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Equity, Human Rights, and Health: Here, There and Back Again

Equity, Human Rights, and Health: Here, There and Back Again

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Published by Unicef Innocenti
Prof. Sofia Gruskin from the Institute for Global Health tackles the interplay of Equity, Human Rights and Health and the questions surrounding it. Her commentary was first published as part of the 3rd edition of Research Watch on our website www.unicef-irc.org
Prof. Sofia Gruskin from the Institute for Global Health tackles the interplay of Equity, Human Rights and Health and the questions surrounding it. Her commentary was first published as part of the 3rd edition of Research Watch on our website www.unicef-irc.org

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Published by: Unicef Innocenti on Feb 01, 2012
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11/04/2012

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UNICEFInnocenti Research Centre
Research Watch – Health and Equity (No. 3/2012)
Equity, Human Rights, andHealth: Here, There andBack Again
Prof. Sofia Gruskin, Director of Program on Global Healthand Human RightsUSC Institute for Global Health
 
The Countdown to 2015 for Maternal, Newborn and Child Survival monitors coverage of priorityinterventions to achieve the child mortality and maternal health Millennium Development Goals(MDGs). A June 2010 Lancet article summarizing the report offered welcome news to those of usconcerned with the rights and health of children. It noted the need to go beyond the MDGs to trulyimpact newborn, child and maternal survival, and emphasized work underway to develop measuresthat "include elements that are indicative of social determinants of health" (pg 2036). It is promising tosee the donor community beginning to reengage with concepts related to equity and rights. It remainsunclear, however, if relevant measures can actually be married to the MDGs, and alongside thiswhether current discussion of these measures in political for a are actually going to take us where weneed to go in terms of public health policy, research and practice - or at least any time soon.Despite their importance on the global stage and their good intentions, the recent spate of politicaldeclarations with a focus on health do not offer any conceptual, let alone procedural, clarity as to howrelevant measures will be developed or used. The Rio Political Declaration on Social Determinants ofHealth, for example, brought together heads of government, ministers, government representatives,UN officials, and civil society representatives (though civil society was not part of the negotiations) inOctober of this year to move forward concerns with health equity through action on the socialdeterminants of health. Interestingly, the Rio Declaration pays formal tribute to the MillenniumDeclaration, but refers only obliquely to the MDGs.Its focus is achieving health and social equity, and it brings explicit attention to the relevance ofhuman rights principles to achieving its goals. It accompanies this with a detailed call for thedevelopment and implementation of reliable measures of societal well-being, but with no explicit timeframe attached. The Rio Declaration came on the heels of the September Political Declaration on thePrevention and Control of Non-communicable Diseases (the NCD Declaration), which included 34heads of state in the negotiations. The NCD Declaration names the human right to health as relevantto the prevention and control of non-communicable disease, references a range of global and regionalstrategies and declarations, and also does not put the MDGs front and center. It notes, instead, ontwo occasions “internationally agreed development goals, including the Millennium DevelopmentGoals.” [emphasis added para 31 and 65].The NCD Declaration also includes a call for a comprehensive global monitoring framework and for aset of indicators capable of application across regional and country settings to be completed beforethe end of 2012, but explicit attention to health inequities was sufficiently vague that it was good tosee the Rio Declaration specifically noting the need to ensure a focus on reducing health inequities intaking it forward. Alongside their implicit sidelining of the MDGs, and their explicit language aroundthe need for monitoring, accountability and follow-up, it is of concern, therefore, that these new equityand rights-oriented declarations, even as they do not have Programmes of Action attached, do notfind any well-defined equity sensitive measures to propose or support.Why does this matter? It is worth recalling that the Millennium Declaration included strong attention tohuman rights but by the time the MDGs had been drafted this had all disappeared. The lack of

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