UNEDITED E73153
“TIME TO TALK ABOUT ACTION”
International Public Health Congress
“H EALTH 21 in Action”
“It is now time to talk about action … to make use of lessons learnt and the experience gained so far … to emphasize equity and the implications: access to health and health care, quality of the health system, patients’
rights and the imperative of the efficient use of human and financial resources. Courageous choices have to be made.”
Dr Marc Danzon in opening the Congress
Istanbul, Turkey
8–12 October 2000 2001
public health challenges for the new millennium: putting health at the heart of development, putting the emphasis on social and economic determinants of health, and promoting the creation of new partnerships for health and health care. The Congress provided a forum in which policy-makers and practitioners could:
• share the vision of health for all in the twenty-first century;
• update their knowledge of modern technology in public health;
• exchange experience of innovations in public health across the WHO European Region and around the world;
• explore the future role of and potential for action for public health in Europe and beyond; and
• enhance cooperation between public health professionals of different countries.
Keywords
DELIVERY OF HEALTH CARE – trends HEALTH POLICY
PUBLIC HEALTH
INTERPROFESSIONAL RELATIONS POLICY MAKING
HEALTH FOR ALL – congresses
©World Health Organization – 2001
All rights in this document are reserved by the WHO Regional Office for Europe. The document may nevertheless be freely reviewed, abstracted, reproduced or translated into any other language (but not for sale or for use in conjunction with commercial purposes) provided that full acknowledgement is given to the source. For the use of the WHO emblem, permission must be sought from the WHO Regional Office. Any translation should include the words: The translator of this document is responsible for the accuracy of the translation. The Regional Office would appreciate receiving three copies of any translation. Any views expressed by named authors are solely the responsibility of those authors.
WHO Regional Office for Europe, Copenhagen
1. Introduction ... 1
2. Opening of the Congress... 2
3. Sustaining health and development ... 3
4. Promoting health and reducing the burden of disease... 4
5. Strengthening public health ... 5
6. Developing health policies and partnerships for health ... 6
7. From policy to implementation... 8
8. Managing and preparing for disasters... 8
9. Strengthening health systems ... 9
10. Conclusion...11
Annex 1. Programme...12
Annex 2. Participants...14
1. Introduction
The Congress was organized by the Turkish Society of Public Health Specialists, on behalf of the international public health community. It was held under the auspices of the Ministry of Health of Turkey and with the support of the World Health Organization. The meeting was seen as especially timely because of the adoption of HEALTH21 WHO’s new health for all policy for the European Region.
The Congress agenda addressed the public health challenges for the new millennium: securing health at the heart of development, putting the emphasis on social and economic determinants of health, and promoting the creation of new partnerships for health.
The focus was on both the science that underpins policy and practice, and the operating environment in which public health practitioners, planners and managers find themselves. As an occasion to refine the Public Health agenda and to start to reshape its practice to fit political, cultural and economic realities the Congress was an important milestone.
An underlying assumption of the meeting was that each country faced similar types of challenges in public health. The Congress provided an open forum for mutual learning for policymakers and practitioners with a wealth of contributions in the form of papers, posters and abstracts that were intended to advance their thinking. Participants were thus given the means to reflect on the vision captured in HEALTH21 as a policy statement, and to assess its merits as a policy framework integrating a broad spectrum of proposals for public health action.
The essential objectives of the Congress were:
– to share the vision of health for all in the 21st century;
– to exchange innovative experiences in pubic health across the European Region and beyond, and to update participants’ knowledge of public health technologies;
– to explore the future role and action potential of public health in Europe and beyond and enhance cooperation between public health professionals of different countries.
The programme is reproduced as Annex 1, and the list of WHO-invited participants is given in Annex 2.
The format adopted was to link plenary sessions, consisting of keynote speakers and expert panels who reviewed the issues in focus for the session, with working groups moderated by members of these panels together with other resource persons.
