Feature story

World forum in Brazil seeks to close health equity gaps

20 October 2011

Panelists at the side event “The Politics of Health” included (from left to right): Dr. Aaron Motsoaledi, Minister of Health, South Africa; Dr Jarbas Barbosa, Brazil’s Vice-Minister of Health; UNAIDS Executive Director Michel Sidibé; Ms Amina Ibrahim, Chief Executive Officer, Center for Development Policy Solutions, Nigeria.

High-level government officials, medical experts and civil society representatives from 120 countries are gathered in Rio de Janeiro, Brazil, at a three-day meeting focused on the social, economic and political conditions that drive health inequities. Convened by the World Health Organization (WHO), the World Conference on Social Determinants of Health provides a global platform for discussion on a range of topics, including early child development, universal health care, social protections, fair financing, gender equity, political empowerment and global governance.

In a panel session at the conference entitled "Politics of Health: Lessons from the AIDS movement to address the social determinants of health,” UNAIDS Executive Director Michel Sidibé emphasized the need for a greater focus on the underlying dynamics that fuel health inequities. "AIDS has taught us about the need to address social inequities that put women, children and vulnerable populations at risk for HIV," said Mr Sidibé, who chaired the session, together with Brazil's Vice-Minister of Health, Dr Jarbas Barbosa.

Dr Aaron Motsoaledi, South Africa’s Minister of Health underlined the importance of partnerships in addressing the national HIV epidemic. “We have 19 sectors represented in the South African National AIDS Council, chaired by the Deputy President. When we aim to address the social determinants of health, these groups are essential to mobilize all aspects of our society," he said.

The differences within and between countries, in income levels, in opportunities, in health status, and in access to care are greater today than at any time in recent history.

Dr Margaret Chan, Director-General of WHO

Noting the struggle for health and human rights in Brazil, Vera Paiva, Professor of Social Psychology at the University of Sao Paolo said that the mobilization and participation of people affected by HIV has helped ensure the protection of human rights within the country’s HIV response.

Ms Amina Ibrahim—Chief Executive Officer of the Center for Development Policy Solutions in Nigeria and former Special Advisor to the President of Nigeria on the Millennium Development Goals (MDGs)—underscored that political commitment can become “lost in translation” between policy and action. To lessen the implementation gap, she said that Nigeria is devoting considerable effort to briefing ministries and parliamentarians and providing them with evidence of how investing in education, gender and other MDGs benefits their constituents.

According to WHO there is ample evidence that an individual's health status is largely determined by his or her socio-economic position. "The differences within and between countries, in income levels, in opportunities, in health status, and in access to care are greater today than at any time in recent history," said Dr Margaret Chan, Director-General of WHO, at the opening plenary of the conference. "A world that is greatly out of balance in matters of health is neither stable nor secure," she added.

During the conference, the UNAIDS Executive Director congratulated Finland’s Minister of Health, Maria Guzenina-Richardson, on her successful role as Vice-President of the Conference. They reflected on areas for mutual collaboration between UNAIDS and the Government of Finland on health promotion, young people and vulnerable populations.

In recent years, the Government of Brazil—host of this week’s conference—has made major strides in improving the health and well-being of its population. Through the publicly-funded Sistema Único de Saúde, every Brazilian is entitled to free health care, from routine check-ups to complex surgical procedures. Nearly all people living with HIV in Brazil who are eligible for antiretroviral treatment now have access. The Government has also taken bold action to address stigma and discrimination, most recently through the launch of a pioneering anti-homophobia campaign.

Speaking at the opening plenary, Alexandre Padilha, the Brazilian Minister of Health, related that in the 23 years since Brazil adopted its democratic Constitution, the country has faced many crises, but has never given up its commitment to providing universal access to medical services free of charge. Brazil, he said, would not allow the current economic crisis to change this.

Following the opening plenary, the UNAIDS Executive Director participated in a High Level Round Table alongside Dr Margaret Chan of WHO, Rebeca Grynspan of the United Nations Development Programme, U.S. Secretary of Health and Human Services Kathleen Sebelius, and Tereza Campello, the Brazilian Minister of Social Development.

Calling attention to the seismic political shifts occurring in the global North and South, Mr Sidibé noted that the old rules of development no longer apply. “The world is changing! Countries like Brazil and South Africa have shown that policies founded in respect for all of their people, and that distribute opportunity fairly, bring dynamism and growth that is good for all,” he said.

At the end of the conference, governments are expected to endorse a Rio Political Declaration on Social Determinants of Health outlining their pledges to improve the social conditions that affect people's health.