PHA-Exch> Reducing health inequities in a generation: a dream or reality?

[Claudio Schuftan]

From: Ruggiero, Mrs. Ana Lucia (WDC) <ruglucia at paho.org>
crosposted from: EQUIDAD at listserv.paho.org


 *Reducing health inequities in a generation: a dream or reality?*



Shankar Prinja a & Rajesh Kumar b

a. London School of Hygiene and Tropical Medicine, Keppel Street, London,
WC1E 7HT, England.

b. School of Public Health, Postgraduate Institute of Medical Education and
Research, Chandigarh, India.



*Bulletin of the World Health Organization 2009;87:84-84. *doi:
10.2471/BLT.08.062695**

*Volume 87, Number 2, February 2009*



Available online at:
http://www.who.int/bulletin/volumes/87/2/08-062695/en/index.html



"…..Inequalities in health are an indicator of distributional differences in
the health status of populations. Low-income countries, which contribute 56%
of global disease burden, account for only 2% of global expenditure on
health.1 The WHO Commission on Social Determinants of Health has called for
"closing the gap" – resolving health inequities between different groups –
in the course of a generation. It aims to achieve this by improving
conditions of daily living; tackling inequitable distribution of power,
money and resources; and measuring and ascertaining the impact of
interventions.2 However, there are several challenges to realizing this
dream.



Health is generally not high on the political agenda. Policy and planning
are heavily influenced by a few elite groups who are least affected by
health inequalities. Powerful interest groups, such as the pharmaceutical
industry, influence health policies in most countries. The revenue of the
top 10 global pharmaceutical companies is more than the gross national
income of the 57 lowest-income countries.3 Progressing towards the
recommendations of the Commission would mean rejection of the biomedical
model of disease causation and re-emphasizing the concepts of social
medicine. None of this is in the interest of the power groups. Hence, the
very step of agenda setting in the course of policy-making is laden with
problems. It is difficult to convince politicians and bureaucrats about the
long-term benefits of social interventions when they are focused on
biomedical interventions that impact their status in the short term…." [au]
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