 Hello and welcome back to the People's Health Dispatch. Today we're meeting Roman Vega who has taken on the role of the People's Health Movement Global Coordinator as of January 2022. His appointment as Global Coordinator is vital in a moment of strengthening of people's movements and health movements across Latin America and the Caribbean which continue to provide important lessons to the world. Today we're talking to Dr. Vega about what health movements experienced in 2021 and the main prospects lying ahead in 2022. Thank you so much Roman for joining us today. Thank you very much for this invitation. So to start us off when we're looking at 2021 what would you say were the key issues and most important achievements for health activists? Well I consider that the challenges continue to be practically the same as we had in 2020 and in previous periods. In the first place we have been facing the COVID-19 pandemic in a continuous transfer of neoliberal policies that have been implemented in most of the countries in our region and in the world. At the same time we have been facing the aggravation of the global climate crisis that has also hit many of our countries and has become a challenge linked to the pandemic, the framework of relations of society and nature that constructs the same explanation of these two processes of the pandemic and of the global climate crisis. And as we all know what has been working there is a process of destruction of nature that has made the pandemic more frequent on the one hand and that at the same time has made the global climate crisis more serious. These processes are intertwined by the economic policies and the social policies of neoliberal cuts aimed at the accumulation of capital, productivity, extractivism, economic growth and limited. All this has led to the social inequalities and as a consequence of this the inequalities in health have hit the populations in an incredible way, especially to sectors that have been fragilized and vulnerable by neoliberal policies, in particular the great mass of informal workers, youth and especially in youth women. What we observe in the different countries is a growth of the loss of employment, of the income and obviously the difficulties to access the integral tension in health. The curative cuts linked to the business of neoliberal health policies that difficult strategies to promote health, prevention of diseases, all that has been very serious in our countries, so we have had a tremendous response from conservators, tremendously neoliberal, to the serious economic crisis due to the pandemic, due to the global global climate crisis. All this has generated significant responses from social movements and health movements. I can exemplify this in the situation that Chile lived in, its social failure in the year 2019 before the pandemic, the social failure that Colombia lived during practically two months, the mobility of the communities, the youth, the workers who lost their income and their jobs, and that led to confront in the framework of these responses of neoliberal governments, new neoliberal policies, new generations of health policies, deeply neoliberal, that sought to deliver more and more to the private sector, to the great multinationals and private corporations, not only the health services, but the management of medical technologies and, as a consequence, the difficulties to access to integral health care, so we have lived a very difficult situation created by these crises, interlinked by insufficient responses from governments and by a desire and a expectation of the peoples to respond to these policies fundamentally in order to transform the living situations. That is the scenario that we have lived and that a large part of the population of the world has also experienced. What was the relationship of health activism to the overall political situation, specifically in the global south, and what were some of the key developments in this regard? In a sentence, what is going on? From Latin America, for example, we have paradoxical situations to say it in some way. On the one hand, neoliberal authoritarian governments, such as the one of Bolsonaro in Brazil or the government of Duque in Colombia or the government of Buquele in El Salvador, have given responses to the popular needs of the longuids, precarious, if they have given any real response, because they have generally favored the economic interests of the elites, of the dominant sectors of our societies, of the big companies and corporations, have imposed taxes that have been inadequate and that have been developed in the framework of the crises that we have experienced, have been developed to favor the great entrepreneurs, the great national and multinational capitalists. But also, in these circumstances, from Latin America, we live moments of change, fruits of the dynamics of social struggle and of the health sector. For example, we have achieved in this period to have new governments, progressist, democratic, democratic, left-wing in several countries. The case of Argentina, Bolivia, Peru, Chile, recently with the Triumph of Borek, the case of Honduras and even Mexico, are lights that tell us that the pendulum is turning in a different way in Latin America. There are new opportunities to deepen the dynamics of economic transformation and social transformation and of health. In the framework of these new governments, there are proposals for transformation of the health systems, to overcome the sectoral reforms that were imposed by Pinochet in Chile that inaugurated the neoliberal reforms in health. Today, something different is being proposed in the direction of a radical, substantial transformation in the content of the health policies of our countries, looking beyond ordinary policies in terms of the history, the colonial implications of the formation of policies, of the exclusion of sectors that have been very important in our history such as indigenous, peasant, Afro-descendants whose knowledge and practices in health have been excluded, traditionally, even in the framework of universalizing policies in the health sector. Therefore, there is this paradoxical dynamic of governments entrenched in neoliberal, very authoritarian, conservative, and progressive dynamics. This happens in Latin America and in this framework, some processes of unitary dynamics and mobilization of the health sector, of health workers, first of all, that they are reclaiming their labor rights, that is to say, the improvement of their employment conditions and work, deeply precarious by the policies of labor informality generated by neoliberalism to increase the profits of the capitalists in the health sector. Today, a wave of protest, of struggle is raised, resisting the continuity of these labor policies from the health workers, but at the same time, excelling background transformations of these policies. Together with this, also dynamic mobilization of different sectors of society, looking for a greater social inclusion, a much more integral social protection, a democratization of economic relations, and something very particular that draws our attention. Democratizing governance at a national, regional, and global level of the dynamics of formation of health policies. In Latin America, in this period in which, for example, it must be very important to consult citizens on the measures adopted for the management of the pandemic, what we observe in the studies, in the investigations that we have done, is that precisely the most vulnerable sectors, the excluded communities, have also been politically excluded in the decision dynamics on the policies and the answers to the pandemic. That is a generalized fact in all Latin America, but along with that, there have been processes that I could call autonomous institutions that confront the power instituted, the functional participation dynamics, the neoliberal logics, from self-experiences, autonomous, organized, control of territories, initiatives of autonomous solidarity