Reflections Rector Ole Petter Ottersen MD, PhD Chair The Lancet, University of Oslo Commission on Global Governance for Health
" ……at present, the social determinants of health have mostly failed to achieve traction in health policy making. There has been a frequent failure to translate ideas into practice.” Richard Horton
Challenges • “Human health is the result of complex biological systems influenced by social-economic-political processes in local, national and global levels”. • “…there is a fundamental mismatch between most issues of global nature and the architecture of governance we currently use.” • “What are the incentives for actors outside the arena to integrate health considerations into their decision-making processes?” Quotesfrom membersofthe Commission
We have much to buildon! • World Health Assembly (WHO) • Alma Ata declaration • Commission on microeconomics and health • Foreign Policy and Global Health initiative • Joint Action and Learning Initiative on national and global responsibility for health (JALI) • Chatham House Initiative on Moving towards universal coverage • WHO and the International System • Commitments to Sustainable Financing: Need for a New Model? • Rio +20 • Closing the Gap in a generation, Commission on Social determinants of health • UN Commission on life saving commodities for women and children • Commission on Information and Accountability for women’s and children’s health • People’s Health Assembly
Buildonstrengthsof theCommissioners Increase synergy
Behind every government is its people
"[A] man is developinghimselfwhenhegrows, or earns, enough to providedecentconditions for himself and his family; he is not beingdevelopedifsomeonegives him thesethings."Julius KambarageNyerere, from his book UhurunaMaendeleo (Freedom and Development), 1973.
Note from Richard Horton to the first meeting of the Commission: • The developing model is changing • Social determinants need to be prioritised • The democratic deficit need to be addressed • Regional, as opposed to global, governance is gaining in importance • New coalitions are challenging the notion of global governance • Civil society is now an important global force • The private sector cannot be ignored, but its role is ambiguous • Integration is a new imperative • Accountability can be a catalyst for transformative global change