The purpose of the plenary sessions was to articulate the Public Health agenda, to identify the key issues. The plenaries were the occasion for advocacy, and the scrutiny of both the evidence now available and the ideas in currency in the health field.
The working groups were designed to reinforce, illustrate and expand on the key issues. The working groups had an explicitly pedagogic purpose to benefit those who participated in them.
Consequently, they are not covered by this report.1
It is understood that an account covering the second half of the Congress, Focus on Turkey, is being prepared by the Turkish organizers of the Congress.
This report summarizes the work of the plenary sessions, the themes and the conclusions and recommendations that emerged. It is hoped that as a source of ideas and practical possibilities, the report can be used by Public Health professionals and others as a working document.
This report reflects the logic adopted for the Congress itself. At the start there was a review of fundamental issues bearing on the conditions for population health and the health of individuals.
This led into a consideration of public health functions and the tasks of developing policy and securing action. Specific attention was given to managing disasters as a public health task.
Finally, the challenges facing the health sector, and particularly the provision of health care, were addressed.
2. Opening of the Congress
The Congress was welcomed by the Minister of Health, Dr Osman Durmus, on behalf of the Government of Turkey. He drew delegates’ attention to the challenges and opportunities in public health that have been highlighted by the adoption of HEALTH21, and the active response of the Turkish Government and health professionals to these challenges. He wished participants a stimulating and productive congress.
Dr Marc Danzon, WHO Regional Director for Europe, welcomed participants on behalf of WHO. He drew attention to the importance of the Congress. It was now time to talk about action.
That meant it was important to make use of lessons learnt and the experience gained so far in our efforts to improve the health of people.
He focused on the emphasis being given to health determinants and to the broad concept of health that recognizes a broad range of factors influencing health. The contributions of different sectors, especially the economic sectors, were important in securing improvements in population health. This would necessarily involve an active dialogue with other sectors. Although they might be difficult, they would be necessary, not least in the field of health impact analysis.
He pointed out that in the field of health promotion many choices were apparently individual behavioural matters, such as tobacco consumption, nutrition, and personal oral health. In fact these choices are made in a context with heavy political and economics implications. He referred to the focus in the Congress on health systems and health policies, and stressed the importance of values and their influence on the technical choices that might be made.
He reminded the Congress of the strong emphasis in HEALTH21 on equity and the implications:
access to health and health care, quality of the health system, patients’ rights, and the imperative of the efficient use of human and financial resources. Courageous choices had to be made.
1 A separate informal document “Transforming ideas into practical action”, a collation of abstracts and summaries of the work of the different groups, prepared by their participants, is being distributed to Congress participants.
Dr Zafer Öztek, President of the Society of Public Health Specialists of Turkey, welcomed participants on behalf of the Society as the third co-sponsor of the Congress. He recalled that the Society had for some years had been holding national public health congresses, and that it was now felt timely with the challenges of HEALTH21 to hold a congress with both national and international dimensions.
He drew attention to the objectives and strategy of the meeting and the wide scope of the issues that would be raised and discussed. He hoped that the Congress would serve its purpose of taking forward the work of translating the goals of HEALTH21 into practical action. He was sure that it would contribute to strengthening the ties of cooperation and mutual learning among public health professions in the different countries represented in the Congress.
Part of the opening session was a short video prepared by WHO on the history and future challenge of public health in Europe.
3. Sustaining health and development
Ecological footprint
National socioeconomic environment Civil society
Social network
from birth throughout the lifespan
The point of departure taken was a concept of multi-level environmental influences on a person’s health. At the outermost level was the global natural environment (the ecological footprint), raising implications for the consequences for health of the consumption of natural resources.
Next is the political socioeconomic environment, which is represented by the institutions of government. The essential point here is the capacity of the policies adopted and the actions taken for influencing health positively or negatively, equitably or inequitably. Then comes civil society, the informal organizations by which people engage with each other and provide mutual support which can enhance the quality of life and health. Finally there is the individual’s personal network which provides the immediate social support.
