Global action to address health inequalities and wider inequalities in our societies is supported by many organisations and initiatives.
Health inequalities are present throughout the world. They are not confined to poor health in poorer countries and good health in wealthy countries. Because of its universality, achieving health equity requires international action, as well as action at the local and national level.
The UN Sustainable Development Goals
Adopted in 2015, the United Nations Sustainable Development Goals (UN SDGs) are a universal call to action to end poverty, protect the planet and improve the lives of everyone, everywhere. The 17 Goals are part of the 2030 Agenda for Sustainable Development. This agenda sets out a 15-year plan to achieve the Goals. Each Goal comes with a set of indicators. These help measure progress in each of the 193 countries that agreed to work towards achieving the goals.
The SDGs inform and guide initiatives to tackle health and social inequalities, on the global, national and local level. Just one Goal (SDG3 Good Health and Wellbeing) focuses on health directly. However each of the SDGs aims to address the determinants of health. The actions target global challenges such as poverty, inequality, climate change, environmental degradation, peace and justice. The SDGs are therefore a useful tool for addressing health inequalities, as well as the wider socioeconomic inequalities that lie at their roots.
The SDGs and COVID-19
The COVID-19 pandemic, with its dramatic effects on health, economic growth, employment, and poverty, might jeopardise progress towards the SDGs. The impact may be especially felt in developing countries. Here, a lack of safety nets and universal health coverage might mean there is less capacity to treat those infected with the virus and to mitigate the economic and social fallout of the pandemic.
In fact, the COVID-19 experience shows that countries that had made more progress towards the SDGs were better able to deal with the crisis. For instance, past success in ensuring clean water (SDG6), reducing the number of people who live in slums (SDG11), and reducing non-communicable diseases (SDG3) make it easier to mitigate the risk of contracting the virus. Additionally, increasing internet and smartphone access (SDG9) helps authorities communicate with the public. This resulted in more successful application of measures. However, improved healthcare systems (SDG3) and social protection systems (SDGs1 and 8) proved to most significantly impact countries' ability to deal with the crisis.
Looking ahead, the outlook for the Sustainable Development Goals after 2020 is mixed. For success, countries to need to
- minimise the damage caused by COVID-19,
- recover quickly from the damages,
- hold on and build further on the positive changes introduced to its healthcare, social protection, and governance systems during the COVID-19 crisis,
- sustain and bolster the positive gains made regarding planet-related SDGs during the COVID-19 crisis; and
- re-energise the effort toward sustainable development.
Within the EU
The Eurostat report 'Sustainable development in the European Union' monitors progress towards the SDGs in the EU in 2020. The report covers progress made by the EU as a whole, as well as on Member State level. A summary of the report is available here. Eurostat also offers multiple interactive tools that make it easy to explore the European Union's progress towards the SDGs. This page offers a comprehensive but accessible overview of the EU's progress on each individual goals, as well as its individual indicators. Other pages offer an overview of progress on each SDG for each European Member State, or help visitors discover what each SDG means for them, in the national as well as the European context.
Around the world
Each year the United Nations report on progress made to achieve the SDGs, on a global as well as national level.
- The UN's Sustainable Development Goals Report for 2020 is available here.
- Find a summary of global progress towards the SDGs that have a 2020 deadline here.
Data on progress towards the SDGs is also made available.
- Use this link to access data that is used for the yearly progress reports.
- For data and an overview of progress per country, use the country profiles that are available here.
The World Health Organization
The World Health Organization (WHO), a specialised agency of the United Nations, aims to achieve better health for everyone, everywhere. It works with 194 Member States, across six regions, and through more than 150 offices worldwide. Because of its expertise and recognition, WHO is an important actor in informing and coordinating global action addressing health inequalities.
In 1948 the WHO defined health as: a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. This represents a move to a holistic approach towards health. This approach considers not just the direct causes of physical and mental ill-health, but also the social, economic and environmental determinants that influence health and wellbeing outcomes.
