Editorial: Social determinants of health – redistribution, regulation and rights

Dear reader,

The evidence for political action on the social determinants of health is assembled by the WHO Commission on Social Determinants of Health (CSDH) in its report “Closing the gap in a generation: Health equity through action on the social determinants of health” (2008). The Commission concluded that “unequal distribution of health-damaging experiences is […] the result of a toxic combination of poor social policies and programmes, unfair economic arrangements, and bad politics”. The report provides the basis for a moral imperative to take equity as a core principle in the health sector and as priority for general government, both at national levels and within the global sphere.

Last week the first World Conference of Social Determinants of Health (WCSDH) was held in Rio de Janeiro. There has been some excellent analysis and updates written on this conference and its directions. In essence, during the Rio conference the core issues of our time that affect health and well-being were discussed rather cautiously by the government delegations. The recent financial, food and fuel crisis and the ‘slow-burn’ climate and development crises were acknowledged by all, but states failed to agree upon binding and coherent global frameworks to deal with these issues. Such a framework for action was six years ago described by Bob Deacon and colleagues in a policy brief of the Globalism and Social Policy program. They called upon securing “the 3 Rs” of redistribution, regulation and rights which are fundamental to our wider social vision. These policies should provide for:

  • systematic resource redistribution between countries and within regions and countries to enable poorer countries to meet human needs,
    effective supranational regulation to ensure that there is a social purpose in the global economy, and
    enforceable social rights that enable citizens and residents to seek legal redress where necessary against unjust or ineffective governments at whatever level.

Six years later, health inequities within and between countries have grown because the financial sector, transnational cooperations working in the food, energy and mining sectors, as well as political elites did not agree upon or respect these policies. Rather they function in a clout of “self-regulation” and “voluntary codes”, often part of the so-called corporate social responsibility. That is why there is so strong voice by many participants of the Rio conference to enforce corporate social accountability, not merely by big commercial actors, but similarly via advocating parliamentarians and governments that they have the obligations to respect their citizens’ rights above the drive for unsustainable economic growth.

Alas, the WHO member states present in Rio agreed upon a rather general, soft-toned “political declaration” while a group of public interest civil society organizations, academia and individuals produced an Alternative Rio Declaration that addresses the health and social crises much more upfront. I signed onto the alternative declaration for Wemos and the Medicus Mundi International Network which I represented at the Rio Conference.

Remco van de Pas, Wemos
remco.van.de.pas@wemos.nl

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Editorial adapted from a post of Remco van de Pas at “Get involved in global health!”, the global health policy blog of the MMI Network. Original version dated 20 October 2011 with references and links to resources: http://bit.ly/qqrtjn.

 

MMI Network: News, Events and Resources

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MMI Network meeting and conference
Mother and Child health – before and after 2015
Brescia, Italy, 27-28 October 2011

The future of mother and child health is the focus of a conference jointly organized by Medicus Mundi Italy and the Medicus Mundi International Network, on Friday, 28 October 2011 in Brescia, Italy, The afternoon before the conference, on 27 October 2011, MMI Network members are invited to a Board meeting and an extraordinary Assembly at the office of Medicus Mundi Italy.

www.bit.ly/mmi-brescia

 

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MMI Network event: DWA Cuamm
Mothers and children first
Padua, Italy, 5 November 2011

“Last year, on 11th November Doctors with Africa Cuamm celebrated its 60th anniversary. On that occasion, we publicly asserted one of our commitments: to guarantee mothers access to safe childbirth and neonatal health free of charge, thereby contributing in an innovative, albeit indirect way, to achievement of the 4th and 5th Millennium Goals, i.e. the reduction in maternal and childhood mortality. We wish to keep up the fight and spend all our energy in giving signals that go against the tide compared to the current crisis situation and period of decline. We wish to activate the positive energy in that part of Italy that bravely looks towards a more just future, for Africa too. The event on 5th November will be a new opportunity to say, all together: Mothers and children first!”
Source | ”Text mit Bild” Comment (Source)

www.mediciconlafrica.org/en/mothers-and-children-first

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MMI Network papers: DWA Cuamm
Mothers and children first. Mothers’ access to safe childbirth
and neonatal health free of charge

