The Director of International Relations writes from Mozambique, the first destination of a mission that will take him to Ecuador, Bolivia and Bosnia in the follow-up and execution of our public health interventions. The reflection on health as a right and health as a result of both national and international politics and decisions are the focus of these comparative, global and critical notebooks.
Between destination and destination, we will always find ourselves on the road, on the trip. It is as entrenched in our profession, as is the search for a better world. Who does not understand, I even dare to say, does not enjoy and learn from it, I doubt that he or she can grow in this job and create projects that really transform.
Mia Couto says that “the journey does not begin when distances are travelled, it begins when our internal borders are crossed“. After more than twenty years travelling the world, mine have been blurring, and they are like these suitcases that you choose to leave behind when taking the return trip because they are full of clothes and things that you know you are not going to need anymore. Borders are not a part of me anymore. They do not belong to me. I neither adore them nor desire them. Maybe that is why the famous Mark Twain told us that “Travel is fatal to prejudice, bigotry, and narrow-mindedness“. I have felt a Frankenstein for years ago now, a collage, a puzzle that still has pieces to fit. I am a thief of moments and planetary experiences that metabolizes experiences and, at the same time, distributes them among continents. Because they do not have owner, just as the traveller has no owner.
“The journey does not begin when distances are travelled, it begins when our internal borders are crossed” – Mia Couto.
Sometimes the trip lasts a few days, sometimes it is months. Seeing with time, they are decades of a continuous movement looking for answers and asking questions. A conclusion is rarely reached. Everything changes and evolves but, from time to time, with the distance that years give and the height (thousands of hours of plane flights) an idea forms. These thoughts reach us at dawn, half asleep, and they are so inspiring. This idea is usually formed once you have seen common elements in different parts of the planet.
I think we are walking backwards in building of both new and fairer planetary order. The model of nation-state is still current while international organisms, that once dreamed of more integrating humanity, vanish and sink. Moreover, countries with conservative governments manage to influence in the spaces of union and integration, making them more excluding and selfish with time. Human beings wander without direction in the Mediterranean. Refugees without hope. Central American families hit with excluding walls. Walls that grow like weed in what they call Holy Land…
I do not have many details of the ins and outs that lead these organisms to forget about their mission on the planet. Once again, I can speak from what I know in-depth: health. Although I am sure that this reflection will apply to other agencies of the United Nations, to other spaces of the so-called “union”.
The World Health Organization (WHO), created after the Second World War, enjoyed recognition and influence over what the countries dictated. The member countries contributed with a fee to its operation. This gave not only some democratical guarantees but also some autonomy in decision making. Over the years, and under the influence of the health economic gurus (I have always felt that economy and health are an antithesis), WHO began to search “new forms of financing”. In plain language, member states lowered their fees and WHO initiated a process of privatization and acceptance of non-governmental capital. This tendency gradually consolidated and, nowadays, the decision-making regarding global health politics is in their hands, to a large extent, of philanthropists like Bill Gates. Under the goodness and million-dollar marketing campaigns, one of the biggest technology companies has as much weight or more than many member countries. Does anyone really believe that an entrepreneur like Bill Gates is in the world to fight for the right to health of the most disadvantaged? And even if it is the case and this good man has enlightened himself, who chose and named him for this mission? Because, after all, the governments of the member countries are elected democratically (we could also question this as a fact), but what about the Microsoft’s board of directors? I, at least, did not vote…
In a present and future in which the large multinationals fight for obtaining huge databases of the population to sell them to the insurance companies. The badly called “artificial intelligence” (in my opinion) designs algorithms that put a price on our lives. Interference is one of the largest private IT companies in the world-health order is, at least, suspicious.
These philanthropists are already calling to finance projects that, of course, have the usage of technology as a central axis. This way, difficult and rough markets are opened thanks to the development cooperation guided by remote control in the great “cities”. I am not against a health centre using a tablet, but it saddens and pisses off that nobody is taking care of the most important things: potable water, sanitation services, electricity… These public goods need great investments to make them work. They have to be accessible to the parts of the population without many resources. However, this does not mean “business” for multinationals. But the absence of these services causes thousands of deaths each year on the planet. Tablets are useful, drinking water in a health centre is essential.
Tablets are useful, drinking water in a health centre is essential.
These philanthropists say, and the agencies that already dominate repeat like parrots, that these services are each country responsibility. In an extreme cynical exercise they wash their hands off while they dismantle public systems and drain off content the country structures. If they can bring down the balance and even influence the laws of African, Latin American or Asian countries from Washington, London or New York to give entry to private health (see World Bank’s report on strategies to enhance private health in Africa). Can’t they fight with us, side by side, to squeeze and support the states to assume health as a right of all? I insist…they are not here for that. They are here to take advantage of any space that allows them to increase their market share.
Can we feel nostalgia for future times? I miss the arrival of leaders that look into the eyes of humanity and overcome the already obsolete ideas of the nation-state and neo-liberal globalization and plunder goods and even weapons. But there is. as always, light in the chaos. The globalization of the social movements can and must be a response. The People Health Movement, arises as a response to the privatization and commercialization of health and, among other things, observes and puts WHO in its place. It is not an easy task to fight for universal health and its success depends on people, organizations and movements that are part of it. We continue to work to make PHM a strong and active actor in Mozambique and Austral Africa, in addition to continuing to support and contribute on its European work to defend health from the already threatened welfare state.
I miss the arrival of leaders that look into the eyes of humanity and overcome the already obsolete ideas of the nation-state and neo-liberal globalization and plunder goods and even weapons. But there is. as always, light in the chaos. The globalization of the social movements can and must be a response.
Inner and outer borders must fall to avoid being carried away by an exclusionary and individualistic discourse that prevails nowadays.
I am more and more convinced that global social movements are the ones that can be a counterpoint to the neoliberal globalization. Inner and outer borders must fall to avoid being carried away by an exclusionary and individualistic discourse that prevails nowadays.
Iván Zahínos Ruiz
International Relations Coordinator
*Translated from Spanish into English by Susanna Pujol Clivillé