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Abstract: The health care industry is is one of the world’s largest and fastest-growing industries and healthcare spending is rising faster than economic growth, consuming around 10 percent of gross domestic product (GDP) of most developed nations. However volume and increase of spending do not relate directly with population’s health improvement. In many countries, the increase of health care needs and spending is related to population ageing, but an increasing burden of disease worldwide is strictly related to the neoliberal model of society and its globalization. Its impact on health may be direct (as in the case of the spreading consumption of processed foods) or indirect, as consequences of environmental degradation or macro-economic policies increasing inequality. The dominant bio-medical and technological approach to health is an additional co-factor of increased healthcare costs, but the introduction and marketing of new products often does not respond to real health needs or diagnostic and therapeutic improvements, and is mainly driven by the market. In addition, in times of financial crisis while life and health conditions of the population worsen, neoliberal policies impose cuts on public expenditure including on public health expenditure, pushing population into the poverty trap.
In a convivial de-growth perspective, together individual and collective behaviours, the quality and characteristics of health policies need to be rethought and public policies in all sectors should be formulated taking into consideration their impact on health. A paradigmatic shift toward a more caring and equitable society, would be necessarily based on substantial reorientation of policies at national level and citizens engagement at community level. Nevertheless, due to global interdependence and the unavoidable interactions between global forces and national systems, a deep rethinking and reorganization of global health governance and its reformulation into Global Governance for health are essential.
The paper argues that a human rights approach to health should reorient global public policies in all sectors, and social determinants of health should be taken into consideration in global priority setting. Using examples from the food industry and the experience of the Framework Convention on Tobacco Control (FCTC) it argues about the inadequacy of solely relying on Corporate Social Responsibility (CSR) and industry’s self-regulatory approach, and advocates the establishment of binding international instruments to regulate and monitor market forces critically influencing health worldwide. Besides strong commitment and and health conscious leadership at the global level, the effective enacting of such policies needs strong support from, and connection with, civil society which can be built on a global scale taking advantage of the opportunities offered by the globalization process (such as networking and knowledge sharing facilities), interlinking local experiences, to increase awareness, and organize and coordinate advocacy.

Contribution to the 3rd International Degrowth Conference for Ecological Sustainability and Social Equity in Venice in 2012.