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Blog Post - Smart Global Health
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Horton: Metrics Professionals, Human Rights Advocates Must Unite to Battle Development Inequities

June 19, 2013

Nellie Bristol, Research Fellow
Global Health Policy Center, Center for Strategic and International Studies

Human rights and global health metrics experts should join together to ensure marginalized populations aren’t left out in the push for broad health gains, The Lancet editor Richard Horton urged June 17 at the Global Health Metrics and Evaluation Conference in Seattle.

“The combined force of the health metrics and human rights communities encourages us to look for unintended adverse patterns in health that might be hidden by national averages,” Horton said. “What the health metrics and the human rights communities can do together is to give special attention to these vulnerable, socially excluded, and marginalized populations.”

While research is indeed finding overall improvements in economic development and health indicators in specific locales, it also sometimes is uncovering worsening inequities in access to care and health outcomes for vulnerable and marginalized populations, Horton said. He cited studies from northern India, Vietnam, and Nepal that found gains in economic development, maternal access to health care, and child health but also discovered ethnic and gender inequities within those advances.

While human rights and health metrics experts are not a natural combination and often speak different languages, together they could highlight inequities in development and spur coalitions to push for their resolution, Horton said. Fundamental principles of human rights include equality and non-discrimination. “What these mean to us in the metrics community is surely an abiding commitment and concern to count and to measure the least advantaged and most marginalized groups in our society. It is deeply meaningful to do so,” he said.

Ensuring establishment of a health and development “floor” for all global citizens is a daunting task for those involved in the post-2015 global development goal process. As more countries enter middle-income status, large pockets of poverty remain that will be difficult to address. Groups like the Institute for Health Metrics and Evaluation, a sponsor of the Seattle conference along with The Lancet and others, are becoming increasingly sophisticated and timely in their analysis of global disease burden, often with impressive geographic and demographic specificity. But the data will need to generate additional political will and resources to address the seemingly intractable delays in progress suffered by vulnerable groups. The goal, as Horton said, must be “to make the uncounted counted, to make the invisible visible, and to give those without an opportunity to speak and shape their futures that opportunity.”

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