Commission on Global Governance for Health: Just another report?

TY - JOUR

T1 - Commission on Global Governance for Health

T2 - Just another report?

AU - De Vos, Pol

AU - Schuftan, Claudio

AU - Sanders, David

AU - Labonte, Ronald

AU - Woodward, David

AU - Birn, Anne Emanuelle

AU - Bodini, Chiara

AU - Stefanini, Angelo

AU - Serag, Hani

N1 - Funding Information: Pol De Vos a [email protected] Claudio Schuftan b David Sanders c Ronald Labonte d David Woodward e Anne-Emanuelle Birn f Chiara Bodini g Angelo Stefanini g Hani Serag h a Public Health Department, Institute of Tropical Medicine, 2000 Antwerp, Belgium Public Health Department Institute of Tropical Medicine Antwerp 2000 Belgium b People's Health Movement, Ho Chi Minh City, Vietnam People's Health Movement Ho Chi Minh City Vietnam c University of Western Cape, Cape Town, South Africa University of Western Cape Cape Town South Africa d University of Ottawa, Ottawa, ON, Canada University of Ottawa Ottawa ON Canada e New Economics Foundation, London, UK New Economics Foundation London UK f Dala Lana School of Public Health, Toronto, ON, Canada Dala Lana School of Public Health Toronto ON Canada g Center for International Health, University of Bologna, Bologna, Italy Center for International Health University of Bologna Bologna Italy h Global Secretariat of the People's Health Movement, Cairo, Egypt Global Secretariat of the People's Health Movement Cairo Egypt We welcome the report of The Lancet –University of Oslo Commission on Global Governance for Health (Feb 15, p 630) 1 and agree with its diagnosis that the root causes of health inequity are political and power imbalances, which drive an unequal neoliberal globalisation that current global governance institutions are unable or unwilling to address. As members of the People's Health Movement, which has contributed background papers to this report, we are disappointed that its recommendations avoid defining actions “to root out the very causes of persistent health inequities”. 1 While an Independent Scientific Monitoring Panel and a Multi-Stakeholder Platform on Governance for Health (MSPGH) could be mechanisms to track and mitigate adverse policies, it would require some form of intergovernmental agreement to ensure its findings were influential in national and international decision making. We are deeply concerned that the proposed MSPGH is recommended before considering how existing governance platforms might be strengthened. There is a risk in multiplying multilateral organisations until they individually become less powerful. We are also troubled by the call in the report 1 for “commitments to global solidarity and shared responsibility”, which obfuscate the power imbalances among countries and between governments and stakeholders, such as transnational corporations. In an increasingly globalised world economy, an appropriate global governance system is essential. We therefore propose that the Commission on Global Governance for Health should advocate for: the restoration of WHO as the legitimate supranational global health organisation, to be supported by member nations with non-earmarked financing; opposition to involvement of multinational companies and other private interest groups in international health policy making by WHO and its decision making processes; an increased WHO active presence in the governance structures of multilateral organisations whose decisions influence the global social and economic determinants of health (ie, the World Trade Organisation, the World Bank, the International Monetary Fund, amongst others); increased financial support to WHO to recruit expertise to work effectively across these other global governance sectors; and reforms to global governance, including economic governance, in line with democratic standards considered appropriate at the national level. Bottom-up (health) activism will continue to be an essential strategy for health equity, as it was to the development of Europe's social security systems (1850–1950) 2 and to the setting up and development of Brazil's national health system in the 1980s. 3 But its benefits will be limited if it is countered by inappropriate structures at the international level. The development of effective global health policies is not compatible with global neoliberal structures. People's Health Movement's key aims are to assist in building such evidence-informed activism—from grassroots to policy level. 4 Without a strong global movement to combat health inequity, we may end up just knowing more about its causes. We declare that we have no competing interests.

PY - 2014

Y1 - 2014

UR - https://www.scopus.com/pages/publications/84898780530

UR - https://www.scopus.com/pages/publications/84898780530#tab=citedBy

U2 - 10.1016/S0140-6736(14)60674-7

DO - 10.1016/S0140-6736(14)60674-7

M3 - Letter

C2 - 24759241

AN - SCOPUS:84898780530

SN - 0140-6736

VL - 383

SP - 1379

EP - 1380

JO - The Lancet

JF - The Lancet

IS - 9926

ER -