The SDG Agenda offers a unique mandate and framework to advocate for a holistic approach to public health able to account for the multidimensional determinants of health and drivers of illness. There is a need to build upon the SDG framework and generate the necessary bulk of impact and operational evidence to turn this interdisciplinary vision into a truly interdisciplinary approach able to grant effective and sustainable solutions to major global health challenges.
Social protection is at the intersection of the development and health agenda. Nonetheless, the research into the public health potential of social protection schemes is still fragmented, especially in LMIC. For example, although cash transfer schemes are already an element of the response to health challenges in many countries, their impact on health-related outcomes has been only partially demonstrated and poorly understood: several large reviews concluded that conditional cash transfers have an impact on improving beneficiaries health behaviours, the magnitude of which seems to vary across countries and initiatives. The impact on health outcomes is less consistent, with evidence suggesting some effect on improving nutritional status, child growth and adult morbidity status, but not on maternal health, malaria and diarrhoea. These results are consistent with what is also known for HIV/AIDS: while there seems to be a positive impact on sexual behaviours, the impact on actual HIV outcome has been documented only in one study.
Not only is impact evidence limited and fragmented, but also the mechanism through which the impact of social protection strategies operate remains unclear. Achieving a sufficient level of understanding is crucial to design and implement public-health relevant social protection strategies, but also to understand why some interventions do not achieve the expected impact. Finally, it remains unknown how the scope of these schemes can be effectively and cost-effectively broadened to encompass public health objectives, while preserving their primary objective to protect people from poverty.
Given the broad scope and complexity of such agenda it is unlikely that one single research group will successfully fill the knowledge gaps. A network approach based on the share of knowledge and expertise as well as of existing platforms and opportunities may represent a far more efficient way to optimise financial and intellectual resources available. The SPARKS network was created with this rationale and with the aim of efficiently moving towards a more action-oriented type of research to ultimately tackle health inequalities.