Social justice in health policies and programs: How to get there and what is the evidence which policies work?

Health policies are interventions implemented on populations with winners – people who benefit of it, and losers – people who benefit less. Therefore there are always opposing interests – who will benefit more. Since resources are limited and less than the needs, choices or prioritizing competing demands are inevitable, i.e. always some claims are declined. However, maximizing individuals' health is not the same as maximizing health of whole populations, although that population is sum of individuals.

Focusing on individual's health maximization effectively deprives resources from another individual. Does this mean that the right to highest attainable health of the former is greater than the same right of the later? Do people value one more than the other? The right of an individual to the highest attainable health should not be achieved by denying this right to others. Therefore achieving sustainable wellbeing needs different approach.

What should we strive for when allocating resources in health: increasing average health status, or decreasing health inequalities? Is social justice and sustainable wellbeing possible without health equity?

I've established that evidence in health is relative and depends on the distribution of the benefit in any specific case. The appraisal of any intervention should start with analyzing the distribution of the benefit at local level. I have identified eight combinations of this distribution, leading to very different results. Once this is sorted out, social justice requires choices to be made in order to reduce health inequalities as act of fairness and a premise for sustainable wellbeing.