In the magazine
Debate
Special reports
- Special Report: Greening the global economy
- Special Report: Cities of the world unite
- Special report: The power of value chains
- Special report: Social academia
- Special report: Who is the enemy?
- Special report: The rise of solar energy
- Special report: Health for all
- Special report: Deep democracy
- Special report: Wobbly legs
- Special report: The Dutch treatment
RSS Feeds
Authors
Radical new approach to global health
Special report: Health for all
January 30, 2009 Françoise Barten and Ted Schrecker and David Woodward
Despite major advances in knowledge and unprecedented gains in global wealth, health inequities between the rich and poor are increasing, both within and among countries (1). Poverty, poor living and working conditions and the inability to influence these conditions are directly related to poor health. The 2008 report of the World Health Organization’s (WHO) Commission on Social Determinants of Health observes that ‘social injustice is killing people on a grand scale’ (2).
The WHO report is one of three recent publications that highlight the urgent need to improve universal access to health care by means of a new approach to health. This approach, which is gaining momentum among specialists worldwide, involves addressing health issues in a comprehensive way – with a focus on systems instead of sectors – and tackling head-on the socio-economic causes of poor health and health inequity.
It is not the first time that such a proposal has been made. The Alma Ata Declaration of 1978, which established the ‘Global Strategy for Health for All (HFA) by the Year 2000’, emphasizing the need for a new international economic order as a prerequisite to reducing health inequity (3). This was not realized. Today’s call to revisit the essence of Alma Ata assumes special urgency as governments rethink the operations of the global economy in the wake of the 2008 financial crisis. Moreover, it comes at a time of profound changes in the global health policy landscape, as private funders take an increasingly influential role.
Based on the insights of the three recent publications – the Commission on Social Determinants of Health report, the World Health Report 2008 and Global Health Watch 2 – this special report analyzes the current situation and points to approaches to reduce health inequities, including what needs to be done, how, and by whom. It highlights the need, not only for a reorientation of global health policies and priorities, but also for fundamental changes to the global economy and genuine democratization of global governance.
By Françoise Barten, a senior scientist in international health at the Radboud University Medical Centre, UK, in the department of primary and community care; Ted Schrecker, a scientist and associate professor at the University of Ottawa’s Institute of Population Health and David Woodward, an independent consultant on development issues and previously the head of the New Global Economy programme at the new economics foundation in London.
Footnotes
(1) Marmont, M. (2007) Achieving health equity: from root causes to fair outcomes. The Lancet, Volume 370, Issue 9593.
United Nations Development Programme (2005). Human development report 2005- International cooperation at a crossroads: aid, trade and security in an unequal world. UNDP.
(2) Commission on Social Determinants of Health. (2008) Closing the Gap in a Generation: Health equity through action on the social determinants of health (final report). WHO. Retrieved via the WHO website.
(3) WHO. (1978) Declaration of Alma Ata: Report on the International Conference on Primary Health Care, Alma Ata, ISSR. WHO.
From Alma Ata to Almaty
January 30, 2009 Françoise Barten , Ted Schrecker , David Woodward
The global health policy landscape has changed considerably over the past decade. There is more money available to allocate to health initiatives than ever before, a large percentage of which has come from private funds and public private partnerships (PPPs). Some experts have welcomed these changes, while others have had considerable reservations. Despite positive developments, such as increased access to antiretroviral therapy for patients with HIV/AIDS, the health situation in poor countries and for the poor communities of rich countries remains abominable. It is often in the world’s poorest countries that the highest percentage of health costs is met with private, out-of-pocket spending. This creates poverty traps that can be impossible for people to escape. Read more>>


Readers' Comments
Please log in to make your comment. In order to log in you may have to first register.