Why do health inequality solutions continue to fail?

How to reduce health inequality?

It was the subject of the most recent episode of the Podcast on global health issues with Dr Garry Aslanyan.

https://www.youtube.com/watch?v=6xzzxg56j80

Understanding health inequality

“The inequality of health is produced by and in the social relations which govern the production and exchange of concrete material things that we need to survive and flourish, to ensure well-being, like health,” said the guest Hani KimExecutive director of the good foundation in Seoul, Korea. “Depending on the material conditions, I mean how much we have and control various economic resources – resources that can produce things such as money, land, references and work. What you have and the quantity of these resources that you control critically determine what you need to do to get what you need to ensure your well-being. “”

In other words, she explained, the relations between the various actors within global health-that IT nations, non-governmental organizations, private philanthropies or groups of stakeholders in countries are deeply rooted in a system that perpetuates the inequalities of resources and power between countries and countries.

“These inequalities, as well as material and power relations, have a deep impact on strategies and directions that the field of global health employs to achieve its objectives,” added Kim.

The role of local voices

Kim stressed that global health efforts are often led by elites that impose solutions from above, assuming that they have the best answers. This trend normalizes and universalizes their perspectives at the cost of marginalizing the views that do not align with them.

She has prioritized to invite and listen to partners from countries facing local health challenges. Although she has seen progress in this area, she stressed that there is still a long way to go. In addition, she warned that the inclusion simply to include local voices is not enough – it is essential to ensure that they are really representative, not only elites of their own communities.

“We live in a structure where the inequalities of resources and power are so omnipresent that even in these countries, the degree of inequality is immense. So determine what the workers’ classes really want cannot be done simply by selecting some so-called representatives, “said Kim. “The needs and desires of these communities are better expressed by movements and actions led by members of these communities and working class groups in their local context. This is intrinsically difficult to capture by simply selecting one or two representatives for forums, meetings and conferences organized by elites. »»

Act

Kim stressed that the realization of changes obliges individuals to act in their own areas – whether students, researchers or teachers – and to recognize their inherent limits.

“Let us keep against the temptation to portray a vision of the world where we can do, simply because it is something we can do, is the most important or the best approach,” added Kim. “The resolution of health inequalities is only possible when inequalities and material relations are treated. And history teaches us that difficulties in equality have been carried out and won by oppressed and exploited courses, not by the elites. »»

Build a lasting change

Another guest on the podcast, Seye AbimbolaAssociate professor of research on health systems at the Sydney University of Public Health School, echoes a large part of what Kim said, but added another critical perspective: many change efforts fail because people assume that change will occur alone.

“The change does not only occur by accident or on the automatic pilot,” said Abimbola. “You have to build things and be part of the construction of structures that always do good by people on behalf of which, with whom and for whom we must work.”

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Image credits: TDR Global Health Matters.