Alma-Ata

http://www.who.int/social_determinants/links/events/wha2006/en/index.html
World Health Organization – May 2006

Website: http://www.who.int/social_determinants/links/events/wha2006/en/index.html


"Managing the Politics of Equity and Social Determinants of Health" - the title of the informal briefing the Commission held at the 59th World Health Assembly. The briefing drew sharper focus on the necessity of major health stakeholders to step up action on the social causes of ill-health. High-level policy makers, civil society members and WHO staff attended the briefing, proclaimed as a "historical moment" by a floor delegate. Among the attendees was Dr Halfdan Mahler considered to be the father of the Alma Ata Declaration and former WHO Director-General from 1973 to 1988.

"He gave us the dream. He launched new ideas and made us realize that it was possible to achieve health for everybody," Commissioner, Dr Giovanni Berlinguer noted. Dr Berlinguer outlined the evolution of global health politics over the past three decades and lamented the impact of changes in the political economy which saw public health recoil under the shadow of major financial institutions. He told delegates that the setting up of the Commission on Social Determinants of Health was an opportunity to add momentum to a global movement that wanted to see health inequalities addressed.

Bolivia's Health Minister Dr Nila Heredia pointed out her country's challenges to address inequalities in health, stating the low health budget and historical factors as some of the major obstacles (see her presentation below). She mentioned poverty, poor housing and low levels of education, particularly among women, as some of the key social determinants of health in Bolivia. The government was exploring several programs to address health inequalities which included a "zero malnutrition" program and the promotion of a social security system that would allow segments of society to gain free access to health.

Civil society representative, Dr Hani Serag challenged WHO and the Commission to address the "profound determinants such as violence, wars, and neo-liberal policies" and to allow the different components of the Commission to work independently. Dr Serag further challenged WHO to return to the principles of the Alma-Ata Declaration (see below).

Commissioner Dr Ndioro Ndiaye stressed the importance of including sectors outside the health domain to be part of the developing healthy societies: "If we do not look at the intersectoral angle, that health is not just a medical problem … we will not succeed." The Commission already engages different ministries and sectors outside health to work collaboratively on social determinants of health and equity.

The Declaration of Alma-Ata

Presentations

Equidad y determinantes sociales de la salud [pdf 119kb]
Presentation by Dr Nila Heredia, Minister of Health, Bolivia

Canada’s Participation and Response [pdf 146kb]
Presentation by Jim Ball, Public Health Agency of Canada

Addressing Unhealthy Policies [pdf 367kb]
Presentation by Drs Hani Serag, Alaa Shukrallah, People’s Health Movement

The Global Burden of Disease

Our aim was to calculate the global burden of disease and risk factors for 2001, to examine regional trends from 1990 to 2001, and to provide a starting point for the analysis of the Disease Control Priorities Project (DCPP).

Methods
We calculated mortality, incidence, prevalence, and disability adjusted life years (DALYs) for 136 diseases and injuries, for seven income/geographic country groups. To assess trends, we re-estimated all-cause mortality for 1990 with the same methods as for 2001. We estimated mortality and disease burden attributable to 19 risk factors.

Findings
About 56 million people died in 2001. Of these, 10·6 million were children, 99% of whom lived in low-and-middle-income countries. More than half of child deaths in 2001 were attributable to acute respiratory infections, measles, diarrhoea, malaria, and HIV/AIDS. The ten leading diseases for global disease burden were perinatal conditions, lower respiratory infections, ischaemic heart disease, cerebrovascular disease, HIV/AIDS, diarrhoeal diseases, unipolar major depression, malaria, chronic obstructive pulmonary disease, and tuberculosis. There was a 20% reduction in global disease burden per head due to communicable, maternal, perinatal, and nutritional conditions between 1990 and 2001. Almost half the disease burden in low-and-middle-income countries is now from non-communicable diseases (disease burden per head in Sub-Saharan Africa and the low-and-middle-income countries of Europe and Central Asia increased between 1990 and 2001). Undernutrition remains the leading risk factor for health loss. An estimated 45% of global mortality and 36% of global disease burden are attributable to the joint hazardous effects of the 19 risk factors studied. Uncertainty in all-cause mortality estimates ranged from around 1% in high-income countries to 15–20% in Sub-Saharan Africa. Uncertainty was larger for mortality from specific diseases, and for incidence and prevalence of non-fatal outcomes.

