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  1. 1

    Priorities for research on equity and health: Implications for global and national priority setting and the role of WHO to take the health equity research agenda forward. Final report.

    Ostlin P; Schrecker T; Sadana R

    Geneva, Switzerland, World Health Organization [WHO], 2010 Nov. [43] p.

    The current issues paper was commissioned by the Equity Analysis and Research Unit of WHO, Geneva, to update the advice provided in 2005. It sets forth the broad parameters for a global research agenda on equity and health, taking stock of contemporary efforts, stakeholder discussions, relevance to Member States and expected innovations. Organised in three sections (Background, Research priorities, and Next steps), this paper aims to stimulate further thinking, debate and refinement of strategic approaches focussing WHO support and collaborations to advance global research on equity and health. It is not a comprehensive review of research in the area of equity and health, nor of approaches to support research policies and their implementation in this area. Key strategic issues on which this paper aims to stimulate discussion are: 1. Based on recommendations and learning from the Commission on Social Determinants of Health, the Knowledge Networks set up to support the CSDH, and other contemporary efforts, what areas of research could WHO concentrate support on to best advance greater health equity? 2. What aspects of research, including the development of concepts, methods, norms and standards, and synthesis approaches could best benefit from global collaboration? 3. How can WHO support and guide collaborations to maximise the relevance of global research on equity and health to specific countries and sub-populations; and 4. What core strategies and innovative opportunities could increase research collaborations and the uptake of research, involving a wider range of investigators, institutions and civil society organisations from low- and middle-income countries? (Excerpts)
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  2. 2

    A conceptual framework for action on the social determinants of health.

    Solar O; Irwin A

    Geneva, Switzerland, World Health Organization [WHO], 2010. [79] p. (Discussion Paper Series on Social Determinants of Health No. 2)

    Complexity defines health. Now, more than ever, in the age of globalization, is this so. The Commission on Social Determinants of Health (CSDH) was set up by the World Health Organization (WHO) to get to the heart of this complexity. They were tasked with summarizing the evidence on how the structure of societies, through myriad social interactions, norms and institutions, are affecting population health, and what governments and public health can do about it. To guide the Commission in its mammoth task, the WHO Secretariat conducted a review and summary of different frameworks for understanding the social determinants of health. This review was summarized and synthesized into a single conceptual framework for action on the social determinants of health which was proposed to and, largely, accepted by, the CSDH for orienting their work. A key aim of the framework is to highlight the difference between levels of causation, distinguishing between the mechanisms by which social hierarchies are created, and the conditions of daily life which then result. This paper describes the review, how the proposed conceptual framework was developed, and identifies elements of policy directions for action implied by the proposed conceptual framework and analysis of policy approaches. (Excerpt)
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  3. 3

    Action on the social determinants of health: learning from previous experiences.

    Irwin A; Scali E

    Geneva, Switzerland, World Health Organization [WHO], 2010. [52] p. (Discussion Paper Series on Social Determinants of Health No. 1)

    Today an unprecedented opportunity exists to improve health in some of the world's poorest and most vulnerable communities by tackling the root causes of disease and health inequalities. The most powerful of these causes are the social conditions in which people live and work, referred to as the social determinants of health (SDH). The Millennium Development Goals (MDGs) shape the current global development agenda. The MDGs recognize the interdependence of health and social conditions and present an opportunity to promote health policies that tackle the social roots of unfair and avoidable human suffering. The Commission on Social Determinants of Health (CSDH) is poised for leadership in this process. To reach its objectives, however, the CSDH must learn from the history of previous attempts to spur action on SDH. This paper pursues three questions: (1) Why didn't previous efforts to promote health policies on social determinants succeed? (2) Why do we think the CSDH can do better? (3) What can the Commission learn from previous experiences -- negative and positive -- that can increase its chances for success? (Excerpt)
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  4. 4

    Reducing health inequities through action on the social determinants of health.

    World Health Assembly (62nd: 2009: Geneva)

    Geneva, Switzerland, World Health Assembly, 2009 May 22. 5 p. (WHA62.14)

    The Sixty-second World Health Assembly calls upon the international community, including United Nations agencies, intergovernmental bodies, civil society and the private sector: (1) to take note of the final report of the Commission on Social Determinants of Health and its recommendations; (2) to take action in collaboration with WHO's Member States and the WHO Secretariat on assessing the impacts of policies and programmes on health inequities and on addressing the social determinants of health; (3) to work closely with WHO's Member States and the WHO Secretariat on measures to enhance health equity in all policies in order to improve health for the entire population and reduce inequities; (4) to consider health equity in working towards achievement of the core global development goals and to develop indicators to monitor progress, and to consider strengthening international collaboration in addressing the social determinants of health and in reducing health inequities. (Excerpts)
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  5. 5

    Wealth and child survival: India and Bangladesh [letter]

    Billal DS; Hotomi M; Yamanaka N

    Lancet. 2008 Oct 25; 372(9648):1459.