The WHO Department of Social Determinants of Health
The WHO Department of Social Determinants of Health, part of the WHO Global Office, leads WHO’s efforts to address the social, physical and economic conditions that impact health. It compiles and disseminates evidence on what works to address these determinants, assists capacity building activities and advocates for action.
The WHO Commission on the Social Determinants of Health
The WHO Commission on the Social Determinants of Health aimed to support countries and global health partners in addressing the social factors leading to ill health and health inequalities. It increased awareness of the determinants of health and the need to create better social conditions for health The Commission’s final report was delivered in 2008.
The WHO Triple Billion Targets
The WHO Triple Billion Targets set ambitious goals for better health for billions of people by 2023. They function both as a measurement of progress and a policy strategy. The targets focus on 1 billion more people:
- benefiting from universal health coverage
- better protected from health emergencies
- enjoying better health and wellbeing
The Triple Billion Targets aim to significantly improve health through evidence-based interventions, strengthening of health information systems, and support for public health policies that take a holistic approach towards health. The measurement of these targets has been aligned with the UN’s Sustainable Development Goals.
To learn about progress towards the targets, visit the Triple Billion dashboard,
WHO Regional Office for Europe
Leaving no one behind
WHO Europe’s current Programme of Work is called United Action for Better Health. The Programme sets out the priorities for the period 2020-2025 based on citizens’ needs and expectations from their health authorities:
- universal and affordable access to care
- effective protection against health emergencies
- healthy communities in that are part of an economy of wellbeing.
Through the European Programme of Work, the WHO Europe aims to support health authorities in member states to meet those expectations.
The programme was built on the principle of leaving no one behind, thereby mainstreaming action to address the persistent health inequalities in and between countries across WHO Europe’s work.
The programme’s four flagship priorities are:
- The WHO Mental Health Coalition, whose aim is to position and promote mental health as a priority across WHO Europe member states.
- The Empowerment through Digital Health initiative which will, among other things, review evidence on digital health and solutions.
- The WHO European Immunization Agenda 2030 that aims to address inequalities in vaccine coverage within and between European countries.
- Healthier behaviours: incorporating behavioural and cultural insights, which aims to invest in new insights that can help build a culture of health that enables everyone to make health choices.
The WHO Europe Office for Investment for Health and Development
Also known as the WHO Venice Office, the Office for Investment for Health and Development provides tailored policy support to countries to design, implement and evaluate multisectoral policies health and health equity. It generates and disseminates knowledge and assists Member States by building partnerships and networks.
Its work programme encompasses 3 closely interrelated areas:
- Social determinants of health and health equity
- Healthy settings networks
- Investment approaches for health and wellbeing.
The Health Equity Status Report
The WHO Venice Office led the 2019 WHO report the European Health Equity Status Report. The report identified the essential conditions needed to create and sustain a healthy life for all. The report urged governments to take policy action to address these five conditions, which are:
- good quality and accessible health services
- income security and social protection
- decent living conditions
- social and human capital
- decent work and employment conditions.
The report provided evidence that these conditions drive health inequalities in all of the 53 Member States of the Region and set out solutions to reducing these inequities. It was accompanied by a report on case studies of success stories, promising practices and lessons.
WHO Pan-American Health Organisation
The PAHO Independent Commission on Equity and Health Inequalities in the Americas studied the leading causes in health inequalities in the Americas and evaluated the available factors that lead to health inequalities in the Americas. The commission published its final report containing 12 recommendations in 2019.
In 2020, PAHO assessed 32 national health plans to report on whether and how countries in the Americas integrate the achievements of health equity into strategic lines of action in the health sector. It provides a snapshot of approaches and advances, allowing for knowledge sharing among countries on options for attention to equity in health policy. It will also facilitate future monitoring of trends in the integration of health equity aims and approaches in policies.
More information on PAHO’s work on health equity is available here.
WHO Regional Office for Africa (AFRO)
AFRO’s Social and Economic Determinants of Health Programme provides technical support to Member states and WHO to reduce the health equity gap through action on the determinants of health. Its website offers a range of documented country experiences on addressing the social determinants of health, as well as on making progress towards the Rio Declaration on Environment and Health.
