Some notes and lessons from the first day of the WHO World Conference on Social Determinants of Health
Rio de Janeiro – Representatives from about 120 countries, including 60 ministers, gathered for what is estimated to be the largest health conference since Alma Ata. This three day event, convened by the World Health Organization and hosted by the Government of Brazil, brings together representatives from all sectors of society and will culminate with the likely endorsement of a “Rio Declaration on Social Determinants of Health,” which will outline the agreements and pledges to improve the social conditions that affect health.
Today at the conference, the overall mood was optimistic as leaders in public health and politics outlined steps that countries could take to improve equity in countries across the globe. In recent years, inequity has grown within and among countries, as globalization has created big benefits for only some nations and pushed others toward even greater poverty.
In her remarks, World Health Organization Director-General, Dr. Margaret Chan, stressed the importance of sustainable development and of governments coming together to address the social determinants of health. Dr. Chan stated that a country without equity and good access to social services, including education, health, water and sanitation and proper housing, is not a good society. A number of today’s panelists stressed the economic burden of poor health. Rebecca Grynspan, UNDP associate administrator and former vice president of Costa Rica put it best when she said, “Being poor in this world is very expensive.” Countries could save a great deal of money by improving the health of its citizens, something that is becoming more important in light of the recent economic crisis.
The most important lesson to take away from this conference is the importance of inter-sectoral cooperation. Dr. Chan stresses the importance of participation of all stakeholders, and particularly civil society. In a press conference she said,”The power is in the hands of the people. The people of each and every country need to tell their political leaders what is important.” She believes that civil society can really drive changes. In addition she emphasizes the importance of communication and media, which create a level playing field and allows for a well informed public that will be able to better inform their representatives of their expectations. She points out that she, as the director-general, can only advocate and that the power is in the hands of the people.
It is important to increase knowledge and social mobilization to close the gap in health. In order to create sustainable development, governments must work with their citizens, as community and stakeholder participation are essential.
One topic that got particular attention, probably in light of the UN High-Level Meeting was non-communicable diseases (NCDs). During the opening roundtable, a number of panelists pointed to health inequities with regards to NCDs. Padilha pointed out that you must alter social determinants to lower the rate of NCDs and emphasized that smoking, sedentary lifestyles, unhealthy eating is more common in the poorer segment of the populations.
Dr. Chan suggests addressing social determinants of health with the three “A”s: Awareness, Action, and Accountability. In light of the recent financial crisis, never has it been more important to address the growing inequities in health and the social determinants that affect health outcomes. Currently, as Grynspan says, “Poor people pay with their health,” as they often have more limited access to healthy food and good medical care, among other things. Hopefully this conference will lead the way to more effective partnerships and allow for countries to discuss plans to address the social inequalities in their country, paving the way for increased civil society engagement and a healthier world.
Gahan Furlane is a blogger for GLOBAL HEALTH Magazine.