    Your Aug 16 Editorial1 emphasises that India is far from its target of reaching Millennium Development Goal 4 on child survival, despite its impressive rate of economic growth compared with the other south Asian nations. You state that India is spending only 3% of its gross domestic product (GDP) on health, which is less than the other countries in the Asia-Pacific region; however, India has actually been spending only 0|9% of its GDP on heath for the past two decades.2 2-3% of GDP is the predicted level of spending by the Indian Government by 2010.2 Although the link between poverty and child mortality is very strong, some countries are better at translating their economic growth into pre venting child deaths. For example, India's gross national income (GNI) per head has in creased by a staggering 82% from US$450 in 2000 to $820 in 2006, yet its child mortality rate only declined by 19% from 94 per 1000 births to 76 per 1000. Over the same period, Bangladesh saw a much smaller 23% in crease in GNI per capita-from $390 in 2000 to $480 in 2006-but its child mortality dropped by 25% from 92 to 69 per 1000 births.3,4 The maternal mortality rate also declined from 440 per 10 000 births in 1997 to 315 in 2001 in Bangladesh.5 All countries, even the poorest, can reduce child mortality if they pursue the right policies and prioritise their poorest families. Good government choices save children's lives but bad ones are a death sentence. (full-text)
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  6. 6

    Addressing gender-based violence: A critical review of interventions.

    Morrison A; Ellsberg M; Bott S

    Research Observer. 2007 Spring; 22(1):25-51.

    This article highlights the progress in building a knowledge base on effective ways to increase access to justice for women who have experienced gender-based violence, offer quality services to survivors, and reduce levels of gender-based violence. While recognizing the limited number of high-quality studies on program effectiveness, this review of the literature highlights emerging good practices. Much progress has recently been made in measuring gender-based violence, most notably through a World Health Organization multicountry study and Demographic and Health Surveys. Even so, country coverage is still limited, and much of the information from other data sources cannot be meaningfully compared because of differences in how intimate partner violence is measured and reported. The dearth of high-quality evaluations means that policy recommendations in the short run must be based on emerging evidence in developing economies (process evaluations, qualitative evaluations, and imperfectly designed impact evaluations) and on more rigorous impact evaluations from developed countries. (excerpt)
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  7. 7

    Reversing the epidemic: from commitment to action.

    Sharma M

    Choices. 2001 Dec; 5.

    The HIV/AIDS epidemic is the world's most serious development crisis. Nearly 58 million people have been infected, and 22 million are already dead. The epidemic continues to spread, with over 15,000 new infections every day. The devastating scale and impact of this catastrophe is a call of the utmost urgency for each of us to act. On 27 June 2001, the United Nations General Assembly Special Session on HIV/AIDS (UNGASS), adopted the "Declaration of Commitment on HIV/ AIDS." The Declaration recognized in clear and forthright terms the driving forces of the epidemic, including social, economic, and cultural aspects; and set specific measurable goals in four key areas: prevention of new infections; provision of improved care, support and treatment; reduction of vulnerability; and mitigation of the socio-economic impact of HIV/AIDS. The global community is challenged to respond to the epidemic in a new way, with strategic attention to its human rights and gender dimensions, greater accountability for results, and courageous and visionary leadership. (excerpt)
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  8. 8

    UNAIDS: an overview.

    Joint United Nations Programme on HIV / AIDS [UNAIDS]

    Geneva, Switzerland, UNAIDS, 1996. 9 p. (Facts about UNAIDS)

    Around 6 million people worldwide have died of AIDS since the start of the epidemic. Well over 20 million are living with HIV, the virus that causes AIDS. Already, there are communities and even whole cities where one out of every three adults is infected, and the repercussions of these dense clusters of illness and death will linger for decades. The epidemic and its impact are becoming a permanent challenge to human ingenuity and solidarity. Since the first of January 1996, UNAIDS -- the Joint United Nations Programme on HIV/AIDS -- has carried the main responsibility within the UN system for helping countries strengthen their long-term capacity to cope with this challenge. Based in Geneva, Switzerland, the new programme is cosponsored by six organizations of the UN family -- United Nations Children's Fund (UNICEF), United Nations Development Programme (UNDP), United Nations Population Fund (UNFPA), United Nations Educational, Scientific and Cultural Organization (UNESCO), World Health Organization (WHO), and the World Bank. Together with its cosponsors and other partners around the world, UNAIDS is hard at work on its mission -- leading and catalysing an expanded response to the epidemic to improve prevention and care, reduce people's vulnerability to HIV/AIDS, and alleviate the epidemic's devastating social and economic impact. (excerpt)
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  9. 9
    Peer Reviewed

    Priorities for research to take forward the health equity policy agenda.

    World Health Organization [WHO]. Task Force on Research Priorities for Equity in Health; World Health Organization [WHO]. Equity Team

    Bulletin of the World Health Organization. 2005; 83:948-953.

