From: <b class="gmail_sendername">Alice Fabbri</b> <span dir="ltr"><<a href="mailto:alealifab@gmail.com">alealifab@gmail.com</a>></span><br><div class="gmail_quote"><br><u></u>
<div text="#000000" bgcolor="#ffffff">
<br>
The Social Determinants of Health are a crosscutting theme coming
out of Primary Health Care and the Alma Ata conference of 1987. PHM
urges WHO to put a focus on SDH and equity in all aspects of their
reform and prioritization processes. The Assembly is invited to
adopt the resolution proposed by the Executive Board during the
January session. This is an important opportunity for discussion and
an important step forward. <br>
Please see below for more information and recommendations!<br>
<br>
<span style="vertical-align:baseline;font-variant:normal;font-style:normal;font-size:19px;background-color:transparent;text-decoration:none;font-family:Arial;font-weight:bold">Social Determinants of Health: Outcome
of the World Conference on Social Determinants of Health (SDH)
(Rio de Janiero, Brazil, October 2011) (</span><a href="http://apps.who.int/gb/ebwha/pdf_files/WHA65/A65_16-en.pdf" target="_blank"><span style="font-size:19px;font-family:Arial;color:rgb(17,85,204);background-color:transparent;font-weight:bold;font-style:normal;font-variant:normal;text-decoration:underline;vertical-align:baseline">A65/16</span></a><span style="vertical-align:baseline;font-variant:normal;font-style:normal;font-size:19px;background-color:transparent;text-decoration:none;font-family:Arial;font-weight:bold">)</span><span style="font-size:19px;font-family:Arial;color:rgb(255,0,0);background-color:transparent;font-weight:bold;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline"></span>
<h3 dir="ltr"><span style="font-size:16px;font-family:Arial;color:rgb(102,102,102);background-color:transparent;font-weight:bold;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline">The issues
before the Assembly </span></h3>
<span style="vertical-align:baseline;font-variant:normal;font-style:normal;font-size:15px;background-color:transparent;text-decoration:none;font-family:Arial;font-weight:normal"></span><br>
<span style="vertical-align:baseline;font-variant:normal;font-style:normal;font-size:15px;background-color:transparent;text-decoration:none;font-family:Arial;font-weight:normal">The Commission on the Social
Determinants of Health was established by the Director-General of
WHO in spring 2005 as a, “global network of policy makers,
researchers and civil society organizations”(</span><a href="http://www.who.int/social_determinants/thecommission/finalreport/about_csdh/en/index.html" target="_blank"><span style="font-size:15px;font-family:Arial;color:rgb(17,85,204);background-color:transparent;font-weight:normal;font-style:normal;font-variant:normal;text-decoration:underline;vertical-align:baseline">see more</span></a><span style="vertical-align:baseline;font-variant:normal;font-style:normal;font-size:15px;background-color:transparent;text-decoration:none;font-family:Arial;font-weight:normal">) to address social causes of illness
and issues of inequity. It issued its final report in 2008 (</span><a href="http://whqlibdoc.who.int/publications/2008/9789241563703_eng.pdf" target="_blank"><span style="font-size:15px;font-family:Arial;color:rgb(17,85,204);background-color:transparent;font-weight:normal;font-style:normal;font-variant:normal;text-decoration:underline;vertical-align:baseline">Closing the Gap in a
Generation</span></a><span style="vertical-align:baseline;font-variant:normal;font-style:normal;font-size:15px;background-color:transparent;text-decoration:none;font-family:Arial;font-weight:normal">). Resolution (</span><a href="http://apps.who.int/gb/ebwha/pdf_files/WHA62-REC1/WHA62_REC1-en-P2.pdf" target="_blank"><span style="font-size:15px;font-family:Arial;color:rgb(17,85,204);background-color:transparent;font-weight:normal;font-style:normal;font-variant:normal;text-decoration:underline;vertical-align:baseline">WHA62.14</span></a><span style="vertical-align:baseline;font-variant:normal;font-style:normal;font-size:15px;background-color:transparent;text-decoration:none;font-family:Arial;font-weight:normal">) on SDH requested the DG to convene a