The United Nations Children’s Fund (UNICEF)
UNICEF works with governments and partners, including civil society, to deliver the majority of its programmes. Its work builds on the Sustainable Development Goals and addresses both health and the determinants of health. A complete overview of UNICEF’s activities to reach the SDGs is available here.
UNICEF Health Strategy 2016 – 2030
The UNICEF Health Strategy 2016 – 2030 sets out two overarching goals: to prevent maternal, newborn and child deaths, and to promote the health and development of all children. To achieve these goals, UNICEF takes the following three approaches:
- Addressing inequities in health outcomes
- Strengthening health systems, including emergency preparedness, response and resilience
- Promoting integrated, multi-sectoral policies and programmes.
Multiple Indicator Cluster Surveys
Using the UNICEF-supported Multiple Indicator Cluster Surveys (MICS), countries around the world periodically survey households to gain insight in key indicators of children’s and women’s wellbeing. The survey helps governments identify those who are most disadvantaged and in need of intervention. The UNICEF Innocenti Office for Research collects a substantial amount of data on health and the determinants of health in children and families worldwide. Data, journal articles and data visualisations are available here.
United Nations Development Programme (UNDP)
UNDP works in 170 countries and territories around the world to eradicate poverty while protecting the planet. It helps countries develop strong policies, skills, partnerships and institutions so they can sustain their progress. Its work is led by the United Nations Sustainable Development Goals.
UN Special Rapporteurs
UN’s special rapporteurs examine, monitor, advise, and publicly report on global challenges. The Special Rapporteur on extreme poverty and human rights, and the Special Rapporteur on the right to physical and mental health facilitate the acquisition of knowledge of and action for health equity worldwide.
International Organization for Migration (IOM)
IOM is a United Nation’s Organisation that is dedicated to promoting humane and orderly migration for the benefit of all. The Migration Health Division delivers and promotes comprehensive, preventive and curative health programmes which are beneficial, accessible and equitable for migrants and mobile populations.
The Organisation for Economic Co-operation and Development (OECD)
OECD is an international organisation that works to build better policies for better lives. Its goal is to shape policies that foster prosperity, equality, opportunity and wellbeing for all.
In the field of health, OECD helps countries achieve high-performing health systems. It does so by measuring health outcomes and the use of health system resources, as well as by analysing policies that improve access, efficiency, and quality of health care.
Besides making available comprehensive data on health and wider social and economic indicators, OECD publishes biannual reports on health and education in the OECD region.
Other initiatives and organisations
Global Health 50/50
Global Health 50/50 is an independent, evidence-driven initiative that aims to advance action and accountability for gender equality in global health. It advocates for a gender-lens, gender equality and health equity at the core of all it does. It acts as a channel, bringing together academic research, knowledge of how policy change can occur, and advocacy to change policy and practice.
Among other resources, Global Health 50/50 offers a Gender and Health Index, a range of how-to guides for addressing gender inequalities in health, and a self-assessment toolkit. Find the resource database here.
The International Union for Health Promotion and Education (IUHPE)
The IUHPE’s mission is to promote global health and wellbeing and to contribute to the achievement of equity in health between and within countries. IUHPE is an independent global network committed to improving health and wellbeing through education,
community action and healthy public policy.
IUHPE works specifically on the topics of non-communicable diseases, sustainable development, social determinants of health and health promotion systems. It specifically provides knowledge, resources and tools for those organisations working on these topics.
The Health Equity Initiative
The Health Equity Initiative aims to cultivate and nurture a next generation of leadership, and to build a collaborative community for promoting health equity in Southeast Asia and China. The fellowship program brings together professionals from a wide range of sectors and disciplines to foster the next generation of leadership in advocacy for social justice.
University of Global Health Equity
Based in Rwanda, The University of Global Health Equity fosters the next generation of global health professionals. It aims to create leaders and changemakers who strive to deliver more equitable, quality health services for all. Programmes are offered to students who have experience as (health)care professionals, researchers, and public health and policy experts to ensure that students understand the complexity of delivering care in all settings.