It was important to recognize that all of these levels of environment had definite health impacts and that the impacts could be traced from birth through a person’s lifespan finally to death. A particular important concern that had emerged was the cumulative effects of these influences, thereby emphasizing the importance of a good experience in early childhood as a basis of a healthy subsequent life.
Attention was drawn to the interplay of health and economic development and the importance of poverty reduction as an essential prerequisite to health improvement; likewise improved population health was a major contribution to economic development. There were important
developments in train to simulate the effects of changes in economic policy and changes in health status in a population. These would become an important policy-making tool.
The link between employment and health was stressed, and the need to emphasize good occupational health services to support a more productive workforce and workplaces which would be health supportive to workers.
There was substantial evidence that better education was associated with improved health status.
It was pointed out that the link between education and health should not be seen purely at the mechanical level of instruction in good hygiene or behaviours to avoid. The real task was imparting, through the education system generally, the values of a caring society.
Finally, the significance of health as a bridge to peace was introduced. There was now considerable experience in the European Region showing that the common basic value of good health was one of the few, perhaps the only, ways to bring antagonists in civil and other conflicts to the same table. The painful process of rebuilding a society can start with a dialogue about immediate health problems which can then lead into the tasks of rehabilitation and reconstruction.
4. Promoting health and reducing the burden of disease
Health as a state of successful coping between internal and external systems
Attention was brought to the various attempts that had been made over time to capture the concept of health in a simple but meaningful definition. The definition given in the World Health Organization Constitution captured the multi-dimension nature of health, but did not make clear the dynamic nature of a health state. It was therefore necessary to see health as a means of coping with both the body’s internal systems and the systems of the external world. The need to find a balance was a continuing task through life, and would be affected by the individual’s experiences and circumstances.
Unhealthy behaviours, the target of much health promotion and education, were to be seen therefore as “bad” coping. This was important in identifying what would be the most appropriate ways of supporting an individual who was trying to modify a “bad” behaviour.
At the same time there was need for public health based strategies to combat the effects of the actions of others, such as the tobacco industry, who were engaged in the marketing of products which encouraged and sustained unhealthy behaviours. More positively, the need for strategies to promote healthy behaviour in such fields as oral health and nutrition was also stressed.
Nutrition is an important determinant of health and nutritional wellbeing, especially amongst the poor and the food insecure, and requires a community-centred food-based strategy as well as the collaboration between ministries of health and agriculture.
Better health of women and girls as a major public health target was emphasized. Improving their health would benefit the population as a whole, and would promote gender equity. In view of the epidemic of sexually transmitted diseases and HIV and the high maternal and infant mortality and morbidity in some parts of the European Region, it is important to promote and protect sexual and reproductive health for the population as a whole (including men and boys).
Violence to women was identified as a specific urgent problem: one fifth of women suffer violence to their person at some stage in their life.
5. Strengthening public health
Secure a champion for public health action who will make that action understood and attractive
Build partnerships at different levels across the public sector, and engage the private sector, professions and civil society
Work in communities, close to people
Mobilize investment for health, and build in accountability Agree on policy choices,
and reallocate resources and responsibilities accordingly Learn and develop knowledge
Look around and ahead and keep the focus on people
The round table was asked to address the questions: what is public health and what is the way forward to strengthen public health as a function?
A consensus emerged that the contrast drawn in recent years between “old” and “new” public health was a false antithesis. A conflict had been sparked between one school of thought, which was concerned with the technical tasks of disease control, and a new school. The new school had at times rejected medical involvement in public health in favour in radical community action.
HEALTH21 reconciles and builds on all aspects of public health.
The resurgence of communicable diseases in recent years had demonstrated that the old public health was still needed along with health protection and promotion strategies, necessary for community development. In consequence, public health could be seen as a wide ranging set of policy objectives, the requisite activities, and professional and community actors, each with their particular responsibilities, operating in a political and social context.
