Session 6: Resilience - Strengthening Health System Equity and Tackling Inequalities
On February 8, 2024, IANPHI held a session during the annual meeting on strengthening health system equity and tackling inequalities.
Moderated by Shelly Bratton, Lead, National Public Health Institute Program, U.S. Centers for Disease Control and Prevention, the session provided a global perspective on inequity, exemplifying its impact with country cases, particularly focusing on the disproportionate effects of diseases such as COVID-19 on marginalized populations. The session delved into IANPHl's initiatives on inequity, highlighting emerging themes and potential areas for collective action, including working group activities and a call for new members. Furthermore, the working group reported on the Latin America Health Equity Working Group workshop.
Global Health Equity: The Journey at CDC
Dr. Vikas Kapil, Chief Medical Officer & Associate Director for Science Global Health Center, U.S. Centers for Disease Control and Prevention
In his presentation, Dr. Vikas Kapil described the journey that the CDC embarked on over the past year and a half, emphasizing its continuous nature rather than a one-time endeavor. Dr. Kapil highlighted the publication of U.S. CDC'sGlobal Health Equity strategy in late 2022, which involved extensive engagement with stakeholders globally. The strategy aimed to contextualize U.S. CDC's Health Equity work within a global framework, aligned with the organization's core strategy on Health Equity. He articulated a vision centered on ensuring that everyone can achieve the highest level of health without being disadvantaged by social, economic, demographic, or geographical factors. Dr. Kapil underscored the importance of a human rights-based approach to health and outlined six guiding principles for implementation, emphasizing prioritizing populations with the greatest need, engaging affected communities, and fostering ethical practices. He discussed the strategy's focus on measurable goals and shared examples of training activities and initiatives aimed at advancing global Health Equity. He concluded by stressing the importance of intentional and systematic efforts to embed Health Equity into public health activities, addressing social determinants and inequities as key factors in addressing global health challenges.
Reflections on Inequalities and its Impact
Gerry Eijkemans, Director Social and Environmental Determinants for Health Equity, Pan American Health Organization (PAHO)
Dr. Gerry Eijkemans, representing the Pan American Health Organization (PAHO), delivered a comprehensive presentation underscoring the organization's commitment to addressing health equity in the Americas. Beginning with historical context, she highlighted PAHO's inception in 1902 amid health crises during the construction of the Panama Canal and US railroads. Dr. Eijkemans emphasized the region's ongoing challenges, particularly exposed by the COVID-19 pandemic, and the imperative to tackle social determinants of health inequities. She outlined PAHO's strategies, including intersectoral action and community participation, as well as initiatives such as eliminating neglected diseases and addressing non-communicable diseases with an equity-focused approach. Dr. Eijkemans underscored collaboration between countries, civil society organizations, and local governments as essential for meaningful progress, emphasizing the need for concrete actions to translate rhetoric into tangible outcomes. The presentation concluded with a call to action, highlighting the importance of advancing health equity within health systems and programs, with PAHO and WHO offering partnership and support in this endeavor.
Resilience: Strengthening Health System Equity and Tracking Inequalities - INS's Mozambique Experience
Dr. Sofia Viegas Depuly Director General, Instituto Nacional de Saude, Mozambique
Dr. Sofia Viegas presented on the lnstituto Nacional de Saude (INS) and its role in transforming data into actionable insights. The National Health Observatory - NHO, established in 2015, serves as a virtual center for observing Mozambique's health and well-being, accelerating evidence generation on health determinants. Utilizing secondary data from diverse sources, including demographics, economics, and environment, the INS facilitates data triangulation for informed decision-making. Governed by an advisory committee representing various stakeholders, including government ministries and civil society, the INS plays a crucial role in public health governance. Through seven thematic platforms and multidisciplinary working groups, the national health observatory (NHO) analyzes routine health data alongside socio economic factors, producing analytical products such as bulletins and reports to inform policies and interventions. Dr. Viegas highlighted the INS's achievements, including its role in raising awareness of health inequities and hosting events to address the impacts of climate change on health. Emphasizing the importance of addressing population growth and health inequities, she concluded by affirming the INS's commitment to fostering equitable health and well-being in Mozambique - a country with a population predicted to double in the next 25 years.
