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World conference on social determinants of health 2011


From 19-21 October 2011, World Health Organisation Member States and civil society and social movement representatives met in Rio de Janeiro, Brazil, to discuss the social, economic and political determinants of health.

Read our blog on the conference:
“Healthy and unhealthy lives – socially determined”

Declaration by Civil Society Organisations & Social Movements, 18 October (inc Health Poverty Action)

Urgently required actions by Member States and the World Health Organisation include:

  • Implement equity-based social protection systems and maintain and develop effective publicly provided and publicly financed health systems that address the social, economic, environmental and behavioural determinants of health with a particular focus on reducing health inequities.
  • Use progressive taxation, wealth taxes and the elimination of tax evasion to finance action on the social determinants of health.

The Alternative Declaration was endorsed by 22 civil society public interest organisations and networks and more than a hundred individuals. More signatures are being received evey minute. Endorse the declaration or share your comments at globalsecretariat[at]phmovement.org


Health Poverty Action and Baby Milk Action Press Release


Health campaigners: Rio Declaration betrays the promise to “close the gap in a generation”

Rio de Janeiro: 20 October 2011 [updated: 21 October 2011]

Health campaigners have expressed their disappointment with the Rio Declaration issued by the WHO World Conference on Social Determinants of Health today, 21 October. Campaigners had gathered at the meeting in Rio de Janeiro (note 1) to call on government representatives to counter what WHO’s own expert Commission called “the toxic combination of poor social policies, unfair economic arrangements and bad politics” which results in the unequal distribution of health-damaging experiences (note 2). Campaigners are concerned that the Rio Political Declaration on Social Determinants of Health will do little to address growing health inequalities or to prevent the wholesale privatisation of public health systems, which some governments are already ushering in under the cover of deficit reduction strategies during the current financial crisis.

Professor David Sanders of the University of Western Cape received a standing ovation during the final discussion panel on the closing day of the conference after questioning why trade, climate change, the brain drain of health workers from developing countries to rich countries and other issues have been totally ignored in the official Rio Declaration.

Campaigners have issued an alternative civil society Rio Declaration (note 3), developed through widespread consultation in a process led by the People’s Health Movement. Many of the recommendations made there coincide with the recommendations of the Commission on the Social Determinants of Health, which WHO itself set up. Its recommendations relating to the need to redistribute power and resources have been largely ignored – or buried, in the words of Professor of Public Health Fran Baum from Flinders University in Australia, one of the members of the Commission speaking in Rio.

Action items campaigners wanted to be introduced into the official declaration include:

  • Use of progressive taxation, wealth taxes and the elimination of tax evasion to finance action on the social determinants of health;
  • Regulate and protect populations from health hazards emanating from commercial activities, such as those created by the tobacco, alcohol, breast-milk substitutes, high fat and sugar processed food, and the petroleum and extractive industries.
  • Develop and adopt a code of conduct in relation to the management of institutional conflicts of interest in global health decision making (note 3);
  • Provide equitable universal health care coverage including high quality promotive, preventive, curative and rehabilitative health services throughout the life cycle, based on comprehensive primary health care;
  • Press for high income countries to adequately compensate poor countries for their substantial losses in the form of migrant health professionals; innovative mechanisms that may include repatriation to sending countries of taxes paid by immigrant health professionals should be explored.
  • Recognise explicitly the ways in which the current structures of global trade regulation shape health inequalities and deny the right to health;
  • Develop and implement reliable measures of societal wellbeing that go beyond economic instruments.

Mike Brady, Campaigns and Networking Coordinator at Baby Milk Action, said: “Social determinants of health is a shorthand term for the social, economic, political, cultural, and environmental factors that impact on health. WHO Director General, Dr. Margaret Chan, said during the opening ceremony, ‘We have to put the health of people before the health of corporations’, which is right, but we needed WHO, meaning the Secretariat and the Member States, to commit to action, not just issue platitudes. Member States must reassert their democratic legitimacy to set health policies in the public interest and face down vested interests that continue to sabotage health, often while proclaiming to be a force for good. On this occasion our leaders have failed the people they are supposed to represent.

Corinna Heineke, Head of Policy and Campaigns at Health Poverty Action, adds: “The marginalisation of poor people is both a result and a cause of poor health. In order to tackle the shocking inequalities and health outcomes of the poorest we don’t just require doctors, nurses and well-equipped clinics. We also need to address the structural causes of poor health such as trade systems that deny the poorest access to medicines or the racism that prevents indigenous mothers from seeking skilled assistance during birth complications. Unfortunately WHO Member States have failed us on the political economic determinants of health.

Notes for editors
1.    For details of the WHO World Conference on Social Determinants of Health: https://www.who.int/sdhconference/declaration/en/
2.    For the Commission on the Social Determinants of Health report “Closing the Gap in a Generation”: https://www.who.int/social_determinants/thecommission/en/
3.    For the Statement of Concern from the Conflicts of Interest Coalition (consisting of 147 civil society organisations and networks): https://coicoalition.blogspot.com/2011/09/coi-coalition-statement.html

Video from the final roundtable debate

Watch a video of Prof David Sanders’ talk at the final roundtable of the conference. He is a paediatrician, member of the People’s Health Movement and a Professor Emeritus of the University of the Western Cape, South Africa.

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