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World Health Organization (WHO) Report on Health Equity

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World Health Organization (WHO) Report on Health Equity

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This WHO article underscores the multifaceted nature of health equity, emphasizing the significance of addressing discrimination and prejudice to achieve equitable health outcomes. It advocates for evidence-informed actions, such as redesigning health systems and addressing wider structural determinants of health, to effectively tackle health disparities and ensure access to quality healthcare for all. Additionally, it highlights the importance of monitoring health inequalities and the impact of interventions to track progress towards health equity.

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WHO/Anna Kari
Hidden cities is a joint WHO / UN-HABITAT report about urbanization and global health issues. Photo stories from around the world reflect the hidden realities urban dwellers are facing, and highlight some health inequities.

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Health equity is a public health concept describing equity of access to health resources, for genetic, socio-environmental and economic determinants of health varying according to individuals, families and social or societal groups.

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UNICEF Report on Maternal and Child Health Inequalities

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UNICEF Report on Maternal and Child Health Inequalities

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This report from UNICEF DATA provides comprehensive insights into maternal mortality rates and statistics globally. It highlights the significant progress made in reducing maternal mortality ratios (MMR) from 2000 to 2020, albeit at a slower pace than needed to achieve Sustainable Development Goal (SDG) targets. The document underscores the persistent challenges, such as regional disparities and stalled progress in certain regions, particularly in sub-Saharan Africa. It emphasizes the need for concerted action to accelerate progress in maternal and newborn health, including joint efforts by UNICEF, the World Health Organization, and other partners to implement strategies outlined in the Every Newborn Action Plan (ENAP) and Ending Preventable Maternal Mortality (EPMM) groups. Additionally, the report discusses the causes of maternal death and highlights the social, economic, and environmental factors influencing maternal mortality, emphasizing the importance of intersectoral collaboration to improve maternal health outcomes worldwide.

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Maternal mortality rates and statistics - UNICEF DATA

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Maternal mortality declined by 34 per cent between 2000 and 2020 Maternal mortality refers to deaths due to complications from pregnancy or childbirth. From 2000 to 2020, the global maternal mortality ratio (MMR) declined by 34 per cent - from 339 deaths to 223 deaths per 100,000 live births, according to UN inter-agency estimates.

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The UDHR, adopted by the United Nations General Assembly in 1948, stands as a foundational document in the realm of human rights, proclaiming the inherent dignity and equal and inalienable rights of all members of the human family. Among its provisions, Article 25 specifically addresses the right to health as an essential component of the right to an adequate standard of living.

Article 25 of the UDHR: Article 25 of the UDHR unequivocally asserts that everyone has the right to a standard of living adequate for the health and well-being of themselves and their families. This encompasses not only access to basic necessities such as food, clothing, and housing but also includes the right to medical care and necessary social services. By enshrining the right to health within the broader context of an adequate standard of living, the UDHR recognizes health as a fundamental human right essential for individuals to lead dignified and fulfilling lives.

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United Nations Sustainable Development Goals (SDGs)

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United Nations Sustainable Development Goals (SDGs)

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This resource outlines Goal 3 of the SDGs, which focuses on ensuring healthy lives and promoting well-being for all. It discusses targets and indicators related to health equity and universal healthcare coverage.

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The pandemic and other ongoing crises are hindering progress in achieving SDG3, exacerbating existing health inequalities and threatening progress towards universal health coverage. As a result, 68 million children are known to be un- or under-vaccinated as of 2022 from TB and malaria increased. This has been particularly challenging in low- and middle-income countries, where health systems were already under-resourced before the pandemic. The pandemic has also highlighted the need for stronger global health security systems to prevent and respond to future pandemics. Overcoming these setbacks and dealing with longstanding shortcomings in health-care provision requires an urgent strengthening of health systems.

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Goal 3 | Department of Economic and Social Affairs

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Ensure healthy lives and promote well-being for all at all ages

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The Lancet Global Health Journal Article on Social Determinants of Health

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The Lancet Global Health Journal Article on Social Determinants of Health

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In this article published in The Lancet, Vart critically examines a study conducted by Mirza Balaj and colleagues on the relationship between parental education and childhood mortality. Vart acknowledges the study's comprehensive data on parental education and childhood mortality but raises important methodological considerations regarding the assessment of socioeconomic determinants of health. Specifically, Vart discusses the challenges in determining the causal pathways between parental education, parental age, and child mortality, highlighting the potential confounding effects of factors such as age and income. The article underscores the need for careful consideration of these factors in future research on the social determinants of health.

