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Dimecres, 24 de juliol de 2013

Addressing global health inequities requires a global social protection scheme

13:30 - Classroom 3. Faculty of Medicine. University of Barcelona (c/ Casanova, 160) Barcelona

ISGlobal Talk


Inequity will be the main topic of this talk by Goril Ooms (Institute of Tropical Medicine, Antwerp).

Inequities are inequalities that are also unjust. For example, people with a propensity for diabetes live, on average, shorter lives, than people without that propensity. That is an inequality, not necessarily an inequity. But if the inequality could be mitigated through reasonable efforts of society – like prevention or healthcare – and it is not mitigated, the inequality becomes an inequity.

As Norman Daniels defines it, in his book ‘Just Health' a "health inequality between social groups is unjust if it results from an unjust distribution of the socially controllable factors affecting population health". Allow me to use ‘social protection' as shorthand for the ‘socially controllable factors affecting population health'. Thus the definition of social protection goes hand in hand with the definition of health inequities: what we consider as fair and reasonable measures of social protection determines which inequalities are inequities – i.e. those that would not exist if we had fair and reasonable social protection.

At the global level, we have no social protection scheme, and most people involved in global health don't seem to see the need for such a scheme. What we have is discretionary development assistance, designed to be temporary, and humanitarian aid. In other words, it seems reasonable not to have any permanent distribution of controllable factors affecting population health – like financing of health care – across borders. That means that global health inequities don't really exist, as inequalities between countries cannot be attributed to unjust distribution, as there is no standard of just distribution.

There is, however, an embryonic form of global social protection: the Global Fund to fight AIDS, Tuberculosis and Malaria. It resulted, at least to some extent, from a global civil society, arguing that "we all have AIDS, if one of us does". Can we build on that?         

Addressing global health inequities requires a global social protection scheme

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