 The Struggle for Health, a landmark book on health and the development and activism, first published by David Sanders and Richard Kever in 1985. Recently, we've just seen the second edition of The Struggle for Health. When it first appeared, The Struggle for Health become the quota text for those who wanted to know more about the politics dimension of health and how it caused ill health, especially in the global south. In many ways, the second edition picks up on where the first edition left us. It continues the story of how corporate sector shapes the health, how corporate sector shapes our health through hijacking full system, research and development of our new medicine, so research and development of new medicines and the delaying of meaningful action to the climate crisis. So today, we are here with William, one of the co-editors of the new edition for The Struggle for Health. He is also an activist for the People's Health Movement to discuss the publication of the book and its relevance on the ongoing health struggles. Welcome, William. Hello, thank you, Tenashi. David Sanders influenced the movement for the right to health in many levels. The Struggle for the Health was one of the channels that he managed to do through, but this was a particular important channel reaching many activists and health workers who were wondering about their role in shaping the health system and in making the Struggle for Health a proper political struggle. In any way, William, did the book play a role in your formation as a health activist in some way? Yes, yes, thank you for the question. Yeah, definitely. And I think it's the case for many, many others as well, other people who have read it at that time. Actually, in the 1990s, I was working as a development worker in the Philippines. So I was a member of the target audience because David, when he wrote it, he really had that kind of people in mind. And I must say, actually, I had read already quite some other material, some other books on political economy, on public health, but the Struggle for Health was unique because it brought together everything in one analysis. And it also added, apart from analysis of political economy and public health, it added, for me, a theory of change. It showed a perspective of change that was really revolutionary, both figuratively and literally. And something that was also very important for me in my formation, that it also added a class perspective because I was a graduate medical school and it is through the book, Through the Struggle for Health, that I understood how my world outlook, the way I looked at the world and I understood how society was functioning, how the role played by medicine and healthcare, how that was shaped by the ruling classes, actually. And when I understood that, working with farmers and workers in the Philippines, that I learned so much more about health. So that was something very new for me and that really changed the way I looked at the role of health workers and health professionals. And that was something very particular about the effect that the Struggle for Health had on me at that time. I think because David also used a lot of examples from his work in Zimbabwe and Southern Africa, I can imagine Tinashe that it was also very important in shaping the health movement in Southern Africa. I would be interested to hear something about that, actually. It's quite important the role that David, the legacy that he left, which is still living. The fact that his work touched on the grass roots, people were right on the grass roots, people who are in the middle kind of level and those who are the important decision makers. So his work was quite important in the fact that it was a cut-crossing kind of work that spoke volumes to all those levels from the community health care worker to, I mean, not even from the community health worker, from a parent himself, from a parent team or herself, community health care worker, a doctor, a nurse, a student and influencing also the political, I mean, the political heads, the police makers. So, Wim, quickly just tell me with the subtitles of the struggle for health, remaining medicine and politics of the underdevelopment, but we know very well that the world has gone through many changes since 1985. While we were working on this new addition, how did you see the underdevelopment change for these decades? Also, and tell me how do you find David's perspective from the first addition, fitting into this changed landscape of many, many years since we have seen the first addition? Yeah, it was 1985, so indeed. 1985, yes. It's almost 40 years. Yes. And it has been, we've been discussing a lot with David when we started the project, and that was one of his questions also. Is it still relevant, this book? Is this analysis still relevant? He asked me over and over again, and we discussed that for hours actually. Even the terminology, is it still relevant to talk about underdevelopment or is it ever been relevant to consider some countries developed and others underdeveloped? Of course, it's not. Of course, we know by now that this terminology is not very appropriate, but we decided to use it anyway. We explained in the book why it's just pragmatic because whatever terminology you use, it's always descriptive. We don't talk about the third world anymore. We can talk about the global north, the global south, or use other euphemisms. But actually, as long as people know, we were very pragmatic. As long as people know what we're talking about, we can still use development and underdevelopment as terminology. And what changed? Actually, we only had to add one chapter to the book. So we used exactly the very same outline with the same chapters, but we decided to add just one chapter. And that is a chapter on health policies under neoliberal globalization. And in that chapter, we describe how things evolved since the 1980s, especially in the global health. David, for example, in 1985, he talked about Alma Ada, of course, about the primary health care movement, community health workers, and how important that was to change medicine and change society. But we had to describe how this whole primary health care movement evolved towards more selective interventions. We also had to describe how the whole aid industry and the philandro capitalists were capturing this global health scene, but on the other hand, in the same chapter, we also talked about the renewed attention for health as a human right and also how in the 2000s, since the year 2000, the people's health movement grow as a movement, a worldwide global movement for health rights. So I think that that's the main trends we had to describe since 1985, but we also concluded that essentially the mechanisms of underdevelopment, the mechanisms of exploitation and global power politics between the industrialized countries and what we call the underdeveloped world, the third world, the global south, how these mechanisms actually didn't change at all. We're still talking about a world that is divided between the centers of capitalism and an exploited world that we refer to as global south. The pandemic itself has highlighted some injustice that we have all seen and also it is also exposed how weak, especially in the global south, our health system is. What do you think could be some of the David Sanders thoughts if he was to be present during the COVID-19 pandemic? Unfortunately, David passed away in 2019 and that was just a few months before the COVID pandemic broke out and so many times actually we asked ourselves that question how would he analyze but actually he would have analyzed it just like he analyzed the AIDS epidemic and you know very well probably how he was able to describe the social and economic drivers of the pandemic. He was able to explain that the pandemic was fueled not just by a virus but by the social and economic injustices and the power relations within society. That was the real driver behind the AIDS epidemic. At that time that's how we explained it I think he would also have been the first one in January 2020 to analyze the COVID pandemic as actually a pandemic of global injustice. We know how useful was the first edition I mean everyone adopted it as a sort of a field and research work guide among health activists and academics all over the world. How do you anticipate how do you think this second edition will be used? Well that's of course hard to say because there's many other books today about global health about social determinants of health I think there's much more material available but the new book The Struggle for Health second edition is available open access online so everyone can read it for free can download it can use the illustrations and that makes it extra exciting of course that makes it very exciting because it becomes very accessible and it's available for everyone with an internet connection. Today as I said a difference with 1985 today we have a global movement we have the people's health movement we have a global movement for health rights for the right to health and I hope that many of those activists if they have an internet connection are able to access it and use it also in their activist work so in that sense I don't think it will make a big difference I've heard anecdotes about the first edition being Serox and then Serox copies being used by medical students or health activists in poor countries today we can just download it so I think it will be as useful as the first edition we invite that's how we end the book as well we invite everyone to join the struggle for health and we hope that just like the struggle for health was David Sander's life we also hope that it may become the life of many more people actually so it's only if we struggle together collectively for health that it can become a reality so thank you so much Wim for re-invoking the spirit of Comrade David Sander in South Africa we say Amandla long live the spirit of Comrade David and congratulations on such a successful project and we hope that it's going to inspire and touch a lot of young activists both in the global in global north and global south thank you so much Amandla Avedo Avedo