Role of the National Health Observatory in Health Equity from Colombia's INS
Carlos Castaneda-Orjuela, Director, Colombia National Health Observatory, National Institute of Health
Carlos Castaneda-Orjuela discussed the observatory's role in analyzing health equity and its impact on decision-making in Colombia. Highlighting Colombia's socio-economic and social inequalities, exacerbated by a history of armed conflict, Mr. Castaneda-Orjuela emphasized the need to address health disparities through equity analysis. The observatory, established in 2013, uses a multidisciplinary approach, incorporating data from various sources and conducting qualitative studies to understand contextual factors. Through annual reports, bulletins, research papers and policy briefs, the observatory communicates findings to decision-makers, informing policies and interventions. He provided examples of the observatory's work, including analyzing health inequalities during the COVID-19 pandemic and assessing avoidable mortality related to health system access. Mr. Castaneda-Orjuela stressed the importance of informing decision-making processes with evidence and outlined future steps, such as incorporating a One Health perspective and addressing emerging issues like climate change and antimicrobial resistance.
Africa CDC's Work on Inequities and Public Health
Dr. Raji Tajudeen, Head of Public Health Institutes and Research Division, Africa CDC
Dr. Raji Tajudeen discussed Africa CDC's response to the COVID-19 pandemic, focusing on addressing inequalities exacerbated by the crisis. He outlined the challenges faced by African countries, including weak health systems and limited access to medical supplies. Africa CDC mobilized member states to strengthen diagnostics capacity, secure essential medical supplies, and procure COVID-19 vaccines through political and technical collaboration. Dr. Tajudeen emphasized the importance of equitable access to vaccines and the need to strengthen Africa's local manufacturing capacity for essential medical products. He highlighted the call for a new public health order, stressing the importance of strengthening public health institutions, expanding local manufacturing capacity, mobilizing domestic resources, and fostering action oriented partnerships to address systemic inequities in health.
IANPH's Work on Equity, Emerging Themes and Potential Areas for Collective Actions
Shelly Bratton, Lead, National Public Health Institute Program, U.S. Centers for Disease Control and Prevention & Co-Chair, IANPHI Committee on Social and Public Health Inequalities
Shelly Bratton highlighted the committee's progress and future plans. The committee, aiming for global representation, emphasized the importance of diverse membership to ensure the committee's work reflects the needs and perspectives of all regions. They successfully launched as an official committee within IANPHI and doubled their representation through outreach efforts. Three driving priorities were identified: integrating health equity into all policies, enhancing national public health institutes' capacity to address inequities, and fostering peer-to-peer exchanges on health equity. These priorities guided the development of three main objectives focused on committee structure, knowledge generation and sharing, and external partner engagement. The committee is finalizing its draft work plan for approval by the executive board and is eager to welcome new members to contribute to their initiatives.
Resilience: Strengthening Health System Equity and Tackling Inequalities in Latin America
Dr. Felix Rosenberg, Chair of the IANPHI Latin American and Caribbean Regional Network and Co-Chair of the IANPHI Committee on Social and Public Health Inequalities
Dr. Felix Rosenberg provided an overview of the Latin American regional network workshop on health equity held in Petropolis, Rio Janeiro, Brazil. Participants from various Latin American countries and beyond gathered to discuss proposals to strengthen health equity at global, national, and local levels. At the global level, the focus was on improving access to health products and supplies, proposing activities such as strategic analysis and comparative regulatory frameworks. Nationally, the emphasis was on addressing unequal access to health services, with proposed activities including defining the role of National Public Health Institutes in researching health service inequities and conducting research projects on primary healthcare and border areas. At the local level, the priority was on addressing challenges in fragile territories, with proposed activities including sharing documentation on participative rapid diagnosis and implementing methodologies in pilot communities to scale up solutions. The workshop's outcomes mirrored the priorities discussed in the broader meeting, demonstrating alignment in addressing health equity challenges.
To close the session, both on-site and virtual participants were invited to continue to share and learn from each other.
"It's time now for the health sector, through the National Public Health Institutes, to act with other sectors of government and social and community organizations to effectively change this reality by focusing the elimination of inequalities and social inequalities and health inequities." Dr. Rosenberg.