Open Letter to the World Health Organisation

INTERNATIONAL ASSOCIATION OF HEALTH POLICY
ASOCIACION LATIONOAMERICANA DE MEDICINA SOCIAL

Open Letter to the World Health Organisation

The participants of the VIIIth Latinoamerican Confernece of Social Medicine and of the XIth Conference of the International Association of Health Policy, held in Habana, Cuba between the 3th and the 7th of July 2000 express our complete disagreement with the Assessment of the World's Health Systems carried out by the World Health Organisation and presented recently in the World Health Report 2000.

This report, that results in a ranking classification of the countries, through its extensive diffusion from the mass media, generated protesting reactions from researchers in the field of health services and from local, regional and national health authorities in several countries.


Supported by a controversial methodology, cover with a superficial sophistication, based on reduced and questionable sources of information, its results conceal very distinct realities and produce unacceptable distortions in the comparison among countries.


Upon classifying each country by a reductionist and market oriented criterion of equity, that keeps in mind barely what the persons spend in health of their own pocket (known as "out of pocket"), abandons other more relevant criteria to evaluate the equity from the point of view of the equality of opportunities and the universal access to the health services in all the levels of complexity, that offer an integral care and of good quality.


It cannot be admitted that in Latin America, Cuba occupy the 25th place, while Colombia is located in the first place in equity.


We, the professionals of health of ALAMES and IAHP know that this does not correspond to the health reality of our countries, which is much more complex than that presented in the World Health Report 2000 of the WHO.


Finally, we feel repulsed with the implicit agenda in that type of evaluations, falsely neutrals, for the implementation of the alternative of health insurances, which are in their great majority private and with for profit goals, although they are directly or indirectly subsidised by public funds.


According to our criteria, that are based on the defense of the public and universal health systems, we consider that Cuba continue occupying the first place in Latin America and one of the leading positions worldwide, in everything that refers to health and social justice.

La Habana, 7th of July 2000