“We continue to work towards strengthening healthcare systems, which has become our key strategy for achieving the Millennium Development Goals (Strategic Plan 2008/2015). In particular, maternal and neonatal mortality are considered to be indirect indicators of healthcare system functioning in terms of service coverage, equity and quality of services. This is why Doctors with Africa Cuamm has, practically and operationally, decided to concern itself primarily, but not exclusively, with maternal and child health through its various programmes and projects. The poor results achieved in Africa in the field of mother-child care have prompted the United Nations General Assembly, held last 22nd September in New York, to launch a global strategy for mother and child health centred on the healthcare system: the continuum of care and primary care at district level (hospital, peripheral health network, families and communities). This confirms that the choice made in 2008 was the right one. Now we have to work intensely to adjust and improve the tools and methods used in our interventions.” (Prima le mamme e i bambini. Mothers and children first. DWA Cuamm, September 2011, English and Italian in one report)

http://bit.ly/p2g6eZ

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MMI Network event: action medeor / Misereor
Doha+10
Berlin, 24 November 2011

The MMI Network members action medeor and Misereor are co-organizers of a conference organized by Action against AIDS Germany: Doha+10. Ten years after the 2001 “Doha Declaration on the TRIPS Agreement and Public Health” – has the access to medicine been improved through or despite the new World Trade Organization frame work? The 2001 „Doha Declaration on the TRIPS Agreement and Public Health“ reaffirms the right of the WTO member states to interpret and implement the TRIPS Agreement to protect public health and to enhance access to medicines. In particular, it confirms the member states’ right to issue compulsory licenses. 10 years after adopting the Doha Declaration, the Doha+10 Conference will assess if these goals have been achieved. | ”Text mit Bild” Comment (Source)

Conference announcment (German): http://bit.ly/oyMgl
Conference flyer (English, PDF): www.bit.ly/peQWuE

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MMI Network news: Wemos
Ethics: from the shadows to the spotlight
Protection of clinical trial participants in countries outside the EU

“No less than fourteen members of the European Parliament took part in the lunchtime debate that Wemos organized in Strasbourg on 14 September 2011 on the subject of unethical drug trials in developing countries. Such a large turnout is unique in the history of Wemos and clearly shows the effectiveness of our lobbying strategy. After the debate, Annelies den Boer from Wemos addressed the European Parliament’s Bioethics Committee. She is impressed by the European measures in the pipeline to combat unethical trials.”

Wemos news release, 11 October 2011: www.wemos.nl/news   
More information on Wemos’ work on medicines: www.wemos.nl/Eng

 

International Health Policy: MMI Updates

Since we started to use the real-time short messaging service “Twitter“, we published there already more than 1300 bits and pieces of news on international health policy. Each update is 140 characters or less – these are the rules of the game. Just enough for a headline, eventually an author, a date, the source – and a shortened link to the website where you find the full information. Have a look at some of our “tweets” published during the last month:

  • Reclaiming solidarity is fundamental for Health for All. Thomas Gebauer in: Equinet Newsletter
    http://bit.ly/qekfNl
  • Planning Guide for the Health Sector Response to HIV. Mazuwa Banda et al., WHO October 2011 (pdf)
    http://bit.ly/r0UTMb
  • Gender mainstreaming in WHO: what is next? Midterm review of WHO Gender Strategy. I Araujo de Carvalho et al., WHO 2011
    http://bit.ly/nNLPEI
  • NCDs: Despicable effects and disgraceful actions. Will Pepsi have the last hurrah? Richard Horton “offline” in: Lancet
    http://bit.ly/pdWcFO