There was a need for greater investment in research and training strategies to strengthen the knowledge base for public policy and action, and to enhance infrastructure and the performance of those who are involved in the public health function. This would involve a wide variety of actors since public health required action at different political and administrative levels and community and other settings.
It was essential to grasp that public health was in no sense, and could not be, the preserve of any one occupational or other group; the training given to each group would have to be appropriate to the tasks they carried out or the role they played.
Above all, the public health function required “champions” prepared to accept the responsibilities of political and professional leadership. Strenuous efforts were needed to build partnerships at the different levels, to mobilize investments for health and to ensure that there was a ready acceptance of responsibility and accountability by actors in all sectors of the economy. This meant negotiating agreements between parties, cultivating a culture of learning and above all, focusing on people.
6. Developing health policies and partnerships for health
No future for straight-line policy-making There is always a possibility:
act, advocate, collaborate, lobby
The complex nature of the problems and opportunities faced in efforts to improve population health required a holistic or “joined up” approach to policy-making for health. It had to be based on an understanding of the nature of health in terms of social, psychological, emotional, and spiritual wellbeing as well as physical health and the treatment of disease.
This approach to policy-making would be based on a realistic appreciation of the macro political and economic environment, and the need for policies and actions which were financially realistic and enjoyed solid, broad political support. Choices among policy options must reflect political as well as technical judgment if they are to be implementable, and implementation itself depended on good management.
Policy-making guided by realism would recognize that however difficult the circumstances, it was always possible to take an initiative. If it was possible to act within one’s mandate and available resources, there was a moral obligation to act. If this was not possible, but the potential for action lay with another body within one’s political or professional network, the obligation was to be an active advocate to that other body.
If effective action required collaboration between two or more bodies, one’s own and others’, then the obligation would be to collaborate.
Finally, if for reasons of legal mandate or the magnitude of resources required, action would only be possible at a higher level, then the obligation would be to join with others to lobby those who were in a position to act. So in all cases, leaders would accept that they had a responsibility to take an initiative even though it might be some time before there was any positive outcome.
There was no future for straight-line policy-making by planners with straitjacket minds.
It was important to recognize that a policy could emerge in various formats in terms of various types of statement and documentation. It may not be a single document and there may not even be an explicit statement of purpose. There were, however, certain criteria to be satisfied. It must be possible to discern the purpose and targets of improved population health, the actions envisaged, the resources required, and the allocation of responsibility for action and evaluation.
This is illustrated by the “Charter on Transport, Environment and Health”, negotiated and adopted by Ministers of Transport, Environment and Health of the WHO European Region at the Third Ministerial Conference on Environment and Health (London, 16–18 June 1999). It promotes cross-sectoral cooperation and the integration of health concerns into transport and land use policies; brings together different sectors and players to cooperate towards achieving transport sustainable for health and the environment; provides health targets and a plan of action to achieve them; allocates the responsibility for the implementation of the plan of action to the different players (Member States, WHO, other international organizations and nongovernmental organizations) and provides a mechanism for follow-up and monitoring of progress achieved.
A comprehensive health policy once adopted would be in itself a key step contributing to better health as it sets the participating actors on the path. However, the path will not necessarily be linear, and the need to build and sustain relationships with a variety of partners will be continuous. Public health actors will often need to find new ways of engaging with all the interests that need to be involved to build trust and mutual understanding.
This means that there needs to be a proper public health infrastructure that motivates public health specialists and allows them to cope with a multiplicity of tasks and initiatives. This will almost certainly not be an old fashioned bureaucracy, but will more likely be build up by alliances and networks and “virtual organizations”, the new form of organization without boundaries. The key skill of the public health actor will be an ability to engage with others in all sectors and to manage across boundaries.