Inequality, Politics and Power

Third World Bank Conference on Inequality

Topic: Inequality, Politics and Power, June 5-6, 2006

Agenda: http://siteresources.worldbank.org/INTDECINEQ/Resources/conference_on_inequality_2006_agenda.pdf


“….The distributions of income, wealth and political power are jointly determined, with economic status both affecting and being affected by political influence. In addition, the impact of inequality on the nature of institutions and on policy choice is one of the key channels through which income and wealth distributions affect economic performance.

The Conference on Inequality will focus on the interaction between economic and political inequalities, and on their consequences for institutional and economic development. The program includes both theoretical and empirical papers prepared by academics and professionals that were selected drawing on a widely advertized call for submissions …”

Papers:

· Endogenous Constitutions, Davide Ticchi and Andrea Vindigni (University of Urbino and Princeton University)

· Trade, Inequality, and the Political Economy of Institutions, Quy-Toan Do and Andrei Levchenko (World Bank and International Monetary Fund)

· Populist Policies in the Transition to Democracy, Daniel Mejía and Carlos Esteban Posada (Brown University and Banco de la República)

· The Colonial Origins of Inequality: Exploring the Causes and Consequences of Land Distribution, E.H.P. Fankema (University of Groningen)

· The Profits of Power: Land Rights and Agricultural Investment in Ghana, Markus Goldstein and Christopher Udry (World Bank and Yale University)

· Revolution and Redistribution in Iran: Changes in poverty and distribution 25 years later, Djavad Salehi-Isfahani (Virginia Tech)

· Are Jurisdictions with the Median Voter and Median Inequality Favored?, Santanu Gupta (Institute of Technology and Management)

· Informatization, Turnout, and Income Inequality, Ryo Arawatari (Osaka University)

· Divide and Conquer: Noisey Communication in Networks, Power, and Wealth Distribution, Wilson Perez-Oviedo
(Cornell Univesity and Banco Central del Ecuador)

· Inflation, Inequality and Social Conflict, Christopher Crowe, (International Monetary Fund)

· Conflict and Wealth, Oskar Nupia (Universitat Pompeu Fabra)

· Kidnaps and Migration: Evidence from Colombia, Catherine Rodriguez and Edgar Villa (Boston University)

· Inequality and Education Decisions in Developing Countries, Catalina Gutierrez-Sourdis (New York University)

· To Segregate or to Integrate: Education Politics and Democracy, David de la Croix and Matthias Doepke (FNRS, IRES, Core and UCLA)

· Are Female Leaders Good for Education? Evidence from India, Irma Clots-Figueras (London School of Economics)

· Why doesn't Capitalism flow to Poor Countries?, Rafael Di Tella and Robert MacCulloch (Harvard Business School and Imperial College London)

· Economic Inequality and Corruption, Boris Begovic (Center for Liberal-Democratic Studies)

· How do Inequality and Households' Position in Income Ladder Affect the Response towards Privatisation? A Study of Indian States, V. Santhakumar and U.S. Mishra (Centre for Development Studies)

· Local Inequality and Project Choice in a Social Investment Fund, M. Caridad Araujo, Francisco H.G. Ferreira, Peter Lanjouw and Berk Ozler (World Bank)

· Social Funds, Clientelism and Redistribution: Chavez, Michael Penfold-Becerra (Instituto de Estudios Superiores de Administración)

· Inequality, Ethnicity and Social Disorder: The Ecuadorian Case, Jeannette Sánchez
·

Enfrentando o Desafio das Doenças Não Transmissíveis no Br.

O mesmo relatório divulgado no dia 09 último, em inglês, me foi enviado agora pelo Dr. Carlos Alberto Machado em inglês. Se alguém desejar o arquivo neste última forma, mande-me uma mensagem que o remeterei.
Abraço
AA

De: Carlos Alberto Machado [mailto:carlos.a.machado@uol.com.br]
Enviada em: sexta-feira, 12 de maio de 2006 17:56
Para: Aloyzio Achutti
Assunto: Fw: Report Banco Mundial
Prioridade: Alta
Relatório No. 32576-BR
BRASIL
Enfrentando o Desafio
das Doenças Não Transmissíveis no Brasil
15 de novembro de 2005
Unidade de Gerenciamento do Brasil
Unidade de Gestão do Setor de Desenvolvimento Humano
Região da América Latina e do Caribe

