Adopted by the 74th WMA General Assembly, Kigali, Rwanda, October 2023
Understanding that early life experiences can impact health in later life and that the major drivers of health lie outside healthcare is essential to direct action to improve health where it is most needed. This is supported by Paragraph 11 of General Comment No. 14 of the Committee on Economic, Social and Cultural Rights, and by Article 24 of the Convention on the Rights of the Child, both of which recognise the importance of the role of the state in providing good living standards and healthy environments for their citizens. The WMA Declaration of Oslo on Social Determinants of Health and WMA Statement on Sustainable Development acknowledge that conditions, including environmental conditions, in which people are born, grow, are educated, live, work and age (sometimes termed “social” or “wider” determinants”) are major influences on healthy life expectancy, quality of life[i] and the magnitude of health inequalities.
Human health is a cardinal component of a society’s ability to prosper; declining human health adversely affects a nation’s productivity, and therefore a nation’s economy, which in turn limits many actions to prevent ill health and deliver healthcare to treat illness.
Therefore, in addition to health practitioners, many actors share in the responsibility to preserve and improve human health. For example, the ability to influence these wider determinants of health are spread across multiple government departments.
A cardinal challenge in striving for improved population health lies in the fact that decision makers tend to focus on short-term economic indicators, such as Gross Domestic Product (GDP)/Gross National Income (GNI), as the primary driver of government policy.
Investment in the health of the population has a long-term positive economic impact, but the focus on GDP/GNI often acts to the detriment of health. Many activities that increase GDP/GNI, such as smoking and the use of fossil fuels, damage health. Conversely, activities such as breastfeeding and parenting, which improve health, are not measured in GDP.
Recognizing this, the World Medical Association and its constituent members on behalf of their physician members, call on Governments to:
- Recognise that well-functioning health systems accessible to all are important, but the principal determinants of health and wellbeing lie outside healthcare;
- Prioritise population health and wellbeing in government policy decisions and incorporate metrics of population health and wellbeing into measures of national progress and performance;
- Acknowledge that securing and safeguarding population health and wellbeing are crucial to a sustainable future;
- Promote equity in health and address inequalities in whatever sphere they exist, by supporting actions that address the wider determinants of health.