Opening speech of the First International Conference on Social Determinants of Health

The real objective of what we have done here was to continue to nurture our dream of building a better world.

National and international civil society organisations and movements working in Defence of the Right to Health.

Your Excellency, Minister of Health, Nazira Abdula.

Ambassador of the Kingdom of Spain: Carmen Bujan,

Your Excellency, the Representative of the European Union in Mozambique: Mr António Sánchez-Benedito Gaspar,

Representatives of the: Spanish Agency for International Cooperation and Development (AECID), Swiss Development Cooperation in Mozambique (SDC), Civil Society Support Mechanism (MASC) and Barcelona City Council,

Ladies and gentlemen, guests and participants at this, the first Conference on the Social Determinants of Health in Mozambique:

It will come as no surprise if I say we are living in times when health, around the world, is being transformed into a highly desirable consumer good and, in some parts of our planet, one within reach of only a very few people. We live in an increasingly global world, especially in relation to economics and finance. However, unfortunately, there remains much work to be done to globalise rights. And health is no exception. On the contrary, we are witnessing unprecedented privatisation and commercialisation that excludes many people, who are seeing their right to live a healthy life become increasingly limited. Social movements and organisations face many difficulties in creating global alliances that match the strength of the neoliberal policies emerging to turn health into a commodity that conforms to the logic of the market. And in this way, there can be no doubt that only if you have money will you be able to live longer and better.

I am also aware it comes as no surprise to anyone if I stress that it is precisely the poorest and most vulnerable populations that suffer the most from the impact of climate change, droughts and floods, wars and, yet again, from economic policies that increase inequalities.

Of course, as people working in public health, you are also familiar with the concept of the double burden of disease suffered by those populations with fewest resources, as is the case in Mozambique: communicable diseases and chronic diseases. This is negatively affecting life expectancy. Here, today, I maintain that the poor suffer from another, even more serious double burden: lack of resources and dehumanised policies that consolidate inequality. This is what most affects your quality of life.

That is why, after 24 years of working in defence of a quality public health system in Mozambique, we at medicusmundi propose a definition of health similar to that of our colleagues of the People's Health Movement, which says: health is a social, economic and political issue and, above all, a fundamental human right. Inequality, poverty, exploitation, violence and injustice are at the root of the disease and death affecting the poorest and most marginalised people. Health for all means that powerful interests have to be challenged, that we have to oppose neoliberal globalisation, and that political and economic priorities must be drastically changed.

Promoting a Conference on the Social Determinants of Health, in these times when health policies are based on the individual, health programmes are vertical, health care is being privatised – it seems revolutionary. And yet, on the contrary, we are proposing something very basic: to achieve health for all provided by an effective public system. Nothing more. We are proposing health be included in all policies and that all policies be about health.

We believe all those present here today understand that our goal is very simple: (1) Firstly, we want all areas, including academia, to focus on a broad approach to health, analysing all the factors which affect people's quality of life, including the health system itself, but also environmental, social and political factors. It is vital to generate quality information on the Social Determinants in order to be able to effectively influence health policies. And (2) secondly, we want to do this with the active participation of society, of social movements, researchers and public health policy makers.

With this conference, we want to hear the voices of experience which are normally not given any space in health policy design in Mozambique.

I would like to thank all participants, all members of the Scientific Committee, all speakers, all donors (the European Union, Spanish Cooperation, MASC, Swiss Development Cooperation and Barcelona City Council), all medicusmundi workers and the Ministry of Health and its staff who frequently work in very difficult conditions. A very special thanks goes to the civil society organisations and social movements that use their strength to demand fair health policies built for and with people at the centre.

We are here to create friendship, collaboration and a new alliance of actors that, finally, has a clear ideology around health as a right for all men and women.

Thank you very much for your attention.