In terms of enhancing the political credibility and weight of public health in the policy-making arena, special attention should be given to fostering those partnerships which will be seen by the political community at large as contributing to the broader goals of economic and social development. A deliberate “investment for health” approach develops credible, effective and ethical policies and programmes that are based on, and address, socioeconomic and other key determinants of health and that engage other sectors of society as well as health.
Lastly, there was a need for research at all stages in the policy process. Monitoring the policy and implementation process would help to identify shortcomings in knowledge and in practice which could then be corrected. Particular attention was drawn to the importance of the role of those actors whose change in workplace behaviour would be crucial to the success of a policy initiative.
The example was given of a “baby-friendly” policy to encourage breastfeeding. This had been properly developed and ostensibly implemented, including a staff training programme. In fact the behaviour of the field staff did not change, and therefore the policy failed. Identifying the nature and the point in the sequence of implementation failures is the essential first step in designing new measures that would be more effective.
7.
From policy to implementation
HEALTH21 is the framework for policy-making and implementation
Implementation requires staying power, ownership, accountability and energy
Dr Jo E. Asvall, Emeritus Regional Director, in an invited presentation, recalled that HEALTH21 reflected twenty years of learning. The objectives identified in the original regional HFA strategy were elaborated in the HFA targets adopted as a common health policy in 1984 and updated in 1991. HEALTH21 was a renewal of the commitment of health for all in Europe and the lessons of the experience so far needed to be carried forward into the implementation phase.
Implementation will be ineffective unless conscious effort is made to ensure that HEALTH21 has staying power. There must be ownership by all stakeholders at all levels of the values, operating principles and policy objectives set out in HEALTH21. This will require leadership from the health sector as well as structures appropriate to each society to deliver results.
Effective implementation at the local level will depend on initiating interlocking actions in different settings, such as kindergartens, schools and workplaces, to reinforce the impact of strategies. Linking health promotion and care programmes across people’s life course creates further synergy. Crucial to this process is the energy in local players, whether in the health care or other sectors, that can be generated by encouraging self-assessment.
8. Managing and preparing for disasters
Disasters reflect the ways societies structure themselves and allocate their resources
The interaction of dangerous phenomena and people:
disaster reduction and especially relief must always take into account social systems
A disaster occurs when the ability of a community to cope with a crisis is overcome by events.
Disasters are consequences of the interaction between natural or human induced phenomena and people. Therefore, they are in fact “manufactured” by human beings.
If one defines public health as “the efforts of society to protect, promote and restore health”, it is self evident that the reduction of disasters and emergency management are core public health functions and responsibilities. Ministries of Health must give themselves dedicated structures and clear allocation of responsibilities in this field.
In the event of a disaster international and national support and assistance is important, but even more crucial is the local capacity to respond to the crisis. Enhancing local capacity implies building local partnerships with a common purpose. There is need for training and building capacities to be ready to act when the need comes. This can only be as effective inasmuch as disaster reduction is mainstreamed in education and society at levels and indeed into the popular culture itself.
It is essential that the immediate response to a disaster is followed up by a timely strategy of rehabilitation and reconstruction. The survivors of the disasters should be made to feel that they are valued human beings who have a continuing contribution to make to their society.
At each stage in the process of disaster reduction there must be a sound strategy for the dissemination of accurate information to the public regarding the situation. Finally, after a crisis there should be a thorough evaluation of the experience so that the appropriate lessons can be drawn. This strategy can prevent distortions and myths, for instance the unfounded fear of epidemics: the actual evidence is that if no epidemic was pre-existing before a disaster, the risk of a new one occurring is very low.
9. Strengthening health systems
Health care is a system:
components need to function together to serve the purpose Check outcomes, activities, inputs –
in this order
The analogy was drawn between a car and a health care service. This was in the sense that both are, in the technical sense of the term, “systems”. The parts need to function properly together in order to achieve the purpose. In health care it is essential to be clear what that purpose is, and to go beyond the rhetoric of service to patients. If the intention is to restore health, then it is necessary to look at the outcomes being achieved by medical interventions, and not just, at the management of the resource inputs.
