Is it Possible to Build a Global Social Contract for Health?

The importance of creating a global social contract and the minimum conditions necessary to guarantee everyone the right to health was the focus of an international seminar entitled Building a Global Health Social Contract for the 21^st Century organised jointly by the ISGlobal Think Tank and the Open Society Foundations and held at the Centro de Cultura Contemporánea de Barcelona (CCCB) on 7 and 8 November.

The seminar was opened by HRH The Infanta Cristina de Borbón, President of ISGlobal's Board of Trustees, who stressed the importance of health equity for achieving greater equality in our society. In his opening remarks, Pedro Alonso—Director of ISGlobal—underscored how the current global increase in inequality is threatening the right to health of vulnerable populations all over the world, adding that "the current political context is an excellent opportunity to address these inequalities, and to define the rights that should be respected by all and the rules everyone should abide by, both nationally and globally; equity is at the centre of everything we do".

The first session was a keynote speech by London School for Hygiene and Tropical Medicine researcher Martin McKee on the challenge of universal health coverage (UHC), a concept he described as both a goal in its own right and an engine of economic growth. The lack of UHC, he added, is one of the main causes of poverty in the world today. McKee went on to emphasise, "We need social health protection, and the system should be based on a global model rather than national solidarity. As it is shared by all, public expenditure on health care helps to reduce the overall cost".

Arguments In Favour of Public Health Care

Although there is no single definition of the concept, we can say that UHC entails meeting the following three criteria: 

• having explicit legislation regulating a system to provide health care for all citizens
• a public health system that provides care for at least 90% of the population
• a situation in which over 90% of pregnant women receive medical care during childbirth.

In McKee's opinion, there are strong arguments in favour of public health care, including the fact that private providers have incentives to inflate costs and do not participate in outreach activities to reach the poor and needy.

The Importance of Taxes for Equity

To limit the influence of private interests, it is essential to have a high level of public funding for health care. Therefore, it is essential to maintain tax levels notwithstanding the difficult economic situation; for every 1% increase in tax revenue, health spending as a share of GDP increases by 0.08%. "Solidarity is still alive in Europe, but we don't know for how long," the speaker concluded.

More information

The seminar on Storify

Seminar photos

Think Tank publications

ISGlobal blog posts on Health Equity