Halfdan Mahler: ¿Has been "hacked" the Primary Care? ¿Ha sido saboteada la Atención Primaria de la Salud?

Nota ESP/ENG

ESP

Casi inadvertida en el mundo mediático, ha sido la muerte de Halfdan Mahler.

Así lo publica New York Times y si buscan en la web poca cosa mas encontrareis en este diciembre de 2016: http://www.nytimes.com/2016/12/15/science/halfdan-mahler-who-director-general-dies.html?_r=0

Recomendable y un poco mas jugosa y próxima a nuestro contexto, la nota de Alfredo Zurita en Data Chaco: http://datachaco.com/noticias/view/81043

Mahler fue Director General de la OMS desde 1973 to 1988, por tres períodos. Durante su gestión ocurrió la paradigmática Conferencia Mundial de Almaty (Kasajistán, URSS, 1978).  El tomo contacto con la realidad de la atención sanitaria y la importancia de su dimensión comunitaria, cuando fue enviado a India para trabajar en la campaña contra la Tuberculosis que lideraba Debabar Banerji. Trabajaron codo a codo y descubrieron juntos la necesidad de universalizar su convencimiento de que este tipo de aproximación a la problemática de la salud sería revolucionaria. Fue el mismo Banerji que elaboró algunos de los documentos preparatorios de la Conferencia que terminaron en la tan célebre declaración.

Con los años se los escucha a ambos hablar sobre cómo ha sido “hackeada” la atención primaria y como los países dominantes han desviado la agenda hacia otros temas haciendo un silencioso, pero sistemático y efectivo sabotaje contra ella. La Atención Primaria de la Salud, de la que se habla mucho y se practica poco, nada tiene de primaria, simple o básica, como se pretende muchas veces reducirla. Tal vez Latinoamérica este viviendo un momento de desarrollo en la atención primaria, sin embargo a nivel global esto no es así y en 2016 a 40 años de Alma Ata, estamos muy lejos de lograr la consigna de “Salud para todos en el año 2000”.

Me pregunto cuanto tiene que ver este silencio estado sobre la desaparición física de Mahler, de la que algunos no quieren ni hablar.

Para conocer mas detalles sobre la opinión de Mahler y Banerji sugiero los siguientes documentos:

1/ Video donde Mahler denuncia lo poco que se defiende a la Atención Primaria y como organizaciones independientes sostienen esta lucha: https://www.youtube.com/watch?v=-kBISf_GZjE

2/ Publicaciones de Debabar Banerji.

•  Banerji D.Hidden Menace in the Universal Child Immunization Program. Int J Health Serv April 1988 18: 293-299, doi:10.2190/D9X9-G438-CXHR-WJQG   
• Banerji D. Politics of the Revised National Tuberculosis Control Programme, Making a Show: The Black Money Bill, Making a Show. Economic and Political Weekly [Internet]. 2015 Jun 5 [cited 2016 Dec 22]. Available from: http://www.epw.in/journal/2016/37/discussion/politics-revised-national-tuberculosis-control-programme.html

Fragmento:  "It lays bare the long and very painful account of how some of the rich countries have unscrupulously and ruthlessly used their influence on international health organizations like WHO, World bank and UNICEF and on major NGOs like the Global Programs on AIDS, Malaria and Tuberculosis, Bill and Melinda Gates Foundation, Global Vaccine Initiatives and International Union Against Tuberculosis and Lung Diseases (henceforth called the “Syndicate”) to impose their agenda on tuberculosis on the poor countries of the world. "

3/ Manifiesto de Amberes. The Antwerp manifesto on primary health care. In: Proceedings of the meeting on selective primary health care. Disponible en: http://www.dhf.uu.se/ifda/readerdocs/ pdf/doss_61.pdf

Suscribieron este Manifisto en Bélgica: S. Annys; C. Barker; W. Bichmann; M. de Bruycker; I. Greindl; A. Heywood; R. Lagasse; P. Mercenier; K. Newell; D. Sanders; P. Streefland; M. Turshen; W. van Damme; A.G. Zurita; D. Banerji; I. Beghin; P. Cosci; H.J. Diesfeld; D. Grodos; A. Kabore; 2. Maiga; M. Moynihan ; K. Pangu; B. Schmidt-Ehry; A. Stroobant; J.P. Unger; C. Varkevisser; M. Baraldini; T. Berche; X. de Bethune; A. Green; K. Gutshoven; J. Killingsworth; A. Mechbal; D. Nabarro; S. Rifkin; D.L. Smith; A. Surakiat; H. van Balen; G. Walt.

