Wednesday, 14 September 2011

Social Determinants of Health. WHO EURO meeting, second day

This is a small update after the second day of the 61st WHO European regional commitee in Baku. Higlights are also available at the WHO EURO website. Let me outline two items from its agenda.

Firstly, the address by WHO DG Margaret Chan. Here some excerpts:

"The greatest challenge of our health plans: maximizing measurable and equitable health gains at a time when budgets for health, nationally and internationally, are stagnant or shrinking."

"Stronger leadership from WHO can promote greater coherence in the actions of multiple health partners and better alignment of these actions with priorities and capacities in recipient countries."

"We need to do a better job in communicating the nature of our work and the impact it has. Even our biggest supporters tell us this. If we want parliamentarians to fund the work of WHO, their constituents need a much better understanding of what we do and why it is important."

"The world needs a global health guardian, a protector and defender of health, including the right to health. Reform in WHO, in my view, starts from a position of strengths: the unique functions and assets of the Organization."

These messages indicate that there is not only a need for an internal WHO reform, but there is sorely needed public and political debate at national level requiered. What is the relevance and value for money that WHO can bring as multilateral agency facing complex health problems? Is WHO merely a development organisation for Low and Middle income countries or is it a global health organisation relevant for national health issues? Within countries facing expanding health budgets; we have as civil society to advocate and debate that (investments in) a global health guardian and leader is best for all our health.

Secondly; member states elaborated further on the Health 2020 strategy, via a ministerial panel on health equity. Member states could exhange here concrete examples to adress the social determinants of health and intersectoral cooperation. Sir Michael Marmot initiated the discussion by focusing on three elements that the health sector, health workers and minsters of health can do to reduce health inequities. 
  1. To put it's house in order to guarantee qualitative services and universal health coverage.
  2. To be a health advocate and embrace cross-sectoral action; whether at WHO/ ministerial or at frontline health care level.
  3. To provide the evidence on health equity and addressing the social determinants by proper monitoring and evaluation.
At the end of the ministerial panel (see for the member state examples highlights of day 2), a general consensus emerged that health ministers should not only address disease control and prevention, but must really engage and guarantee for health with other sectors (like agriculture, transport, financing, housing and education).

Let me end with the final remarks by Michael Marmot:

"With the work on health equity, the European health 2020 strategy and upcoming world conference on social determinants of health, we reach a moment of great clarity in how we have to improve health, similar to the establishment of WHO over 60 years ago, and the Alma-Ata declaration on primary health care 30 years later".

Remco van de Pas

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