Resisting Empire and Building an Alternative Future in Medicine and Public Health

Public health and health services have played important roles during the rise of empire and during its subsequent decline. Conditions during the 21^st century have changed so that a vision of a world without empire has become part of an imaginable future. Latin America has become an especially fertile ground for resistance against neoliberal policies that favored privatization and cutbacks in public services, and for the emergence of alternative policies not based on the neoliberal model.

We offer an updated analysis of several popular struggles in which we have participated during the past decade as researchers and activists.  These struggles include resistance against the privatization of health services in El Salvador and against the privatization of water supplies in Bolivia, as well as efforts to expand public-sector health services in Mexico.  Such scenarios convey a picture very different from that of the historical relation between empire and health – a picture that shows a diminishing tolerance among the world’s peoples for the public health policies of empire and a growing demand for public health systems grounded in solidarity rather than profitability. This change involves demands for popular participation in policies related to natural resources such as water, as well as health services and medications. The struggles considered here confirm certain core principles of public health: the right to health care, the right to water and other components of a safe environment, and the reduction of illness-generating conditions such as inequality and other social determinants of ill health and early death.