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Kent Buse and Devaki Nambiar argue that declarations of commitment to health equity are too often a charade intended to distract from the need to inspire political action on the social and commercial determinants of health The Alma Ata Declaration of 1978 called for health for all.1 Most declarations since reiterate this commitment to health equity, including the 2023 UN political declaration on universal health coverage recently adopted in New York.2 But the meetings and processes producing these declarations differ markedly. The 1978 meeting intended to “exert moral pressure” and was deliberately international and multisectoral, involving political movements. The 2023 universal health coverage process aimed at inclusion, but was criticised for “recycling ancient promises.”3 Declaring commitment alone is meaningless without political action to improve the social and commercial determinants of health. Health equity will not be achieved through technical fixes alone; technical

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