Good morning, and a very warm welcome to you all.
Many thanks to the esteemed participants from Member States in the Region for being here today, and also for the progress you have made so far in addressing the social determinants of health and reducing health inequities.
In just over a week our host country, the Philippines, will celebrate the 150th birthday of their national hero, Jose Rizal.
As you may know, Rizal’s death in 1896 sparked the Philippine independence movement.
Rizal was also a doctor and a student of German physician and sociologist Rudolf Virchow.
Rizal can be considered one of the early social determinants thinkers in our Region.
He was one of a few early physicians to introduce a “primary health care” paradigm to the Philippines when he helped improved access to water and practiced community medicine in Dapitan.
Rizal serves as a powerful image of nation healing – by treating the cause and not just alleviating the symptoms.
Indeed, there have been many social determinants thinkers throughout history.
In ancient Greece, Hippocrates observed that food supply and social relationships produced differing susceptibilities to disease. Freidrich Engels—who produced The Communist Manifesto with Karl Marx—analyzed the class-based origins of mortality.
Today, I’m sure we are all familiar with Sir Michael Marmot's Whitehall studies on social determinants of health among British civil servants.
These examples show that we have understood the social origins of disease and inequity for a long time.
Despite this, we continue to see stark inequities in health opportunities between and within countries. Children in our Region still have dramatically different life chances depending on where they were born.
In Japan or Australia, they can expect to live more than 80 years; in China, 74 years; and in one of several Mekong countries, only around 60 years.
And within countries, the differences in life chances are dramatic.
The poorest of the poor have high levels of illness and premature mortality.
For instance, in several countries in the Region, the under-5 mortality rate is as much as 3 times higher for children from households in the poorest socioeconomic quintile, compared to those from households in the richest quintile.
It is as much as 4 times higher for children whose mothers have little or no education, compared to those whose mothers have secondary education or more.
In fact, within countries at all levels of income, health and illness follow a social gradient: the lower the socioeconomic position, the worse the health.
These differences are not inevitable.
Certainly, since many of them are preventable, they are unfair.
It is these avoidable, unjust differences to which we give the label of “health inequities”.
Putting right these inequities is a matter of social justice.
The work of the WHO Commission on the Social Determinants of Health provides the evidence base for moving this agenda forward.
But it is clear that many Member States face difficulties in translating this evidence into practice, through policies and actions that are relevant to their local needs.
Moving forward requires actions across sectors and also actions within the health sector.
It needs strengthened evidence and knowledge about what works.
It needs partnerships and participation from all stakeholders.
This is why we have convened this regional meeting.
And this is also why Member States will meet in October this year in Rio de Janeiro at the World Conference on Social Determinants of Health.
The focus in this meeting—and in Rio—will be on practical action.
This meeting provides a forum to engage in dialogue.
Here, we will share experiences from around the Region about policies and actions to address the social determinants of health and reduce health inequities.
We will discuss the lessons learned in implementing these policies, and in creating the political commitment for action.
We hope that, afterwards, you will return home with new ideas and new tools for acting on the social determinants of health and improving health equity.
The Commission on the Social Determinants of Health called on Member States to 'close the gap in a generation'.
With this goal in mind, I hope that this meeting will mark a significant step forward in our efforts to strengthen policies and actions to address the social determinants of health and achieve health equity. I wish you fruitful deliberations.
Thank you.