What We Mean by Health Equity

The Task Force for Global Health was founded nearly 40 years ago to advance health equity. Here is what health equity means to us.

In 1984, only 20% of children got vaccinated. Those children primarily lived in high-income countries, leaving hundreds of millions of children elsewhere at risk of the exact same diseases although the world had the tools and the know-how to protect them. Children in poor countries were afflicted by preventable diseases like polio, measles, and diphtheria, suffering painful disabilities and death simply because of where they happened to be born.

Years later, Task Force founder Bill Foege described the human toll behind those numbers. Watch the clip.

Foege, former director of the U.S. CDC and leader of the successful smallpox eradication effort, and his Task Force co-founders were asked by the Rockefeller Foundation, the World Health Organization (WHO), the United Nations Children Fund (UNICEF) and others to lead a coalition of partners to ensure that all children – no matter where they lived – could be protected.

Within just six years, by 1990, global childhood immunization rates soared to 80%. The then head of UNICEF called it “the largest peacetime achievement the world has ever seen.”

This is the crux of what we mean by health equity. We believe that all people should have access to the means to live a healthy life no matter their economic status, race, gender identity, education, or geographic location.

Despite the gains of the last four decades, we still have a long way to go to achieve that vision. Here are just a few disparities:

As the WHO puts it: “Such trends within and between countries are unfair, unjust and avoidable. Many of these health differences are caused by the decision-making processes, policies, social norms and structures which exist at all levels in society. Inequities in health are socially determined, preventing poorer populations from moving up in society and making the most of their potential.”

What it looks like in practice

For these reasons, we prioritize the needs of those at greatest risk of poor health, with a focus on three areas: 1) ensuring vaccine safety and access, 2) eliminating diseases such as polio, hepatitis, and neglected tropical diseases (NTDs) like leprosy and river blindness that afflict the world’s poorest communities, and 3) strengthening health systems to better protect populations.

As one example, we are currently working with up to 30 low-and-middle income countries to roll out COVID-19 vaccines to their citizens. The poorest countries in the world have COVID-19 vaccine rates well below the wealthiest, with high-income locations getting vaccinated about 25 times faster than the lowest. As of today, enough doses have been given in the U.S. to cover 45% of the population while in South Africa, Honduras, Afghanistan and many other countries less than 1% of the population is covered.

Likewise, we work on NTDs because they are only prevalent in the world’s poorest places, being directly related to access to treatment, water supply and sanitation. We manage the donations of billions of treatments from pharmaceutical companies to treat these diseases, which cause blindness, disfigurement, pain, and social stigma.

Grandmother Ngo Yeba Anastasie in Cameroon’s Bafang district is one person who has benefitted from this work. Starting in 2004, she began receiving treatment for river blindness and, 14 years later, she explained that the treatment had helped save her eyesight, enabling her to look after her grandchildren. 

These large-scale community drug distributions have been successful in reducing the spread of these diseases and several of them now have elimination goals tied to the year 2030.

Photos of Anastasie captured while she was receiving treatment at her home. Photo credit: William Nsai.

While we’ve seen real progress in some areas, we know we can do more to achieve the vision laid out by our founders. Each of our 17 programs has unique areas of focus programmatically and geographically, but they share a common goal, which continues to underpin our work. As Foege explained in his book The Fears of the Rich, The Needs of the Poor: My Years at the CDC: “The basis for public health is to achieve health equity; therefore, the bottom line is social justice in health.”

Header photo: Beds in a health facility in Yemen for COVID-19 patients. Photo credit: Sumia Abbas Alturki for Yemen FETP

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