It is necessary to first identify the outcomes being achieved, and then to move back to the activities and the management of resources and the organization of services. This is the way to
identify weaknesses in the present system, and then to move forward to developing a system of health care that is quality driven. Quality in the context of health care is the pursuit of the best possible clinical outcome, patient satisfaction, and the most efficient and effective use of resources.
Strategic and operational planning is one way to make the health system performance focused.
By tracking health care activity through outcomes providers can bench mark their own performance against their peers and particularly the “best in class”. A health care system will run best when the interests of all actors, including the users of services are properly taken into account.
Necessarily the capacity of the system will depend on the level of financial resources. Countries seek to offer free medical care to their populations as an expression of societal equity. But this becomes a sham if the financing of the health care system is inadequate for the claims being made on it, and if the level of funding is unsustainable in the longer run. Growing claims on health care financial resources and pressures to reduce expenditures in public systems mean that some intensive rethinking will be required both on generating funds for the health care system, the “resourcing” of health care functions, and agreeing on a basic minimum package of care.
This rethinking includes the rewards given to health workers and the linking of the resource allocation to health care objectives, so that all components of the system (including public health), are appropriately funded, responsive to public needs, and interested in healthy rather than sick people. Equity remains a fundamental concern in designing future financing systems.
Undoubtedly, information will be a key factor in future health care. There is now the promise of information technology, creating new possibilities for the collection ordering and dissemination of information and knowledge. It will be possible to relate the relevant general scientific and technical knowledge to information requirements relating to the individual person and their health state. Information technology provides another path to patient and indeed person empowerment, and it is the responsibility of governments to ensure that the necessary infrastructure gets put in place.
Information will be essential to an effective continuous quality development strategy in health care, ensuring that outcomes are properly documented to facilitate benchmarking by providers.
Continuous quality development is essential, not only as an aid to providers to improve their performance, but a way of making savings which can be deployed to more productive services. It is the way to identify procedures that are manifestly ineffective, and therefore should be stopped.
But information is also key to the whole field of public health functions. It is centre in policy development, in engaging the general public and in decision making. It supports the whole process of governance or stewardship, ensuring the most appropriate use of resources to achieve desired objectives. The developments in information technology should be enlisted to strengthen WHO’s role in health intelligence monitoring and information exchange.
In terms of health policy objectives, the agenda laid down in the Declaration of Alma Ata, 1978 remains valid. This is a vision of health care based in communities, with leadership by local health care personnel. It embraces disease prevention, health protection and promotion, and care and treatment, focused and organized in a way which involves the community and satisfies their needs and requirements. Despite the power of the argument, progress towards realizing the vision is still slow, and consequently development of primary health care is very much continuing business for public health actors.
There is growing acceptance that more emphasis and attention should be given in future to the role of the nurse as part of promoting the primary health care agenda. The family health nurse has an intimate and continuing contact with the local population and community and could be used much more effectively in the tasks of securing population health improvement.
10. Conclusion
The HEALTH21 framework is relevant and vital for action today and in the years ahead Public health systems and infrastructures are important, and need to involve partners across
society in the implementation of health for all goals
There is rich experience in several countries with innovation in policy-making, management of change, and knowledge development
In countries and in local communities, there is an opportunity for courageous choices that are inspired by HEALTH21 values, operating principles and options for action Turkey’s ongoing
effort in developing a new health policy and action plan for public health is appreciated
While it had not been the intention of the Congress to establish a consensus, participants had shown a common appreciation of the above statements.
The Congress had been an occasion to step back to reflect, to pool experience and learn, and to think about the challenges ahead and prepare. The Congress had given participants, who were drawn from a wide range of public health professions in Turkey and other countries, an opportunity to exchange views on developments in a number of key areas and to strengthen ties of cooperation. Warm thanks were due to the hosts who had created a milieu that made this possible through excellent local organization and fitting culinary and musical social events.
