Join a Global Conversation on a New Approach to Reducing Health Inequities

inequityJoin a Global Conversation on a New Approach to Reducing Health Inequities

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.

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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.

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The Power of Law in Achieving Health and Well-Being

Law Health JusticeThe power of law in achieving health and well-being

As someone who studied psychology, I am interested in human behaviour and how we can change it to improve society. So, I’d like to give my perspective of why the Framework Convention on Global Health (FCGH) – a legally binding international treaty – has the potential to change people’s behaviours to help us achieve better health and well-being around the world.

Law is an expression of how we want society to be and, with this in mind, can thus be used as a powerful tool to change culture and behaviour. One could see law as the blueprint for society – the architecture of society and the scaffolding around which living society moulds itself. With such frameworks, we can build better societies where everyone can enjoy scientific and social-political advances. To this end, law is an expression of intent – it is a declaration to say that global civilisation has not yet reached its peak and that there is still so much to achieve; laws can provide what we envision as a better future and how we want to reach it. For example, the idea of an international treaty based on the right to health can slowly change people’s understanding of what norms we want to strive for.

That is not to say that laws are stagnant or perfect. Laws should change with the times. In our globalised world, now more than ever, we need stronger expressions of how we want the world to be. Do we want a world where only a minority of people can access the recent breakthroughs in healthcare? Do we want a world where we value profits over people’s health and well-being? Do we want to live in a world where billions of people are left behind while few enjoy the advances that global civilisation has made over the past centuries?

Law has been, and is still currently, used by powerful actors to cause suffering and hardship; such when limiting the affordability of medicines in some instances. But laws that are formulated with the full participation of citizens – that reflect the real needs of citizens – can be a powerful tool used to enable communities to flourish.

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Lead In Our Environment is a Major Cause of Global Health Inequity

LeadLead In Our Environment is a Major Cause of Global Health Inequity

I believe we need a global treaty, like the Framework Convention on Tobacco Control (FCTC), to ensure that basic health is a right that every citizen enjoys, no matter where they live and no matter how poor or rich their families might be. There are vast health inequities that separate various countries and various communities within countries. It is for this reason that several of us from around the globe have come together in a call for the governments around the world to agree to a Framework Convention on Global Health (FCGH).

Science and medicine is frustratingly known for its “good news, bad news” stories on a daily basis, as a recent Kristin Anderson Moore blog reveals. She referred to data in America that show a significant decline in teen birth rate from 55.6 births per 1,000 females ages 15-19 in 1975 to 24.2 in 2014. There was also a decline in overall youth violence (in spite of an upsurge in the 1990s). For example, rate of serious violent crime among juveniles ages 12-17 declined from almost 40 per 100,000 in the early 1980s to 7.6 in 2015 and the homicide rate among youth ages 18-24 fell substantially.

There are scientific studies that link these significant declines in teen pregnancies and in youth violence to the reduction of lead toxicity in American communities. This is the good news. The bad news? Lead continues to be a serious environmental risk factor for health. Indeed, lead exposure is another inequity that people face around the world. Children and women of reproductive age in certain parts of the world are more exposed to lead than their counterparts in other parts of the world.

Lead is a toxic, deadly chemical, causing serious illnesses and accounting for far too many deaths around the world. It is one of the major causes of cognitive deficits in children everywhere. We have known this for many decades and many countries have laws and regulations that restrict the use of lead. Yet after many decades since its deadly consequences became known, lead continues to be a persistent environmental hazard. One of the major sources of lead poisoning is our transport system. For example lead gasoline is still in use in many countries around the world.

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