listed
briefly as below:
• The Jan Swasthya Abhiyan aims to draw public attention to the adverse
impact of the policies of iniquitous globalisation on the health of Indian
people, especially on the health of the poor.
• The Jan Swasthya Abhiyan aims to focus public attention on the passing of
the year 2000 without the fulfillment of the 'Health for All by 2000 A.D.'
pledge. This historic commitment needs to be renewed and taken forward,
with the slogan 'Health for All - Now!' and in the form of the campaign to
establish the Right to Health and Health Care as basic human rights. Health
and equitable development need to be reestablished as priorities in local,
national, international policy-making, with Primary Health Care as a major
strategy for achieving these priorities.
• In India, globalisation's thrust for privatisation and retreat of the state with
poor regulatory mechanisms has exacerbated the trends to commercialise
medical care. Irrational, unethical and exploitative medical practices are flourishing
and growing. The Jan Swasthya Abhiyan expresses the need to confront
such commercialisation, while establishing minimum standards and
rational treatment guidelines for health care.
• In the Indian context, top down, bureaucratic, fragmented techno-centric
approaches to health care have created considerable wastage of scarce resources
and have failed to deliver significant health improvements. The Jan Swasthya
Abhiyan seeks to emphasize the urgent need to promote decentralisation of
health care and build up integrated, comprehensive and participatory approaches
to health care that places "Peoples Health in Peoples Hands".
The Jan Swasthya Abhiyan seeks to network with all those interested in
promoting peoples' health. It seeks to unleash a wide variety of people's
initiatives that would help the poor and the marginalised to organise and
access better health care, while contributing to building long-term and
sustainable solutions to health problems
The Jan Swasthya Abhiyan is being coordinated by National Coordination
Committee consisting of 21 major all India networks of peoples movements
and NGOs.

R.S.Dahiya