created from the communities themselves. I think that has also been experienced in other regions of the world, particularly in Africa, where these same policies of management of the pandemic, in the framework of the enormous inequalities, for example, of access to vaccines, have made people organize, protest, mobilize, put on the agenda of discussion of that debate, of that substantially inadequate content of global, regional and national policies. I think we live a peculiar moment, a historic opportunity for social movements to confront the Cuban status established during decades of neoliberalism in different regions of the world. So in this context of achievements and setbacks in 2021, looking forward to 2022, what are some of the big, the major priorities for the people's health movement and other movements of people's movements and other sectors? We have the same tendency, the denunciation, the rejection of neoliberal policies in the global, regional and local plan. We have to continue the struggles because the decisions of the World Health Organization have really been in favor of those who have been subjected to situations of inequality between countries and between the North and the South Global. That is a huge challenge that goes through the democratization of the decisions in the framework of the contents of politics, of health, of the OMS and of the sectional of the OMS in each region. We will have to ask, for example, to the sectional of the OMS, such as the Pan American Organization of Health in the region of the Americas, that they are transparent, that they do not work around the interests created by the governments and the elites that represent and that they have a greater commitment with the popular sectors, the workers, the indigenous populations, the women, the young people, the Afro-descendants, who have lived the tragedy of this pandemic, the deaths, the infections and the economic, social sequels, of all this that this drama, so tremendous that we have lived in this time. We will have to do that, resist, seek changes in the policies of the World Organization of the OMS, which is setting an agenda for the service of the interests of the big pharma, the complex that we call financial industrial medicine, co-linked, in function of converting health into a business to accumulate capital. We will have to continue doing that. But at the same time, we have to raise and take advantage of the opportunity of economic, social and political crisis that we live in and of mobilization dynamics to seek changes, to deepen changes, to transform the realities that we have. What makes the movement of the health of the people has to be done in that context. I think we are preparing precisely for this. We are deciding to develop a huge campaign claiming the right to access to vaccines, to health services, the transformation of the health systems, understanding the relations between society and nature, that is to say, a focus linked to the determinants, to the social, economic, political determination of health, the relations of power behind those relations that inform what is happening in the framework of the crises that we have said that we are living. So the broad action of mobilization, of generation of capacities and of incidence in the content of the policies at all levels, would be important in the movement of the health of the people. But to do that, the movement of the health of the people has to strengthen their leadership, their leadership capacity, in terms of their own structure of internal government, but also in their ability to relate to the dynamics of struggle of other social movements. We are not the only movement that raises the flags of health in a broad and integral way. There are other movements and we will have to know how to dialogue with those movements enthroned in the consciousness, in life and in the popular experience, very deeply. This is an essential task because without it we will not be able to accumulate the necessary forces to transform the realities that we live in. And in doing that, the movement for the health of the people will have to correspond in their work experience to the diversity that represents the global scale. We are a movement of many countries, of many regions, of many continents, of many cultures, of many languages, of many experiences of struggle. And we should reflect that. One of the challenges, for example, is to be able to be a movement effectively multilingual, to be able to understand, to dialogue, to take our messages collectively built around all the corners of the world, to each one of the spaces where people are claiming dynamics of participation, of mobilization, of political incidence. Those are challenges of the movement for the health of the people. And I think that precisely that is what is planning the movement for the health of the people. We have important opportunities that we should take advantage of in that direction. I think that the health campaign for everyone will have to be one of the most important flags that will have to move the movement for the health of the people. And the incidence in democratization of the global governance, without which we will not be able to achieve objectives, will have to be another huge flag of the movement for the health of the people. That is why we call unity, compromise, strengthening, organization, to arrive where we do not have presence or where we are weak, to qualify much more those spaces where we are strong, but we need more quality of our work and to establish very close relations with our affiliated networks, with our friends and friends on the side of those who we must join to make changes in the world today, in the regions and in the countries. It is a dynamic of deep mobilization, of organization, of unity and of struggle. What could condense the clamor of the movement for the health of the people at the present moment? Well, thank you very much. I think they are great, important tasks and just at the heights of the moment, right? I think we can leave it there. I do not know if it has anything else to comment on, if it wants to share some other reflections, it is open. Of course, yes. I think we have to take advantage of this interview that you have kindly organized to give a message of hope, a message of a convocation to action because the moment is this. In Latin America we will have, and this is an invitation that I want to do from here, we will have to join each other to understand what are the challenges that each country faces, what are the opportunities that each country has. For example, we urgently need a Latin American conference to understand what are the proposals for transformation of the health systems that the progressive governments agency, but also to shorten the dynamics of citizen mobilization, solidarity, not only in each country, but among countries. Because we are sure, because of the experience that we have already experienced from other progressive governments, that the changes will not be possible with the only will of the governments. It requires action in the memory of the governments, of their proposals, of their promises, and that claim cannot be done, but the citizenship in conditions of a struggle that we can call democratic, because it is the right that we have to organize ourselves, to speak, to mobilize ourselves, and that is the moment. It is the same call that we make to other regions where the movement of people's health is moving in Africa, in Asia, in Europe. Let's join our hands, our wills, our arms, our actions so that the changes can be possible. This is a moment of struggle, and we will have to organize that struggle with decision and with a lot of will. Well, thank you very much. Well, congratulations for your new moment for the movement of Salud de los Pueblos, y de usted a cargo. Creo que ya dio muchas reflexiones. Creo que ya está claro cuáles son las prioridades, cuáles son las grandes tareas, y un momento de esperanza de lucha, como usted dijo. Mil gracias.