“All social movements and scientific disciplines are subject to powerful institutional and natural forces that shape their social, economic, political, and environmental milieu.. like the health promotion movement, WHO is also subject to larger forces. Since Alma Ata, the rhetoric, aspiration, influence, and—arguably—the achievement of WHO has diminished, coincident with a decline in many public goods.”

– Halfdan Mahler Director General, WHO: 1973-1988

The World Health Organization marks its 75th anniversary today. The establishment of the organisation was a milestone for humankind. The declaration in its constitution that “the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social conditions,” was revolutionary.

Three quarters of a century down the line, whilst the WHO has made gallant strides in fostering improvement of public health globally, we are still very far from achieving the lofty aim set by world leaders when they formed the WHO.

Inspired by the far-reaching steps taken by governments and international institutions at the onset of the COVID-19 pandemic in 2020, health workers had high hopes of improved health employment and governments’ unalloyed commitment to enthroning universal access to public healthcare. Today, that hope is more measured.                                                                                                 

Powerful forces which put profit before people, and undermine universal access to quality public services, have put paid to “health for all” being little more than a rhetorical slogan over the last four decades. And despite the obvious lessons from the pandemic, they have not relented. 

We will win the quest to achieve “Health for All” when we make governments live up to the founding principles of the WHO with close collaboration and mobilisation of trade unions, communities, civil societies and governments

These forces include big pharma, global health companies, health insurance companies and other corporations who see the health sector as simply another economic arena for maximising profit.

They also include international financial institutions such as the World Bank and the IMF whose loan conditionalities and policy advice lead to cuts in government spending, which have dire consequences for public funding and delivery of healthcare particularly in  low- and middle-income countries, but increasingly so in even high-income countries.

The International Conference on Primary Health Care which was jointly organised by the WHO and UNICEF at Alma Ata in 1978 was an attempt to breathe new life into the aspirations of the WHO for a world where “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” as envisaged in 1948 was attainable for everybody.

But this was just at a time the world itself was being changed by powerful forces with a strong for-profit motive, and powerful governments sold on the ideology and agenda of neoliberalism that could help these forces to flourish.

The structural adjustment programmes (SAPs) of the 1980s were the first major blows against the spirit of 1948, which birthed the WHO and the dying cry of that era which the Alma Ata’s call for “Health for All by 2000” represented. Over 42 of the 52 independent African countries at the time cut their health spending by up to 50% between, based on World Bank and IMF conditionalities. And in some countries like Nigeria, per capital expenditure on health reduced by 75% between 1980 and 1987.

In the wake of the global financial crisis of the 2000s, fiscal consolidation became the norm in the Global North as well. Cutting public funds for health and care became part of the neoliberal orthodoxy. The COVID-19 “panic” changed this situation for a moment in time. Within months, the United States spent $4.6 trillion on its COVID-19 response. The European Central Bank made €1.35 trillion available for its pandemic emergency purchase programme.  

But after that, we witnessed “vaccine apartheid” and the making of some 30 new “pandemic billionaires” whilst millions of people remained vulnerable because of inadequate access to pandemic test, medicines, and vaccines.

Public Services International has raised the voice of workers to demand an end to what Dr Tedros, Director General of the WHO rightly described as “a cycle of panic and neglect” for health and social care. We continue to put forward the perspectives of health and care workers and the communities we serve, as Member States of the WHO negotiate an international pandemic accord.

We will win the quest to achieve “Health for All” when we make governments live up to the founding principles of the WHO with close collaboration and mobilisation of trade unions, communities, civil societies and governments. PSI will and its affiliates will not stop until this is won.