Fwd: qotd: Lancet/Oslo Commission: The political origins of health inequity

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Subject: qotd: Lancet/Oslo Commission: The political origins of health
inequity
Date: Tue, 11 Feb 2014 07:12:33 -0800
From: Don McCanne <don@mccanne.org>
To: Quote-of-the-Day <quote-of-the-day@mccanne.org>



The Lancet
February 11, 2014
The Lancet—University of Oslo Commission on Global Governance for Health
The political origins of health inequity: prospects for change
By Ole Petter Ottersen and 23 other co-authors

Executive summary

Despite large gains in health over the past few decades, the
distribution of health risks worldwide remains extremely and
unacceptably uneven. Although the health sector has a crucial role in
addressing health inequalities, its efforts often come into conflict
with powerful global actors in pursuit of other interests such as
protection of national security, safeguarding of sovereignty, or
economic goals. This report examines power disparities and dynamics
across a range of policy areas that affect health and that require
improved global governance: economic crises and austerity measures,
knowledge and intellectual property, foreign investment treaties, food
security, transnational corporate activity, irregular migration, and
violent conflict.

Global health inequities

* About 842 million people worldwide are chronically hungry, one in six
children in developing countries is underweight, and more than a third
of deaths among children younger than 5 years are attributable to
malnutrition. Unequal access to sufficient, safe, and nutritious food
persists even though global food production is enough to cover 120% of
global dietary needs.

* 1·5 billion people face threats to their physical integrity, their
health being undermined not only by direct bodily harm, but also by
extreme psychological stress due to fear, loss, and disintegration of
the social fabric in areas of chronic insecurity, occupation, and war.

* Life expectancy differs by 21 years between the highest-ranking and
lowest-ranking countries on the human development index. Even in 18 of
the 26 countries with the largest reductions in child deaths during the
past decade, the difference in mortality is increasing between the least
and most deprived quintiles of children.

* More than 80% of the world's population are not covered by adequate
social protection arrangements. At the same time, the number of
unemployed workers is soaring. In 2012, global unemployment rose to
197·3 million, 28·4 million higher than in in 2007. Of those who work,
27% (854 million people) attempt to survive on less than US$2 per day.
More than 60% of workers in southeast Asia and sub-Saharan Africa earn
less than $2 per day.

* Many of the 300 million Indigenous people face discrimination, which
hinders them from meeting their daily needs and voicing their claims.
Girls and women face barriers to access education and secure employment
compared with boys and men, and women worldwide still face inequalities
with respect to reproductive and sexual health rights. These barriers
diminish their control over their own life circumstances.

Conclusion

The overarching message of the Commission on Global Governance for
Health is that grave health inequity is morally unacceptable, and
ensuring that transnational activity does not hinder people from
attaining their full health potential is a global political
responsibility. The deep causes of health inequity are not of a
technical character, devoid of conflicting interests and power
asymmetries, but tied to fairness and justice rather than biological
variance. Health equity should be a cross-sectoral political concern,
since the health sector cannot address these challenges alone. A
particular responsibility rests with national governments. We urge
policy makers across all sectors, as well as international organisations
and civil society, to recognise how global political determinants affect
health inequities, and to launch a global public debate about how they
can be addressed. Health is a precondition, outcome, and indicator of a
sustainable society, and should be adopted as a universal value and a
shared social and political objective for all.

http://www.thelancet.com/commissions/global-governance-for-health

The political origins of health inequity: prospects for change (38 pages):
http://download.thelancet.com/pdfs/journals/lancet/PIIS0140673613624071.pdf


Comment: In reviewing the enormity of the global health inequities and
the problems that perpetuate them, our compromised status in the United
States seems to be minuscule in comparison. Yet when you think of the
difficulties that we do have with addressing our own health inequities,
it is mind-boggling to contemplate the international scene.

In a related Lancet article, Professor Ole Petter Ottersen is noted to
be at pains to point out that this is far from "a doom and gloom
report." Yet they conclude, "Health equity should be a cross-sectoral
political concern, since the health sector cannot address these
challenges alone. A particular responsibility rests with national
governments."

Judging from the difficulties that we have had with merely tweaking some
of our injustices without addressing effectively the major problems, it
is difficult to see how nations will be able to work together in making
real progress in improving the health of all - but we have to try.

As this is being written, Prof. Ottersen, in closing remarks in a live
webcast from the University of Oslo at which this report was presented,
reemphasized that that the improvement in global health will require the
involvement of national political systems. And we thought single payer
was tough.