Influence of health rights discourses and community organizing on equitable access to health: the case of HIV, tuberculosis and cancer in Peru

Abstract

BackgroundThe right to health is recognized as a fundamental human right. Social participation is implied in the fulfillment of health rights since Alma Ata posited its relevance for successful health programs, although a wide range of interpretations has been observed for this term. While Peruvian law recognizes community and social participation in health, it was the GFATM requirement of mixed public-civil society participation in Country Coordination Mechanisms (CCM) for proposal submission what effectively led to formal community involvement in the national response to HIV and, to a lesser extent, tuberculosis. This has not been the case, however, for other chronic diseases in Peru. This study aims to describe and compare the role of health rights discourse and community involvement in the national response to HIV, tuberculosis and cancer.MethodsKey health policy documents were identified and analyzed. In-depth interviews were conducted with stakeholders, representatives of civil society organizations (CSO), and leaders of organizations of people affected by HIV, cancer and tuberculosis.Results and discussionA health rights discourse, well established in the HIV field, is expanding to general health discussions and to the tuberculosis (TB) field in particular. Both HIV and TB programs have National Multisectoral Strategic Plans and recognize participation of affected communities’ organizations. Similar mechanisms are non-existent for cancer or other disease-focused programs, although other affected patients are starting some organization efforts. Interviewees agreed that reaching the achievements of HIV mobilization is difficult for other diseases, since the HIV response was modeled based on a global movement with strong networks and advocacy mechanisms, eventually succeeding in the establishment of financial sources like the GFATM. Nevertheless, organizations linked to cancer and other diseases are building a National Patient Network to defend health rights.ConclusionsThere are new efforts to promote and protect health rights in Peru, probably inspired by the achievements of organizations of people living with HIV (PLHA). The public health sector must consolidate the participation of affected communities’ organizations in decision-making processes and implementation of health programs. PLHA organizations have become a key political and social actor in Peruvian public health policy.

Empowerment Praxis: Community Organizing to Redress Systemic Health Disparities

“…Such analyses provide an understanding that the processes of community organizing are not fixed; rather, they are dynamically negotiated, evolving processes guided by the social, political (Prilleltensky & Prilleltensky, ; Zimmerman, ), cultural, and place‐based context in affected communities (Grills et al, ). In addition, they align with the literature on community organizing, the social change objectives of social justice focused community‐based organizations, and the interests of disenfranchised communities (Campbell & Murray, ; Cheezum et al ; De Souza, ; Gonzalez et al ; Grills et al, 2012; Grills et al, ; Minkler & Wallerstein, 2012; Obama, ; Sandoval & Cáceres, ; Speer & Christens, ; Speer et al, ; Taber, ).…”

“…A growing body of literature suggests community organizing is a potentially impactful community empowerment strategy for developing and implementing targeted public health prevention and promotion programs (De Souza, ; Gonzalez, Villanueva, & Grills, , ; Sandoval & Cáceres, ; Speer et al., ). Community organizing refers to a process that “engages people, organizations, and communities toward the goal of increased individual and community control, political efficacy, improved quality of life, and social justice” (Orr, , p. 2).…”

Building a Network of Health Professionals for Breast and Cervical Cancer Control in the Andean Region

“…22,23 It requires collaboration among health professionals and advocates at every stage of the continuum of care. The workshop leveraged the growing momentum in Peru—a leader in the region as evidenced by the evolution of Plan Esperanza, sustained government support, and public buy-in—to exchange insights within and across health systems and to catalyze the reduction of mortality and morbidity as the result of breast and cervical cancers in the region.…”

Globalization and Health: developing the journal to advance the field

“…Sustained use and access to antiretroviral therapy was another frequently occurring topic under this construct. The changing discourse surrounding HIV and AIDS from an incurable disease to a chronic illness was also investigated and the policies, both global and at national level, were explored to see if they were reflective of this change [38]. In this regard, HIV was also closely linked with the NCDs theme, as more papers emphasised HIV’s chronicity.…”