Fight for Equity - Closing the Gap in OUR Generation


Published on

Presentation given during the forum "Global Health - Why Bother?" - a pre-conference forum dedicated to the 7th Conference for Global health and Vaccination Research, September 25, 2012, The Norwegian University of Science and Technology (NTNU), Trondheim, Norway.

Video of the presentation here:

Published in: Health & Medicine
  • Be the first to comment

  • Be the first to like this

No Downloads
Total views
On SlideShare
From Embeds
Number of Embeds
Embeds 0
No embeds

No notes for slide

Fight for Equity - Closing the Gap in OUR Generation

  1. 1. Fight for Equity Closing the Gap in OUR GenerationRamon Lorenzo Luis Rosa Guinto, MD Regional Coordinator for the Asia-Pacific and Founding Coordinator, Global Health Equity InitiativeInternational Federation of Medical Students‟ Associations (IFMSA) Youth Commissioner, Lancet-University of Oslo Commission on Global Governance for Health
  2. 2. Alma Ata, 1978The International Conference on PrimaryHealth Care calls for urgent action by allgovernments, all health and developmentworkers, and the world community to protectand promote the health of all the people ofthe world by the year 2000.
  3. 3. From Beaglehole and Bonita, 2012
  4. 4. Life expectancy at birth (men)Glasgow, Scotland (deprived suburb) 54India 61Philippines 65Korea 65Lithuania 66Poland 71Mexico 72Cuba 75US 75UK 76Glasgow, Scotland (affluent suburb) 82 (WHO World Health Report 2006; Hanlon,P.,Walsh,D. & Whyte,B.,2006)
  5. 5. Source: Dr. Ramon Paterno, University of the Philippines
  6. 6. The Jubilee Line of Health InequalityTravelling east from Westminster, each tube stop representsup to one year of male life expectancy lost at birth (2002-06)Male LifeExpectancy Male Life78.6 (CI 76.0-81.2) Expectancy Canning Town 72.8 (CI 71.1-74.6)Female Life Expectancy84.6 (CI 82.5-86.7) Female Life Expectancy 81.4 (CI 79.3-83.6) Westminster Canary London Bridge Wharf River Thames Canada North Bermondsey Water Greenwich Waterloo Southwark Electoral wards just a few miles apart geographically have life expectancy spans varying by years. For instance, there are eight stops between Westminster and Canning TownLondon Underground Jubilee Line on the Jubilee Line – so as one travels east, each stop, on average, marks up a year of shortened lifespan. 11 Source: Analysis by London Health Observatory using Office for National Statistics data revised for 2002-06. Diagram produced by Department of Health
  7. 7. Definitions• Inequalities/Disparities in health – „differences‟ in health across individuals / population groups• Inequities in health – avoidable differences• „Where systematic differences in health are judged to be avoidable by reasonable action they are, quite simply, unfair. It is this that we label health inequity.‟ WHO Commission on Social Determinants of Health (2008) From Mike Rowson, 2011
  8. 8. Source: Ravi Narayan, SOCHARA, India
  9. 9. Social Production of Disease Do we not always find the diseases of the populace traceable to defects in society? Dr. Rudolf Virchow Father of Social Medicine
  10. 10. Rudolf Virchow remedy for epidemics was: “prosperity, education & liberty”Doctor, Pathologist, Biologist, Politician: first to recognizeLeukemia, elucidated embolism, founded “Social Medicine”founded discipline of Anthropology,
  11. 11. Tuberculosis TB deaths in England4.5 4 BCG Vaccination3.5 32.5 2 Streptomycin1.5 10.5 0 1838 1860 1880 1900 1920 1940 1960 TB deathsWerner and Sanders, Questioning the Solution: The Politics of Primary Health Care and Child Survival,Healthwrights, 1997, p. 76. (cited also in WHO SDH Background papers)
  12. 12. The Constitution of WHO, 1948“Health is a state of complete physical, mental, and social well-being and not merely the absence of disease orinfirmity… a fundamental human right”
  13. 13. Alma Ata Declaration, 1978 “The Conference strongly reaffirms that health… is a fundamental human right” “The existing gross inequality in the health status of the people particularly between developed and developing countries as well as within countries is politically, socially and economically unacceptable”
  14. 14. Alma Ata Declaration, 1978 “Economic and social development… is of basic importance to the fullest attainment of health for all and to the reduction of the gap between the health status of the developing and developed countries.”
  15. 15. Alma Ata Declaration, 1978 “Involves, in addition to the health sector, all related sectors and aspects of national and community development, in particular agriculture, animal husbandry, food, industry, education, housing, public works, communications and other sectors…”
  16. 16. Dahlgren and Whitehead, 1991
  17. 17. Social Determinants of Health• Conditions in the social, physical, and economic environment in which people are born, grow, live, work, and age, including access to health care• Policies, programs, and institutions• Social structure, community factors
  18. 18. “Unequal distribution of health-damagingexperiences is not in any sense a „naturalphenomenon, but is a result of the toxiccombination of poorsocial policies andprograms, unfaireconomic arrangementsand bad politics.”WHO Commission on SocialDeterminants of Health, 2008
  19. 19. Commission on SocialDeterminants of Health 1. Improve Daily Living Conditions 2. Tackle the Inequitable Distribution of Power, Money, and Resources 3. Measure and Understand the Problem and Assess the Impact of Action.
  20. 20. Global Governance
  21. 21. Basic question: What good does it do to treat people‟s Illnesses …only to send them back to the conditions that made them sick?
  22. 22. Picture of Presidents inJakarta MM2011
  23. 23. Mission Our mission is to offer future physicians a comprehensive introduction to global health issues. Through our programming and opportunities, we develop culturally sensitive students of medicine, intent on influencing thetransnational inequalities that shape the health of our planet.
  24. 24. IFMSA Small Working Group onHealth Inequities
  25. 25. Country Initiatives
  26. 26. IFMSA Global HealthEquity Initiative • Institutional voice for global health equity within IFMSA • Accessible clearinghouse of information and capacity- building tools • Dynamic forum for exchange and dialogue • Key platform for advocacy and campaign for global health equity
  27. 27. SDH and HE to shape the post-MDG world eradicate extreme improve maternal poverty and health hunger achieve universal combat HIV/AIDS, primary malaria and other education diseasespromote gender equality ensure environmental and empower women sustainability reduce child develop a global mortality partnership for development
  28. 28. Revitalize the H4A movement and enhance capacity for SDH actionat national and sub-national levels
  29. 29. Transformative scale-up of medicaleducation – integrate SDH & GHE thinking
  30. 30. The 21st century physician as championof social determinants approach to health
  31. 31. The Power of Medicine "Medicine… has the obligation to point out problems and to attempt their theoretical solution…The physicians are the natural attorneys of the poor…” Dr. Rudolf Virchow Father of Social Medicine
  32. 32. The Power of Young People“The youth arethe hope of the Fatherland.” Dr. Jose Rizal National Hero of the Philippines
  33. 33. Fathers of Social Medicine
  34. 34. It‟s more fun in thePhilippines