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This report examines barriers to access to essential medicines and healthcare services, particularly in low-income countries. It highlights the role of pharmaceutical companies, patents, and trade agreements in shaping access to healthcare.

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access to medicine | Oxfam International

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New Oxfam report: The proliferation of substandard medicines in poor countries is being used by rich countries as an excuse to tighten intellectual property rules, boosting the profits of large pharmaceutical companies while making it harder for poor people to get access to the medicines they need.

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World Bank Health Financing Revisited pdf

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World Bank Working Paper on Health Financing

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World Bank Working Paper on Health Financing

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This publication by Gottret and Schieber revisits the topic of health financing, providing insights into various aspects of financing healthcare systems. It likely offers a comprehensive analysis of different health financing mechanisms, including public and private financing, insurance schemes, and out-of-pocket payments. The document may also discuss the challenges and opportunities associated with different financing models and their implications for achieving universal health coverage and improving health outcomes. Additionally, it may propose strategies for strengthening health financing systems to ensure equitable access to healthcare services and financial protection for all individuals.

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United Nations High Commissioner for Refugees (UNHCR) Policy Brief on Health Services for Displaced Populations

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United Nations High Commissioner for Refugees (UNHCR) Policy Brief on Health Services for Displaced Populations

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UNHCR is dedicated to ensuring refugees have access to healthcare, aligning with international conventions like the 1951 Refugee Convention. They advocate for refugee inclusion in national health systems and provide guidance, infrastructure, and funding for healthcare services. Primary healthcare practitioners offer essential services, while community health workers provide education and support within refugee communities. UNHCR prioritizes vaccinations for refugees, ensuring timely access to essential vaccines. In emergencies, they procure and distribute medicines and medical supplies to save lives and treat acute conditions. Overall, UNHCR's efforts underscore their commitment to promoting health equity and fulfilling refugees' right to healthcare.

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UNHCR's public health strategy aims to foster the conditions, partnerships, collaboration and approaches that enable refugees to access healthcare and essential health services. Advocating for the inclusion of refugees into national health systems at affordable costs and sufficient quality is a priority. This strategy is in line with the Global Compact on Refugees and the 2030 Agenda for Sustainable Development.

In all situations, UNHCR advocates for refugee inclusion in national health systems and plans. When and as appropriate, UNHCR then provides guidance, infrastructure and capacity building, and funds laboratory diagnostics, medicines, medical equipment and supplies.

Through UNHCR's advocacy, funding and support, refugees benefit from increased access to healthcare in these areas:

Primary healthcare and referrals for secondary healthcare

Primary healthcare practitioners provide support in the areas of sexual and reproductive health, nutrition, child health including immunizations, mental health and the treatment of communicable and noncommunicable diseases. Primary healthcare practitioners also make referrals to secondary healthcare for a higher level of clinical care.

UNHCR improves primary healthcare for refugees by advocating for refugee inclusion into national health systems, strengthening health infrastructure (e.g. constructing or renovating facilities, providing medicines, medical equipment and laboratory diagnostics), funding and training health workers.

Community health

Whether in camps or urban settings, the overall health of host and refugee communities impacts each individual. Community health initiatives mostly take place outside of health facilities and focus on how community members can take action together to maintain or improve their health and prevent disease.

UNHCR trains community health workers to meet with refugees to diagnose, treat and make referrals for common illnesses (e.g., diarrhoea and malaria) and follow up with pregnant women, newborns and people living with chronic diseases (e.g., diabetes and hypertension). Fluent in refugee languages and cultures, community health workers teach refugees about health, hygiene and preventative health measures such as immunization from the same perspective more easily relatable.

Noncommunicable diseases (NCDs) prevention and treatment

Noncommunicable diseases, such as heart disease, cancers, diabetes, chronic respiratory disease and mental health conditions, are the greatest source of preventable illness, disability, and mortality worldwide. Displacement can disrupt refugees' treatment for these diseases or delay diagnosis, putting them at even greater risk.

In 2014, UNHCR began improving access to noncommunicable diseases care by ensuring that it is effectively integrated into primary healthcare. Through a capacity-building project, procurement of evidenced-based and cost-effective essential medicines and data collection and monitoring via the iRHIS (Integrated Refugee Health Information System), access to healthcare for noncommunicable diseases is now more available to refugees. UNHCR trains health staff on noncommunicable diseases care including screening, diagnosing and managing patients using clinical protocols (aligned with host country protocols). Capacity building includes training of staff to provide advice on smoking cessation, monitoring of disease control and awareness of complications.

