from [log in to unmask]

Highlights from the 7th meeting of WHO’s Commission on the Social
Determinants of Health

By Fran Baum (Commission member)

Attendance

AmartyaSenattended for the first time

Stephen Lewis has resigned – because of time pressure but is supportive of
role of CSDH

Bill Foegeand David Satcherwere sick



Margaret Chan

Margaret Chan spent about 45 minutes with Commission. She said that she
hopes the CSDH will help her change the culture of WHO in response to the
idea that Commissions don’t change things.

She noted that she was happy to hear that WHO was inclusive of NGOs as they
are crucial. She noted that the WHO constitution means that NGOs can’t have
the same status as member states so this is a good way to include NGOs.

She felt the WHO staff are “buying in” to the process” – and noted that “it
will be important to me because it fits with my priorities”.

Tackling inequity is crucial – PHC crucial but need to recognise that the
world is different to 1978 – we didn’t have HIV/AIDS, chronic disease, no
global players, NGOs not so evident. There is a new context and new
landscape of global public health and WHO needs to work with the new
players. 1.2 billion peopledo not receive services – this is the biggest
gap. She explained that for her PHC is equal to equitable access,
affordable services, community involvement, women being change agents. She
asked the question “how can we adopt the principles of PHC and have a
modern focus?”.

She has set up a task force on PHC chaired by the new Deputy Director
General Asamoa- Bah (Ghanaian known as AB) – is planning for the 60th
anniversary of WHO and the 30th anniversary of PHC (known as 60/30). She
posed the question “how can WHO partner to provide services for people in
greatest need – Africa is 10-15% of population, has less than 5% of the
resources and 20% of the disease burden. She noted that “health is at “the
receiving end of failure in others sectors”.

She also felt PHC “does have its baggage” and need to look for an
alternative word – she said she needs help with this.

Stressed that she sees PHC as being multi-sectoral, involving community
participation and universal access.It includes food, housing, shelter.

She wants to reach out to UNICEF. Big challenge of co-ordination with other
UN agencies – lots of non-alignment of them.

Noted there has never been so much investment in health and that we
“mustn’t do business as usual”.

Said WHO will have to ask the ask of “what don’t we do?”.Will have to have
strong discipline to do this – pandemics will be core. Have to take into
account “if everything is important, then nothing is”. Will have to ask if
we “can sunset some programs”.

Civil society engagement

No members of civil society were present (other than those on CSDH).
Invitations had been issued but the proximity of WSF meant people were
unable to attend. EugenioVillaris now main responsible officer in WHO.
Considering civil society meeting in Adelaideback-to-back with Indigenous
Symposium at end of April.

A meeting of Francophone civil society was held in Senegaland attended by
Commissioner NdioroNdiayaand HernanSandoval – very lively and useful
discussion.

Knowledge networks

The Social Exclusion, Gender, Public Health Conditions and Measurement
networks reported. All going well.Reports from most of the knowledge
networks will soon be on the CSDH web site so suggest people check the site
for updates. Of particular note was the presentation from the PH conditions
KN which is essential internal to WHOand about increasing awareness in the
organisation and action on SDH within WHO programs. Erik Blasmade
presentation – it was good and already an educational strategy for WHO is
being implemented and a “Knowledge and Practice network” established.

Other key issues

Presentations were made on indicators – generally scepticismfrom
Commissioners about investing too much time in this

Environment – (Maria Neiru- WHO).Very good presentation and highlighted the
conflict between economic development and environmental protection. Key
message that polluting is done in the “north” and disease burden is felt in
the “south” e.g. pollution/chemical dumping in Africa.

International Agencies

Ricardo Lagos and Michael Marmot made presentations to World Bank. Lagos’s
speech was very powerful but unsure what influence.

US Commission

Foundation funding has been found for a US Commission. Paula Bravermanwill
be research director. Will meet in New Orleansin November – hope some
Commissioners can be there.

Interim Statement

The CSDH will not be issuing an interim report – instead it will put out an
interim statement. A draft outline was circulated prior to the meeting
together with the statement of values. Thanks to members of the steering
council who provided comments on these – this helped me make interventions
at the CSDH. I was generally pleased with the tenor of the discussions and
am hopeful the statement will be strong about growing inequities and about
strategies to make a fairer world. Ted Schrekerand David Leggewere
particular helpful with comments on Michael Marmot’s HarveianLecture and
the key points I made in response about the need for:

• systematicresource redistribution between countries and within regions
and

countriesto enable poorer countries to meet human needs,

• effectivesupranational regulation to ensure that there is a social
purpose in

theglobal economy, and

• enforceablesocial rights that enable citizens and residents to seek legal
redress

wherenecessary



werelargely supported by nearly all other Commissioners.

AmartyaSenwas very supportive but argued for using term “fair distribution”
instead of re-distribution because that made people feel they were going to
lose something.

Giovanni Berlinguerargued strongly that there is a social movement on SDH
with long history and the CSDH needs to ensure it is part of this tradition
and PascoalMocumbiargued for a strong note of passion in the report.
Ricardo Lagos said we have to make the report part of the tradition of
1948, then Alma Ata. He also noted that arguments for SDH are well-known so
we have to make practical political recommendations for action

Sennoted that we have to position ourselves as different from MCE because
that report made people’s wellbeing  looklike a means rather than an end.

I somewhat heretically argued against using phrase “causes of causes” too
prominently because it encourages linear thinking – Sensupported this on
the basis of need to acknowledge people’s agency more strongly (and so
capabilities)



Timeline for interim statement: June meeting draft will be reviewed and
finalised– early July 2007 agreed statement will be ready for release and
open for comment – comments by end of September.

Communicating the CSDH message

Long discussion on how to get central messages over the international
community and governments.Feeling a “headline message” is needed – to
engage the media

High consciousness of need to communicate with people/countries where
English is not spoken.

Next meetings

8th meeting Vancouver 7th- 9th June

9th meeting Beijing24th-26th October

10th meeting likely to be in Japanin January



Fran Baum 28/1/07
---
PHA-Exchange is hosted on Kabissa - Space for change in Africa
To post, write to: [log in to unmask]
Website: http://lists.kabissa.org/mailman/listinfo/pha-exchange

-------------------
Problems/Questions? Send it to Listserv owner: [log in to unmask]


To unsubscribe, send the following message in the text section -- NOT the subject header --  to [log in to unmask]

SIGNOFF SDOH

DO NOT SEND IT BY HITTING THE REPLY BUTTON. THIS SENDS THE MESSAGE TO THE ENTIRE LISTSERV AND STILL DOES NOT REMOVE YOU.

To subscribe to the SDOH list, send the following message to [log in to unmask] in the text section, NOT in the subject header.

SUBSCRIBE SDOH yourfirstname yourlastname

To post a message to all 1200+ subscribers, send it to [log in to unmask]
Include in the Subject, its content, and location and date, if relevant.

For a list of SDOH members, send a request to [log in to unmask]

To receive messages only once a day, send the following message to [log in to unmask]
SET SDOH DIGEST

To view the SDOH archives, go to: https://listserv.yorku.ca/archives/sdoh.html