World Conference on Social Determinants of Health, Rio de Janeiro, October 19-21, 2011
Guest post by Margot Lettner
“Why should a Japanese cow enjoy a higher income than an African citizen?”
This is how Dr. David Sanders of the People’s Health Movement contrasted subsidies available to livestock and people while launching Global Health Watch 3: An Alternative World Health Report at the World Conference on Social Determinants of Health, Rio de Janeiro, on October 19.
The launch, held as a pre-opening stakeholder event, introduces a contrarian but constructive look at global health inequities, their ideological underpinnings and our current policy responses.
Global Health Watch 3 is a collaborative global health critique by health activists and academics coordinated by five civil society organizations: People’s Health Movement (PHM), Health Action International, Medact, Medico International, and the Third World Network. Previous reports issued in 2005 and 2008.
The report comments on several issues in health systems, three of which stand out. First, the comprehensive vision of primary health care agreed to by WHO Member States in 1978, known as the Alma Alta Declaration, has been replaced by “selective” care and a return to a vertical, medicalized service delivery model that values technical efficiencies rather than root causes – breastfeeding is widely seen to prevent childhood diarrhea, yet food security is not. Second, mental health should be viewed in the context of the growing worldwide inequalities that often compromise it – structural problems of inequity, rising consumerism and marginalization of communities. Third, the report argues that present reward-and-review systems often remove research from the concerns of local communities – and the documented benefits of community-based research.
But the report’s realpolitik lies in its timely analysis of our global political and economic architecture, including “the three F’s” of our current financial, food and fuel crises. In this season of “increasing disquiet” in streets around the world, in our “post-democratic time” as plutocracy rises, as Conference participants put it, how do we hold international organizations accountable? How can U.N. agencies like WHO be accountable if they partner with organizations that are not? As Member States and so its major stakeholders, what influence do governments have on WHO’s mandate? More broadly, is the public interest now a myth? Is “venture philanthropism” its replacement? What of the continuing resistance to regulation in favour of self-assessing voluntary measures?
The morning after Global Health Watch 3 launched, Andreas Loverdos, Greek Minister of Health and Social Solidarity, speaking at the Conference’s opening roundtable, noted that demand for mental health services has increased during Greece’s current fiscal crisis. He added that overall demand for health care in Greece has increased 40% while he has 20% fewer resources. Occupy Wall Street, speaking to a very human crisis, has come to Rio.
Read more about Global Health Watch 3 at www.ghwatch.org; for information about PHM and Canada’s Country Circle go to www.phmovement.org. Margot Lettner is Principal, Wasabi Consulting and an Associate of The Wellesley Institute. She is currently in Rio de Janeiro as a delegate to the World Conference on Social Determinants of Health. She is also an editor of Influency Salon, a magazine of contemporary Canadian poetry. She can be reached at email@example.com.