Inequity in Sustainable Health Today: A Global Perspective

The global healthcare landscape is fraught with inequities, especially in achieving sustainable health outcomes. This article is brought to you by the Sustainable Health Equity Movement (SHEM), a coalition dedicated to advancing health equity globally. It includes contributions from Professor Luis Eugenio De Souza, Immediate Past President of the World Federation of Public Health Associations.

Inequity in Sustainable Health: The Global Context

The COVID-19 pandemic starkly highlighted global health inequities, disproportionately affecting socio-economically vulnerable communities. Disadvantaged populations faced higher infection and mortality risks, compounded by systemic inequities that treat health as a commodity. In high-income countries, overwhelmed healthcare systems foreshadowed dire challenges for low- and middle-income nations. The stockpiling and profiteering of wealthy nations led to a global outcry, prompting an open letter to the UN, supported by over 120 entities representing five million public health professionals. This letter called for ethical worldwide leadership and the establishment of a Global Health Equity Task Force within WHO to coordinate an equity-focused pandemic response.

The Birth of the Sustainable Health Equity Movement (SHEM)

Two years later, the Sustainable Health Equity Movement (SHEM) was founded, emphasizing the need to address social inequality and the climate crisis to achieve sustainable health equity. SHEM advocates for embedding health equity principles in all policies, highlighting how unequal power dynamics, economic disparity, environmental damage, and conflicts exacerbate health inequities through inadequate access to health services, environmental risks, and unmet educational needs. SHEM’s call for a globally binding framework promotes health equity and economic reforms, including fair taxation, worker protection, and environmental equity. The movement also proposes establishing a Sustainable Health Equity Commission with a UN Rapporteur to monitor progress.

SHEM’s Vision for the Future

Three years later, SHEM reiterated that sustainable health equity means achieving and maintaining equitable health outcomes for all people, including future generations. This vision encompasses three main actions: ensuring the right to health by providing access to comprehensive health services for all; creating conditions for a healthy life by addressing social and environmental determinants of health; and fulfilling all human rights, including economic, social, cultural, civil, and political rights.

The Urgency of SHEM’s Mission Today

Despite unprecedented advances in reducing mortality rates and increasing life expectancy over the past 60 years, health inequities persist. There are signs that global life expectancy could decrease due to the ongoing impact of climate change. Current global governance often prioritizes economic interests over human well-being, as evidenced by insufficient and delayed agreements such as the 2030 Agenda, the COP climate agreements, the UN Tax Treaty, and the recently failed Pandemic Treaty. The inaction against ongoing acts of genocide, such as in Gaza (Palestine) and Darfur (Sudan), further reveals a broken human deal.

A Call to Action

As founding members of SHEM, we, along with Prof. Luis Eugenio De Souza, Immediate Past President of the Brazilian Association of Collective Health, emphasize the need for a profound transformation of global, national, and local political, economic, and knowledge governance to uphold human democracy, peace, justice, and dignity. This transformation is essential to preserving human life in balance with other life forms on our shared planet.

The fight against inequity in sustainable health is far from over. SHEM must intensify its call for ethical principles of equity, ensuring everyone has access to the health services they need regardless of socioeconomic status. By addressing the root causes of health inequities, we can build a healthier, more equitable world for future generations. 

Please note that this article initially appeared in Science Direct.