Why Do Churches Need to Continue to Struggle for Health for All?

Abstract

The changing international arena (1) In 1978, one hundred and forty-four countries signed a commitment for for all by the year 2000 (2) at a memorable international conference at Alma Ata, Kazakhstan, which was jointly organized by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF). The ministers of from the 144 countries represented at the meeting shared the vision of health for all; and their conference declaration led to a decade of hope, determination and excitement in the development of national systems. No longer would the WHO and its member states think in terms of disease control and top-down programmes. Instead, they would act to improve the status of whole nations. Health and care would become the joint responsibility of governments and communities, thus creating maximum coverage of populations with basic care, as well as preventive and curative services. Water and sanitation, which greatly determine risks, would be part and parcel of primary care approaches. Following its formation in 1968, the Christian Medical Commission (CMC) of the WCC played an influential role in informing international policy makers at the WHO. CMC did this in the light of its reflection on the Christian understanding of healing and justice, and the redefinition of the role of Christian churches in their ministry of healing. Jesus's call to his disciples to preach the gospel and heal the sick implied that the task of healing was entrusted to the whole congregation and not just to professionals, and also, therefore, healing was not confined within the walls of hospitals. Christian agencies were created in many developing countries, and took up the challenge not only of sustaining church hospitals but also of promoting health, particularly for women and children. This vision and commitment, however, died away in the 1990s. The WHO seemed no longer to have the lead role in international policies. This was taken over by the World Bank and, later the G8, the multinational pharmaceutical industry, and several major private funds, often based in the United States (e.g. the Bill and Melissa Gates Foundation, the Bill Clinton Foundation, the Helen Keller Foundation, the Kaiser Foundation, etc.). At the same time, the Christian Medical Commission ceased to exist. Today, hundreds of millions of people still lack access to basic and adequate care, access to clean drinking water, sanitation, and basic education and shelter. Public services in many countries are insufficient or inadequate; budgets are too small to sustain adequate care infrastructures, and often are inappropriately managed so that it becomes impossible to maintain a smooth running care system. Community based or community managed care cannot be adequately sustained or successful if it is not matched with a minimum of government care services, such as an immunization programme for children, obstetric services and a functioning drug supply chain. Everything appeared to be in flux: the international policy agenda changed, leading policy makers changed due to a new power balance, and the underlying values and principles of policy changed. The People's Health Movement (PHM) was initiated as a result of despair and frustration with international policy makers and the WHO. The slogan, for all by 2000 became just a faint echo from the past. Primary care was not a leading principle anymore for policy makers but had been replaced by Global Private Public Initiatives (GPPIs) and partnerships (3), and privatization of public services. Today, public services are not meeting the needs of those populations with the poorest and the greatest care needs, especially those living in rural areas, nomadic people, native or tribal people, women and children with special care needs, homeless people, persons with psychiatric conditions, and persons with physical challenges. …