This chapter examines the politics of global poverty, inequality and development. The first section provides the background for our analysis of global poverty and inequality. Any meaningful discussion of poverty and inequality necessarily has to be in relation to development – which, as we show, is itself contested in theory and practice. The second section provides an outline of a relational perspective of global development. The third section focuses on the United Nations’ 2030 Sustainable Development Goals (SDGs) agenda. We conclude with some critical observations about the political significance of the relationship between development, poverty and inequality.

Environmental violence encompasses both the violence between humans and the Earth, and the violence that humans perpetrate on each other through the Earth. The concept of Sustainable Development, while aimed at improving both the human–Earth relationships and the relationships between humans, has problematic historical baggage: It is rooted in a Western idea of development, which is imbued in violence against various non-Western peoples and is perpetuating controversial takes on economic growth and appropriate technology. This renders the concept of Sustainable Development questionable, adding complications to the realization of its many, at times contradicting, goals. This chapter discusses issues in the concept of Sustainable Development and its implementation, suggesting a shift to the pursuit of a different concept: Sustainable Life.

Along with the establishment of values and belief systems, the early years, from birth to 12 years, are increasingly recognised as the crucial time in which the foundations for life are laid, with significant consequences for educational success, resilience and future participation in society. The formative years are the years in which the capacity for carers and educators to make a difference can and does have profound effects. Carers and educators need specialist preparation because they are required to promote and teach health and wellbeing and to have the skills and knowledge to understand and manage the plethora of issues related to young children. Around the world, including in Australia, early years education is undergoing significant reform as the potential for educators to improve children’s quality of life is better understood. These reforms herald health and wellbeing as central constructs of this agenda. This chapter explores the concepts of health and wellbeing and shares some of the initiatives that have put health and wellbeing on the agenda for early years learners in contemporary times.

As will become evident through the course of this chapter, development in its human rights context is primarily a value that translates into individual and communal well-being. This well-being may be linked to industrial or other financial development, although the correlation between the two is neither self-evident nor necessary. If this right to well-being is to make a difference in the lives of people, whether in poor or rich nations, it must be susceptible to quantifiable measurement through which one is able to assess its progress and realisation. In the last decade experts have developed a list of detailed indicators which allow us to assess well-being more accurately. At the same time, wealthy nations have abandoned ad hoc unilateral efforts to assist their poorer neighbours to escape perpetual cycles of poverty by entering into institutionalised multilateral commitments to contribute part of their annual earnings to developmental goals. These goals are also vigorously pursued by multilateral development banks, such as the World Bank and the African Development Bank.

Decent work and economic growth benefits greatly from a healthy population. In this vein, health policy itself can promote improved work and employment by making health sectors better employers. There are a range of opportunities to improving the quality of jobs and reducing inequalities, beginning with addressing particular management behaviors in particular units, to strong and well enforced antidiscrimination law, to paying a higher minimum wage. The political difficulty of making such adjustments, especially in the eyes of managers and policy makers, take the form of added costs to organizations and reduced pay differentials that benefit higher paid workers. The goal is thus to focus efforts on political actors such as unions and civil society that will support SDG8. A case study of Romania presents an overview of policy actions taken to address health workforce shortages, by tackling issues related to recruitment, retention and international mobility of health workers.

Education has become the principal pathway to good health, financial security, stable employment, and social success. Due to the fact that education is strongly associated with life expectancy, morbidity and health behaviours it is widely recognized that health and education are mutually influential. While the focus has primarily been on the impact of education on health, advancing health and wellbeing remains a critical pathway to achieve education and life-long learning. As such, a re-orientation of systemic thinking and practice that builds on health and wellbeing as central elements of achieving quality education during the life course is key to achieving SDG 4 quality education.

