6.6 Social determinants of health: outcome of the World Conference on Social Determinants of Health (Rio de Janeiro, Brazil, October 2011)

Secretariat papers 

The Board is invited to consider an account (Document EB130/15) of progress made in the implementation of resolution WHA62.14 on reducing health inequities through action on the social determinants of health, as well as a summary of the outcome of the recent World Conference on Social Determinants of Health, and its political declaration.

Watchers' notes of EB discussion

The afternoon discussion went on with Member States comments on EB Document 130/15: “Social determinants of health: outcome of the World Conference on Social Determinants of Health”. While appreciating the report, all Member States congratulated the Secretariat and the Brazilian Government for the successful conference held in Rio de Janeiro last October.

All Member States reaffirmed their commitment and recognized the importance of incorporating Social Determinants of Health (SDH) in all policies through a multi-sectoral approach raising policy makers awareness on this issue.  In particular Mozambique, speaking on behalf of the African Region, highlighted the importance of addressing SDH if countries want to achieve the Millennium Development Goals.

The Norwegian delegate definitely made one of the most comprehensive statement. He mentioned equity as common denominator, he recalled the need for a strong WHO to provide technical support and guide Member States in implementing strategies based on a SDH approach, and finally proposed to include SDH in non-communicable diseases monitoring. It is important to report that Switzerland proposed to held a High Level Meeting on SDH in 2013.The Swiss delegate also questioned the health sector capacity to effectively engage in true dialogue with other sectors to develop coherence. As an example, he reported that “in Rio, we seemed to only have health ministries represented. We didn't really have a multi-sectoral approach".

The last who took the floor was the civil society with the statement by Medicus Mundi International (MMI) and People’s Health Movement (PHM). While recognizing that the Rio Conference was an excellent initiative, MMI and PHM stated that the opportunity to purposively build upon the valuable report of the Commission on Social Determinants of Health was actually missed.

They urged Member States to consider the following as imperatives while addressing the SDH:

1. Building and strengthening of equity-based social protection systems and effective publicly provided and publicly financed health systems.

2. Use of progressive taxation, wealth taxes and the elimination of tax evasion to finance action on the social determinants of health.  

3. Use of health impact assessments to document the ways in which unregulated and unaccountable transnational corporations and financial institutions on the one hand, and the global trading regime on the other, constitute barriers to Health for All.

4. Reconceptualisation of aid for health as an international obligation and reparation, that is legitimately owed to developing countries under basic human rights principles.  

5. Development and adoption of a code of conduct in relation to the management of institutional conflicts of interest in global health decision making.  

6. Development of monitoring systems that provide disaggregated data on a range of social stratifiers as they relate to health outcomes.

The discussion on the resolution on SDH proposed by Brazil, Chile and Ecuador closed this session.

The main objectives of this resolution would be the endorsement of the Rio Declaration by WHA 65th as well as the inclusion of SDH as a priority in the WHO reform process. Estonia, on behalf of European Union, and Canada requested to shorten the Rio Declaration and build the resolution on it without going beyond the wording there used.  

PHM Comment

See WHO Watch topic page and WHO SDH site for background. 
 

PHM Comment at EB130

Document EB 130/15 reports on the World Conference on Social Determinants of Health held in Rio de Janeiro in October 2011. The conference was an opportunity to purposively build upon the valuable report of the Commission on Social Determinants of Health.
Unfortunately, in many ways, the Conference was an opportunity missed. The political Declaration does not break new ground and does not chart out a fresh approach to problems that are widely acknowledged as pervasive, acute and requiring urgent attention.

We urge Member Countries to consider the following as important imperatives while addressing the social determinants of health:

1. Building and strengthening of equity‐based social protection systems and effective publicly provided and publicly financed health systems.

2. Use of progressive taxation, wealth taxes and the elimination of tax evasion to finance action on the social determinants of health.

3. Use of health impact assessments to document the ways in which unregulated and unaccountable transnational corporations and financial institutions on the one hand, and the global trading regime on the other, constitute barriers to Health for All.

4. Reconceptualisation of aid for health as an international obligation and reparation legitimately owed to developing countries under basic human rights principles.

5. Development and adoption of a code of conduct in relation to the management of institutional conflicts of interest in global health decision making.

6. Development of monitoring systems that provide disaggregated data on a range of social stratifiers as they relate to health outcomes.