Las otras inequidades en salud: un reto para la bioética

Contrary to what one may think health and equity are not issues that have always gone hand in hand following the formal recognition of the former by the Universal Declaration of Human Rights (1948). It was not until the Alma Ata Declaration in 1978 when the close ties between both began to be seriously considered, and in 2000 this led to several international organizations formalizing their concern for the factors that determine whether a health system is fair or not. Since then, the term «equity in health» has taken on a special meaning when weighing up the strength or weaknesses of certain health systems. However, over the years, equity in health has gradually been identified almost exclusively with a financial issue that focuses on distributing health resources. As a result, one often forgets to provide the necessary care for those in other unfair situations, which, as regards access to and providing health care, leads to unfair situations that are not directly related to financial reasons and do not require investments, but consensus and the honest determination to make changes. This leads the Bioethics of the 21st century to face two challenges: to warn of these inequities and to promote initiatives that are able to make effective changes.