News

74th World Health Assembly

Statement on Agenda Item 22.1 Social Determinants of Health

Honorable Chair, distinguished delegates,

The ISN urges the WHO and Member States to adopt the resolution on Social Determinants of Health and accelerate action to tackle the root causes of kidney failure, alongside efforts to reduce the burden of the disease.

Social, environmental, and economic determinants have a tremendous impact on kidney health and on the likelihood of developing non-communicable diseases (NCDs). As explained by Sir George Alleyne, Director Emeritus of the Pan American Health Organization during the ISN’s 2021 Global Kidney Policy Forum, there is a positive association between low income, low source economic status or low educational status and NCDs, and as a manifestation of that inequality, only 4% of people in need of kidney care in low- and middle-income countries have access to kidney replacement therapy, compared to 60% in high-income countries.

The risk of developing chronic kidney disease begins in utero with lack of gender equality, poor maternal education, health and nutrition and is worsened by lack of access to primary care, early diagnosis, and essential medicines, and lack of clean water, sanitation and hygiene.

CKD disproportionately affects the poor and is more prevalent among vulnerable populations including black, immigrant and indigenous people who have less access to care[1], and who frequently have other comorbid NCDs.

In turn, kidney disease exacerbates poverty through the high-level out-of-pockets expenditures needed to afford kidney replacement therapy, and through job losses and interruption of education.

Hence, we call upon Member States and the WHO to:

• Adopt the proposed resolution on Social Determinants of Health and prioritize actions to tackle the root causes of kidney disease and other NCDs
• Strengthen actions to reduce health inequities and inequalities, addressing the social, economic and environmental determinants of health that lead to a higher burden of kidney disease in minority and vulnerable populations

[1] Kidney Health Inequalities in the UK: An agenda for change https://kidneyresearchuk.org/wp-content/uploads/2019/09/Health_Inequalities_lay_report_FINAL_WEB_20190311.pdf