The origins of social determinants of health and universal health coverage at the World Health Organization, 2005–2015

Jan 2023

Health and development require one another: there can be no development without a critical mass of people who are sufficiently healthy to do whatever it takes for development to occur, and people cannot be healthy without societal developments that enable standards of health to be maintained or improved.

The book Health and Developmentedited by Iris Borowy and Bernard Harris, unites eleven case studies from nine countries in three continents and two international organizations since the late-nineteenth century. Collectively, they show how different actors have struggled to reconcile the sometimes contradictory nature of health and development policies, and the subordination of these policies to a range of political objectives.

Marcos Cueto, science editor of HCS-Manguinhos, is the author of the case study about the World Health Organization (WHO). In The origins of social determinants of health and universal health coverage at the World Health Organization, 2005–2015, Cueto examines the beginnings of two health proposals that emerged simultaneously at the World Health Organization (WHO) in 2005 and began complementing one another while competing for pre-eminence in the global debate on the relation of health and development: Social Determinants of Health (SDH) and Universal Health Coverage (UHC).

The first one was portrayed outside the realm of traditional medical interventions and sought to improve the living conditions of the poor; the latter was an intervention that emphasized a change in the scope and organization of health services. These two proposals became the latest reiteration of a long history of controversies regarding what should encompass health policies within the larger scheme of societal improvements, what their goals should be, and how they should be financed. The main argument of this paper is that during the period between 2005 and 2015, SDH and UHC encapsulated a competition in Global Health between a focus on environmental causes of health and vertical focus on specific diseases.

 

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