World wellbeing watch

The rallying call of “Health for All” has inspired generations of health activists and arguably had a decisive role in recent progress on universal health coverage.1 Much of the impetus for that slogan came from the Alma Ata declaration, which also made clear that ensuring health and wellbeing for all required policy and action in many other social and economic sectors. Yet, across the globe, government efforts to create the conditions outside the health sector that promote and protect health have lagged behind those to strengthen healthcare systems.

To some extent this is to be expected as such efforts are outside the purview of those working in the health sector and are governed by interests that often extend beyond health considerations.2 In other cases, the lack of guidelines and role clarity, inadequate resources, and differing priorities have hampered efforts to act across sectors in the service of health.3 Process matters, and thinking about upstream drivers has been cast as a political process (largely unsuccessful) involving the “art of the possible, by the closest approximation of knowledge and action.”4