Inequalities challenge health progress

What would it take to reach a ”grand convergence” in global health by 2035? What actions are necessary in order to reduce mortality in low- and lower middle-income countries to the levels of the healthiest middle income countries of today? The authors of the new EBA report ”Sweden’s Development Assistance to Health – Policy Options to Support the Global Health 2035 Goals” argue that continued economic growth in these countries, together with strategic interventions by aid donors would make this possible.
“We have, for the first time in history, the resources and the knowledge to make this a reality within a generation”, says Dr Gavin Yamey from the University of California.
Among things needed are: Wider and broader coverage of today’s effective health interventions; Development of new health tools through research; Stronger targeting of countries with the largest health needs; Expansion of universal health care and financial risk protection.
The authors of the EBA report highlight five major global health challenges: a) Reducing deaths from infections and reproductive, maternal, new-born and child health conditions; b) Preparing for the next influenza pandemic and tackling antimicrobial resistance; c) Curbing the global rise of non-communicable diseases and injury mortality and morbidity; d) Tackling impoverishment from medical expenses in poor countries and e) Improving key global functions such as leadership, stewardship, technical norms and standards.
At the launching seminar in Stockholm, November 7, many agreed that aid should be shifted away from countries that can and will take increasing responsibility for their domestic health care, as their economies grow. More resources would hence be available for global public goods and to tackle cross-border threats. But there were also questions raised.
One of the main challenges of reaching a grand convergence is inequality. The remarkable progress we’ve seen the last decades with decline in poverty and improved health has been uneven within and between countries. Reaching marginalized and discriminated populations will need to be a top priority for further progress. Political, social and economic factors and barriers behind health inequity can therefore not be ignored. It is not enough to deal with health challenges only within the health sector itself. This multi-sectorial approach and perspective is also one of the more challenging discussions for the new global post-2015 agenda, where many argue for greater justice and the inclusion of human rights, good governance, transparency and accountability mechanism in the formulations of goals, including one on health.
Hence, I see that the EBA report provoked an important discussion not only for Swedish development assistance to health, but also for a discussion on a transformative global agenda and the role of aid in this context.

By: Julia Schalk