2012: EC/WHO global agreement on health inequities at the global level

Key elements of the agreements

Health inequalities should be addressed with the human rights approach: besides helping countries to increase their financial and management capacities, communities need also support to be empowered to know, use and demands their rights, including the right to access to equitable health services.

Specific action points for 2011 included collaboration on:

  • The European SDH health divide review and in preparation of the Rio Conference.
  • Developing tools for policy-making and guidance for equity-based approaches
  • Inequalities in non-communicable diseases, in the context of the forthcoming Moscow consultation and beyond
  • The inequalities dimension of the joint work on healthy and active ageing.

Update on the progress made with the implementation of the agreements so far

Most of the work of SDH in WHO has focused in the organization of the World Conference on social determinants of health (Rio de Janeiro October 2011) when a Rio Political declaration was approved. A resolution endorsing the Declaration was approved by WHO’s executive board and is to be considered by WHA65.

  • Several WHO control of diseases programmes are in different levels of incorporating a SDH approach aimed at increasing effectiveness in achieving equity targets of those programmes.
  • Manuals to guide health equity metrics have been produced by WHO and progress was achieved in documenting the process of institutionalization of health impact assessments in the sector normativity.
  • EC services (DG DEVCO in the lead) supported EU Delegation in Geneva in the preparations for the Rio Conference on SDH, in particular in commenting of the draft Rio Declaration and in participating in the final negotiations of the declaration.
  • EC-WHO cooperation on supporting countries in moving towards Universal Health Coverage under the Investing in People 2012 programme is in preparation (about 10 countries will benefit from the cooperation). An equity approach will be key for in-country support on further developing social health protection and health financing policies and strategies.

Major challenges

  • Operationalizing a social determinants of health approach for concrete country action due to broad scope of the topic and little action orientation of the Rio Declaration on SDH.
  • Political interest from MSs and key CSOs actors has substantially increased but limited capacities at country levels weaken public policy responses.
  • Global financial crisis is creating new problems and making the equity agenda more challenging.
  • Health financing mechanisms at the country level do not provide necessary social protection and access to health care

Future steps

  • Equity considerations will be an important focus for the WHO-EC collaboration on support to countries on national policy dialogue and health systems financing
  • Joint action in capacity building on health equity metrics within the context of national policy dialogue (support for development and sharing of tools, guidance and knowledge)
  • Future collaboration on active ageing will be addressed under the area of innovation and health