The World Health Organization (WHO) states that health is ‘a fundamental human right’, but many millions of people around the world remain deprived of this right.
Health inequities occur due to a wide range of social determinants of health – where we are born, where we grow up and where we live; access to education and employment; systemic racism; sexism and more – which, while deeply rooted, are ‘a consequence of political and economic choices’.
The consequences are significant. It is estimated that a lack of access to healthcare causes about 15,000 deaths a day. While the greatest burden of health inequity falls on people in low- and middle-income countries, health inequity remains a challenge everywhere, including in high-income countries. The USA has the highest rates of avoidable deaths among high-income countries, while in Europe, health inequity poses the greatest challenge to achieving public health goals in the coming years.
Health equity – defined as ‘when everyone can attain their full potential for health and well-being’ – benefits us all and makes society stronger and more resilient. It should be a priority for everyone. Achieving health equity requires action and collaboration among all stakeholders involved in health and social systems.
Here, we look at each of the ‘five Ps’ of health stakeholders – policymakers, payers, providers, patients and pharma – to see where each has the greatest potential to effect meaningful change, and examples of initiatives to close health equity gaps.
Policymakers: shaping the environment to make change possible
Perhaps no stakeholders have the potential to make greater inroads into improving healthy equity than policymakers, who can shape health policy and system strategies to address the fundamental political, economic and social factors that determine health.
The impact can be wide-reaching. Take A New Public Health Order for Africa for example, a framework developed by the Africa CDC to strengthen the self-sufficiency of African public health systems. Built on pillars including a strengthened public health workforce and expanded manufacturing of vaccines, diagnostics and therapeutics, the framework will enable the ‘second independence of Africa’, according to the Director General of the Africa CDC.
In Europe, the JAHEE (Joint Action Health Equity Europe) was formed in 2018 with the aim of achieving greater equity in health outcomes through strengthening cooperation between participating countries. With actions across five policy domains – monitoring, governance, living environments, health systems and migration – the initiative enabled increased levels of national policy action and capacity to address health inequities.
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