Day two of the People’s Health Assembly focused on social and physical environments that destroy or promote health. Brian Ashley, South Africa, spoke eloquently about the shape of the climate crisis and its impact on health. I spoke about the reasons why there is so little action on the social determinants of health equity despite the strength of evidence on their impact. There were also testimonies from Marta Giane Torres about the impact of mining on the health of Amazon communities and Dan Owalla and colleagues spoke about how the People’s Health Movement in Kenya had supported community mobilisation in northern Kenya.

Day three focused on access to health services as a social determinant of health with a plenary session addressed by the South African Director General of Health—Malebona Precious Matsoso—who stressed that the global financial crisis should not be seen as an excuse to cut health and social services. Dave McCoy described the “devastating set back” that has seen legislation passed in the UK to effectively abolish the NHS and described this as “reckless vandalism.” Eduardo Espinoza, Vice Minister for Health El Savador, gave a detailed picture of the progressive health reform he is overseeing, which will provide national integrated health services based on the principles of primary healthcare and participatory oversight of the health system through a National Health Forum. A good news story was also presented from Brazil by Paolo Buss, who described progress towards a universal health system based on family health centres and “Bolsa Familia” cash transfer programme. Together these measures are resulting in a reduction of health inequities. The El Salvador and Brazilian examples highlight the value of universal provision of public services to health and well being.

Each afternoon the assembly has 15 “self-organised” workshops where people present their local work on a very wide range of topics. Particular interesting is the work on the health impacts of extractive industries across the globe. These “land grabs” are happening globally, where transnational corporations buy up prime agriculture land to the detriment of the food security of local communities. Also of note is the work of the South African Treatment Action Campaign which won universal access to anti-retroviral treatments, and a range of national campaigns working for the right to health.

Drafting has continued on “Cape Town to Action,” which will summarise our discussions and propose a future programme of action for the People’s Health Movement. This is being drafted through a participatory process that started before the Third People’s Health Assembly and is continuing throughout the assembly with open two hour sessions each afternoon to develop the document. I’ve been part of the drafting group and we have just emailed out the final draft which will be discussed at the final plenary tomorrow morning.

Fran Baum is a professor of public health. She is the director of the Southgate Institute of Health, Society, and Equity, Flinders University, Adelaide, Australia and co-chair of the Global Steering Committee, People’s Health Movement. She is an Australian Research Council Federation fellow.