Global governance
On February 11, The Lancet and the University of Oslo issued a joint commission calling for a political commitment to reform the current system of global governance in favor of one that prioritizes human health over wealth. The Commission of Global Governance for Health brought together 18 leaders of research and policy-making, drawn from a number of different backgrounds, to draft the report.

Data was gathered for two years on how socioeconomic inequality between nations is exacerbated by a system of global governance run by a handful of the wealthiest nations. This imbalance of political power between nations is exactly what the commission is trying to fight.

The main agenda it promotes is that health equity should be a top priority of all political, economic and social sectors.

Richard Horton, editor-in-chief of The Lancet, notes, “Economic growth alone will not deliver good health to the most vulnerable sectors of society without addressing the intertwined global factors that challenge or destroy health lives.”

The commission identifies seven areas where political and economic injustice affects population health:

  • The global financial crisis and ensuing austerity policies
  • Knowledge and intellectual property
  • Investment treaties
  • Food security
  • Transnational corporations
  • Migration
  • Armed violence

Within these areas, there are five key “dysfunctions” that are preventing improvements in health outcomes. They are:

  • Democratic deficits (“the exclusion of civil society and marginalized populations from national and global decision making”)
  • Weak accountability (“inadequate means to constrain power”)
  • Institutional “stickiness” (“decision-making processes that fail to adapt to the changing needs of people”)
  • Inadequate policy space for health (“health concerns are too often subordinated to other objectives, such as economic growth and national security”)
  • Absence of international institutions to protect and promote human health

So where does this leave people?

The Commission makes it quite clear that all of these challenges can only be addressed by moving beyond the health sector. In order to promote human health and address global inequities, they argue that people need to reform their current system of global governance in a number of ways:

1. Create a multi-stakeholder platform on governance for health (“a place for deliberation and debate to strengthen accountability for health”)
2. Form an independent scientific monitoring panel (“to measure and track progress in overcoming the political, economic, and social determinants of adverse health outcomes”)
3. Organize health equity impact assessments of all policies and practices
4. Strengthen existing mechanisms to protect health and build commitment to global solidarity and shared responsibility

It is the hope of the Commission of Global Governance for Health that this report will bring health inequities between nations to the forefront of global policy.

– Mollie O’Brien

Sources: Medical News Today, The Hindu
Photo: Masafumi Matsumoto