Achieving health equity on a global scale through a community-based, public health framework for action.

Despite good intentions and decades of discussion addressing the need for transformative changes globally to reduce poverty and improve health equity, little progress has been made. A fundamental shift in framing the current conversation is critical to achieve "health for all," moving away from the traditional approaches that use the more narrowly focused medical model, which is intent on treating and curing disease. A public health framework for action is needed, which recognizes and confronts the complex, and often-times difficult-to-achieve social determinants of health. A restructuring of global health policy development and implementation will be ineffective unless key areas are addressed including primary education and the environment, in addition to economic considerations. A public health framework that embraces a community-based participatory approach would provide a comprehensive platform for identifying critical components that impact health, and for developing effective strategies for change. A participatory approach would encourage dialogue and problem-solving for region-specific issues among those most affected by the broader health and social justice issues, with those who create policy.