A new policy note and set of indicators adopted under Brazil’s G20 Presidency and developed by its Joint Finance and Health Task Force (JFHTF), in collaboration with the World Health Organization (WHO), highlights the critical importance of addressing the social determinants of health equity. In particular, the policy note adds to the JFHTF’s Framework for Economic Vulnerabilities and Risks (FEVR) to evaluate health, social and economic risks related to pandemics. The endorsement of this policy note is the culmination of the JFHTF’s first priority under the Brazilian G20 Presidency, on the theme of “unpacking the centrality of financing initiatives designed to tackle social determinants of health”.
The COVID-19 pandemic underscored the relationships between the economy, livelihoods, health and social vulnerability, and uncovered and exacerbated social, economic and health inequities. Addressing social determinants of health can help mitigate these vulnerabilities and improve pandemic outcomes. For example, investing in universal social protection through cash payments and subsidized services can reduce poverty, improve access to essential services, and bolster overall health, social and economic resilience.
In the policy note, published by the Brazilian G20 Presidency today, specific social determinants of health indicators were drawn from WHO’s Operational framework for monitoring social determinants of health equity. The Framework, released by WHO in early 2024, gives guidance on tracking social determinants of health. Based on evidence of their importance to pandemic prevention, preparedness and response (PPPR), key social determinants were proposed as indicators for use in the FEVR.The G20 unanimously endorsed the policy note and recognized the importance of the following social determinants indicators for PPPR, recognizing that investments in areas which lie outside of health policy have a profound impact on health equity:
- proportion of population covered by at least one social protection benefit (%)
- proportion of urban population living in slums, informal settlements or inadequate housing (%)
- population using safely managed sanitation services (%)
- net school enrolment rate (pre-primary, primary, secondary, tertiary) (%).
Finance and health ministers from all G20 countries discussed the next steps with this policy note as an agenda item during their meeting in Rio de Janeiro in October.
“We are pleased to have contributed to this G20 initiative to draw attention to the crucial need to address health inequities through a social determinants lens,” noted Dr Etienne Krug, Director of the WHO Department of Social Determinants of Health. “We call upon ministers to invest in these proven measures to address health inequities and use the FEVR indicators to monitor their impacts.”
Dr Sudhvir Singh, Unit Head for Equity and Health in the WHO Department of Social Determinants of Health and coordinator of the policy note added, “We look forward to supporting countries to monitor and act on key social determinants of health as part of their overall health and pandemic preparedness strategies.”