The Houses of Parliament, Westminster, London.

Written by Amelia Tait of the UCL Institute for Global Health.

On Tuesday 4 December, the Attlee Suite in the Houses of Parliament was filled to the brim with more than 140 audience members, policy makers, and global health experts from around the world meeting to discuss the growing global burden of non-communicable diseases.

Professor Anthony Costello, Director of UCL’s Institute for Global health, chaired the debate and opened by remarking that the “wicked problem” of NCDs accounts for 63% of deaths worldwide.

Non-communicable or lifestyle diseases, such as heart disease, stroke, cancer and diabetes are medical conditions of a non-infectious nature, and – in Costello’s words – are “the biggest killer of people in the world”.

Learning from HIV?

The panel’s experts led a debate on the ways in which the NCD movement can learn from the precedents set by the HIV/AIDS movement in the 1980s.

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Mr Michel Sidibé, Executive Director of UNAIDS,
delivering the UCL Lancet Lecture 2012.

Written by Helen Fry, a recent MSc graduate from the UCL Institute for Global Health.

The game of global health governance is changing, and if global health players such as the World Bank and the World Health Organization do not rethink themselves they will become obsolete, argued Michel Sidibé in the UCL Lancet Lecture 2012 on 13th November.

Drawing on his experience as Executive Director of UNAIDS, Sidibé outlined his vision of global health governance for the post-2015 development era.

Sidibé began by exploring the history of AIDS, which he described as “a journey from despair to hope”.

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Professor Saskia Sassen

On 13 June, renowned sociologist Professor Saskia Sassen, who popularised the term ‘global city’, came to London’s Global University to give a talk on some of her current research.

Centring around the idea that in recent history changes to the socio-economic make-up of capitalist nations has brought about changes to the way society values and includes its members, the talk focused on how the dynamics and metrics of exclusion – and expulsion – have altered throughout much of our society, and largely for the worse.

We started by learning the definition of social expulsion, as opposed to exclusion. Imagine, if you will, those people that reside at the edge of a system (not necessarily a geographical edge). Exclusion would be the prevention of people outside of that system entering it. Expulsion, however, is the act of those already within the system being ejected from it, and finding themselves on the other side of the line.

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Far from ‘closing the gap’ in life expectancy, health inequalities in Europe have deepened further. Drawing upon his forthcoming review of health inequalities in Europe, Michael Marmotargued that social inequalities, with their impact on life expectancy, should be at the top of the public agenda and we should place fairness at the heart of decision-making for health.

Integral to Marmot’s work is the graded relationship between social deprivation and a multitude of health outcomes. He reports that male life expectancy in the Russian Federation is 20 years less than in Iceland, but also highlights “huge differences within countries” and that “the gradient is increasing”.

Alcohol use: a cause or consequence of inequality?
What is driving the social gradient in health? Panel member Christopher Gerry stressed that “Alcohol matters”, and quoting Richard Peto said: “More than half of all deaths of people of working age in Russia are caused by alcohol.” But importantly, Gerry identified alcohol as just the proximate cause: “What makes people drink in the way that they do is the real question.”

Marmot was quick to distinguish between immediate causes and the underlying psychosocial mechanisms that drive unhealthy behaviours. In the case of Russia: “Some people are utterly convinced that alcohol plays a role, the main role” in health inequalities. But he disagreed, while acknowledging its role in violent deaths.

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