Global action on social determinants of health

This commentary argues that there are three major crises confronting global health: ongoing financial crises; deepening ecological crises; and rapidly escalating income and wealth inequalities within and between nations. Global rhetorical responses to these crises frequently invoke policy sentiments similar to those advised by the 2008 WHO Commission on Social Determinants of Health (CSDH). However, actual policy decisions run counter to the evidence reviewed by the Commission, and its final report recommendations. Failure to re-regulate financial capitalism, introduce regulatory standards for transnational companies, or subordinate trade and investment liberalization treaties to development goals and human rights treaties will exacerbate global health inequities into the future. More positively, there is increasing support for systems of global taxation. The challenge for global health, however, will remain the willingness of states to make domestic and foreign policy choices that strengthen income redistribution, economic regulation, and citizen rights.