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Activism and the Struggle for Health

Learning objectives

This topic has been developed to enable participants to:

  • develop a shared understanding of the role of social movements in ‘the struggle for health’ and the role of a ‘people’s health activist’ (what does an activist do?);
  • identify and analyse the kinds of skills and knowledges that are needed to support activist work in the particular settings in which they are working;
  • identify our own personal learning needs and develop appropriate learning plans.


People's Health Activism provides an overview account of people's health activism and links and references to further reading. It commences with five case studies of activism and some headings for reflection. It includes brief notes on the logic of the social movement and the role of the activist. The paper characterises the elements of activist practice in terms of principles, forms of action and skills. It includes an annex on policy analysis. 

There have been people (as individuals, organisations and networks) working towards better health care and working to address the social determinants of health in many different settings and countries and for many decades (and centuries). Until recently these were local struggles which were largely oriented around local circumstances and the ‘need’ to become part of a global people’s health movement was not so pressing. However, with increasing globalisation it is clear that even the most ‘local’ issue or struggle has at least some roots in the economic and political dynamics and the policy discourses at the global level.

PHM brings to this conjunction two different values. The first of these is a clear focus on globalisation and health informed by a clear analysis of the political economy of health at the global level. However, PHM also provides inspiration and organisational support for activist engagement on local and more specific issues where there is presently little activism.

The vision of a ‘global people’s health movement’ does not imply some kind of absorption of the huge diversity of individuals, organisations and networks who are part of this wider people’s health movement into a monolithic, centrally organised PHM. These individuals and organisations have their own history, commitment and identity. To speak of strengthening the people’s health movement implies stronger communication links and collaboration when appropriate. However, the diverse purposes, ways of working and identities should in no way be compromised by building closer links through the PHM with the rest of the wider people’s health movement globally; indeed this rich diversity is the movement.

PHM engages of course with the contemporary politics of health development but a major function of PHM, as an organisation / network is movement building: building the people’s health movement.  More about Building PHM.  

We are not the first generation of political activists. Our history has been created through the struggles of thousands of generations of activists. It makes sense to try to learn from their experience.  One approach to synthesising some of the lessons of this experience is to review the political theories which have informed or arisen out of these generations of struggle. Reflecting on the theories which have emerged from previous activist engagements invites us to be more reflexive about the theories which inform our own practice.  Political theory gives us a language for talking about the strategies of activist engagement and the contexts within which such activism takes place.  Political theory for activists provides a starting place for such an exploration. 

Discussion Questions

Case studies

Read the case studies of health activism in the background paper:

  • the Promotores de Salud in Guatemala
  • Community monitoring in India
  • Treatment Action Campaign
  • Universities Allied for Essential Medicines
  • WHO Watch

Reflect on the three analytical questions:

  • what were the large scale dynamics of social change that the activists were engaging with?
  • what were strategies (drivers of change) deployed by these activists?
  • which of the ‘levers of power’ (inspiration, delegitimation, mass refusal, practising differently, others) can we discern in these episodes?

Read also also the story of the Green Area of Morro da Policia. Reflect on these analytical questions here also: the large scale dynamics of social change; the strategies deployed by the activists, and the levers of power. 

Elements of activist practice

The background paper identifies the elements of activist practice in terms of principles, forms of action and skills. Do these make sense?  What is missing? 


Identify an episode of social change relating to health which involved popular struggle (like the campaigns linked above); hopefully this will be an episode that you were involved in; otherwise find such an episode in the literature or on the web (other than those referred to above). 

Prepare a brief description of the background, context and what happened. Identify  the large scale dynamics of social change that the activists were engaging with; identify the strategies deployed by the activists, and the levers of power which they sought to access. Discuss the theories of social and political change which might have informed the work of the activists.