At the 1992 United Nations summit meeting in Rio de Janeiro, the assembled peoples declared, “Human beings are the center of concerns for sustainable development. They are entitled to a healthy and productive life in harmony with nature.” Out of that meeting came Agenda 21.

The minimal essentials of Agenda 21 included meeting primary health care needs in rural and urban areas; control and elimination of communicable diseases; paying special attention to vulnerable, super-exploited groups of people; meeting the health challenge that is forcing millions of people into cities; and recognizing and reducing the health hazards from environmental and occupational pollution.

Since 1992, the world has seen two diametrically opposed forces lining up on these questions. On the one hand, the humanistic, pro-people attempt to follow the dictates of the Rio accords; on the other, demands by the World Trade Organization (WTO) dictated by the International Monetary Fund (IMF).

Today, the 10th anniversary of that meeting is underway in Johannesburg, South Africa, where the people’s movement is reaffirming the irrefutable fact that sustainable development cannot be achieved under conditions where billions – not millions – of the world’s people live in poverty and suffer debilitating illnesses.

The meeting taking place in South Africa has been a seminal event that has found world progressive and humanistic leaders meeting with the leadership of almost every country except the United States. Rather than helping to formulate means to achieve the goals of the Rio Accords, Bush prepares for war with Iraq and for spending billions on his version of security

Life expectancy of 49 years in developing countries compares very poorly with the 75 years in the developed world. In fact, life expectancy actually fell in many developing countries since 1992.

The demands of the IMF and WTO that developing countries actually eliminate their public health programs is the culprit in massive early death and diseases. These dictates from the IMF and WTO come directly from private corporations wishing to increase their rate of profit regardless of the impact on human beings.

A strong and sustainable public health strategy is necessary to: reverse the rising poverty and inequalities around the world; reverse the dictates of the drug companies; stop environmental degradation and begin the enforcement of Kyoto Accords and force all governments to put public health above private profit .

The 1999 Battle in Seattle was the beginning of a movement by activists in the United States making clear that they were not going to sit idly by while world imperialism, lead by the U.S., ruins the world. No WTO, IMF or World Bank meeting has taken place since without major confrontations. Public Health activists are especially important since they often have the key facts and figures that dramatize the effects of imperialism on world populations.

These protests must continue. Every meeting of public health professionals and workers must take note of the international crisis as exposed at the South Africa meetings of the U.N. World Summit on Sustainable Development.

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