global event before WHA65 in order to discuss renewed plans for
redressing the alarming trends of health inequities through
actions on the SDH. </span><br>
<span style="vertical-align:baseline;font-variant:normal;font-style:normal;font-size:15px;background-color:transparent;text-decoration:none;font-family:Arial;font-weight:normal"></span><br>
<span style="vertical-align:baseline;font-variant:normal;font-style:normal;font-size:15px;background-color:transparent;text-decoration:none;font-family:Arial;font-weight:normal">(</span><a href="http://apps.who.int/gb/ebwha/pdf_files/WHA65/A65_16-en.pdf" target="_blank"><span style="font-size:15px;font-family:Arial;color:rgb(17,85,204);background-color:transparent;font-weight:normal;font-style:normal;font-variant:normal;text-decoration:underline;vertical-align:baseline">A65/16</span></a><span style="vertical-align:baseline;font-variant:normal;font-style:normal;font-size:15px;background-color:transparent;text-decoration:none;font-family:Arial;font-weight:normal">) is the report by the Secretariat on
the process and outcome of the World Conference on Social
Determinants of Health (Rio de Janeiro, Brazil, 19–21 October
2011), and also summarizes progress on the implementation of
resolution WHA62.14. </span><br>
<span style="vertical-align:baseline;font-variant:normal;font-style:normal;font-size:15px;background-color:transparent;text-decoration:none;font-family:Arial;font-weight:normal"></span><br>
<span style="vertical-align:baseline;font-variant:normal;font-style:normal;font-size:15px;background-color:transparent;text-decoration:none;font-family:Arial;font-weight:normal">The WHA65 is invited to adopt the
resolution (</span><a href="http://apps.who.int/gb/ebwha/pdf_files/EB130/B130_R11-en.pdf" target="_blank"><span style="font-size:15px;font-family:Arial;color:rgb(17,85,204);background-color:transparent;font-weight:normal;font-style:normal;font-variant:normal;text-decoration:underline;vertical-align:baseline">EB130.R11</span></a><span style="vertical-align:baseline;font-variant:normal;font-style:normal;font-size:15px;background-color:transparent;text-decoration:none;font-family:Arial;font-weight:normal">) (Outcome of the World Conference on
SDH), which includes identified actions for member states (and
particular actions for the donor countries), for the
‘international community’ and for the Secretariat. </span><br>
<h3 dir="ltr"><span style="font-size:16px;font-family:Arial;color:rgb(102,102,102);background-color:transparent;font-weight:bold;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline">PHM comment</span></h3>
<span style="vertical-align:baseline;font-variant:normal;font-style:normal;font-size:15px;background-color:transparent;text-decoration:none;font-family:Arial;font-weight:normal">Action on the SDH is a critical
component of Primary Health Care (Declaration of Alma-Ata 1978)
and a prerequisite of eliminating health inequities. The PHM
welcomes the progress in the analyses mandated by Resolution WHA
62.14. However in the absence of any provision in the new GPW
framework for the management and accountability for cross cutting
issues such as SDH carries a serious risk that this work will be
allowed to wither.</span><br>
<span style="vertical-align:baseline;font-variant:normal;font-style:normal;font-size:15px;background-color:transparent;text-decoration:none;font-family:Arial;font-weight:normal"></span><br>
<span style="vertical-align:baseline;font-variant:normal;font-style:normal;font-size:15px;background-color:transparent;text-decoration:none;font-family:Arial;font-weight:normal">A commitment to addressing the SDH
needs to be incorporated into all aspects of policy making.
Political will is an essential element for work on SDH including
the political will of higher income countries to support moves to
a more equitable and sustainable allocation of global resources.
