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Summary Literature Health Policy and Action
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Summary literature - Healthpolicy and action
Lecture 1 Monday
Progress report on the roadmap to implement the 2030 Agenda for
Sustainable Development, building on Health 2020, the European
policy for health and well-being –
WHO, 2019
Background
The roadmap to implement the 2030 Agenda for
Sustainable Development (building on Health
2020 - European policy for health and well-being)
was adopted by the WHO. The roadmap aims to
strengthen the capacities of Member States to
achieve better and more equitable and
sustainable health and well-being for all at all
ages in the WHO European Region. It proposes
five interdependent strategic directions and four
enabling measures to implement the 2030
Agenda for Sustainable Development.
The present report summarizes the current
implementation of the roadmap to implement
the 2030 Agenda in the WHO European Regio.
Good progress has been made in some areas. I.e.
the gap between men and women in terms of healthy life expectancy is decreasing, maternal and
child mortality targets have been reached in most countries, progress in sexual and reproductive
health and rights is improving, the capacity of all countries for early warning, risk reduction and
management of national and global health risks is increasing in the Region, etc.
Interventions must be significantly scaled up if the Region is to reach a number of the health-related
SDG targets by 2030. For example, both globally and in the Region, SDG target 3.6 (halve the number
of global deaths and injuries from road traffic accidents by 2020) will not be met. Also, the region is
not on track to meet the HIV target. And other targets are not achieved too.
There is a need to accelerate progress in relation to health equity, gender equality and human rights.
Gender inequalities intersect with other forms of discrimination, contributing to inequities in income,
living conditions, social and human capital, and work and employment. It is recognized that
addressing these issues is a prerequisite for achieving universal health coverage. While efforts to
address health equity are being made, progress has been hampered because of the complexity of
these issues and uncertainty about what constitute the most effective health policies and
investment. Health systems need to be further strengthened to achieve universal health coverage.
Access to affordable, effective, quality medicines is a major concern for many Member States. High-
quality and accessible primary health care is fundamental to advancing universal health coverage.
,Implementing the roadmap in European Member States
The 2030 Agenda and the SDGs have provided new impetus for public health policy and action in
many countries of the Region. The 2030 Agenda encourages Member States to conduct regular and
inclusive reviews of progress at the national and subnational levels.
Making the goals national and local
Analysis of the voluntary national reviews highlights the wide range of institutional mechanisms
developed to implement the 2030 Agenda.
- Political oversight mechanisms have been established in all reporting countries.
- Implementation priorities in the Region range from broad policies addressing all the SDGs
together, to more narrow approaches focused on a single Goal.
- Few countries have been training or building the capacity of public servants for implementing
the SDGs.
Health and governance of the SDGs
Of 43 Member States that had submitted a voluntary national review by 2019, 38 had established
national development strategies. As many of the national health policies will expire soon, further
efforts to harmonize national health strategies and plans with the 2030Agenda and the SDGs are
required, including priorities, accelerators and accountability mechanisms.
Equity and leaving no one behind
All Member States have clearly stated their commitment to leaving no one behind. However, an
analysis by the United Nations Department of Economic and Social Affairs in July 2018 highlighted
four main findings. Most countries in the analysis mentioned the concept of “leaving no one behind”,
but few referred to explicit strategies, although social protection was the strategy area mentioned
most frequently. Even fewer countries explicitly mentioned the need to improve participation by
vulnerable groups in decision-making process.
Financing for development
A recent paper from the Inter-Agency Task Force on Financing for Development summarized aspects
of the financing of the SDGs and highlighted the need for domestic resource mobilization. Eastern
European countries rely on a mix of funding to implement their SDG priorities: public budget, local
and regional budgets, foreign private direct investment, remittances and international development
assistance.
Health determinants
Action for health throughout the life course is rarely considered when implementing action to
achieve the health-determining SDGs. More frequently, countries propose the strengthening of
activities that are good for the economy and the environment, but pay less attention to the social
dimension.
Subnational and local action
A majority of Member States have engaged with local authorities when planning for and
implementing the 2030Agenda, developing national development strategies or designing specific
projects and policies.
Universal health coverage
Reports on SDG activities in the voluntary national reviews often included clear commitments with
regard to effective prevention programmes and ensuring access to essential health services. Few
reports provided information on uptake or outcomes for specific population groups.
,Progress in advancing the roadmap through action by WHO and its
partners
Governance
The last three sessions of the Regional Committee for Europe included specific high-level sessions
dedicated to the implementation of the SDGs.
Support for Member States
All European WHO country offices, in coordination with the Regional Office, have directly supported
the implementation of the SDGs in Member States.
United Nations cooperation
The focus on SDG implementation in countries has highlighted the need for strong coordination
within and beyond the United Nations system, across agencies, sectors, levels and technical areas.
, Building of the global movement for health equity: from Santiago to
Rio and Beyond - Marmot et al., 2012
Abstract
Health inequalities are present throughout the world, both within and between countries. The
Commission on Social Determinants of Health drew attention to dramatic social gradients in health
within most countries and made proposals for action. These inequalities are not inevitable. The
purpose of this article is to report on activity that has taken place worldwide after the report by
the Commission on Social Determinants of Health. First, we summarize the global situation. Second,
we summarize an interim report of the emerging findings from an independent review of social
determinants and the health divide, which was commissioned by the WHO European region. The
world conference on social determinants of health will be held in Rio de Janeiro, Brazil, in October,
2011. This summit provides an opportunity to galvanise support, prioritize action, and respond to the
call by the Commission on Social Determinants of Health for social justice as a route to a fair
distribution of health.
Introduction
In Afghanistan, the lifetime risk of a maternal death is one in 11; in Europe, the lowest is one in 31
800. Some of the appalling premature loss of women’s lives could be mitigated by provision of skilled
birth attendants. But much of it arises because of the nature of social and economic arrangements,
both globally and locally. The evidence brought together by the Commission on Social Determinants
of Health (CSDH) attributed health inequities to the circumstances in which people are born, grow,
live, work, and age, in addition to the healthcare systems put in place to deal with illness. Wide
inequities in the distribution of power, money, and resources account for these conditions of daily
life. Health inequities are not confined to poor health for people in poor countries and to good health
for everyone else. Gross social inequities deprive subgroups of the population of the opportunity to
benefit from economic and social development and damage social cohesion and integration with
consequent social and health effects. Reduction of these inequities is a matter of social justice and
requires action at the societal level— globally, nationally, and locally.
The evidence brought together by the CSDH has led to much support for action to reduce the
unnecessary loss of life and loss of healthy life experienced worldwide, but much more is needed.
Additionally, many of the responses to the global financial crisis have slowed progress.
The WHO European region has set up a European review of social determinants and the health
divide. The review will publish its conclusions and recommendations in 2012. In this paper, we
summarise an interim report giving emerging findings. First, we begin with a review of global actions
on the social determinants of health.
Principles of action
Not all inequalities are inequitable. Among those who accept that equality is important, the question
is equality of what? In this case equality of opportunity or equality of outcome. The CSDH endorsed
the view that health inequalities, between social groups or populations, which are deemed avoidable
by reasonable means, are unjust. These are labelled as health inequities.
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