Chantal Blouin Ottawa, CSIH, October 29th 2013

}  Refers to all global governance areas that have an impact on population health. ◦  International rules, treaties and arrangements

related to security, migration, human rights, trade, investment, food

}  Not only a matter of global health organisations such as WHO, Global Fund, or UN-AIDS

}  Introducing health equity as a goal for all sectors of global governance

}  People’s health also depends on global governance outside the health sector. ◦  Rules or agreements that were not designed to

harm or benefit health can have very important impact

}  Therefore, actions at the global level are necessary to improve health and to redress health inequities.

}  We consider ‘health’ as a political challenge rather than as a technical outcome.

}  Ex: rules of representation, transparency, and accountability relate to who participates in global decision-making processes – and to how these are shaped by actors with different values, interests, and power.

}  Ex: the outcomes of global decision-making process

}  The economic crisis has been reverberating in all corners of the globe since 2008.

}  Health risks associated with unemployment, reduced income and heightened economic insecurity brought on by economic crises.

}  For instance, in Europe, the crisis has translated into the reversal of the long-term decline in suicides.

}  Negative consequences of financial and economic crisis on population health are neither unique to this crisis nor a new phenomenon.

}  Increasingly, we hear calls to address the human costs of recessions. ◦  In 2009, the Director-General of the WHO called for

global action and solidarity to protect health and social expenditures in time of crisis.

}  Growing consensus on the importance of social policies to shelter people from the worst impacts of economic upheaveals.

}  Social protection, not austerity measures

}  Are crises becoming more frequent and severe? Is the global economy increasingly volatile? If so, what are the instruments of global governance that could constrain this volatility?

}  Recent work at the European Central Bank indicates that financial market liberalisation increases the risks of severe economic crisis.

}  Shouldn’t we go beyond mitigation of the impact of the crisis and move toward prevention?

}  Restrictions on cross-border financial transactions

}  Global tax on financial transactions }  Regulation of banking practices }  Economic crises have showed to us again and

again that the financial world should be on our radar as a major health risk. Reducing the frequency and severity of crisis will protect and promote health.

}  Illustrations of how trade governance impacts health ◦  TRIPS and access to medicine ◦  Tobacco control measures (Uruguay, Australia, US,

Canada) ◦  WHO Framework Convention on Tobacco Control

(FCTC) vs. bilateral investment treaties (BITs)

}  2 Proposals to fill existing gaps in the institutional framework in global governance for health

}  1- UN Multi-stakeholder Platform on Global Governance for Health

}  2- Independent Monitoring Panel on the Global Social and Political Determinants of Health

}  Policy forum (not a funding platform) }  A space for diverse stakeholders to frame issues,

set agendas, examine and debate policies in the making that impact on health and health equity, identify barriers and propose solutions applied to concrete policy processes.

}  Share and review information, influence norms and opinions, and shape action by making recommendations to the decision-making bodies of participating state, intergovernmental, market and social actors.

}  Independent monitoring of ◦  the complex interaction of forces that lead to health

outcomes, and the risk factors we face ◦  effectiveness of different global governance

arrangements for enabling and protecting health

◦  PLUS integrating Health impact assessments