Many higher income countries have benefited unjustly from their
relationships with lower income countries and should work to
rebalance the maldistribution of power and resources.</span><br>
<span style="vertical-align:baseline;font-variant:normal;font-style:normal;font-size:15px;background-color:transparent;text-decoration:none;font-family:Arial;font-weight:normal"></span><br>
<span style="vertical-align:baseline;font-variant:normal;font-style:normal;font-size:15px;background-color:transparent;text-decoration:none;font-family:Arial;font-weight:normal">“The social determination of health is
much more than a collection of fragmented and isolated
“determinants” that, from a reductionist viewpoint, are associated
with classic risk factors and individual lifestyles. We must not
allow the concept of social determinants of health to become
banal, co-opted or reduced merely to smoking, sedentary behavior
and poor nutrition, when what we need is to recognize that behind
those symptoms and effects lies a social construction based on the
logic of a globalized hegemonic culture whose ultimate goal is the
commercialization of life itself.” (</span><a href="http://www.phmovement.org/sites/www.phmovement.org/files/RIO-WCSDH-Civil-Soc-Position-English.pdf" target="_blank"><span style="font-size:15px;font-family:Arial;color:rgb(60,120,216);background-color:transparent;font-weight:normal;font-style:normal;font-variant:normal;text-decoration:underline;vertical-align:baseline">Civil Society Position,
Rio</span></a><span style="vertical-align:baseline;font-variant:normal;font-style:normal;font-size:15px;background-color:transparent;text-decoration:none;font-family:Arial;font-weight:normal">) The social determination of
health need to be properly embedded in policy-making around
non-communicable diseases, too, so as to not stigmatise
individuals while letting corporate agents off the hook or
dismissing the socio-economic causes of the causes. </span><br>
<span style="font-size:15px;font-family:Arial;color:rgb(255,0,0);background-color:transparent;font-weight:normal;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline"></span><br>
<span style="vertical-align:baseline;font-variant:normal;font-style:normal;font-size:15px;background-color:transparent;text-decoration:none;font-family:Arial;font-weight:normal">WHO is properly concerned with
measurement and evaluation. However, unless the indicators adopted
for monitoring various programs are disaggregated using meaningful
stratifiers, progress on the SDH remains invisible. We call for
continued research, monitoring and evaluation, health impact
assessments, and support to address the root causes of the
inequities underlying the SDH.</span><br>
<span style="vertical-align:baseline;font-variant:normal;font-style:normal;font-size:15px;background-color:transparent;text-decoration:none;font-family:Arial;font-weight:normal"></span><br>
<span style="vertical-align:baseline;font-variant:normal;font-style:normal;font-size:15px;background-color:transparent;text-decoration:none;font-family:Arial;font-weight:normal">WHO has a leading responsibility to
demonstrate leadership on SDH within the UN system. There is a
need to further develop the capacity of the Secretariat to provide
technical assistance in the implementation of the Rio Declaration.
We also urge Member States to approve the necessary funding for
the work on SDH as detailed in the respectiv</span><a href="http://apps.who.int/gb/ebwha/pdf_files/WHA65/A65_16-en.pdf" target="_blank"><span style="vertical-align:baseline;font-variant:normal;font-style:normal;font-size:15px;background-color:transparent;text-decoration:none;font-family:Arial;font-weight:normal">e </span><span style="font-size:15px;font-family:Arial;color:rgb(17,85,204);background-color:transparent;font-weight:normal;font-style:normal;font-variant:normal;text-decoration:underline;vertical-align:baseline">Report on financial and
administrative implications</span></a><span style="font-size:15px;font-family:Arial;color:rgb(255,0,0);background-color:transparent;font-weight:normal;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline">.</span><br>
<span style="font-size:15px;font-family:Arial;color:rgb(255,0,0);background-color:transparent;font-weight:normal;font-style:normal;font-variant:normal;text-decoration:none;vertical-align:baseline"></span><br>
<span style="vertical-align:baseline;font-variant:normal;font-style:normal;font-size:15px;background-color:transparent;text-decoration:none;font-family:Arial;font-weight:normal">WHO has a key role in ensuring that
initiatives to address the SDH are included in other UN
deliberations and programs, e.g. Rio+20 and the post-2015
development framework. The Health in All Policies approach demands
that SDH are addressed in areas such as trade, taxation, TNCs,
financial institutions, and privatization of social programs. </span><br>
<span style="vertical-align:baseline;font-variant:normal;font-style:normal;font-size:15px;background-color:transparent;text-decoration:none;font-family:Arial;font-weight:normal"></span><br>
<span style="vertical-align:baseline;font-variant:normal;font-style:normal;font-size:15px;background-color:transparent;text-decoration:none;font-family:Arial;font-weight:normal">A major consideration is how to manage
the conflicts of interest within global health decision-making
institutions and we call for a code of conduct to help facilitate
this </span><span style="text-indent:0px;letter-spacing:normal;font-variant:normal;font-style:normal;display:inline!important;font-weight:normal;float:none;line-height:normal;text-transform:none;font-size:12px;white-space:normal;font-family:Arial,Verdana,sans-serif;word-spacing:0px"></span>
</div>
</div><br>