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Special section on economic inequality and the right to health

Guest Editors: Gillian MacNaughton, Kayum Ahmed, Matt McConnell, Sylvain Aubrey

The emergence of neoliberalism 50 years ago has led to a marked increase in economic inequality and an undermining of social, economic and cultural rights. The Global Wealth Report 2022 “estimate[d] that the bottom 50% of adults in the global wealth distribution together accounted for less than 1% of total global wealth at the end of 2021. In contrast, the richest decile (top 10% of adults) own[ed] 82% of global wealth.”[1] Further, Oxfam reports that globally, over the past two years, the wealthiest have become much wealthier, while at the same time, “[p]overty has increased for the first time in 25 years.”[2] Neoliberal policies have actively embraced free market capitalism and economic inequality and rejected ideas of solidarity by restructuring economies, privatizing, deregulating, reducing taxes on the wealthy, and transferring obligations of states to private entities.[3]

There are multiple links between this extreme economic inequality and the right to health.

  1. “In countries at all levels of income, health and illness follow a social gradient: the lower the socioeconomic position, the worse the health.”[4]
  2. People with higher incomes often have greater access to health care and to better health care – even in countries with a universal healthcare system.
  3. Economic inequality results in disparities in access to health-enhancing economic and social rights, such as the rights to education, decent work and social security.
  4. Economic inequalities result in disparities in access to civil and political rights; for example, those with greater wealth exercise more influence over health-related policymaking.[5]
  5. Economic inequality may contribute to social and political unrest, which may increase risks to the right to health, including the right to healthcare and the underlying determinants of health.[6]
  6. Profit-driven economic systems centered on capitalism tend to advance a narrow, biomedical model of health, while suppressing marginalized health systems that draw on Indigenous epistemologies, traditional medicine, or approaches that do not promote the use of pharmaceuticals.

To address economic inequality, and its right to health consequences, states must change fiscal policies that remain focused on neoliberal goals such as those that promote unsustainable growth and ignore the plight of the majority and the planet. If universal good health was afforded prominence, the health workforce would not be in its current precarious state, facing a global shortage of about 10 million workers by 2030, spread unequally, with the worst shortages being in the lowest income countries.[7] To fulfil an equal right to health, states must invest in health workers, in health infrastructure, and stop egregious gouging of the health dollar by the private sector, especially in the pharmaceutical sector. Yet, with few exceptions, the role of fiscal management in contributing to increased inequality and unequal access to healthcare and the social determinants of health has not been examined by right to health scholars.[8]

In this call for papers we invite submissions that will address the general themes of economic inequality, fiscal management, and the right to health. This may include papers that present:

  • research into economic inequality and the impact on the right to physical and mental health rights
  • economic inequality and occupational health
  • case studies of rights-based responses to economic inequality and health
  • right to health violations and impacts on individual or community income/wealth
  • rights-based approaches to framing ‘the economy’ that put people and health first
  • ways of addressing economic inequality that promote health and sustainable economies
  • rights-based budgets that prioritize social and economic rights, and health systems
  • balancing states’ right to health obligations with economic growth
  • the right to health across economically unequal neighbourhoods, regions or geographies
  • the interpretation of equality as a component of the right to health
  • the role and limitations of market or commercial approaches in delivering on the right to health

Submission details

  • Papers and perspective essays must be submitted by 20 July 2023
  • Full papers have a maximum word length of 7,000 words, including references. We also invite Perspective Essays of up to 3000 words, including references, and Viewpoints of between 900-1500 words, including references, on any of these topics.
  • Author guidelines are available here.

Questions about this special section can be directed to Carmel Williams, williams@hsph.harvard.edu; Gillian MacNaughton, gillian@SERAglobal.org; or Kayum Ahmed, ahmedk@hrw.org.


[1] Credit Suisse Research Institute, Global Wealth Report 2022: Leading Perspectives to Navigate the Future, p. 32; see also L. Chancel, T. Piketty, E. Saez and G. Zucman, World Inequality Report 2022, https://wir2022.wid.world/www-site/uploads/2023/03/D_FINAL_WIL_RIM_RAPPORT_2303.pdf, p. 10.

[2] Oxfam, Survival of the Richest: How we must tax the super-rich now to fight inequality (2023), https://webassets.oxfamamerica.org/media/documents/Davos_2023_full_report_English_EMBARGOED_1.pd, p. 2.

[3] G. MacNaughton and D.F. Frey, “Introduction,” in G. MacNaughton and D.F. Frey (eds), Economic and Social Rights in a Neoliberal World (Cambridge, UK; Cambridge University Press), pp. 1-23.

[4] Commission on the Social Determinants of Health, Closing the gap in a generation: Health equity through action on the social determinants of health (World Health Organization (2008), p. 8.

[5] UN Department of Economic and Social Affairs, Inequality Matters: Report of the World Social Situation 2013 (New York: United Nations), p. 70-71.

[6] Ibid. p. 22.

[7] M. Boniol, T. Kunjumen, T. S. Nair, et al. “The global health workforce stock and distribution in 2020 and 2030: a threat to equity and ‘universal’ health coverage?” BMJ Global Health 2022;7:e009316. doi:10.1136/ bmjgh-2022-009316

[8] See, as a notable exception, A. Rudiger, “Human Rights and the Political Economy of Universal Health Care: Designing Equitable Financing” Health and Human Rights, 2022, 18/2, pp. 67-78.