[EQ] What We Mean by Social Determinants of Health

What We Mean by Social Determinants of Health

Vicente Navarro, Department of Health Policy and Management

Johns Hopkins University Bloomberg School of Public Health
keynote address was given at the Eighth IUHPE European Conference on September 9, 2008,
 in Turin, Italy, and was originally published in IUHPE – Global Health Promotion, Vol. 16, No. 1, 2009, SAGE Publications

International Journal of Health Services, Volume 39, Number 3, Pages 423–441, 2009 doi: 10.2190/HS.39.3.a

 

Available online as PDF file [19p.] at: http://baywood.com/hs/ijhs393A.pdf

“……This article analyzes the changes in health conditions and quality of life in the populations of developed and developing countries over the past 30 years, resulting from neoliberal policies developed by many governments and promoted by the World Bank, International Monetary Fund, World Health Organization, and other international agencies. It challenges interpretations by the analysts of “globalization,” including the common assumption that states are disappearing.

 

The author shows that what has been happening is not a reduction of state interventions but a change in the nature and character of those interventions, resulting from major changes in class (and race and gender) power relations in each country, with establishment of an alliance between the dominant classes of developed and developing countries—a class alliance responsible for the promotion of its ideology, neoliberalism. This is the cause of the enormous health inequalities in the world today.

 

The article concludes with a critical analysis of the WHO report on social determinants of health, applauding its analysis and many of its recommendations, but faulting it for ignoring the power relations that shape these social determinants. It is not inequalities that kill people, as the report states; it is those who are responsible for these inequalities that kill people…..”

 

 

 

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This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
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“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
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[EQ] Global health funding: how much, where it comes from and where it goes

Global health funding: how much, where it comes from and where it goes

 

David McCoy1,*, Sudeep Chand1 and Devi Sridhar2

1University College London, Centre for International Health and Development, London, United Kingdom.

2University of Oxford, Department of Politics and International Relations, All Souls College, Oxford, United Kingdom.

Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine

 

Abstract at: http://heapol.oxfordjournals.org/cgi/content/full/czp026

 

“…..Global health funding has increased in recent years. This has been accompanied by a proliferation in the number of global health actors and initiatives. This paper describes the state of global heath finance, taking into account government and private sources of finance, and raises and discusses a number of policy issues related to global health governance.

 

A schematic describing the different actors and three global health finance functions is used to organize the data presented, most of which are secondary data from the published literature and annual reports of relevant actors. In two cases, we also refer to currently unpublished primary data that have been collected by authors of this paper. Among the findings are that the volume of official development assistance for health is frequently inflated; and that data on private sources of global health finance are inadequate but indicate a large and important role of private actors.

The fragmented, complicated, messy and inadequately tracked state of global health finance requires immediate attention. In particular it is necessary to track and monitor global health finance that is channelled by and through private sources, and to critically examine who benefits from the rise in global health spending…..”

 

KEY MESSAGES

 

It is frequently stated that global health funding has increased dramatically over the past decade. However, there are inadequate data to describe the precise volume of global health expenditure; the source of this funding; its management; and how it is spent.

 

A detailed description of global health funding is needed to improve the efficiency, accountability, performance and equity-impact of the many actors that populate the global health landscape.

 

In particular, it is necessary to track and monitor the activities of non-OECD donors as well as the funding that is sourced by and channelled through private actors.

 

 *      *     *

This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ KMS Area]

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.
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[EQ] The effects of global health initiatives on country health systems

The effects of global health initiatives on country health systems:
a review of the evidence from HIV/AIDS control

 

Regien G Biesma1,*, Ruairí Brugha1,2, Andrew Harmer2, Aisling Walsh1, Neil Spicer2 and Gill Walt2
 1 Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland.

2 Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, UK.

 

Health Policy and Planning 2009 24(4):239-252; doi:10.1093/heapol/czp025

 

Available online at: http://heapol.oxfordjournals.org/cgi/content/full/24/4/239

 

“…..This paper reviews country-level evidence about the impact of global health initiatives (GHIs), which have had profound effects on recipient country health systems in middle and low income countries.

 

We have selected three initiatives that account for an estimated two-thirds of external funding earmarked for HIV/AIDS control in resource-poor countries: the Global Fund to Fight AIDS, TB and Malaria, the World Bank Multi-country AIDS Program (MAP) and the US President's Emergency Plan for AIDS Relief (PEPFAR).

 

This paper draws on 31 original country-specific and cross-country articles and reports, based on country-level fieldwork conducted between 2002 and 2007. Positive effects have included a rapid scale-up in HIV/AIDS service delivery, greater stakeholder participation, and channelling of funds to non-governmental stakeholders, mainly NGOs and faith-based bodies.

 

Negative effects include distortion of recipient countries’ national policies, notably through distracting governments from coordinated efforts to strengthen health systems and re-verticalization of planning, management and monitoring and evaluation systems. Sub-national and district studies are needed to assess the degree to which GHIs are learning to align with and build the capacities of countries to respond to HIV/AIDS; whether marginalized populations access and benefit from GHI-funded programmes; and about the cost-effectiveness and long-term sustainability of the HIV and AIDS programmes funded by the GHIs. Three multi-country sets of evaluations, which will be reporting in 2009, will answer some of these questions. ……”

 

 *      *     *

This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ KMS Area]

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.
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    IMPORTANT: This transmission is for use by the intended recipient and it may contain privileged, proprietary or confidential information. If you are not the intended recipient or a person responsible for delivering this transmission to the intended recipient, you may not disclose, copy or distribute this transmission or take any action in reliance on it. If you received this transmission in error, please notify us immediately by email to infosec@paho.org, and please dispose of and delete this transmission. Thank you.