The Lancet – University of Oslo Commission on Global Governance for Health

1. The Lancet – University of Oslo Commission on Global Governance for Health Can global forces be harnessed? Presentation to the LEVE Seminar: Livelihoods in transition and the quest for human wellbeing Oslo, Dec 7th, 2012 Kristin Ingstad Sandberg and Ann Louise Lie University of Oslo In Collaboration with The Harvard Global Health Institute

2. Outline • Aspirations and focus of the Commission • About the Commission and the Youth Commission • How does the Commission reach its policy proposals?

3. It just isn’t right…. Marketing of unhealthy food and the accumulation of power among transnational corporations The Bhopal Gas Tragedy – who’s responsible? Agri-business contributing to food crises The right to water – or Coke?

4. “There is a growing collective sense in this room that leads to confidence in that some things are unacceptable…We should dare to address the difficult and unacceptable truths, and find a language for doing that; how to combine an analytic tone with what we are really concerned about”. Quote from Commissioner

5. The aspiration of the commission: Harnessing global forces for health • The double connotation of “harness” • To tame, reign in, or keep forces in check • To utilize; to turn a force into something positive

6. The starting point of the Commission Global Health Governance • The debates around global health governance have usually addressed the governance of the global health system—that is, actors whose primary intent is to improve global health, and the rules, norms, and processes that govern their interaction. Global Governance for Health • What merits increased attention, however, is a broader consideration of the many actors and forces outside the global health system and the ways in which they influence health and health inequities. Ottersen, O.P., Frenk, J., Horton, R. The Lancet-University of Oslo Commission on lobal Governance for Health, in collaboration with the Harvard Global Health Institute, The Lancet, Vol 378 Nov 5. 2011

7. Global Health Governance versus Global Governance for Health “Nearly all social determinants of health fall outside the direct control of the health sector” (Chan, Launch of the Final Report”, WHO

8. Beyond the Social Determinants of Health ”Where systematic differences in health are judged to be avoidableby reasonable action they are, quite simply, unfair. It is this that we label health inequity. ” Sir Michael Marmot

9. About The Commission • The Commission was established through deliberations between Richard Horton, Editor of the Lancet, Dean Julio Frenk, Harvard School of Public Health, Norwegian Minister of Foreign Affairs Jonas Gahr Støre, and Ole Petter Ottersen, rector at UiO. Horton Støre Frenk Ottersen

10. About The Commission • 18 members from 16 different countries and 5 continents • Experts in a wide variety of fields relating to global governance and health, such as trade, environment, human rights law, war and conflict, public health, epidemiology, diplomacy, political economy

11. The Commission • Chair: Ole Petter Ottersen (Norway) • Vice-Chair: Jashodhara Dasgupta (India) • Chantal Blouin (Canada) • Paulo Buss (Brazil) • Virasakdi Chongsuvivatwong (Thailand) • Julio Frenk (Mexico/USA) • Sakiko Fukuda-Parr (Japan/USA) • Bience Gawanas (Namibia) • Rita Giacaman (Palestine) • John Gyapong (Ghana) • Jennifer Leaning (USA) • Sir Michael Marmot (UK) • Desmond McNeill (UK/Norway) • Getrude Mongella (Tanzania) • Nkosana Moyo (Zimbabwe) • Sigrun Møgedal (Norway) • Gorik Ooms (Belgium) • Ayanda Ntsaluba (South Africa)

12. 3rd Meeting in New Delhi 8-10 November

13. Resource Group and Youth Commission The commission leans on a Resource Group (Head: Sidsel Roalkvam), with members from the University of Oslo and Harvard University A parallel Youth Commission has been established «to ensure that the Commission moves beyond conventional wisdom» Sidsel Roalkvam

14. The Youth Commission

15. How does the Commission reach its proposals? Workstream 3 Workstream 2 Workstream 1 Recommendations/Policy Proposals on how health can be more effectively protected and promoted in global governance processes.

16. Research strategyStreams of work The cases should show agency being exercised by different people, telling stories not just to illustrate problems, but stories of hope and courage to inspire, showing what can be done. Quote by Commission member

17. The potential function of the Commission . • Framing: A paradigm shift about health, injustice and global action. • Set an agenda: identify major determinants of health that need to be addressed at the global level (e.g. regulation of TNCs, trade agreements, knowledge dissemination etc.) • Prioritize: Specific policy proposals for immediate consideration.

18. Audience for the Commission Report:Targeting actors who can take action: • Medical community/readers of the Lancet who will become idea messengers/norms entrepreneurs. • National governments who can change: Formal rules, mobilize financial and human resources, implement accountability mechanisms and enforce compliance. • NGOs, media, citizens who can put pressure on governments. • Foundations who can finance change. • Private sector who can support positive change. • International institutions.

20. To get in touch Home-page: www.uio.no/global-governance-health E-mail: info-ggh@helsam.uio.no

21. The approach: Formative research • Originally a strategy for bringing knowledge to bear on implementation processes of (small-scale)interventions transposed to global governance. • Formative defined: “capable of alteration by growth and development” Develop conceptual clarity and systematize empirical data on for instance: • Barriers to implementation • Understanding nature and implications for local adaptation. • Detecting differences between original intention and actual effects