Macroeconomics and Health (CMH)

MacroHealth Newsletter

No. 12, January 2005

New Commission to build on MH efforts towards better health and greater health equity

Three years after Macroeconomics and Health work in countries was begun, many governments have come to see health as an important investment within national planning. The work in countries has been spearheaded by national commissions or bodies that bring together ministries of health, planning and finance. They are charged with identifying priority health interventions, the cost of providing these interventions and options for mobilizing and spending public health funds. This information is used for strengthening national health and development planning.

Macroeconomics and Health work in countries will soon be complemented by the work of the new Commission on Social Determinants of Health (CSDH). Creation of the CSDH was initiated following the 2004 World Health Assembly, when WHO announced the beginning of a process to act upon the social causes of health inequities.

It is widely accepted that many determinants of health lie outside the health sector. Social factors, including food security, social exclusion and discrimination, human settlements, early childhood development and employment conditions underlie a significant portion of the global burden of disease and death and are a primary factor in stratification of health status within and between countries. As a result, the CSDH emerged to build on existing efforts to work towards better health and greater health equity. The CSDH, to be launched in March 2005, will demonstrate the scientific basis and opportunities for action on the social determinants of health and will strengthen the political and public health leadership.

The CSDH implementation process will be undertaken in several pilot countries and will incorporate lessons learned from the Macroeconomics and Health process. As an example, Macroeconomics and Health work has been built on supporting country capacity to undertake policy-oriented research and manage information. This will be a key component of the knowledge networks to be undertaken by CSDH. The CSDH knowledge networks are organized around nine key social determinants of health. Comprised of global experts and an organizational hub, the groups will seek to consolidate, disseminate and promote the use of knowledge that demonstrates the imperative and opportunities for action on the social determinants of health. Their work will focus on building both knowledge and leadership to inform policy and lead to effective, equitable interventions on key social determinants.

The Commission on Macroeconomics and Health (CMH) in 2001 triggered a shift in the perception of health from consumption to investment. By bringing the importance of health investments to the attention of key decision-makers, the CMH and follow-up Macroeconomics and Health work have blazed a trail for other health and development initiatives. While the CMH presented a complete picture of the circular health-development-poverty relationship and its policy implications, the CSDH will set the foundation for sustained processes to profile and integrate the social determinants of health within public policy and practice.

The commitment to equity and to addressing poverty in its many dimensions is manifested in efforts by both developing and developed countries towards achievement of the Millennium Development Goals. Together with the work started by the CMH, the CSDH will provide another piece to the complex puzzle of working towards sustainable, equitable health improvements and development.

Timothy G. Evans
Assistant Director-General, Evidence and Information for Policy, WHO