Fátækt og heilsa
Ræða Davíðs Á. Gunnarssonar, ráðuneytisstjóra í heilbrigðis- og tryggingamálaráðuneytinu,
flutt fyrir hönd Norðurlandaþjóðanna á haustþingi Evrópudeildar Alþjóðaheilbrigðismálastofnunarinnar
í Kaupmannahöfn 18. september 2002.
Sjá einnig ræðu DÁG:
Nordic statement on Proposed programme budget for 2004-2005
Nordic Statement on
Poverty and Health
Poverty and Health
Mr. President,
Allow me, on the behalf of the Nordic Countries - Denmark, Finland, Norway, Sweden and Iceland -, to thank the Regional Director for an excellent report on Poverty and Health. The work on this issue clearly demonstrates the vision of WHO as one unified organisation and thereby outlines a perspective for the future of the European Region.
In our view the report reflects the foundations for WHO's current health policy, and the need to emphasise the fact that poverty is the main determinant of health and health inequalities. The efforts in this field by the Regional Office and the establishment of the Venice Centre for Investment for Health and Development are very important steps in the long-term process to improve health where most needed in the European Region.
It is important to focus on determinants of health and public health policies addressing relevant determinants breeding inequalities and poverty related ill-health. Both absolute and relative poverty are damaging to health. For example, single parent women and their children, face higher health risks also in more affluent societies, like the Nordic countries. The selection of the 12 case studies in the report of the Secretariat was a vital point of departure. The conclusions of these studies could in the future serve as a concrete and constructive way to share knowledge in the field of poverty and health.
The case studies clearly demonstrate that financial barriers play an important role concerning access to health services. Firstly, poor people may delay seeking care because they cannot afford to pay for health services and therefore risk severe consequences. Secondly, people may be forced to find alternative financial sources, i.e. by selling assets or taking loans and thereby getting into debt. This definitely supports the view that the amount of service fees should always be limited. The health system itself must never become one of the causes of poverty.
An important remark by the Regional Office is that prevention of diseases and health promotion often are not included in the curricula or education of health personnel. In most countries there is greater emphasis on issues related to hospital and medical treatment of diseases. Therefore, more financial resources ought to be made available for prevention programs. It is urgent that this kind of training be seen as an integrated part in the development of skills and knowledge among professionals.
In all Nordic Countries public health programmes are main instruments to level out inequalities in health between different groups of people. In this respect, equal health opportunities for all children must always be a key objective. In our opinion, WHO EURO should put more emphasis on the negative health impact of poverty on childhood. Huge differences in child mortality within the region should not be accepted. Evidence tells that efforts focused on children living under less favourable conditions, have a decisive impact on their health later in life.
The Nordic countries strongly support the strengthening of the health dimension of sustainable development. We want to stress the fact that poverty and ill health contribute to environmental degradation and that a healthy environment is essential for good health and poverty prevention.
It is also apparent that eradication of poverty heavily depends on achievements closely associated issues such as economy, education, employment, working conditions, social welfare, environment, nutrition and housing. Therefore, the issue of poverty should be tackled in partnership with a wide range of different agencies on an international as well as a national level.
The Nordic countries would like to emphasize that the relationship of poverty and health should be addressed by all Member States and and also the more affluent ones. However, the support by the WHO should be concentrated on areas and countries were people are clearly in need of assistance to improve their health and living conditions.
In conclusion, the Nordic countries welcome the initiative to launch a new phase of Health for all, as spelled out by the Regional Director in his adress. Such an initiative provides a significant opportunity to advance evidence and implementation of public health policies contributing to more equitable health.
Tank you, Mr. President.