Refining the social contract for health to build on the Millennium Development Goals

Published: 12 October 2012 13:53 CET

On 16 October 2012 from 11am to 12.30pm, the International Federation of Red Cross and Red Crescent Societies (IFRC), in partnership with other organisations, will be holding the High Level Panel ‘Building a Social Contract for Health’. Speaking for the IFRC will be Stefan Seebacher, Head of the Health Department, International Federation of Red Cross and Red Crescent Societies.

By Beverly Bernard

The social contract for health stems from our mutual responsibility to alleviate poverty and misery. It has deep historical roots and strong foundations, but it still needs to be refined and improved.

In that respect, Universal Health Coverage must be within the Post-2015 policy framework to build on the Millennium Development Goals (MDGs) and ensure a continued pledge towards health and inclusive growth. This is a belief shared by many civil society organisations (CSOs) worldwide.

The MDGs have sparked incredible worldwide commitments to eradicate poverty, and specifically to improve access to - and outcomes of - health care services. Much has been achieved but there is still a long way to go before we can talk about equitable and quality health care systems. In addition to this situation and in a context of economic hardship, we are faced with a number of new challenges such as the threat of pandemics, the increased incidence of non-communicable diseases, the effects of climate change, the variable age distributions within different populations and the integration of communications technologies.

The EU has renewed its commitment to Universal Health Coverage through its 2010 Communication on ‘The EU Role in Global Health’. Following on, the EC has declared its intention to produce a Programme for Action on global health by 2013. This comes at a moment of considerable foreseen transformations in development policy with the adoption of the Agenda for Change on Increasing the Impact of EU Development Policy (AfC) introducing differentiated partnerships between low-income countries and middle-income countries, new forms of financing and increased associations with the private sector. These developments – and others such as the adoption of the Multi-Annual Financial Framework 2014-2020 – are going to shape the future of development aid. The EU needs to clarify its vision and make sure the health needs of the ‘bottom billion’ that currently reside in middle-income countries are also guaranteed.

In a context of shared responsibility between EU institutions, donors, civil society organizations and financial institutions, it is desirable that we strengthen existing or emerging synergies to shape the next stages of health policy making, acting coherently and affirmatively for available, accessible, acceptable and quality health systems. As a motor for political change and as a leader of human rights protection, the EU has a key role to play on the international stage regarding this objective.

There are deep inequities in access to healthcare within countries and between them. Our challenge is to bridge the gap between health systems and vulnerable populations.

Health systems are commonly seen as part of the problem but they are also part of the solution. Making the right to health a reality for all – including vulnerable communities and individuals – implies tackling health systems from the top by ensuring political will as well as the availability and coherence of financial inputs. Accordingly – and as a major ODA donor – the EU should pursue its efforts to reach the collective 0.7% of GNP dedicated to development aid by 2015. There is also a need to create innovative and evidence-based instruments to strengthen efficient, results-oriented and ethical financial input structures.

Where the formal health system is still unable to reach those that are most in need, the potential of community-based organisations and their activities has to be recognised. Working with communities and finding tailored solutions to inclusion can only be achieved through local involvement.

With 187 National Societies and millions of volunteers around the world, the IFRC and civil society at large offers complementary support at all levels of governance without undermining states’ prerogatives.

Our presence at the local level, close to current realities and the most vulnerable, is a strength decision-makers can draw from to create the best conditions for inclusive growth, development and health-for-all policies.

That said, we strive to reach further and to do better. Parallel to what we do in the areas of humanitarian aid and disaster management, we acknowledge that there is a growing need to develop comprehensive social protection, education and health activities too. Our Strategy 2020 reflects this with our aims to enable healthy and safe living and to promote social inclusion and a culture of non-violence and peace.

In that sense, in addition to being a service provider, our experience positions us as an important stakeholder and a partner at the decision table.

The right to health is a right that stakeholders need to shape on the basis of their strengths and the partnership opportunities that still need to be exploited. In that perspective, knowledge gaps need to be bridged to allow ‘scaling-up’ and ‘spreading-out’ strategies for successful health interventions.

You can catch the live video stream for the event on Tuesday 16 October, 2012 at 11am CET.