Greater equity in health should be a progress indicator
15 June 2009 | New York - With a growing recognition that “blind faith in economic growth and gain as the be-all, end-all, cure-for-all has been misplaced,” WHO Director-General Dr Margaret Chan today responded to leaders who have been calling for a redesign of international systems.
Speaking at the United Nations Headquarters in New York today, Dr Chan said that it is time to build policies based on fairness – using differences in the health status of populations within and between countries – as the “key measure of how we, as a civilized society, are making progress.”
“The world is in such a great big mess,” she said at the UN Secretary-General’s Forum on Advancing Global Health in the Face of Crisis on Monday. The meeting was attended by senior government officials and experts in health and international development.
In the last year, this warming world has suffered a fuel crisis, a food crisis and a financial crisis. This list of challenges grew last week with the addition of pandemic influenza.
The impact of these crises is not felt equally. Pandemic influenza, for example, will hit hardest in developing countries, which have large vulnerable populations. With their weak health systems, these struggling countries will take longer to recover. In many ways, developing countries facing the pandemic are virtually empty-handed, said Dr Chan.
“Fairness, I believe, is at the heart of our ambitions for global health,” she told the world’s ambassadors. But fairness is in short supply. Differences in income, life expectancy, and opportunities are greater now than at any time in recent history. These extremes of privilege and misery, Dr Chan noted, are often “a precursor for social breakdown.”
The soul-searching following the financial crisis has led to a questioning of “blind faith in economic growth.” From this self-examination, leaders are calling for a restoration of other values, especially fairness, to a central role in policy formation.
“We hear clear calls, from leaders around the world, to give the international systems a moral dimension,” said Dr Chan, “to redesign them to respond to social values and concerns... A focus on health as a worthy pursuit for its own sake is the surest route to the moral dimension, the surest route to a value system that puts the welfare of humanity at its heart. Greater equity in the health status of populations, within and between countries, should be regarded as key measure of how we, as a civilized society, are making progress.”
One method for achieving fairness, she suggested, would be for more countries to embrace primary health care. As she noted, a primary health care approach introduces greater fairness as well as efficiency, and allows health systems to reach their potential as cohesive, stabilizing social institutions.
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