Hesham Eman/VIPC 2007

WHO’s work on addressing social determinants of health and reducing health inequities is founded on its Constitution and the 1978 Declaration of Alma-Ata, which affirm health as a basic human right. These foundations also assert governments’ responsibility to address social and environmental determinants in order to fulfil citizens’ rights to the highest attainable standard of health.

These values are reflected in policy frameworks such as the Ottawa Charter and the Health for All policy framework, which both stressed the importance of intersectoral action and community participation in policies to address social determinants of health and health inequities.

More recently in Europe, the Tallinn Charter of 2008, endorsed by the 53 Member States of the WHO European Region and key European institutions and international agencies, further affirms the central role of health systems in addressing health inequities. The Charter points out that while the structure and magnitude of health systems in Europe (and elsewhere) may vary due to historical, economic and cultural factors, they share a common set of functions related to service delivery, resource generation, financing and stewardship.

In response to increasing concern about persisting and widening inequities globally and in Europe, WHO established the Commission on Social Determinants of Health in 2005. The purpose of the Commission was to synthesize the evidence on social determinants of health and health inequities, and to set out the range of policy options that would be most promising in addressing them in different regions and country contexts.