Role of physicians and national medical associations in addressing the social determinants of health & increasing health equity, by Clive Needle

07 April 2015

With a stellar cast of speakers and participants from across the world in the magnificent setting of the British Medical Association (BMA) Great Hall in London, England, this event initiated by the Institute of Health Equity (IHE) and the World Medical Association (WMA) had an important sense of momentum and occasion. Informal discussions as participants gathered brought out frequent comments about being for the cause of social justice from a health perspective while being less sure about how to act concretely. The aim of the speakers was to show how positive steps are being taken in twenty countries and to mobilise commitments towards a global declaration for wider action during the year that Professor Sir Michael Marmot is President of the WMA 2015-16. The initiative stems from a similar national event,  that EuroHealthNet attended and has since advocated, held while Professor Marmot was a previous president of the BMA, plus enthusiasm in particular from the Canadian Medical Association to build global learning and change.

Professor Marmot as ever set an inspiring tone in his keynote presentation, balancing his excitement at developments in places such as Colombia, Bangladesh and Peru with sharp doses of reality at the scale of the social and health gradients persisting and widening in the context of social, economic and environmental crises. He was followed by a succession of country or association exemplars, with strong European inputs from France, Finland, Hungary, Portugal, Denmark, Sweden and UK. All gave cause for hope but no-one suggested solutions were easy or swift, and realities such as the difficulties of organising a meeting in sub-Saharan Africa put challenges in context.

But discussion sessions showed common purposes and determination to build on the work of these champions to build systematic change in a generation, as called for by the global Commission on SDH. These ranged from the use of new online tools published by WHO (here), to changing education and training models for medical students, to developing a global network of physicians within the ambit of the WMA, or linking with sustainable development goals and agendas in health systems, a subject close to the heart and plans of EuroHealthNet and WHO Europe.

Sensitive strategic questions arose, such as whether physicians need to move from advocacy to activism; how working across professional boundaries, for example with social care, can be achieved; how changes in communications and access to patient data can be ethically harnessed; how universality remains key while focussing on particularly vulnerable individuals and populations.

EuroHealthNet is proud to be associated with the work of Professor Marmot and colleagues at IHE via studies such as DRIVERS and other research or policy and advocacy work in Europe. We are seeking to contribute by building more cross sectoral partnerships with social, economic and environmental bodies at national and sub national levels across the continent, including with public health, primary care and social care associations, and work closely with WHO Europe, the EC and others to find and implement evidence based solutions to these needs.

The background documents, speaker profiles, links and further information are available here.