Communicable diseases prevention and treatment

Conflict and displacement that lead to refugee situations are a recognized public health risk. They increase the population's vulnerability to communicable diseases because of weakened health systems, overcrowding, poor water and sanitation conditions, interrupted immunization activities and delayed diagnoses. The main cause of death in many conflict and displacement situations is not violence, but the spread of communicable diseases such as malaria, measles and diarrhea.

UNHCR approaches the control of communicable disease from multiple sectors by increasing the provision of or access to vaccinations (especially against measles, polio and tetanus) and to water and sanitation facilities. During all stages of refugee situations, UNHCR focuses on measures for HIV prevention and treatment. In addition, using the iRHIS, UNHCR undertakes surveillance for conditions that have the potential to lead to communicable disease outbreaks.

Immunization

When refugees flee their homes, healthcare gets put on hold, including immunizations. As a result, refugees, especially children, are at increased risk of contracting vaccine-preventable diseases including measles, polio, viral hepatitis, diphtheria and whooping cough. Refugee children are also at very high risk to be "zero-dose" (no immunization) or under-immunized. Adult refugees may face more severe forms of childhood diseases if they were not immunized as children.

UNHCR promotes that all new refugee arrivals under 15 years old immediately receive measles, polio and tetanus toxoid vaccines. While vaccines are most commonly obtained and administered through ministries of health or UNICEF, UNHCR often funds vaccination activities to reach as many refugees as possible. Depending on the situation, UNHCR may also procure vaccines and provide logistical support for their importation, transportation (including cold chain management) and storage. Through a 2020 partnership with GAVI, the Vaccine Alliance, UNHCR is identifying and addressing the needs of zero-dose refugee children. The partnership is working closely with communities and local partners to identify and overcome key barriers to immunization in communities, including gender divides and the gap in demand and access.

Essential medicines, medical supplies and equipment

Essential medicines are the medications considered to be most effective and safe to meet the most important health needs in a country. The World Health Organization (WHO) maintains a list of essential medicines that serves as a guide for states and institutions. Every two years, UNHCR reviews and adapts the WHO list for refugee contexts. UNHCR then procures and imports medicines from the UNHCR Essential Medicines and Medical Supplies List for emergency and ongoing refugee situations taking into account national essential medicine lists. These medicines are distributed for use with refugees by partners (including governments, national and international NGOs, and Red Cross/Red Crescent partners).

During an emergency, UNHCR procures, imports and distributes standardized medicine and medical supply kits (e.g., Interagency Health Kits, noncommunicable disease kits, cholera kits, Interagency reproductive health kits, etc.). The procurement and importation of essential medicine, medical supplies and equipment is vital in refugee contexts. They ensure timely access to safe medicines and save lives by treating acute conditions and ensuring continuity of care for those with chronic conditions.

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Health is a fundamental human right for all, including refugees. Making it possible for refugees to access healthcare is a top priority for UNHCR.

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The 1951 Refugee Convention, also known as the Convention Relating to the Status of Refugees, is a foundational international treaty that defines who is a refugee, outlines their rights, and establishes the legal obligations of states towards refugees. It stipulates that refugees should not be discriminated against and should have access to essential services, including healthcare, on par with host populations. By ratifying this convention, states commit to providing refugees with protection and assistance, including access to healthcare, ensuring their well-being and dignity. The convention continues to serve as a cornerstone of international refugee law and guides the actions of states and international organizations in addressing the needs of refugees worldwide.

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The 1951 Refugee Convention and its 1967 Protocol are the key documents that form the basis of UNHCR’s work. Learn more about them and view the original text.

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World Health Organization (WHO) releases the largest global collection of health inequality data

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World Health Organization (WHO) releases the largest global collection of health inequality data

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The World Health Organization (WHO) has introduced the Health Inequality Data Repository (HIDR), a vital tool for addressing health disparities on a global scale. This repository, comprising nearly 11 million data points from over 15 sources, offers comprehensive insights into population health and its determinants, allowing for the tracking of health inequalities across diverse demographic, socioeconomic, and geographical dimensions. The HIDR's data reveal significant disparities in health service coverage, particularly among women, newborns, and children in low- and middle-income countries, where the rich-poor gap has nearly halved in just a decade. Moreover, the repository underscores the importance of eliminating wealth-related inequality, which could potentially save the lives of 1.8 million children under five. Through this initiative, WHO aims to move beyond conventional data collection methods and towards disaggregating health data to better understand who is being left behind. This call for routine health inequality monitoring, expanded data collection, and increased capacity for analysis and reporting signifies a critical step towards advancing health equity and leaving no one behind in the journey towards universal health coverage.