The goal of SDG 1 is to end poverty in all forms everywhere. Health systems are a significant determinant of the risk of impoverishment and financial hardship. We review methods for calculating catastrophic health spending and impoverishing spending, noting a distinction between those who are impoverished by out-of-pocket (OOP) health spending and those who are further impoverished by OOP health spending. Catastrophic health spending tends to be concentrated among poor households, but there is a high level of variability between countries. In particular, countries with higher public spending on health as a share of GDP have lower OOP spending, which in turn is associated with lower catastrophic health spending and impoverishment. Policymakers can also make progress on reducing the risk of impoverishment by making reforms to coverage policies. We conceptualise progress towards universal health coverage through an analysis of the coverage of people, services, and costs. Risk of financial hardship is minimised when the entire population is covered, the right services are covered to meet the population’s health needs, and costs are financed largely through pre-payment with risk pooling to avoid high user charges. The most successful systems use user charges sparingly, design user charges as fixed copayments rather than percentage-based coinsurance, and include income-based exemptions and OOP maximums.

This introductory chapter makes the case for moving beyond the concept of Health in all Policies and towards a Health for all Policies approach. Health for All Policies is a framework emphasising co-benefits: the ways in which improved health or better health systems and policies can attain other goals. In terms of the SDGs, it captures the extent to which better health status, and use of health budgets, policies, and infrastructures, can contribute to all of the SDGs, whether fairly obvious ones (health enables education) to ones that require more thought (health care systems’ procurement and waste disposal systems affect life under the seas). The case for co-benefits is not just that it shows what health policy can do for other goals. It is not just that it shows what health policy should do for other goals such as sustainability or reducing gender and other inequalities. It also opens up new perspectives on coalitions, politics, and governance.

This chapter examines the wide-ranging and often poorly defined SDG 17 (means of implementation) in the context of health policy and governance. It fundamentally asks: How can health policies and systems contribute to achieving goals from SDG 17? The author argues that there are significant synergies between health policy and SDG 17 as many of the factors that potentially make ‘sustainable development’ possible require healthy populations and functional health systems. When health and sustainable growth goals align, good population health, resting on environmentally sustainable food chains, adequate support for public health systems, good access to healthcare, and good enough governance for health, can provide benefits to the global economy and help to move towards a model of sustainable development.

Inequalities, specifically in Post-Apartheid South Africa, have been extensively analyzed, yet little attention has been paid to the effect of health policy on inequalities. The chapters goal is to demonstrate how SDG 3 (Health for All) can work with SDG10 (Reduce Inequalities) to fight longstanding societal inequalities. One of the first steps is the creation of the National Health Insurance (NHI), whose goal is to cover the entire population with adequate health care at an affordable price. Health and health outcomes are, however, not only affected by provision or access to healthcare and health services. They result from multidimensional and complex factors linked to the social determinants of health. So while the NHI may reduce inequality and inequity in health care, further attention will need to be placed on socio-economic inequality given the social and economic disparities among the population groups in the country.

Achieving co-benefits places the focus on politics and governance. This chapter presents two basic frameworks for identifying opportunities to make successful policy for co-benefits. One is for addressing the problem of change within government, in the framework commonly used by advocates of intersectoral policy. We adopt a framework that can clearly identify key dynamics and opportunities for the construction of cross-cutting policies, as well as the areas in which, under current circumstances, progress is likely to be limited and advocates might find themselves frustrated or defending their achievements against attack. The second approach to analyzing politics and the possibility of action is grounded in the analysis of agenda-setting, which has been profitably applied to the area of intersectoral policy for health. In both cases, these are basic analytic frameworks for understanding which action is likely to be effective, in order to improve the likelihood that proposals for achieving co-benefits do achieve their potential benefits.

The logic of co-benefits produces many theoretically interesting ideas, but to become convincing, it must be paired with competent policy analysis and evaluation. This chapter focuses on the many examples of co-benefits in practice and research literature in order to demonstrate that many policies have effects, intended or unintended, beyond their main targets.

This finally introductory chapter emphasises the goal of the book: Rather than reinvent the idea of HiAP, we propose that it simply needs to be expanded. Instead of just offering the one-directional relationship that HiAP proposes (other sectors è health), an expansion of thought is required to make this offer two-dimensional. Health for all policies posits that other sectors help the health sector, and that the health sector helps other sectors. This new relationship highlights what health can do for other sectors while simultaneously attaining co-benefits for its own sector.