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National and Global Responsibilities for Health

Preventable and treatable injuries and diseases are overwhelming sub-Saharan Africa, the Indian subcontinent and other impoverished areas of the world. Every year, 8 million children die before they reach the age of 5, more than 300 000 women die in pregnancy or childbirth, and more than 4 million people die of AIDS, malaria, or tuberculosis. By 2005, 80% of deaths from noncommunicable diseases were in devel- oping countries. Healthy life expectancy in Africa is 45 years, a full quarter-century less than in high-income countries.1

Why are health outcomes among the world’s poor so dire, even when international health assistance has quadrupled over the past two decades? The World Health Organization (WHO) perceives health to be “a shared responsibility”,2 but global health actors often act out of self- interest rather than adopting harmonized approaches.

We are establishing the Joint Learning Initiative on National and Global Responsibilities for Health to articulate an overarching,  coherentframeworkforsharingthe responsibility for health that goes further than the United Nations Millennium Development Goals. The Initiative forges an international consensus around solutions to four critical challenges: (i) defining essential health services and goods; (ii) clarifying governments’ obligations to their own country’s inhabitants; (iii) exploring the responsibilities of all governments towards the world’s poor; and (iv) proposing a global architecture to improve health as a matter of social justice.

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1.         World Health Organization. World health statistics 2010. Geneva: WHO; 2010. Available from: [accessed 2 September 2010].

2.         About WHO [Internet site]. Geneva: World Health Organization; 2010. Available from: [accessed 2 September 2010].


Health Inequality