3 Reasons to Make Global Health a Social Justice Issue

Let's face it: notions of social justice are often absent in global health debates. Other frames -- global health as "foreign policy" or as "economic investment," for example -- have far more powerful champions and advocates on an institutional level. Large global health funders generally eschew the language of social justice in favor of other vocabularies to describe their efforts.

But there are serious reasons to consider global health a social justice issue. And to mark today, the World Day of Social Justice -- a new holiday celebrated for the first time last year -- I figured it was a timely argument. Accordingly, here are three major reasons why global health advocates should continue to frame global health as a social justice issue:

1). It helps focus attention on the political and economic forces that reproduce poor health: Viewing health issues in terms of social justice requires us to look beyond the immediate biological or behavioral causes of poor health and disease. After all, there are a host of political and economic forces that fuel disease among specific populations, countries and classes. The WHO's Commission on the Social Determinants of Health captured this belief in 2008, when their much-anticipated report concluded that, indeed, "social injustice is killing people on a grand scale." If we can see health issues more broadly, it might spur action on the kinds of initiatives that powerful global health funders typically avoid.

2). It challenges the status quo: From the civil rights movement to mobilization around HIV/AIDS, we've seen the power that social justice movements have had in changing history. While it can be uncomfortable to some, framing an issue in moral terms can inspire collective citizen action -- and is especially crucial when attempting to go beyond the constructed limits of possibility. Remember the struggle at the turn of the millennium over whether treating drug-resistant TB and HIV/AIDS could even be afforded in "resource-poor" settings? Breaking the status quo often requires significant grassroots support, and the social justice frame can help inspire such mobilization efforts.

3). It expands the set of available practical tools: Advancing global health as a social justice issue doesn't mean that multiple types of information and arguments -- such as economic analysis -- can't be used in decision-making about how to respond to health inequities (though some believe they're mutually exclusive). In fact, when global health is seen as a social justice issue, developing a robust science of global health delivery (such as one Harvard project is doing) to ensure that aid does as much as possible for the sick becomes an ethical imperative. The social justice ideal can challenge leaders and advocates to do more, and better, using the best tools (emphasis on plural) available in the global health toolbox.

These reflections are but a starting point. Martin Luther King, Jr. recognized the importance of this struggle when he declared that "of all the forms of inequality, injustice in health care is the most shocking and inhumane." Let's make February 20th the day we honor social justice by reflecting on the ways we can work to support public health efforts around world, where in so many places, the inequalities are indeed shocking and inhumane.

Photo Credit: NESRI