World leaders unite to embed social participation in health systems
BMJ 2024; 386 doi: https://doi.org/10.1136/bmj.q1460 (Published 10 July 2024) Cite this as: BMJ 2024;386:q1460
- Antoine Boivin, co-director1,
- Dani Mothci, chief executive2,
- Vincent Dumez, patient co-director3,
- Farin Shore, peer worker in harm reduction4,
- Amanda Bok, chief strategy officer5
- 1Canada Research Chair in Partnership with Patients and Communities, Université de Montréal, Montreal, Canada
- 2Patient representative, International Alliance of Patients’ Organizations, London, UK
- 3Patient author, Centre of Excellence on Partnership with Patients and the Public, Montreal, Canada
- 4Patient author, Doctors of the World, Canada
- 5The Synergist, Brussels, Belgium
- Correspondence to: A Boivin antoine.boivin{at}umontreal.ca
For the first time in the World Health Organization’s 76 year history, world leaders have unanimously committed to strengthen, systematise, and sustain social participation in health and wellbeing.1 This landmark resolution recognises social participation as “empowering people, communities, and civil society through inclusive participation in decision making processes that affect health across the policy cycle and at all levels of the system.”2 Governments will be held accountable for progress to 2030.
Health is created by people, communities, and civil society.3 Patients develop deep knowledge in caring for themselves and others, navigating complex systems, and finding solutions in everyday life.4 Civil society often fills gaps in access for marginalised communities.5 While people are increasingly being engaged as partners in health systems,678 recognition and influence are highly variable, and too many are still excluded.9
If people are empowered to fully partner in health, the resources, intelligence, and capacities of our health systems will exponentially increase. Global challenges such as access to care, climate change, widening social inequalities, demographic changes, and staff shortages are overwhelming our health systems.10 They can be overcome only if everyone is mobilised: complementary in their knowledge and interdependent in their actions.
In the past decades, numerous political statements affirmed the value and principles of social participation.111213 The WHO resolution marks an important step forward, in three ways.
Firstly, it outlines clear government responsibilities to ensure that social participation is adequately resourced with stable public funding, and designed in a way that influences health related policies and system change. The resolution holds governments accountable for nurturing a fair playing field, reducing power differences, and making room for everyone.
Secondly, the resolution makes social participation a core function within health systems, rather than a set of ad hoc initiatives. This global perspective is important to reshape health systems, nurture trustful and long term relationships with communities, and build alliances across health sectors.
Thirdly, it offers powerful mechanisms to influence governments. Because they endorsed the resolution, governments have a political imperative to act and must show progress every two years.1 The resolution supports national implementation through technical guidance, examples of global practice, and a common evidence base.14
Ensuring progress
Social participation is a principle to be honoured and enabled by governments but also a right to be seized. As an international community, we can move forward by recognising people’s knowledge, sharing power, and fostering cooperation.
Lived experience and knowledge, especially that of people who struggle the most to access health, is pivotal in helping us design better and more inclusive health systems.15 We need to acknowledge the extent to which individuals, communities, and civil society are already engaged in health. Grassroot movements, election campaigns, civil society coalitions, and patient organisations offer powerful catalysts for change1617 and can use the WHO resolution to influence governments.
To ensure the resolution has traction, we need strong, visible, and shared leadership from civil society and governments. We must have equal partnerships: among policy makers and patients, and among health professionals and communities. We need researchers to share the evidence, inform the design of effective approaches to encourage participation, and offer robust indicators to track progress.181920
Health issues transcend national borders, and all countries must participate to achieve a healthy world. We need to share success stories, challenges, and solutions; learn from people across the globe; gain understanding from our diversities; build coalitions; and nurture the next generation of leaders to have the passion and expertise to ensure that no one is left behind.
The social participation movement is global, but the power to act is rooted locally in the alliances we forge with each other. Share your ideas. Engage in dialogues. Extend a hand.
Acknowledgments
We thank Ghislaine Rouly, Ellos Lodzeni, Simon Denegri, Tessa Richards, and Myriam Fournier-Tombs for their contribution to this editorial.
Footnotes
Competing interests: The BMJ has judged that there are no disqualifying financial ties to commercial companies. The authors declare no other interests.
Provenance and peer review: Commissioned; not externally peer reviewed.