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Programme Director’s November 2020 Message

Health and Wealth – close relatives?

It has been a truism for a long time that wealth distribution equals health status – the more prosperous you are, the better your health. This applies both between and within local to global communities. What can we do about this?

In 2008 WHO published a report from the Commission on the Social Determinants of Health. This called for us to:

  1. Improve the conditions of daily life – the circumstances in which people are born, grow, live, work, and age.
  2. Tackle the inequitable distribution of power, money, and resources – the structural drivers of those conditions of daily life – globally, nationally, and locally.
  3. Measure the problem, evaluate action, expand the knowledge base, develop a workforce that is trained in the social determinants of health, and raise public awareness about the social determinants of health.

Arguably the first of these 3 principles relate to People (Sustainable Development Goals, SDGs, 1-5), the second to Prosperity (SDGs 7-11) and Peace (SDG 16) whilst now we are aware that the Planet has to be healthy too (Planet, SDGs 6, 12-15). Can we achieve any of this without Peace, Justice and Strong Institutions (SDG 16) whilst working in Partnership (SDG 17) with others? Probably not.

Our Actions

For the year 2018/2019 we submitted over 2000 reports and, in 2019/2020 despite COVID-19, we repeated this achievement. A very commendable effort but there is so much still to do. We have continued to help women and girls from local to global. The pandemic has, however, highlighted the discrepancies in both health and wealth signalled back in 2008 which, in its turn, simply highlighted what we had known for some time.

How have we helped those in need? This is not simply supplying goods to people but rather helping people to become more resilient. Can we do this without paying attention to the foundation needed to allow development and improvement in all SDGs? Analysis of our actions during this last year have shown that we have concentrated on People (this includes poverty alleviation, no hunger, health, education and gender equality) but will we succeed in increasing resilience without paying attention to the other Ps? Without ‘wealth’ (or no poverty) we cannot succeed and inequity will continue.

Can we, should we, redistribute our attention and focus?

  • Without ‘wealth’ (or prosperity and no poverty) we will not succeed in improving health;
  • Without education (not just schooling) people may be unaware and unable to help themselves;
  • Without good jobs and at least a basic income, all the essentials cannot be bought (Prosperity);
  • We need a sustainable home – the planet earth;
  • Whilst there is injustice, no peace and weak institutions the SDGs will not succeed and these cannot be delivered without genuine partnerships (not exploitation).

We will not succeed in our aim of gender equity, not just equality, and fairness for all without addressing the gaps.

Learning from others is important. Chatham House has recently published a report ‘The COVID-19 Gender Gap: How Women’s Experience and Expertise Will Drive Economic Recovery’ which has 3 recommendations:

  1. Invest in social infrastructure and family-friendly policies;
  2. Accelerate advances in women’s workforce competencies through professional and vocational education;
  3. Invest in the development of women-owned businesses in all countries.

Health throughout the life course

One of the asks of the UN is Universal Access to Healthcare. This needs to look at the whole life course of people since pre-natal and early childhood experiences affect us all throughout our lives. In case you think this doesn’t map to the SDGs take a look at the report from the WHO – ‘A life-course approach to health: synergy with sustainable development goals’. This report recognises the links between health and wellbeing for all with the interdependence of people, prosperity and environment (planet). It helps to re-assure that no-one need left behind.

There are several areas in which we could work to improve the lives of women and girls everywhere.

COVID-19 effect

Women form the largest proportion of those working in health and the care sectors. This applies in both the paid and unpaid sectors.

With the pandemic estimated to cost between 5 and 15 million jobs women will be impacted more than men.

Economic crises hit women harder, here’s why:

  • Women tend to earn less.
  • Women have fewer savings.
  • Women are disproportionately more in the informal economy.
  • Women have less access to social protections.
  • Women are more likely to be burdened with unpaid care and domestic work, and therefore have to drop out of the labour force
  • Women make up the majority of single-parent households.

In addition, stay-at-home orders have helped to fuel an increase in domestic violence.

Unlike in the UK and some other countries healthcare is not free at the point of need. This means that many cannot afford healthcare so the UN wishes to see a Universal Basic Income for all. It is really a part of ensuring availability and access. We can advocate/lobby for this whilst another way to help is through cash transfer schemes. There is sufficient evidence and experience to argue that cash transfers help the development and availability of both health and social care schemes. The UN Department of Economic and Social Affairs highlights that we are falling short of a promise of universal health coverage by 2030.

Advocating for universal access to health care and a universal basic income for all could be a way forward to help reach towards this aspiration and improve the lives of women and girls, and thus their families, everywhere. Several governments have begun to discuss ways of moving this agenda forward so now is the time to get involved in the debate.

Will you join in and help to deliver what is needed? Please do – we need you!

Kay Richmond
SIGBI Programme Director