Global Health Equity: The Imperative of Equity-Centred Evidence-Informed Decision Making

Introduction 
In a world that is increasingly interconnected, the pursuit of global health equity stands as a collective responsibility. Achieving health equity is not only a moral imperative, but also essential for the sustainable development of nations and the wellbeing of communities worldwide. As we navigate the complexities of healthcare disparities, the role of evidence becomes paramount. This blog delves into the crucial intersection of evidence and global health equity, exploring how the global community can foster and embed equity-centred, evidence-informed decision making to strengthen evidence ecosystems. 

The Nexus of Evidence and Health Equity 
Health equity, defined by the World Health Organization as ‘the absence of unfair and avoidable differences in health among groups of people’, is at the core of a just and compassionate society. However, achieving this lofty goal requires informed, strategic decision making rooted in evidence. The nexus between evidence and health equity lies in understanding the determinants of health, identifying disparities, and crafting interventions that are both effective and equitable. 

• Understanding Social Determinants of Health: To address health disparities, it is essential to recognise the social determinants that influence health outcomes. These include economic stability, education, social and community context, healthcare access and the physical environment. Robust evidence illuminates the interconnected web of these determinants, guiding policymakers towards targeted interventions. 
   
• Identifying Disparities Through Data: Data serves as a powerful tool in uncovering health disparities. Evidence-driven data collection and analysis enable the identification of vulnerable populations, ensuring that interventions are tailored to address specific needs. Disaggregated data, including factors such as gender, ethnicity and socioeconomic status, provide a nuanced understanding of health inequalities. Advances in technology have transformed global health data collection, analysis and dissemination. 

Big data, artificial intelligence and digital health tools enable real-time monitoring of health trends and the rapid identification of emerging threats. The COVID-19 pandemic has underscored the importance of timely and accurate data in mounting effective responses and mitigating the impact on vulnerable populations. 

Embedding Equity in Evidence-Informed Decision Making 
To advance global health equity, evidence must not only be gathered but also embedded in the decision-making processes of governments, organisations and communities. Here are key strategies to achieve this integration: 

1. 1. Inclusive Governance and Decision Making: Establishing inclusive governance structures ensures that diverse voices are heard in decision-making processes. This inclusivity is vital for understanding the unique challenges faced by different populations and tailoring interventions accordingly. Evidence-based policymaking requires a commitment to representation and participation. 
    
2. 2. Capacity Building for Evidence Use: Strengthening the capacity of individuals and institutions to generate, interpret and apply evidence is fundamental. This involves investing in training programs, fostering research collaboration and supporting the development of expertise in evidence synthesis. A knowledgeable workforce is essential for making informed decisions at all levels of the healthcare system. 
    
3. 3. Community Engagement and Empowerment: The global community plays a pivotal role in shaping the landscape of health equity. Collaborative efforts across borders, organisations and sectors are essential. To foster evidence-informed decision making that is inherently equitable, countries and organisations must share data, research findings and best practices. International partnerships should prioritise the empowerment of local communities and the building of capacity in regions that face significant health disparities. Engaging communities in the decision-making process, listening to their needs and empowering them to advocate for their health fosters a sense of ownership and sustainability. Evidence should be accessible and understandable to all, empowering communities to actively participate in shaping their health outcomes. 

Strengthening Evidence Ecosystems for Global Health Equity 
Building robust evidence ecosystems is key to sustaining the momentum toward global health equity. An evidence ecosystem encompasses an interconnected network of researchers, policymakers, healthcare providers and communities collaborating to generate, share and apply evidence. Here's how the global community can strengthen these ecosystems: 

1. 1. Investment in Research Infrastructure: Robust research infrastructure is the bedrock of evidence ecosystems. Investments in research institutions, data collection systems and technological advancements facilitate the generation of high-quality evidence. Global collaboration in research ensures a broad perspective and a more comprehensive understanding of health challenges. Strengthening evidence ecosystems involves investing in research infrastructure, supporting data collection and analysis and promoting interdisciplinary collaboration. By fostering an environment where diverse voices are heard and valued, we can ensure that evidence reflects the nuanced realities of different communities. 
    
2. 2. Open Access to Data and Findings: Transparency and open access to data and research findings are essential for building trust and collaboration. Removing barriers to information ensures that evidence is widely accessible, empowering stakeholders at all levels to make informed decisions. According to the National Library of Medicine, the advance of knowledge is based on the open flow of information. Only when a researcher shares data and results with other researchers can the accuracy of the data, analyses and conclusions be verified. Different researchers apply their own perspectives to the same body of information, which reduces the bias inherent in individual perspectives. Unrestricted access to the data used to derive conclusions also builds public confidence in the processes and outcomes of research.  Open data initiatives foster a culture of sharing and collaboration across borders. 
    
3. 3. Global Partnerships for Research and Implementation: Health challenges are often global and solutions require international collaboration. Establishing partnerships between researchers, policymakers and practitioners on a global scale accelerates the translation of evidence into action. Collaborative efforts ensure that interventions are contextually relevant and leverage diverse perspectives. The global community plays a pivotal role in shaping the landscape of health equity. Collaborative efforts across borders, organisations and sectors are essential. To foster evidence-informed decision making that is inherently equitable, countries and organisations must share data, research findings and best practices. International partnerships should prioritise the empowerment of local communities and the building of capacity in regions that face significant health disparities. 

Conclusion 
The journey towards global health equity is complex, but evidence serves as the guiding light that illuminates the path forward. By fostering equity-centred, evidence-informed decision making and strengthening evidence ecosystems, the global community can work together to dismantle health disparities and build a world where everyone has the opportunity to attain their highest level of health. It’s a shared responsibility that transcends borders and requires a collective commitment to justice, equity and the wellbeing of all. 

References 
World Health Organization. (n.d.). Health equity. https://www.who.int/health-topics/health-equity/building-the-evidence-for-action#tab=tab_3 

Cochrane. (n.d.). Global leaders in evidence-based healthcare highlight the urgent need to advance global health equity. https://www.cochrane.org/news/cochrane-partners-international-coalition-advance-global-health-equity-world-evidence-based 

Disclaimer
The views expressed in this World EBHC Day Blog, as well as any errors or omissions, are the sole responsibility of the author and do not represent the views of the World EBHC Day Steering Committee, Official Partners or Sponsors; nor does it imply endorsement by the aforementioned parties.