Degrowth and health: local action should be linked to global policies and governance for health

Volume and increase of spending in the health sector contribute to economic growth, but do not consis- tently relate with better health. Instead, unsatisfactory health trends, health systems’ inefficiencies, and high costs are linked to the globalization of a growth society dominated by neoliberal economic ideas and policies of privatization, deregulation, and liberalization. A degrowth approach, understood as frame that connects diverse ideas, concepts, and proposals alternative to growth as a societal objective, can contribute to better health and a more efficient use of health systems. However, action for change of individual and collective behaviors alone is not enough to influence social determinants and counteract powerful and harmful market forces. 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, equitable, and sustainable degrowth society will require supportive 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 re- thinking of global health governance and its reformulation into global governance for health are essential. To support degrowth and health, a strong alliance between committed national and global leaderships, above all the World Health Organization, and a well-informed, transnationally inter- connected, worldwide active civil society is essential to include and defend health objectives and priorities in all policies and at all levels, including through the regulation of global market forces.