Achieving health equity will not happen by default... we have to work together for it

There is a reason why April 7 is celebrated every year as World Health Day (WHD). It marks the day the World Health Organization’s (WHO) constitution came into force in 1948.

The Geneva-based specialised, non-political, health agency of the United Nations, the WHO’s constitution was drafted in 1946 by the “Technical Preparatory Committee” under the chairmanship of Rene Sand (Belgian social worker and physician) and was approved by an International Health Conference of 51 nations in New York in 1946.

This year, WHD comes at a time the world is in the midst of a pandemic. And the last several months have illustrated the need to focus attention on addressing health inequalities.

Health equity is when everyone has an opportunity to be as healthy as possible. Equity is the absence of differences among groups of people, whether those groups are defined socially, economically, geographically or demographically. Inequity in health is a evaluative standard concept. It refers to those inequalities that are judged to be unjust or unfair because they result from socially derived processes.

There is sufficient evidence that the health of a population is fundamentally dependent on fair access to social goods and services within the society. But to achieve health equity, we need to pay attention to ensuring access and social determinants of health (SDH).

Achieving health equity requires ensuring access to the resources needed to be healthy and SDH involves non-medical factors that influence health outcomes. In countries, at all levels of income, health and illness follow a social gradient. The lower the socio-economic position, the worse, the health.

Many studies have estimated that SDH accounts for between one-third to half of the health outcomes. And addressing it becomes that much more important.

Historically, in the context of health equity, the greatest emphasis has been placed on economic status and has included wealth-related inequities. It is not enough to say that health varies between the rich and poor. Other variables contribute to health inequities, including gender, place of residence, race, age, lack of civil registration, migrant and refugee status, and so on. These factors have been crucial during the Covid-19 pandemic.

The idea of Universal Health Coverage (UHC) is aligned to address inequities. UHC is for everyone and everywhere. A Primary Health Center (PHC) and UHC are, of course, mutually reinforcing.

Ensuring universal health coverage, based upon primary healthcare ensures people receive comprehensive care. It paves the path for health equity. While a good system with a well-trained, capable, and motivated workforce can improve health equity, achieving equity will not happen by default. It would require concerted and focused actions to address inequities. We all have to work together. Collect reliable data, tackle inequities and most important act beyond the border. Everyone should realise the concept of Vasudhaiva Kutumbakam, a Sanskrit phrase which means the whole world is a family.

WHD is an opportunity to reaffirm commitment to ensure all people and communities have access to quality healthcare services, where and when they are required, without suffering financial hardship. With time, perseverance and effort it is possible to move towards building, as the WHO outlines it — “a fairer, healthier world”.

Dr Chandrakant S Pandav is former Professor and Head, Centre for Community Medicine, All India Institute of Medical Sciences, Delhi

The writer is former Professor and Head, Centre for Community Medicine, All India Institute of Medical Sciences, Delhi.Views are personal.