ENG

Almost unnoticed in the media, it was the death of Halfdan Mahler.

New York Times published about and there is not too much on the world wide web : http://www.nytimes.com/2016/12/15/science/halfdan-mahler-who-director-general- Dies.html? _r = 0

A little more interesting and more focused for Latin-Americans, is Alfredo Zurita´s post on Data Chaco web page: http://datachaco.com/noticias/view/81043

Mahler was Director-General of WHO from 1973 to 1988, for three periods. During his administration, the paradigmatic World Conference of Almaty took place (Kazakhstan, USSR, 1978). He met the reality of health care and the importance of its community dimension, when he went to India to collaborate in the campaign against Tuberculosis headed by Debabar Banerji. They worked side by side and discovered together the need to universalize their conviction that this type of approach to health problems would be revolutionary. It was Banerji himself who produced some of the preparatory documents for the Conference, which ended in the celebrated declaration.

Over the years, they began to talk about how primary care has been "hacked" and how the dominant countries have diverted the agenda to other issues by making a silent but systematic and effective sabotage against it.

The Primary Health Care, has nothing of primary, simple or basic, as is often claimed to reduce. Perhaps Latin America is living a moment of development for primary care, but globally it is not the case. Up to 40 years from Alma Ata, we are very far from achieving the aim of "Health for all by the year 2000."

I wonder what that means this silence near Mahler's physical disappearance.

For more details on the opinion of Mahler and Banerji I suggest the following documents:

1/ Video where Mahler denounces the little that is defended to Primary Care and as independent organizations support this fight: https://www.youtube.com/watch?v=-kBISf_GZjE

2 / Publications by Debabar Banerji.

• Banerji D. Hidden Menace in the Universal Child Immunization Program. Int J Health Serv April 1988 18: 293-299, doi: 10.2190 / D9X9-G438-CXHR-WJQG

• Banerji D. Politics of the Revised National Tuberculosis Control Program, Making a Show: The Black Money Bill, Making a Show. Economic and Political Weekly [Internet]. 2015 Jun 5 [cited 2016 Dec 22]. Available from: http://www.epw.in/journal/2016/37/discussion/politics-revised-national-tuberculosis-control-programme.html

Fragment: "It lays bare the long and very painful account of how some of the rich countries have unscrupulously and ruthlessly used their influence on international health organizations like WHO, World Bank and UNICEF and on major NGOs like the Global Programs on AIDS, Malaria and Tuberculosis, Bill and Melinda Gates Foundation, Global Vaccine Initiatives and International Union Against Tuberculosis and Lung Diseases (henceforth called the "Syndicate") to impose their agenda on tuberculosis in the poor countries of the world. "

3 / The Antwerp manifesto on primary health care. In: Proceedings of the meeting on selective primary health care. Available at: http://www.dhf.uu.se/ifda/readerdocs/ pdf / doss_61.pdf

The Manifisto was subscribed in Belgium: S. Annys; C. Barker; W. Bichmann; M. de Bruycker; I. Greindl; A. Heywood; R. Lagasse; P. Mercenier; K. Newell; D. Sanders; P. Streefland; M. Turshen; W. van Damme; A.G. Zurita; D. Banerji; I. Beghin; P. Cosci; H.J. Diesfeld; D. Grodos; A. Kabore; 2. Maiga; M. Moynihan; K. Pangu; B. Schmidt-Ehry; A. Stroobant; J.P. Unger; C. Varkevisser; M. Baraldini; T. Berche; X. de Bethune; A. Green; K. Gutshoven; J. Killingsworth; A. Mechbal; D. Nabarro; S. Rifkin; D.L. Smith; A. Surakiat; H. van Balen; G. W