{"id":12000,"date":"2011-10-24T13:37:07","date_gmt":"2011-10-24T12:37:07","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=12000"},"modified":"2013-06-12T11:38:59","modified_gmt":"2013-06-12T10:38:59","slug":"fran-baum-the-conclusion-of-the-rio-conference","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2011\/10\/24\/fran-baum-the-conclusion-of-the-rio-conference\/","title":{"rendered":"Fran Baum: The conclusion of the Rio conference"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" alt=\"Fran Baum\" src=\"http:\/\/www.bmj.com\/site\/blog\/icons\/fran_baum.jpg\" width=\"160\" height=\"130\" align=\"left\" \/>The final day of the\u00a0Rio conference\u00a0was on Friday\u00a0and the official declaration from the conference still doesn\u2019t deal with the underlying factors that are driving health inequalities between and within countries. Perhaps this is not surprising as addressing these factors (which include trade policy and the need to redistribute wealth more fairly) would directly challenge the global status quo of power and resources. The importance of these factors was emphasised by David Sanders (paediatrician, member of the People\u2019s Health Movement, University of the Western Cape, South Africa) who, in one of the final plenary sessions, emphasised that both over and under nutrition have their roots in unfair trade. He also spoke of the \u201cbrain-robbery&#8221; that is draining Africa of its nurses and doctors as they leave to fill the gaps in rich countries. When he spoke many of the audience, especially civil society members, leapt to their feet and applauded loudly. Ron Labonte (University of Ottawa) gave a superb presentation on the impact of economic globalisation on health and laid bare the ways in which the existing status quo is, quite literally, killing us. The opening video shown on Friday morning also addressed the importance of challenging power structures, and\u00a0the need for governments to regulate the private sector to promote and protect health.\u00a0The video (<a href=\"http:\/\/www.who.int\/sdhconference\/en\/\">see WCSDH website<\/a>) emphasised the importance of the post-war social welfare systems and the need for governments to invest in the health and wellbeing of\u00a0their citizens.\u00a0<!--more--><\/p>\n<p>As I leave Rio and reflect on the conference, the strengths for me have been that there is clearly a strong network of public servants, public interest civil servants, and academics all committed to the principle of achieving a fairer world in which health is more equally distributed. These networks have created a social movement for health equity and judging by the passion of many at the conference the movement is a force to be reckoned with.<\/p>\n<p>The conference discussions and papers have also completely avoided the \u201clifestyle drift\u201d that <a href=\"http:\/\/www.bmj.com\/content\/340\/bmj.c684.extract\">David Hunter and colleagues<\/a> (<em>BMJ<\/em> 2010;340:c684) have warned is a real danger in policy designed to address the social determinants of health. There is broad acceptance that improving population health equitably requires changes in policies and environments that shape people\u2019s opportunities for health. I\u2019ve not heard anyone suggesting that it is\u00a0a matter of people changing their lifestyles without first changing their conditions of everyday life. That health equalities can be reduced is being shown in Brazil with the success of their health and social reforms.<\/p>\n<p>There is also broad acceptance that while access to effective, accessible, affordable health care is vital, it is not enough to ensure health equity. Another consensus view emerging is that, as expressed by the South African Health Minister Aaron Motsoaledi\u00a0is that \u201chealth is not just another commodity but is a human right.\u201d The denial of this right to many indigenous people, especially through the impact of colonialisation has also been assessed. The ways in which loss of land and culture has had a profound impact on indigenous people was pointed out forcefully by Papaarangi Reid from New Zealand. She noted that improving health means analysing not just the situation of those who are denied health but also the fact that \u201cwhen some people are getting less, other people are getting more.\u201d Again the discussion dug down to the underlying determinants of health. There has also been open discussion of the need to control the power of corporations. Some felt this could happen through persuasion while most civil society people and some of the politicians showed distrust of markets because of their sole mandate to produce profit.<\/p>\n<p>So as I leave for the airport I am heartened by these positive factors. While disappointed with the official declaration, I\u2019m glad that an alternative declaration was drafted\u00a0which can now be circulated and used to advocate for more progressive positions from WHO and countries (see www.phmovement.org). Globally we are facing environmental, financial, and social crises and responding to these in a way that reduces inequity and promotes health is perhaps the greatest challenge we face.<\/p>\n<p><em><strong>Fran Baum<\/strong> is a professor of public health. She is the director of the Southgate Institute of Health, Society, and Equity, Flinders University, Adelaide, Australia and co-chair of the Global Steering Committee, People\u2019s Health Movement. She is an Australian Research Council Federation fellow.<br \/>\n<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>The final day of the\u00a0Rio conference\u00a0was on Friday\u00a0and the official declaration from the conference still doesn\u2019t deal with the underlying factors that are driving health inequalities between and within countries. [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2011\/10\/24\/fran-baum-the-conclusion-of-the-rio-conference\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[223],"tags":[],"class_list":["post-12000","post","type-post","status-publish","format-standard","hentry","category-guest-bloggers"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Fran Baum: The conclusion of the Rio conference - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2011\/10\/24\/fran-baum-the-conclusion-of-the-rio-conference\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Fran Baum: The conclusion of the Rio conference - The BMJ\" \/>\n<meta property=\"og:description\" content=\"The final day of the\u00a0Rio conference\u00a0was on Friday\u00a0and the official declaration from the conference still doesn\u2019t deal with the underlying factors that are driving health inequalities between and within countries. 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