Health systems around the world are designed for the rich, but our development goals, such as the millenium development goals, are focused on the poor. The solution? Reform our health systems so they work for the poor, in line with the Alma Ata message. Speaking at the opening of the 3rd People’s Health Assembly, organised by the International People’s Health Movement (PHM), South Africa’s Minister of Health, Aaron Motsoledi, went on to call for global support of efforts to ensure universal health coverage in an era when powerful forces are using every tool available to undermine such efforts.

The 3rd People’s Health Assembly runs from 6 to 11 July 2012 at the University of the Western Cape in Cape Town, South Africa, and its final output will be a call to action for health activists and governments. Each day of the meeting is built around a particular theme: day one opened with discussions on the world’s financial crisis and its economic underpinnings, day two will focus on the social and physical environments of health, day three on universal coverage and equity, day four on mobilising for health for all, and day five the call to action.

The meeting started on an activist note, with a demonstration during the opening plenary in support of Fernando Lugo, Paraguay’s ousted president—a staunch supporter of social rights and health for all. Thomas Deve, one of the speakers, pointed out that much of Southern Europe is now suffering under the same structural adjustment programmes as Africa experienced in the 1980s and 1990s, and that “privatization of services is an abdication of responsibility by all levels of government.”

The day’s workshops developed the economic issues around health, with various sessions pointing out that what happens in one country increasingly impacts on others through global trade agreements—from generic pharmaceutical controls in India potentially affecting access in Uganda, to Australian tobacco control legislation being challenged using Malaysian trade agreements. Without national enactments, global resolutions remain largely inefficient. The increasingly gendered nature of trade was mentioned in a number of different contexts.

In the spirit of the meeting, Ronald Labonte suggested reformers push back against these strictures and take lessons from neoliberalism’s successful messaging style, positing four initial messages: a life that is secure, opportunities that are fair, a planet that is liveable, and governance that is just. But the key to success is mass mobilisation, which is where the lessons learnt from South Africa’s successful Treatment Action Campaign come in. As Zackie Achmat put it, every person is capable of understanding science, law, and economics, and of being a revolutionary agent for health reform. The next few days will see how this can translate into action.

Annie Neo Parsons is a researcher and PhD candidate at the University of the Western Cape School of Public Health in South Africa. Her PhD focuses on how global funding for antiretroviral treatment in South Africa has impacted on the health service provision of primary care services to people receiving antiretroviral treatment in the public sector.