Public health action in the spirit of health for all needed a vision that offered a framework for learning and for national and community development. Change depended in equal measure on political commitment, public support, motivated health and other workers, and sound organization, management and leadership.
The Rapporteur suggested that in HEALTH21 we can make a start, each in our own operating environment, and be inspired in the tasks of resolving problems by the words of the former Secretary General of the United Nations, Dag Hammarskjöld:
“Working at the edge of the development of human society is to work on the brink of the unknown. Much of what is done will one day prove to have been of little avail. That is no excuse for the failure to act in accordance with our best understanding, in recognition of its limits but with faith in the ultimate result of the creative evolution in which it is our privilege to cooperate.”
Annex 1
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ROGRAMME (excerpt)2Sunday, 8 October
18:00–19:00 Opening Session Professor Zafer Öztek
President, Society of Public Health Specialists, Turkey Dr Marc Danzon, Regional Director, WHO
Dr Osman Durmus, Minister of Health, Turkey Monday, 9 October
09:00–12:30 Plenary Sessions
A. Sustaining health and development
Keynote(Professor Clyde Hertzman, Canada)
Panel(Moderator: Professor Clyde Hertzman, Canada) B. Promoting health and reducing the burden of disease
Keynote(Professor Klaus Hurrelmann, Germany)
Panel(Moderator: Professor Klaus Hurrelmann, Germany) C. Round Table on strengthening public health
(Moderator: Dr Herbert Zöllner, WHO) 14:00–17:30 Working Groups (parallel)
A. Sustaining health and development
Poverty and health –(Ms Ulrika Ericsson and Dr Tim Baker, Sweden) Education and health –(Dr Maksut Kulzhanov, Kazakhstan;
Dr Rusudan Klimiashvili, WHO)
Employment and health –(Professor Nazmi Bilir, Turkey)
Peace and solidarity through health –(Dr Richard Alderslade, WHO) B. Promoting health and reducing the burden of disease
Reproductive health –(Dr Assia Brandrup-Lukanow, WHO)
Tobacco, alcohol and drugs –(Associated Professor Özen Asut, Turkey) Physical activity –(Professor Gülseren Akyüz, Turkey)
Nutrition –(Dr Tourgeldy S. Sharmanov, Kazakhstan; Mr Brian Thompson, FAO) Oral health –(Professor Gülçin Saydam, Turkey)
2 This excerpt relates to the technical programme of the Congress, 8–10 October. Note that the second part of the Congress, 11–12 October focused on Turkey and a separate account is intended to be in preparation by the Turkish authorities.
Tuesday, 10 October
09:00–12:30 Plenary Sessions
D. Developing health policies and partnerships for health Keynote(Mr Keith Barnard, Sweden)
Panel(Moderator: Professor Tilek S. Meimanaliev, Kyrgyzstan) E. Managing and preparing for disasters
Keynote(Dr Alessandro Loretti, WHO)
Panel(Moderator: Dr Alessandro Loretti, WHO) F. Strengthening health systems
Keynote(Dr Serdar Savas, Turkey)
Panel(Moderator: Mr Kees de Joncheere, WHO) X. From policy to implementation
Keynote (Dr Jo E. Asvall, Denmark) 14:00–17:30 Working Groups (parallel)
D. Developing health policies and partnerships for health Development of health policies –(Dr Gülin Gedik, WHO)
Management of change and partnership development at all levels – (Dr Richard Alderslade, WHO)
Investment for health and health impact assessment –(Dr Erio Ziglio, WHO) Developing evidence: research and development –
(Professor Deborah Hennessy, United Kingdom)
Transport and health –(Professor Sabahat Tezcan, Turkey;
Ms Francesca Racioppi, WHO)
Tourism and health –(Dr Raymond Xerri, Malta) E. Managing and preparing for disasters
Disaster management and preparedness –(Professor Münevver Bertan, Turkey) F. Strengthening health systems
Primary care and hospital services –(Ms Ainna Fawcett-Henesy, WHO) Quality, outcomes and cost of care – (Dr Pina Frazzica, Italy)
Strengthening public health functions –(Dr Alena Petráková, WHO) Nurses and HEALTH21 –(Ms Kate Billingham, United Kingdom)
Medical education and HEALTH21 –(Professor Iskender Sayek) (IFMSA) Health services financing and management –
(Dr Igor Sheiman, Russian Federation)
Pharmaceuticals and diagnostic technologies –(Dr Joan-Ramon Laporte, Spain);
(Mr Kees de Joncheere, WHO)
Information technology, communication and advocacy – (Dr Gottfried T.W. Dietzel, Germany)
18:00–18:30 Y. Themes emerging from discussions – (Mr Keith Barnard,Sweden)
Annex 2
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ARTICIPANTS3Temporary Advisers Dr Kamal Aliyev
Senior Specialist on Pulmonary Diseases Ministry of Health
4, Kicik Deniz kuc.
