A version of this post first appeared on the blog of the O’Neill Institute for National and Global Health Law.
At the core of the Framework Convention on Global Health (FCGH) is the conviction that today’s health inequities – nationally and globally – are unconscionable but not inevitable. The FCGH could incorporate specific mechanisms for countries to undertake to respond to these inequities, turning right to health (and human rights more broadly) norms of non-discrimination and substantive equality into directives for specific actions, into comprehensive responses. One proposal is that countries develop national health equity strategies. This idea is further explained below, along with information on an upcoming opportunity to you to participate in further solidifying this concept.
Such strategies are rare today. The FCGH could change that. But we need not, cannot, wait until our efforts to create an FCGH come to fruition to begin the process of implementing the measures it might include, such as national health equity strategies. We can begin now to encourage countries to develop such strategies. This would demonstrate their value for global adoption through the FCGH and, even more importantly, would begin to do some of the work of the FCGH — of the right to health, of the demands of justice — today.
The realities of health inequities may be too well known to shock us any longer. People in richer countries live longer than those in poorer countries. And within countries, people who are rich live longer than people who are poor, people with more education longer than people with little schooling. Practically everywhere, certain populations, like indigenous peoples, fair badly when it comes to the potential to live long, healthy lives.
Yet the tremendous nature of this injustice ought to shock us still. It ought to shock us that the residents of one mostly white suburb of St. Louis can expect to live to be over 91 years old – 35 years more than residents of another St. Louis suburb, where most residents are black. It ought to shock us that South Asian women who are among the poorest segment of the population are almost five times less likely to be attended by a skilled birth attendant – one of the most important interventions for reducing maternal mortality – than they would be if they were part of the wealthiest segment. And it ought to shock us that the TB incidence in Canada’s indigenous Inuit people is more than 270 times that of non-indigenous Canadians.