Open Letter To the Public Health Association of British Columbia

To the Public Health Association of British Columbia (PHABC) Board of Directors,

We are writing to express our concern regarding the PHABC’s promotion of partnerships with the business sector at the conference “Shared prosperity for health and well-being: A collaborative dialogue between business and public health” on December 4-5, 2014.

Although the stated mission of these partnerships is “creating the conditions for health and well-being for all”[1], it is well-documented that markets are incapable of providing health services equitably across and within communities and do not serve the interests of those who cannot afford to pay. Julian Tudor Hart describes this as the inverse care law, where those with the greatest healthcare needs often receive the least adequate healthcare. In 1971, he wrote that, “the market distribution of medical care is a primitive and historically outdated social form, and any return to it would further exaggerate the maldistribution of medical resources.”[2] Over 40 years later his words are more urgent than ever.

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De-funding and privatization of public services have only intensified in the face of neoliberal policies, particularly in health. The private sector cannot fill these service gaps, and detracts from the responsibility of governments to provide public services in our right to health. Similarly, corporate projects of “social responsibility” are part of a growing arena of philanthro-capitalism where health is viewed as a profit-making and corporate investment opportunity.

Partnerships between the health and business sectors are fundamental contradictions: while our primary responsibility in health is to improve the health of our community, the primary aim of business is to serve shareholders in the accumulation of profit. Health care is not a commodity to be bought and sold, and we need only to look to the pharmaceutical industry to see that diseases of the poor receive little attention and monopoly over products (and services) inflates prices to unaffordable levels.

To improve health for all, we need to engage in concrete actions on the social and structural determinants of health[3]. The highly unequal distribution of power and wealth under capitalism are the main drivers of health inequities, which result in differential access to the resources that affect health, such as housing, income, and education. There can never be shared prosperity between health and business, as economic growth and wealth creation occurs at the expense of the politically and economically marginalized. This is particularly salient in British Columbia, where resource extraction is causing innumerable harms to the health of our communities and the environment. We only further entrench health inequities when our prosperity is gained at the expense of others. We can only improve the health of our communities when we work to increase their control and decision-making over their health care, resources, and their lives.

Image from Warrior Publications
Image from Warrior Publications

As health workers, researchers, and students, we urge the PHABC reconsider its direction in seeking partnerships in the private sector and to engage in critical dialogue on meaningful actions towards health equity.

Sincerely,

The Alliance for People’s Health

Jannie Wing-sea Leung, MSc
Leah Diana, RN
Azar Mehrabadi, PhD
Thomas Warren
Martha Roberts, RM, MSc(c)

Endorsed by:

People’s Health Movement – Canada

We invite individuals and organizations to endorse this letter. Action toward equity and justice is urgent. If you or your organization would like to endorse this letter, please contact us at allianceforpeopleshealth@gmail.com

[1] http://phabc.org/files/PHABC_2014_Call_for_Abstracts.pdf
[2] Hart JT. The inverse care law. The Lancet. 1971;297(7696): 405-412.
[3] World Health Organization (WHO). Closing the gap in a generation: Health equity through action on the social determinants of health. Final report of the Commission on Social Determinants of Health. Geneva (CH): WHO; 2008.

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