    Despite impressive improvements in aggregate indicators of health globally over the past few decades, health inequities between and within countries have persisted, and in many regions and countries are widening. Our recommendations regarding research priorities for health equity are based on an assessment of what information is required to gain an understanding of how to make substantial reductions in health inequities. We recommend that highest priority be given to research in five general areas: (1) global factors and processes that affect health equity and/or constrain what countries can do to address health inequities within their own borders; (2) societal and political structures and relationships that differentially affect people’s chances of being healthy within a given society; (3) interrelationships between factors at the individual level and within the social context that increase or decrease the likelihood of achieving and maintaining good health; (4) characteristics of the health care system that influence health equity and (5) effective policy interventions to reduce health inequity in the first four areas. (author's)
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  10. 10

    Key elements in HIV / AIDS care and support. Draft working document.

    World Health Organization [WHO]; Joint United Nations Programme on HIV / AIDS [UNAIDS]

    [Unpublished] 2000 Sep 8. [31] p.

    A lot of publications have been produced on care for people living with HIV/AIDS. This document attempts to bring key issues on HIV/AIDS care in one practical and concise publication. It is intended to provide guidance to all partners in the provision of HIV care and support in resource-constrained settings. The purpose of this document is to identify the key elements and interventions in provision of care and support for PLHA and affected communities. Each element of care is discussed and references for more information on how this element should be implemented are provided as much as possible. These references will be interactive for those documents having an electronic file available in WHO or in UNAIDS Secretariat websites. These references are practical publications useful for the implementation of the key elements of HIV/AIDS care. This document also covers structural elements for service delivery. Finally, it discusses prioritization of the various elements of HIV/AIDS care: these two sections are helpful in the process of prioritization and implementation of HIV/AIDS care interventions listed in this document. (excerpt)
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  11. 11

    The role of the health sector in supporting adolescent health and development. Materials prepared for the technical briefing at the World Health Assembly, 22 May 2003.

    Brandrup-Lukanow A; Akhsan S; Conyer RT; Shaheed A; Kianian-Firouzgar S

    Geneva, Switzerland, World Health Organization [WHO], 2003. 15 p.

    I am very pleased to be here, and to be part of the discussion on Young Peoples Health at the World Health Assembly, for two reasons: because of the work we have been doing in adolescent health over the past years together with the Member States of the European Region of WHO, the work in cooperation with other UN agencies, especially UNICEF, UNFPA, and UNAIDS on adolescent health and development. Secondly, because Youth is a priority area of work of German Development Cooperation, and of the German Agency for Technical Cooperation, where I am working presently. Indeed, we have devoted this years GTZ´s open house day on development cooperation to youth I would also like to take this opportunity to remember the work of the late Dr. Herbert Friedman, former Chief of Adolescent Health in WHO, whose vision of the importance of working for and with young people has inspired many of the national plans and initiatives which we will hear about today. In many countries of the world, young people form the majority of populations, and yet their needs are being insufficiently met through existing health and social services. The health of young people was long denied the public, and public health attention it deserves. Adolescence is a driving force of personal, but also social development, as young people gradually discover, and question and challenge the adult world they are growing into. (excerpt)
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  12. 12
    Peer Reviewed

    Annotated bibliography on equity in health, 1980-2001.

    Macinko JA; Starfield B

    International Journal for Equity in Health. 2002 Apr 22; 1(1):[20] p..

    The purposes of this bibliography are to present an overview of the published literature on equity in health and to summarize key articles relevant to the mission of the International Society for Equity in Health (ISEqH). The intent is to show the directions being taken in health equity research including theories, methods, and interventions to understand the genesis of inequities and their remediation. Therefore, the bibliography includes articles from the health equity literature that focus on mechanisms by which inequities in health arise and approaches to reducing them where and when they exist. (author's)
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  13. 13

    The Alma Ata Declaration and the goal of "Health for All" 25 years later: keeping the dream alive.

    Werner D

    Health for the Millions. 2004 Jan; 30(4-5):23-27.

    In 1978, a potential breakthrough in global health rights took place at an international conference organized by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) in Alma Ata in erstwhile USSR(now Almaty in Kazakhstan). In this Alma Ata Declaration, 134 countries subscribed to the goal of 'Health for All by the Year 2000'. They affirmed WHO's broad definition of health as 'a state of complete physical, mental and social well-being'. The world's nations--together with WHO, UNICEF, and other major funding organizations--pledged to work towards meeting people's basic health needs through the comprehensive and remarkably progressive primary healthcare (PHC) approach. Principals and methods garnered from the barefoot doctors' methodology in China and from experiences of small, struggling community-based health programmes in The Philippines and countries of Latin America. The linkage of many of these enabling initiatives to social transformation movements helps explain why the concepts underlying PHC have been praised as well as criticized for being 'revolutionary'. (excerpt)
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  14. 14

    Economic impact of AIDS in developing nations.

    Desmond G; Rockwell R

    AIDS and Society. 1989 Oct; 1(1):5-6.

    Gerald Desmond, Secretary of the United Nations Standing Committee on AIDS, was interviewed in New York by Richard Rockwell, Associate Editor of the Bulletin. (excerpt)
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