Background

Sao Paulo, Brazil, WHO/A. Kari, 2010

WHO convened a global conference on 19-21 October, 2011, in Rio de Janeiro, Brazil, to build support for the implementation of action on social determinants of health. The conference was organized in accordance with resolution WHA62.14 (2009) and hosted by the Government of Brazil. The Brazilian Ministry of Health, the Oswaldo Cruz Foundation (Fiocruz) and the Brazilian Ministry of Foreign Affairs worked closely with WHO on preparing the event.

The conference brought together Member States and stakeholders to share experiences on policies and strategies aimed at reducing health inequities. The event provided a global platform for dialogue on how the recommendations of the WHO Commission on Social Determinants of Health (2008) could be taken forward. The key aim of the process was to draw lessons learnt and to catalyse coordinated global action in five key areas.

• governance to tackle the root causes of health inequities: implementing action on social determinants of health;
• promoting participation: community leadership for action on social determinants;
• the role of the health sector, including public health programmes, in reducing health inequities;
• global action on social determinants: aligning priorities and stakeholders;
• monitoring progress: measurement and analysis to inform policies to build accountability on social determinants;.

The conference was attended by ministers of health; representatives of international agencies, philanthropic institutions and civil society organizations; leading academics and technical experts; and representatives from the private sector. The conference's outcome document, the Rio Political Declaration on Social Determinants of Health, will help to build high-level international backing for the further development and implementation of national policies to address social determinants of health.

The aftermath of the Commission's report

The final report of the WHO Commission on Social Determinants of Health 'Closing the Gap in a Generation (2008)' emphasized the importance of building a global movement to act on social determinants to reduce health gaps between and within countries. In considering and endorsing the Commission's report, the World Health Assembly passed a resolution in May 2009, requesting WHO 'to convene a global event to discuss renewed plans for addressing the alarming trends of health inequities through addressing social determinants of health'. At the WHO Executive Board meeting in January 2010, the Government of Brazil announced its offer to host such a global event and preparations began in the summer of 2010.

In May 2011, an Advisory Group was appointed to support WHO with technical advice on various aspects of the conference. Members of the group acted in their personal capacity. The group was composed of the following members:

• Dr Carmen Amela Heras, Ministry of Health and Social Policy (Spain)
• Ms Jane Billings, Public Health Agency of Canada (Canada)
• Dr Nils Daulaire, US Department of Health and Human Services (United States of America)
• Dr Ilona Kickbusch, Graduate Institute of International and Development Studies (Switzerland)
• Dr Bernardo Kliksberg, UNDP Bureau of Development Policies (Argentina)
• Ms Taru Koivisto, Ministry of Social Affairs and Health (Finland)
• Ms Malebona Precious Matsoso, Department of Health (South Africa)
• Sir Michael Marmot, University College London (United Kingdom)
• Dr Luiz Odorico, Ministry of Health (Brazil)
• Dr Rômulo Paes de Sousa, Ministry of Social Development and Fight against Hunger (Brazil)
• Ms Tone P. Torgersen, Norwegian Directorate of Health (Norway)

The focal point at WHO for the organization of the conference was Dr Rüdiger Krech, Director of the Department of Ethics, Equity, Trade and Human Rights. The WHO Conference Secretariat was in the same department.

The themes of the conference were closely linked to the agenda of the First Global Ministerial Conference on Healthy Lifestyles and Noncommunicable Disease Control (Moscow, the Russian Federation, 28-29 April, 2011), the UN High-level Meeting on Noncommunicable Disease Prevention and Control (New York, USA, 19-20 September, 2011), the UN Conference on Sustainable Development in 2012 (Rio de Janeiro, Brazil) and the 8th Global Conference on Health Promotion in 2013 (Helsinki, Finland).

An invitation-only event

As this was a high-level WHO conference, with only a limited number of spaces, participation was by invitation only. In May 2011, invitations were issued by Dr Margaret Chan, WHO Director-General, to Ministers of Health in every WHO Member State. It was up to Member States to nominate members of their official delegations.

Invitations to non-Member State participants were issued during the months of June and July, after a careful screening against the selection criteria established for the conference. WHO gave due consideration to geographical representation, gender balance, as well as linguistic, disciplinary and cultural diversity. The Organization also wished to ensure that there was an adequate balance between representatives of health and non-health sectors. WHO used the same criteria when selecting case studies for the conference and when constituting the Advisory Group.

In addition to Member States, WHO invited the following groups of stakeholders and partners:

• Representatives of United Nations agencies and international organizations (one representative per organization);
• Representatives of Civil Society Organizations in official relations with WHO, as mandated by WHA resolution 40.25, 1987 (one representative per CSO);
• Representatives of other Civil Society Organizations (including professional associations, trade unions, community-based initiatives and philanthropic organizations) with a proven track record in this field, particularly those working in the non-health sector;
• Technical experts and other individuals who have made a substantial contribution to the area of social determinants or health inequity (as demonstrated through their publishing or academic record). Preference was given to those with a multi-disciplinary background;
• Representatives of private sector organizations whose work advances the fight against health inequities;

The Rockefeller Foundation generously offered funding to enable the participation of Civil Society Organizations that met the above criteria. WHO regrets that it was not possible for individuals to submit an application as these funds were used to cover the expenses of those CSOs that were already on WHO's list of invitees.

From a separate source, there was limited funding available to cover the expenses of one Member State delegate from each Least Developed Country. All other institutional or individual participants were kindly requested to self-fund the costs of their participation.