Putting Health Equity at the Heart of Public Health
The 18th World Congress on Public Health took place in Cape Town, South Africa, from 6–9 September 2026 under the theme Health without Borders: Equity, Inclusion, Sustainability. The Congress brought together people from across the public health sector to reflect on the challenges affecting health and what is needed to ensure that everyone can access quality care.
For rural communities, the theme carries particular importance. Where people live continues to affect their access to health care. The Congress recognised that geographic location remains one of the factors that can shape people’s health and wellbeing. Millions of people still face barriers to essential services, with those living in underserved areas often among those most affected.
This reality was reflected in remarks by Dr Mohamed Janabi, Director of the WHO African Region, who spoke about the barriers that continue to keep people from accessing care. Reflecting on his experience as a doctor, he said: “The greatest barriers to health are often not biological. They are the barriers we create, and the barriers we fail to remove.”
For communities in rural and underserved areas, these barriers can be shaped by distance, limited resources and the availability of health services. Janabi emphasised that health without borders must mean more than crossing national boundaries. “It is about building a world where a child’s future is not determined by where they are born, where another chance of survival is not determined by her income, or where every community has an opportunity not merely to survive, but to thrive.”
The Congress stressed that health inequalities are not inevitable. They are influenced by political, social and economic decisions. Health equity therefore requires more than improving health services. It requires action to address the conditions that affect people’s ability to live healthy lives.
Primary Health Care was central to this discussion. The Congress reaffirmed its importance as the foundation of equitable and resilient health systems and called for investment in accessible, people-centred Primary Health Care, stronger public health services and a health workforce that is properly supported.
Professor Tasleem Ras, Head of the Department of Family, Community and Emergency Care at the University of Cape Town, also challenged delegates to rethink the relationship between Primary Health Care and public health. Speaking during a plenary session, he asked whether the two can be truly integrated. He argued that an African communitarian perspective could help bridge the divide by connecting the individual with their family and community, while recognising the wider factors that influence health.
The Congress also highlighted the importance of communities having a meaningful role in decisions about their health. Communities should be active partners in shaping health priorities, policies and systems, while governments and institutions must remain accountable to them.
The Congress further called for greater recognition of Indigenous Knowledge Systems and a shift in power within global health, ensuring that communities have a real role in shaping research and policy.
As the Congress concluded, its message was clear that health equity requires action and accountability. Governments must invest in health systems and communities, while civil society must continue to hold institutions accountable.