Addressing Social Injustice for Health Equity: A New Approach to Development

1. ‘Social injustice is killing people on a grand scale’ • ‘A new approach to development’ • economic growth is without question important, particularly for poor countries, as it gives the opportunity to provide resources to invest in improvement of the lives of their population…. • but growth by itself, without appropriate social policies to ensure reasonable fairness in the way its benefits are distributed, brings little benefit to health equity…

2. Improve daily living conditions Tackle the inequitable distribution of power, money and resources Measure and understand the problem and assess the impact of action

3. Irish health policy context • ‘Making Knowledge Work for Health’ 2001 • recognition of role of research in economic, health and social development • recognition by Government that the current level of funding for health research in Ireland 0.25% of overall health expenditure is too low

4. Irish development policy context • White Paper on Irish Aid published 2006

5. Published February 2007 • IA will support: • implementation of high quality research increasing research capacity

6. Northern Ireland: funding for health research • England & Wales: Department of Health • Office of Strategic Coordination for Health Research • NI Health & Social Care R&D Office • Wellcome Trust • UKCRC Centre of Excellence • National Institute for Health Research • MRC • ESRC

7. Aim: ‘to increase the capacity of southern institutions to make an effective contribution to poverty reduction’

8. Other funding for development related health research • Philanthropy • DfID • EU • Wellcome • Other funders

9. Bedside

13. Inverse care Impoverishing care Fragmented / fragmenting care Unsafe care Misdirected care Shortcomings of healthcare delivery

14. The Bamako Call to Action on Research for Health November 2008

15. Research for health ‘Research in any discipline or combination of disciplines that seeks to understand the impact on health of policies, programme, processes, action or events originating in any sector including but not limited to the health sector itself and encompassing biological, economic, environmental, political, social and other determinants of health; assist in developing interventions that will help prevent or mitigate impact; and contribute to the achievement of health equity and better health for all’.

16. Action by governments… • Give priority to development of policies for research and innovation for health, especially primary health care • Allocate at least 2% of national health budgets to research

17. Develop mechanisms and tools to enable effective, inter-sectoral, inter-ministerial, cross border research collaboration and coordination

18. Implement the recommendations from the WHO Commission on the Social Determinants of Health • especially those related to health equity

19. Action by funders of research, international development agencies • Better align, coordinate, harmonize global research architecture • in line with Paris Declaration • Invest at least 5% of funds earmarked for the health sector in research • pursue innovative financing mechanisms for research for health • Increase and sustain support to national health research systems

20. Key points • Multi-sectoral, inter-sectoral • Importance of primary, secondary and tertiary education to create research leadership • Role of civil society as key advocate • Primary health care as chief priority in policies for research and innovation to strengthen health systems

21. What can we do? ‘health problems, issues and concerns that transcend national boundaries and may best be addressed by cooperative actions…’ Research for health… We all have a role…