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Climate change, social determinants focus for WHO’s new Healthier Populations pillar

Climate change and its effects on health, social determinants, promotion and prevention and food and nutrition will be the focus of a new Healthier Populations division of the World Health Organization, seeking an end to “business as usual” approaches on the wicked problems of global health.

The unprecedented new pillar of WHO operations was unveiled in detail at a technical briefing at the 72nd session of the World Health Assembly in Geneva.

The new division brings together, for the first time under one banner, population health priorities including: tobacco control, physical activity, nutrition, healthy ageing, violence, children and vulnerable groups, social welfare and wellbeing and a host of climate change and environment-related health impacts. The new division, to be overseen by assistant director-general Naoko Yamamoto, will also tackle issues relating to migration.

These issues were previously dispersed across a number of different WHO sections.

WHO chief Tedros Adhanom Ghebreyesus first announced the Healthier Populations division back in March, but this week’s World Health Assembly was the first time its proposed work was discussed in detail.

Yamamoto said the new division would not pursue “business as usual” but was seeking to expand the WHO’s capacity and accelerate its efforts in improving population health and addressing the social determinants:

Our vision is a world where all people enjoy health and wellbeing, through health protection and promotion, preventive actions, healthy environments and (the) enabl(ing of) healthy life choices. This is our vision for our new division.

Our work will contribute to reducing health inequalities and reducing preventable disease and injury caused by the environmental and social determinants of health through a coordinated, intersectional approach to enable all people to enjoy better health and wellbeing.”

Though there were to be four distinct departments within the division, including a dedicated social determinants of health department and a distinct chapter dealing with climate change and the environment (see below), Yamamoto envisaged all four working closely together and also with country and regional offices and WHO HQ.

The shift was welcomed by public health advocates both present at and following the briefing from afar.

Speaking in Geneva, Ilona Kickbusch said, for those working on the frontlines of population health, it felt like “health and wellbeing is back on the agenda… the determinants are there as an issue”.

“As we have rediscovered Astana and Alma Ata, we are rediscovering the thinking of Ottawa, and that is fantastic,” said Kickbusch, referring to the landmark Astana and Alma Ata declarations on primary care and the Ottawa Charter on health promotion.

“Health is created where people live, love, work and play, and that means that we need to structure environments in a way that they are healthy and that relates to people’s wellbeing, not a narrow understanding of health.”

In particular, Kickbusch welcomed the new division’s environmental focus, emphasising the importance of a “socioecological approach to health” that recognised the “inextricable link between people and their environment.”:

The construction of this division allows for an interface — just think of food, environment, behaviour — you can really create something new… (as) Dr Yamamoto said, we don’t want to work as usual, we really want to address these wicked problems in a totally new way.”

Addressing the briefing, Dr Tedros said healthy populations was one of the three “pillars” of WHO, and was aimed at addressing the “root causes”, with a health-in-all-policies, multi-sectoral approach.

He cited the Ottawa Charter’s preconditions and resources for health — “peace, shelter education, food, income, stable ecosystem, sustainable resources, social justice and equity” — as the rationale for WHO’s new focus:

Healthy populations cannot come by our investment in the health sector, it’s investment in the environment, investment in other areas (that) can bring actually more health to the people.

By doing that, we prevent people from going to hospital in the first place, and that means people are healthy but at the same time it’s savings also, we’re saving money too.”

You can watch the full briefing below.

 

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