Interview with Dr Rüdiger Krech
6 October 2011 - Dr Rüdiger Krech is Director of the Department of Ethics, Equity, Trade and Human Rights and head of the WHO Conference Secretariat for the World Conference on Social Determinants of Health. He tells us about his hopes and expectations for the conference, and discusses the status of the outcome document.
Q: How would you describe your vision for this conference?
Three years ago, when the WHO Commission on Social Determinants of Health launched its final report, we thought we had reached a point of no return. Now, with the global financial crisis – which has even further heightened social and health inequities around the world – this feeling is all the more present. We simply cannot sit on the sidelines any longer – we have to push for decisive action to create fairer societies. For this reason, I feel that there could not be a better time or a better location for this conference.
And we are certainly attracting the right audience. It is very encouraging that more than 90 Member States have already confirmed and over 50 delegations will be headed by Ministers of Health. Some countries will be sending intersectoral delegations, with as many as three ministers. I am pleased that many members of the former WHO Commission on Social Determinants of Health will also attend, including its chair, Sir Michael Marmot, as well as several former heads of knowledge networks. I will be interested to know how they feel when they see a global movement coming together.
The commitment of Member States is very strong, and so is the engagement of our key partners – UN agencies, the scientific community and NGOs. There will be as many as 19 side-events, led by ministries of health and other stakeholders. The Lancet and the WHO Bulletin are also covering the event, which is really crucial for us. The Brazilian government has done a wonderful job in preparing the conference and we are honoured that the Brazilian Vice President, Mr Michel Temer, will be addressing the audience on the first day.
Q: Could you summarize WHO’s policy recommendations in this area?
As detailed data becomes available, the extent of health gaps within countries is becoming more evident and more disturbing. In all countries – whether high, middle or low-income - where you sit on the socio-economic scale and where you live affects the state of your health. So we want to advocate for a 'social determinants of health approach' and build high-level backing for the development of national strategies and action plans to tackle health inequities.
It is absolutely crucial for WHO to move the discourse on social determinants from the 'what' and 'why' to the 'how to’ and to demonstrate that effective policy solutions do exist. There is significant progress on the social determinants agenda in all WHO regions – and Regional Offices – and the conference will be a tremendous opportunity to bring together all the knowledge and evidence that has been developed since the launch of the Commission’s report.
I also think that this event will provide an important platform for WHO and stakeholders to follow up on the UN High-level Meeting on Noncommunicable Disease Prevention and Control. There, global leaders highlighted the importance of engaging sectors such as business, industry, transport, the environment to tackle NCDs – and we seek to further strengthen political commitment in support of intersectoral action.
Q: What is the status of the declaration?
The Rio Declaration on Social Determinants of Health will be a political declaration, expressing commitment to take decisive action to reduce health inequities. Member States started discussing the draft text in early September and we have had eight very productive meetings since then. These are informal meetings of Geneva-based Member State missions and we have over 40 governments who are actively engaged. At the moment, the text stands at a good compromise and we will finalise negotiations during the conference in Rio de Janeiro.
Q: What will happen after the conference?
We anticipate that Member States will take the declaration to the World Health Assembly in 2012, which means that there will be plenty of follow up both on the international and Member State level. Several related conferences are already lined up for later this year – for example in the United Kingdom, in Germany and in Australia. In addition, I would like to make sure that there is proper follow-up during the Rio+20 conference and the 2013 health promotion conference in Finland.
Another key goal we have is to systematize our knowledge after the conference. The knowledge networks have been instrumental in generating evidence on health inequities, and we now have to build up the necessary infrastructure to connect all key stakeholders and facilitate knowledge-sharing. The health sector operates within a rather vertical structure and we need to assist stakeholders to break out of this and push for a degree of horizontal expansion and policy coherence for health.
We would also like to join forces with civil society organizations and academia, whose initiatives will be instrumental in translating the conference's outcomes into action. In this context, WHO will be launching an electronic discussion platform called "Action: SDH" - in the spirit of developing a global community of practice on addressing social determinants of health. We will have a launch event in Rio de Janeiro and will introduce the platform on this website soon, too.