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WHO releases the largest global collection of health inequality data

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The repository allows for tracking health inequalities across population groups and over time, by breaking down data according to group characteristics, ranging from education level to ethnicity.

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CDC Unveils Ambitious Strategy to Advance Global Health Equity

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CDC Unveils Ambitious Strategy to Advance Global Health Equity

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The Executive Summary outlines the CDC's comprehensive strategy to address health equity globally, emphasizing its commitment to cultivating science, optimizing interventions, reinforcing partnerships, and enhancing workforce engagement. It underscores the agency's dedication to integrating health equity into all facets of its work, with specific goals aimed at ensuring that health equity is central to scientific portfolios, program design, and intervention strategies. The document highlights the importance of partnerships, innovative approaches, and data-driven interventions to address multi-level drivers of health disparities. Furthermore, it aligns with the United Nations' framework for achieving the highest attainable level of health by prioritizing the needs of disadvantaged populations, engaging affected communities, and upholding principles of human rights. The summary also provides insights into program-specific goals across various areas such as parasitic diseases, global health protection, HIV & TB, and immunization, indicating a targeted approach to address specific health challenges. Overall, the analysis of the Executive Summary indicates a comprehensive and ambitious approach by the CDC to advance health equity globally, with a focus on evidence-based strategies, collaboration, and capacity-building.

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On April 20, 2021, CDC launched an agency-wide health equity science and intervention strategy to holistically reimagine how the agency approaches health equity. CDC commits to: Cultivate comprehensive health equity science, Optimize interventions, Reinforce and expand robust partnerships, and Enhance capacity and workforce engagement ( also known as CORE commitments). CDC Director, Dr. Rochelle Walensky, states, "As America's public health agency and as a leader of public health globally, CDC is reaffirming our commitment to health for all."

Five pillars guide CDC's global public health work across the agency: scientific expertise, diverse partnerships, innovation, sustainability, and health equity. CDC works to eliminate health disparities and achieve optimum health through all these pillars, and more specifically by addressing health equity to reach those in greatest need through global programs, research, tools and resources, and leadership.

Under CORE, the agency-wide health equity vision is that CDC is a trusted and proven public health leader in advancing health equity. The aim, according to Dr. Leandris Liburd, Director of CDC's Office of Minority Health and Health Equity, is "to integrate health equity into the very fabric of all we do as the nation's leading health agency."

The CORE long-term goals commit CDC to ensure that:

1. Health equity is an integral part of CDC's scientific portfolio

2. CDC programs and interventions embed health equity into their design, implementation, and evaluation

3. CDC uses scientific and data-driven intervention strategies that address environmental, place-based, occupational, policy and systemic factors that impact health outcomes and shape equitable opportunities for health

4. CDC scientific and intervention work uses partnerships and innovative data and analytic approaches to address multi-level drivers of health disparities

Framework and Guiding Principles
The Four United Nations Essential Components for Achieving the Right to the Highest Attainable Level of Health framework, endorsed by WHO, are foundational to CDC's global public health guiding principles, global health equity vision and goals.

Availability: sufficient quantity of functioning Public Health facilities, goods, services, and programs

Accessibility: non-discrimination, physically accessible, affordable, access to information and programs

Acceptability: respectful of medical ethics, culturally appropriate, sensitive to gender issues

Quality: scientific and medically appropriate, good quality public health services

Prioritize the needs of the most disadvantaged or disproportionately affected

Engage affected populations and communities

Collaborate with external partners, including non- traditional, and local partners

Confirm that programs uphold principles of human rights

Implement good and ethical public health practice

Cultivate ethical and knowledgeable staff

Vision: Everyone can achieve the highest attainable level of health, and no one is disadvantaged from achieving this potential because of social position or any other socially, economically, demographically, or geographically defined circumstances or physical condition.

