Preparing for The Future of Global Health: Pursuing Health Equity and Social Justice
In a world of changing physical environment, ideologies, and lifestyles, it is crucial that global health prepares for the changing priorities and evolving needs of populations. This can be achieved by building resilience through multilateral collaborations, aided by the continuing advance of innovative technologies. However, in doing so, health equity and social justice must remain a tangible constant at the core of the future of global health. this will be especially important when considering global health security, multilateralism, and the evolution of innovative technologies.
The COVID-19 pandemic has brought global health security to the forefront of global politics and global development. Differential vulnerabilities in health systems and individual health statuses linked to the social determinants of health that underlay different populations and communities led to drastically different health outcomes.1 Therefore, pre-emptively mitigating these vulnerabilities would reduce disparities in health outcomes. Addressing the weaknesses highlighted by the pandemic, such as the surge capacity of health systems, health workforce capacity, coordination between public health and primary healthcare, and social welfare programs, will be critical to improve our response to the next global health emergency.2 This will require a paradigm shift in politics and international cooperation towards solidarity to ensure that investments in global public goods and infrastructure are sufficient to address existing vulnerabilities that contribute to poor health and development outcomes.
Operational multilateralism must also enhance its accountability mechanisms towards this goal. This will go beyond lip service, to legally binding international agreements that address climate change and matters of health equity, with integrated programs for consistent monitoring and evaluation. Previous examples, such as the International Health Regulations and the Framework Convention on Tobacco Control, have already demonstrated the success of such measures. Moreover, sustainable, non-earmarked funding for global health initiatives that are proportionate to the impact and scope of the work should also be pursued. To this end, it is also essential to raise awareness among a broader range of stakeholders of the positive effects of enhanced investments in health. Indeed economic modelling analyses demonstrate that these benefits extend far beyond the health sector alone, and often surpass common expectations.3,4,5 Such efforts will ensure the optimal distribution of available resources and international cooperation that transcends mere political focus towards true health equity.
Advances in innovative technologies will significantly facilitate many aspects of these processes. The increasingly efficient and diverse communication methods, telemedicine applications in curative and preventive healthcare, novel R&D tools, artificial intelligence, and the capacity to capture and process big data will contribute to enhanced information flow, increased cohesion in governance mechanisms, improved diagnostics and medicines, and efficient service delivery. In addition, new digital tools can serve as platforms for the co-creation of multifunctional solutions to address the needs of different sectors, for example by combining health-related solutions with those for digital finance or digital governance. These “platform approaches” can further encourage and facilitate cross-sectoral collaboration and the mobilization of resources for collective benefit. Harnessing new digital strategies to strengthen health systems resilience and promote multilateralism can thus lead to improved services and outcomes in health, as well as other sectors.
In all of this, the international community must remain vigilant of power imbalances and inequities. Improving global health security is contingent upon equitable access to resources, and the success of multilateral and multisectoral collaborations to establish accountability mechanisms and investments in global public goods and infrastructure. Innovative technologies and the growing body of scientific evidence need to be leveraged to promote collaboration across disciplines and countries in their development process, ensuring equitable access, and sharing of data.
Global health and development are deeply social concepts that are intricately entwined with social justice and colonial history.6 Where historical practices marginalized vulnerable populations and communities, recognizing the mistakes of the past can promote decolonization of the field through shifts in pedagogy and research practices to become inclusive and participatory. This will not only open doors to recognize the specific needs of different populations, but it will also provide a platform for divergent ideas that can be harnessed to converge of the universal goal of health and well-being. It is only through such active efforts to maintain these values as central tenets of human rights and dignity, that health equity can be achieved.