Ahead of the upcoming 23 July elections, Salud por Derecho wants to remind the different political parties about the need to commit to the health of all. To that end, today we are launching Saludables (Healthy), a campaign that covers a wide range of proposals to address different health issues—from climate change to pharmaceutical policy—but with a singular focus: to protect and improve people’s health, both inside and outside our country, and to defend it as an inalienable human right. The following is what we ask from candidates as we call for healthy elections.
Advance global health and fulfil our international responsibilities.
The COVID-19 pandemic has brought the enormous risks that global health and health systems face to the forefront. Preventing and preparing for future public health crises means leveraging human and financial resources and infrastructures to strengthen health systems and align them with the new circumstances. However, beyond preparedness at the national level, coordination and joint action at the international level are also fundamental.
This is why Spain must continue to fulfil its international responsibilities, demonstrating its commitment to global health and to fighting pandemics through financial support for multilateral organisations such as the Global Fund to Fight AIDS, Tuberculosis and Malaria. It must also ensure compliance with Cooperation Law 1/2023, allocating 0.7% of its gross national Income to official development assistance by 2030.
Along these same lines, Spain must also take an ambitious role in negotiating the future Pandemic Treaty. This new legal instrument offers a crucial opportunity to address the challenges that new health emergencies pose, and effective measures must be adopted to ensure equitable access to the vaccines, diagnostics and treatments that are developed. People and the public interest must be at the heart of the Treaty and equity and social justice must be ensured under these terms.
Pharmaceutical and research policy: change the rules of the game to ensure access to medicines.
We have been speaking out against the failures of the current medicines innovation system for years, a model in which the pharmaceutical industry imposes the rules of the game, forcing us (among other consequences) to pay exorbitant prices for cancer and rare disease treatments; countries with fewer resources are also denied access to vaccines for COVID-19. Candidates up for election on 23 July must commit to bold initiatives that will drive change at both the national and European level.
One of the most urgent initiatives is to change the way medicines and other health equipment are priced. To this end, transparency across the entire innovation model must be enhanced, starting with identifying the real costs of research, development and manufacturing behind each medicine so that fair prices can be set without leaving it to the pharmaceutical companies who, safe in their monopolies, set prices according to what governments are willing to pay.
This would prevent, for example, the pharmaceutical costs for our hospitals from continuing to rise, which puts the sustainability of the National Health System at risk whilst taking money away from other equally critical areas, such as health care staff. We also need transparency in these negotiations: we cannot continue to allow companies to impose non-disclosure agreements. This is public money, and the public has the right to know how it is being spent and by what criteria.
Another key issue is the research agenda. Research areas must be defined by the needs of the population and not by the interests of industry, which is currently the case, because we have already seen the consequences: ultimately, research is only conducted on the most profitable diseases with the most expensive medicines, such as cancer, leaving new antibiotics or diseases that particularly affect countries with fewer resources, such as Chagas disease and other neglected tropical diseases, for example, behind.
Likewise, all public investment in R&D must be subject to conditions that ensure that the outcome of this research has a social benefit and is accessible to everyone who needs it. Along these same lines, it is important to be firmly committed to the public production of medicines, investing specifically in therapies that our public health system is developing, like the new CAR-T immunotherapies. The research that is being done at our public hospitals and research centres must be safeguarded to keep it from ending up in private hands.
Similarly, we need to ensure that patents are not an obstacle to future access to medicines produced because of research, preventing monopolies from developing.
In short, we need our representatives to commit to adopting measures that promote an alternative model of pharmaceutical innovation, one that is committed to science and that makes the public sector a priority, placing medical innovation at the service of people and the public good.
Stop the threat that climate change and air pollution pose to our health.
The government that takes office following the election on 23 July must take a strong stance on climate change, which has a direct impact on people’s health and well-being. It is now widely accepted that exposure to extreme heat increases cardiovascular and respiratory diseases, heat stroke, and increased issues with pregnancy and mental health.
But it goes much further: rising temperatures and extreme weather events also threaten crop yields, the availability of food and drinking water and lead to the spread of infectious diseases such as malaria and dengue fever. Furthermore, air pollution from fossil fuel emissions from transport and industry, which are also responsible for global warming, is the number one environmental cause of early death in the European Union.
It is therefore vital that candidates commit to implementing public policies that ensure compliance with the international commitments that our country has made. Spain must implement national policies that limit global warming to 1.5ºC, meeting the objectives of the Paris Agreement, and build a green and clean economy that addresses the multiple challenges to achieving a fair energy transition that leaves no one behind.
National policies that tackle a comprehensive and cross-cutting climate change mitigation agenda geared towards reducing greenhouse gas emissions must also be pursued, as well as initiatives that help us adapt to the new circumstances that the impact of climate change is already creating.
Candidates must commit to spearheading the approval of the new air quality directive that is currently being developed during the Spanish Presidency of the Council of the European Union. This new standard should align with the World Health Organisation’s 2021 recommendations on air quality limit values.
There is also a need to raise the funding required for a Loss and Damage Fund to help people in the most vulnerable countries cope with the impact of climate change on their communities.
Migrants’ right to health.
Here, we continue to call on our political representatives to ensure that the public health system covers all migrants who live in our country. Although some progress has been made since 2012, when a Royal Decree put an end to the universality of healthcare, most notably through RD law 7/2018, there are still obstacles to access to our National Health System for many migrants. It is a reform that has remained pending during this legislative term.
The Spanish Government must guarantee the right to health care for everyone who lives in Spain, regardless of their immigration status, by recognising their right to publicly funded health care and thus restoring truly universal health care. Candidates must commit to eliminating the requirement of a minimum length of stay in Spain before migrants can access health care and guarantee care for people under the age of eighteen, pregnant women, applicants for international asylum, the stateless, victims of trafficking, as well as people in public health and emergency care situations, across the board. Furthermore, candidates must promote whatever legislative changes are needed to ensure that relatives who come to Spain through a family reunification process are entitled to publicly funded health care.
Europe is currently negotiating a new pact on migration and asylum that is even more restrictive, criminalising people who are forced to migrate from their countries of origin. We call on our political representatives to commit to a European migration policy that has human rights at the EU’s borders at its core, as well as to comply with existing maritime laws and enforce effective transparency and accountability mechanisms.