By 2027, building on CDC's core strengths in scientific leadership, innovation, surveillance, laboratory, and using data to drive impact, CDC will assess and strengthen our capacity, infrastructure, policies, and partnerships to consistently and deliberatively apply global health equity principles and approaches to our global health science, interventions, programs, policy development, and communication

By 2027, build the evidence-base to advance health equity in our global health science and interventions

By 2027, implement standard health equity measures that will be seamlessly integrated into CDC global data collection efforts (e.g., surveys, surveillance, routine program, supply chain, laboratory) and used to reach epidemic and accelerated disease control, and disease eradication and elimination among known and unknown groups who are marginalized

Goal 1:
Identify the primary social determinants of health that increase the risk for parasitic diseases in underserved US communities (by 2023), and develop/implement a strategy to increase awareness, promote access to disease prevention services, and increase use of prevention practices (by 2026) with a focus on soil transmitted helminths and malaria.

Goal 2:
By end of 2025, increase access to a package of community care* by 30% in remote areas currently underserved by peripheral health facilities in three high-burden malaria countries where US President's Malaria Initiative operates, as measured by a 30% increase in all cause consults for illness treated by CHWs, to address health services disparities, particularly in rural areas.
*The package of community care includes integrated community case management (iCCM) of pneumonia, diarrhea, and malaria for children under 5 and access to diagnosis and treatment for acute febrile illness for all ages.

Goal 1:
By 2025, CDC to work with the broader community of National Public Health Institutes (NPHI) to support defining and accelerating progress towards health equity goals and developing and adopting health equity strategies in support of the global health security goal to enhance essential public health workforce and functions.

Goal 2:
By 2026, CDC and partners will address disparities in access to preventive health care by promoting primary health care principles through the global health security framework to integrate infectious diseases and other health threats prevention program planning and delivery, thereby reducing their synergistic impact during public health threats and improving our approach to pandemic preparedness.

Goal 1:
Affirm and advance the role of health equity and an equitable, diverse, and inclusive workforce as core principles for the work of CDC through continuous improvement and monitoring by September 30, 2023.

Goal 2:
Advance the reduction of stigma and discrimination through the promotion of civil and human rights to improve the health outcomes of persons at risk of, or living with, HIV and/or TB infection in countries where CDC works by September 30, 2025.

Goal 1:
By December 31, 2026, in all CDC priority countries, underserved populations with immunity gaps* are identified and reached with vaccination services to achieve measurable reductions in mortality and morbidity from targeted VPDs.
*Underserved populations with immunity gaps who have disproportionately high risk for vaccine-preventable diseases (e.g., zero-dose children, populations affected by conflict, disaster and humanitarian crises, nomadic populations, populations with gender-related barriers to immunization, populations without access to recommended vaccines).

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Five pillars guide CDC's global public health work across the agency: scientific expertise, diverse partnerships, innovation, sustainability, and health equity.

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Progress and Challenges in Advancing Global Health Equity (Analysis pt.1)

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Progress and Challenges in Advancing Global Health Equity (Analysis pt.1)

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In examining the multifaceted efforts to address global health inequalities, significant strides have been made towards recognizing health as a fundamental human right. Initiatives by organizations such as the World Health Organization (WHO), United Nations, and Oxfam underscore the importance of evidence-informed actions, universal access to healthcare, and the reduction of barriers to essential medicines. These efforts align with the broader goals of sustainable development and emphasize the need for comprehensive approaches to tackle health disparities worldwide.

However, despite progress, challenges persist in upholding health as a human right. The critical analysis of research methodologies, as seen in The Lancet Global Health Journal article, highlights the complexities in assessing socioeconomic determinants of health and calls for rigorous examination in future studies. Moreover, the plight of refugees, as addressed by UNHCR and the 1951 Refugee Convention, sheds light on the ongoing struggle to ensure equitable access to healthcare for vulnerable populations

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Strategies for Future Action and Collaboration (Analysis pt.2)

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Strategies for Future Action and Collaboration (Analysis pt.2)

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Strategies for Future Action and Collaboration

Amid these challenges, the Universal Declaration of Human Rights (UDHR) stands as a beacon, unequivocally asserting the right to health as integral to an adequate standard of living. The CDC's ambitious strategy further reinforces the commitment to advancing global health equity through evidence-based approaches and collaborative partnerships.

In conclusion, while progress has been made, the journey towards achieving health equity is ongoing and requires continued commitment from policymakers, healthcare professionals, researchers, and civil society. By fostering international collaboration, leveraging evidence-based strategies, and upholding the principles of human rights, the global community can work towards a future where every individual enjoys the highest attainable standard of physical and mental health, regardless of their socio-economic status or background.