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[afro-nets] Small Sucesses in right to health campaign in Egypt

Dear Colleagues and friends,

It is important to celebrate small victories, no matter how partial or 
temporary they maybe. As you all know, the government of Egypt had declared its 
intention and insistence to introduce a new law under the banner of "health 
reform". In reality, this amounted to the privatization of the majority of the 
health care facilities in Egypt as well as running the whole system on market 
for profit basis. In addition, a multi-tier system is developed in which a 
basic package for the poor is provided while higher packages of health services 
are provided for those who can afford it.

Well, reacting to the rising opposition waged by the Coalition for the Right to 
Health in Egypt and with your solidarity actions, this move was at least 
temporarily thwarted. At last the government has declared that it will delay 
this action for at least a year. In fact not only has the action been delayed, 
but many representatives of the Minister of Health have, in public 
confrontations with representatives of the coalition, declared that they are 
rethinking some of the essential points raised by the opposition, such as the 
articles related to the *"contribution of the patients of 1/3 of the costs as 
well as the multiplicity of insurance packages according to peoples means."*

Although we know that this setback for the privatization scheme in the area of 
health services is only temporary, we feel that it is important to celebrate 
it, as it shows that despite the fact that the balance of forces is very much 
tipped in the benefit of the forces of privatization, change can take place 
when people have the will to do so. It shows that we can make a difference 
despite the odds.

I would like to take this opportunity to share some of the important lessons 
learnt from this battle and to look at the prospects for the coming stage of 
our struggle for the right of all people to health and to health care.

Some lessons learnt

Strength of the campaign

1.      One of the most important characteristic of this campaign was and is 
its strong evidence base. A huge amount of knowledge and relevant materials 
were made available through many of the colleagues. This reflected the 
achievements of civil society organizations previous work in monitoring and 
studying the health care system in Egypt, such as the work of the Association 
for Health and Environmental Development (AHED). This strong evidence base gave 
much weight to the coalition member's argument and their ability to confront 
the arguments of the ministry and other international and multilateral 
stakeholders such as the World Bank and the USAID. This was very clear in the 
confrontations that took place between the government officials and the 
representatives of the movement whether in conferences, seminars or in the 

2.      The success in widening the ownership of the campaign. Although the 
campaign started through AHED members which is a health oriented NGO, it was 
soon taken on and carried out by a wide coalition whose member organizations 
were very diversified and included workers organizations, political parties 
(nearly all opposition political parties), women organizations, community 
development, human rights …etc These are organizations which are not 
necessarily engaged in health related issues. However, the campaign was 
successful in showing that health is every body's' business. This new phenomena 
show that a wide based and diversified movement around right to health can 
develop and is developing.

3.      The wide coverage and the success in attracting the media played a 
decisive role in making the arguments of the right to health coalition heard 
and able to reach a wide mass base all over Egypt and isolated the arguments of 
the other side

4.      The way that the public in Egypt in most cases responded positively and 
rapidly to the campaign and was able to see through the "bright camouflaged 
slogans "  raised by the government and the other stakeholders , shows us that 
people have learnt much from the negative experience and the negative impact of 
the policies of privatization carried out in many other sectors during the past 
two decades. Dissatisfaction with this dominant neo-liberal policies is 
increasing. This was true despite people's dissatisfaction with the current 
state of the health care system in Egypt.

5.      International solidarity was very important despite the fact that it 
was approached quit late in the process. However, this is a component which we 
should build upon more for the future stage and confrontation as it can and 
does carry an important weight particularly in reaching other extremely 
important and decisive stakeholders such as the World Bank, the European Union 
and the USAID.

Dear colleagues, this success is only a small step in the confrontation of a 
huge global trend which puts market relations and profits before people. It is 
also a trend whose stakeholders are powerful and insistent. We know that this 
move towards privatization of the health care system, will not stop and we have 
a long and hard confrontation ahead.

In order to succeed against this trend we have to address some salient issues 
from the experience of the past stages of the campaign, among which stands:
•         the need to develop a clear and practical alternatives to the current 
failing and badly functioning health care system both in the public and the 
private health institutions. We have to move from the vision to the practical 
alternatives and to make it clear that we are for reform and change, yet, we 
differ with the forces of privatization in diagnosing the causes of the failure 
and definitely in the solutions they put forth.
•         The need to widen and strengthen the confrontation on the 
international arena. The move towards privatization of health care services as 
part of the move towards privatization of all basic services in Egypt is part 
of an international dominant trend which is taking place nearly everywhere 
else. Its advocates are huge international organizations and corporations. It 
can not be confronted locally only but needs to be confronted internationally 
both on theoretical as well as the practical levels.
•         In addition, there is a strong need in the coming stage to work very 
strongly to increasingly widen the base of opposition to privatization of 
health services in Egypt and to make it a much more popular movement. The 
original successes in this direction should be strongly built upon and further 

Dear colleagues and partners in the PHA exchange, we would like to thank you 
all for your solidarity and actions to assist us here in our confrontation to 
the forces of privatization and we think that we will need to coordinate our 
work together with you and to strengthen it much more in the coming stage if 
there is a chance to succeed in face of these powerful global forces and 
reverse the trends.

Another world is possible

Alaa Shukrallah
AHED Chairperson
PHM Global Secretariat member

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