Reflections on the Third People’s Health Assembly, South Africa The Third People’s Health Assembly was held in Cape Town, South Africa, in July 2012. Driving through the streets of Cape Town on road to the conference at University of West-ern Cape, one could not ignore the anxiety and insecurity clearly visible in my cab driver’s behaviour. Traffic lights were ‘necklaced’ with burning car tyres- the remnants of a protest by the local community against the failure of basic sanitation and electrical services to the surrounding slum dwellings. However the driver’s paranoia was not shared by many locals at the conference, who have traveled these roads on a daily basis for years without inci-dent. Which brings me to the Peoples Health Assembly. Should we be feeling paranoid about the state of global health, or is there reason for hope? The PHA is a unique mixture of leading global public health figures and grass roots activists from across the globe. The structured language of powerpoint is mixed with the spontane-ity and vibrancy of protest songs and chants. What makes the meetings special is the low representation of policy makers – with the exception of the hosts, South Africa, whose Health Minister made an impressive contribution to the conference. Unlike most global health meetings, where the end result is a stupefying docu-ment representing the global bottom denominator of “acceptable” public health thought, the PHA is an opportunity for thinkers to think, dreamers to dream, and actors to build a platform on which to act. The story told through this window on global health is both uplifting and alarming. On the one hand, we have the extraordinary gains in human development that are occurring in Thailand and Brazil, where millions of people are moving out of poverty and for the first time accessing health care and social support. This is counterbalanced by the dismal reports from UK and Greece, where the decline of the ‘civilised” world is occurring with equal rapidity, with the pending destruction of the poster child of global health systems (the UK National Health Service) and the failure of society (Greece) to look after its citizens. This is coupled with the impotence of global leadership to effectively deal with and pre-vent climate change, massive land grabs as nations and global companies position themselves for the impending water and food crises. Key strategies agreed on at the conference were supporting countries to act on the PHM’s Right to Health Campaign; a global campaign on the adverse health and environmental effects of extractive industries; a food security campaign focusing on the health consequences of the growth of transnational food corporations, and a campaign against the privatisation of health services, which will document the ways in which public ownership and control of health services is being undermined by various forms of public private partnerships and outsourcing of previously publicly provided services. The PHA ended with a call to action – a testimony to the evidence that a better life is within reach of all peoples, and the need for effective action to get there. The world needs events such as this, now more than ever. Visit the PHA website: Presentations and the “Call to Action” are accessible at http://www.phmovement.org/en/pha3 Don Matheson, (d.p.matheson@massey.ac.nz)