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The Right to Health: WHO Commission on Social Determinants of Health
Broader than the concern of right to health advocates that the global intellectual property rights regime impairs the realization of the right to health is the recent attention being paid by the WHO to addressing the social determinants (i.e., root economic, social, and cultural causes) of health problems.
In May 2005, the World Health Organization launched the Commission on Social Determinants of Health. The Commission is scheduled to complete its initial work in May 2008. It is chaired by Sir Michael Marmot of the University College, London and has twenty Commissioners. The Commission brings together leading scientists and practitioners to provide evidence on policies that improve health by addressing the social conditions in which people live and work. It collaborates with countries to support policy change and monitor results.
The stated main goals of the Commission are:
- To support policy change in countries by promoting models and practices that effectively address the social determinants of health;
- To support countries in placing health as a shared goal to which many government departments and sectors of society contribute;
- To help build a sustainable global movement for action on health equity and social determinants, linking governments, international organizations, research institutions, civil society and communities.
The Commission pursues its mandate through nine subject-matter working groups known as “Knowledge Networks,” the goal of which is to “synthesize knowledge about the social determinants of health.” The CSDH Knowledge Networks are:
- Early Child Development
- Employment Conditions
- Globalization
- Social Exclusion
- Health Systems
- Priority Public Health Conditions
- Woman and Gender Equity
- Urban Settings
- Measurement and Evidence
The Measurement and Evidence Knowledge Network (MEKN) is particularly important, as it provides support to the other eight knowledge networks by developing methodologies that can be used to effectively measure the “causes, pathways and health outcomes of policy interventions to tackle the social determinants of health and health inequities” which the other knowledge networks are tasked with compiling. The Measurement and Evidence Knowledge Network published its research principles in a 2006 report entitled “The Development of the Evidence Base about the Social Determinants of Health.”
The MEKN published its “Final Report to the World Health Organization Commission on the Social Determinants of Health” in October 2007. Addressed to policy makers, researchers and practitioners, the report outlines “six problems which make developing the evidence base on the social determinants of health potentially difficult.” It suggests tools that can be used to help overcome these problems, and gives guidance on what constitutes an effective evidence-based approach to establishing the social determinants of health. Finally, the report advises policy makers on how to develop effective solutions to health inequities using the social determinants of health approach. Some of their recommendations include:
- Looking to address the causes of inequities in health, rather than focusing solely on “general health improvement;”
- Taking into account the needs of specific groups within a population;
- Basing social determinants of health solutions in evidence;
- “Equity proofing” social determinants of health solutions;
- Involving other social sectors other than the health sector in addressing the social determinants of health;
- Continuous monitoring of the impact of implemented policies; and
- Conducting “cross cultural and cross national research” in order to facilitate monitoring and comparison.
In 2007, the Commission issued its Interim Statement. The Interim Statement sets out the Commission’s vision and goals, the problems it seeks to ameliorate, and the intellectual foundation for a social determinants approach. The Commission views the Interim Statement as “a resource for stakeholders concerned with social determinants of health and health equity, as they build towards a global movement.” Recommendations for action, based on the evidence gathered across all the Commission’s work streams, will be made in the Final Report in May 2008.
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