1. SUMÁRIO EXECUTIVO
1.1 As doenças não transmissíveis (DNTs) são responsáveis por uma parcela
grande e crescente da carga de doenças no Brasil. Atualmente, cerca de 66% da carga de
doenças no País deve-se a doenças não transmissíveis, comparado a 24% de doenças
contagiosas e 10% de ferimentos. A mudança do perfil do Brasil, com maior carga de
doenças não transmissíveis, é uma conseqüência da urbanização, de melhorias nos
cuidados com a saúde, da mudança nos estilos de vida e da globalização. A maior parte
dessa carga de doenças não é um resultado inevitável de uma sociedade moderna – tratase
de um mal que pode ser prevenido, e geralmente a um custo baixo. Este relatório tem
por finalidade apresentar uma visão geral da carga de doenças não transmissíveis no
Brasil e suas raízes, examinar os custos e a efetividade de intervenções de políticas
alternativas para tratar dessa carga crescente, os custos e retornos em potencial da
expansão da prevenção das DNTs e das atividades de controle, além de considerar as
implicações políticas de expandir as atividades para tratar efetivamente dessa carga em
alteração.

Seminário: Desigualdade, Desenvolvimento e Pobreza

Brasília, 17 de maio de 2006 - O Banco Mundial, o Instituto de Pesquisa Econômica Aplicada (Ipea) e o Departamento para Desenvolvimento Internacional do Governo do Reino Unido (DFID) realizam na quarta-feira, dia 17 de maio, em Brasília um seminário internacional sobre a desigualdade de renda na América Latina e no Brasil, e suas conseqüências para o desenvolvimento, a pobreza e o crescimento econômico no país e na região.

O Seminário será aberto pelo Presidente do Ipea, Glauco Arbix, pelo Diretor do Banco Mundial para o Brasil, John Briscoe e por Siegfried Hirsch, representando o DFID e serão apresentados os trabalhos Redução da pobreza e crescimento na América Latina: Círculos virtuosos e viciosos, do Banco Mundial, por William Maloney, e Transferências de Renda, Salário Mínimo e a Queda da Desigualdade no Brasil, por Sergei Soares, do Ipea.

Para participar é preciso inscrever-se nos telefones e e-mails (61) 3329-1009 – czardo@worldbank.org - Sra. Carla Zardo ou (61) 3329-8605 – darruda@wordbank.org - Sra. Daniella Arruda.

A evento será realizado na Auditório da sede o Ipea em Brasília - SBS - Quadra 1 - Bloco J - Ed. BNDES – Subsolo.

Haverá transmissão por videoconferência para o Ipea Rio, na Av. Presidente Antonio Carlos, 51, 10º andar, Centro

Veja a programação:

Brazil - Addressing the Non Communicable Diseases

WB

Abstract: Non-communicable diseases account for a large and growing share of Brazil's burden of disease. Currently, about 66 percent of the disease burden in Brazil is due to non-communicable diseases, compared to 24 percent from communicable diseases and 10% from injuries. Brazil's shift towards non-communicable diseases is a consequence of urbanization, improvements in health care, changing lifestyles, and globalization. Most of this disease burden i s not an inevitable result of a modern, aging society, but preventable-often at low cost. The purpose of this report is to provide an overview of the changing non-communicable disease burden in Brazil and its root causes, to examine costs and effectiveness of alternative policy interventions to address this growing burden, and the costs disease and potential returns from expanding non-communicable disease prevention and control activities, and to consider policy implication of expanding activities to effectively address the shifting burden.

Bridging the "Know-Do" Gap

De: Equity, Health & Human Development [mailto:EQUIDAD@LISTSERV.PAHO.ORG] Em nome de Ruggiero, Mrs. Ana Lucia (WDC)
Enviada em: segunda-feira, 8 de maio de 2006 12:06
Para: EQUIDAD@LISTSERV.PAHO.ORG
Assunto: [EQ] Bridging the "Know-Do" Gap

