Feedback to the Drafting Committee on the discussions on:

a) The Role of the State
b) Water, Sanitation and Primary Health Care in the context of Globalisation

Situational analysis
· Debt and globalisation are impacting negatively on the distribution of all resources, including environment and health, through their destruction and privatization.
· Environmental degradation is increasing the burden of ill health
· Lack of knowledge about environment and health and hygiene are sorely lacking amongst many citizens, especially children.
· Environmental services are a basic right which every citizen should enjoy
· Privatisation of services, including through public private partnerships, has been a very negative experience for many poor people, especially women and children, in countries as diverse as the UK and Argentina
· War and military occupation both severely restrict access to health and basic services, and conflict and psychological stress are also increasingly a result of struggles for access to these services

Priority issues
· Globalisation is driving inequity through privatisation of all public services (water, sanitation, health, and other public services)
· Public Private Partnerships may reduce government deficits, but are impacting negatively on the health of the poor, and are also affecting the general population through spread of communicable diseases
· Local involvement and public-public partnerships for provision and governance of basic services should be prioritised: positive lessons can be learnt from Brazil

Specific recommendations
· Scrapping of debt is a prerequisite for health improvement in poor countries
· The negative effects of privatisation of public services must be exposed to both communities and governments through research and advocacy
· Governments must be rendered accountable through evidence based advocacy and community mobilization and must assume responsibility for provision of basic services through funded partnerships with local communities
· Communities need to have control over the provision of health and other social services and play a role in their monitoring
· The importance of the relationship between environment and health and hygiene needs to be integrated into learning programmes at all levels.
· Learning and advocacy should be promoted at global level through interchange between countries, especially South to South
· Powerful governments must be called to account for continuing military occupation and fuelling of conflict which impact mainly on innocent civilians

Conclusion
· Unfettered globalisation threatens the planets environment and population health. Urgent steps must be taken to prevent the spread of re-emerging diseases which will affect us all.