PHM-Exch> Input required: response to WHO's technical paper for World Conference on Social Determinants of Health

[Claudio Schuftan]

From: PHM Global Secretariat <globalsecretariat at phmovement.org>



This letter is to seek inputs from the largest possible number of civil
society organizations, networks and social movements to inform an inclusive
People’s Health Movement (PHM) response to the draft technical
paper<http://www.who.int/sdhconference/consultation/draft_WCSDH_Technical_Paper.pdf>
[1] published by the Secretariat of the World Health Organizations (WHO) on
the World Conference on Social Determinants of Health (WCSDH). The WCSDH
will be jointly organized by the WHO secretariat and Brazilian government on
October 19-21, 2011 in Rio de Janeiro, Brazil.


The WCSDH is requested by resolution WHA 62.14[2], adopted by the 62nd World
Health Assembly, May 2009 which mandates the Director-General to convene a
global event to discuss renewed plans to address the alarming trends of
health inequities through addressing the social determinants of health.



This resulting conference will provide a space for between 800 and 1200
delegates from all countries (by invitation). This number includes
representatives of governments (head of states, ministers of health and of
other sectors), experts, academics, and civil society, which includes
philanthropic foundations, corporations, as well as public interest
organizations, especially those in official relations with the UN.


The current document for consultation [Technical Paper – First Draft] does
not sufficiently build on the
report<http://whqlibdoc.who.int/publications/2008/9789241563703_eng.pdf>
of
the Commission on Social Determinants of Health (CSDH). While the paper
recognizes the analysis of power structures provided by the CSDH report, it
does not address the need for strategies and actions to tackle the
inequitable distribution of power, money and resources.  The report, to a
great extent, narrows the scope of interventions to intersectoral actions in
terms of better cooperation and coordination between health and non-health
sectors, as well as a promotion of a “health in all policies approach”.  The
report speaks of a ‘win-win’ situation when aligning priorities on global
governance for action on social determinants.



The urgency to reinforce the primary role of the state in the provision of
basic services essential to health (such as water and sanitation), and the
regulation of goods and services with a major impact on health (such as
tobacco, alcohol and food) is addressed in this report.  However, it is
essential that strategies be developed to hold the transnational corporate
actors providing these goods and services accountable, instead of
legitimizing their role in global health governance.



We are concerned about the representation of non-state invitees during the
conference. Under the heading ‘Civil Society’ public interest organisations,
organisations representing commercial interests and front foundations of the
corporate industry are not differentiated. The paper should explain more
explicitly how the people’s voice and participation will be ensured during
this conference.


The conflicts of interest, the representation, and the relevancy to address
the determinants of health are the key attributes of invitees.  They must be
considered when selecting the participants of the conference.


So far, the paper does not mention the human right to health, its
interrelatedness and interdependency with other human rights, as core
considerations while addressing health inequities. The coordinating and
authority role by WHO and its member states, as mandated by its
constitution, to take initiative and leadership to govern mechanisms and
processes to reduce health inequities is understated in this paper.
According to this paper, the health sector should “facilitate rather than
claim leadership” in providing action on the social determinants of health.
  The key question is; if the health sector cannot take leadership, who is
the alternative?


PHM is currently drafting a response to the consultation around the
‘Technical Paper’ and will focus on the following principles:


   - The global health governance is a sub-domain of the global economic
   order and governance structure. Addressing the structural determinants of
   health, reducing health inequities and achieving ‘health for all’ means that
   big economic interests need to be challenged and 'people before profits'
   should be enforced.
   - Public interest civil society organizations and social movements should
   be given an appropriate space to share their analyses and contribute to
   identifying actions and setting priorities.
   - The conference should not act to legitimize and widen the space of the
   commercial sector and private foundations to further shape global health
   decision making. Instead, the conference needs to provide concrete measures
   to hold transnational corporations accountable and reduce their role in
   shaping or influencing global and national health decision making.
   - The Brazilian government and WHO need to create clear and innovative
   channels through which the social movements and public interest civil
   society organizations and networks can contribute to the conference
   declaration.

We request critical reflections, inputs and concrete suggestions especially
regarding the above listed principles as well as the 5 suggested strategies
and conference themes.


We wish that this response will succeed in reflecting the view of the
largest possible number of public interest groups and movements.
Accordingly, we call for contributions from health activists; health and
non-health civil society organizations; professional associations; trade
unions; international organizations and social movements.  The contributions
may further cover the following items:


   - commenting on the principles and themes based on which our response
   should be developed ;
   - sharing analysis and action points that should be included in the
   conference declaration; and
   - other issues you believe that the collective response should include.

Please respond before Saturday 28th May 2011 to:


   - Bridget Lloyd, PHM global coordinator at
   globalsecretariat at phmovement.org
   - Remco van de Pas, Wemos via  remco.van.de.pas at wemos.nl

We hope to finish drafting the response by 31st May 2011 and send it back to
you for possible endorsement. We will need final endorsements by the 2nd of
June to meet the deadline of submission on the 3rd of June 2011.



------------------------------

[1] Refer to the attachment 1: Draft Technical Paper

[2] Refer to the attachment 2: the resolutions of the 62th WHA 2009 (Page
21:  WHA62.14 Reducing health inequities through action on the social
determinants)



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