Bridging the “Know–Do” Gap
Meeting on Knowledge Translation in Global Health

10–12 October 2005 - World Health Organization - Geneva, Switzerland
Organized by the Departments of: Knowledge Management and Sharing (KMS)
Research Policy and Cooperation (RPC) - World Health Organization
With support from: The Canadian Coalition for Global Health Research, Canadian International Development Agency, German Agency for Technical Cooperation (GTZ)
WHO Special Programme on Research & Training in Tropical Diseases - WHO/EIP/KMS/2006.2
World Health Organization 2006
Available online as PDF file at: http://www.who.int/kms/WHO_EIP_KMS_2006_2.pdf
“….Bridging the know–do gap is one of the most important challenges for public health in this century. It also poses the greatest opportunity for strengthenging health systems and ultimately achieving equity in global health….”
“…. the meeting on “Knowledge Translation for Global Health” was convened with the following objectives:
1) To learn from country experiences in bridging the knowpdo gap and to develop a typology of knowledge translation approaches in countries;
2) To clarify knowledge translation concepts and frameworks, and to identify effective and feasible practices and approaches; and
3) To identify priorities and mechanisms for knowledge translation research and action in global health.

Alberta Healthy Living Network - Alberta Healthy Living Network - University of Alberta

Alberta Healthy Living Network - Alberta Healthy Living Network - University of Alberta: "Leadership for integrated, collaborative action to promote health and prevent chronic disease

The Alberta Healthy Living Network (AHLN) is a diverse group of over 100 multi-sector local, regional and provincial organizations and government departments.

This website has been developed with the generous support of the Canadian Diabetes Association."

Health Policy : Welfare state matters: A typological multilevel analysis of wealthy countries

ScienceDirect - Health Policy : Welfare state matters: A typological multilevel analysis of wealthy countries: "Building on the social science literature, we hypothesized that population health indicators in wealthy industrialized countries are ‘clustered’ around welfare state regime types. We tested this hypothesis during a period of welfare state expansion from 1960 to 1994. We categorized data from 19 wealthy countries into 4 different types of welfare state regimes (Social Democratic, Christian Democratic, Liberal and Wage Earner Welfare States). Outcome variables were the infant mortality rate (IMR) and the low birth weight rate (LBW), obtained from the Organization of Economic Co-operation and Development (OECD) Health Data 2000 and from the United Nations Common Statistical Database (UNCSD). A two-level multilevel model was constructed, and fixed effects of welfare state were tested. Through the 39 years analyzed, Social Democratic countries exhibited a significantly better population health status, i.e., lower infant mortality rate and low birth weight rate, compared to other countries. Twenty percent of the difference in infant mortality rate among countries could be explained by the type of welfare state, and about 10% for low birth weight rate. The gap between Social Democracies and other countries widened over the 1990s. Our results confirm that countries exhibit distinctive levels of population health by welfare regime types even when adjusted by the level of economic development (GDP per capita) and intra-country correlations. It implies that countries, as groups, adopt similar policies or through any other ways, achieve similar level of health status. Proposed mechanisms of such process and suggestions for future research directions are presented in the discussion.

"

Health Policy : Welfare state matters: A typological multilevel analysis of wealthy countries

ScienceDirect - Health Policy : Welfare state matters: A typological multilevel analysis of wealthy countries: "Building on the social science literature, we hypothesized that population health indicators in wealthy industrialized countries are ‘clustered’ around welfare state regime types. We tested this hypothesis during a period of welfare state expansion from 1960 to 1994. We categorized data from 19 wealthy countries into 4 different types of welfare state regimes (Social Democratic, Christian Democratic, Liberal and Wage Earner Welfare States). Outcome variables were the infant mortality rate (IMR) and the low birth weight rate (LBW), obtained from the Organization of Economic Co-operation and Development (OECD) Health Data 2000 and from the United Nations Common Statistical Database (UNCSD). A two-level multilevel model was constructed, and fixed effects of welfare state were tested. Through the 39 years analyzed, Social Democratic countries exhibited a significantly better population health status, i.e., lower infant mortality rate and low birth weight rate, compared to other countries. Twenty percent of the difference in infant mortality rate among countries could be explained by the type of welfare state, and about 10% for low birth weight rate. The gap between Social Democracies and other countries widened over the 1990s. Our results confirm that countries exhibit distinctive levels of population health by welfare regime types even when adjusted by the level of economic development (GDP per capita) and intra-country correlations. It implies that countries, as groups, adopt similar policies or through any other ways, achieve similar level of health status. Proposed mechanisms of such process and suggestions for future research directions are presented in the discussion.

"