370014 Baku, Azerbaijan
Fax No.: +994 12 930 711
E-mail: contact through: fma@who.baku.az
Dr Jo E. Asvall c/o Staehr Johansen Falkoner Allé 80, 2nd floor 2000 Frederiksberg, Denmark
Tel. No.: +45 20 32 70 17 or +45 26 17 62 40 Tel/Fax No.: +45 35 35 62 40
E-mail: skovly@inet.uni2.dk
Dr Tim Baker Karolinska Institute
Division of International Health Department of Public Health Sciences Odd Fellow Vägen 19
127 32 Skärholmen, Sweden
Tel. No.: +46 8 708 93 14 Mobile: +46 (0) 73 936 08 35 Fax No.: +46 8 311 590
E-mail: timbaker8@hotmail.com
Mr Keith Barnard (Rapporteur) Chapmanstorg 4
S-41 454 Gothenburg, Sweden
Tel. No.: +46 31 14 71 01 Fax No.: +46 31 14 71 01 E-mail: barnard@tripnet.se Ms Kate Billingham
Senior Research Fellow
Institute of General Practice and Primary Health Care
University of Sheffield, Community Sciences Centre, Northern Gen. Hospital Herries Road
Sheffield S5 7AU, United Kingdom
Tel. No.: +44 114 271 4626 Fax No.: +44 114 242 2136
E-mail: k.billingham@sheffield.ac.uk
Dr Gottfried T.W. Dietzel Ministry of Health
Am Propsthof 78a D-53108 Bonn, Germany
Tel. No.: +49 1888 441 2180 Fax No.: +49 1888 441 4913 E-mail: dietzel@bmg.bund.de
Dr Galandar Djanbakhishov Director
Traumatology Institute 4, Kicik Deniz kuc.
370014 Baku, Azerbaijan
Tel. No.:
Fax No.: +994 12 930 711
E-mail: contact through: fma@who.baku.az
3Listed are participants who were invited directly by or through WHO. They constituted a significant part of the international participants.
Dr Rolf Engelbrecht GSF-MEDIS Institute Ingolstaedter Landstr. 1
85764 Munich-Neuherberg, Germany
Tel. No.: +49 89 31 87 41 38 Fax No.: +49 89 31 87 30 08 E-mail: engel@gsf.de
Ms Ulrika Ericsson Karolinska Institute
Division of International Health Department of Public Health Odd Fellow Vägen 19 127 32 Skärholmen, Sweden
Tel. No.: +46 8 708 93 14 Mobile: +46 (0) 73 693 85 10 Fax No.: +46 8 311 590
E-mail: ulrika_ericsson@hotmail.com
Dr Pina Frazzica
Director General, Centre for Training and Research in Public Health
Cittadella Sant’Elia Via G. Mulè 1
93100 Caltanissetta, Italy
Tel. No.: +39 934 50 52 08 Fax No.: +39 934 59 43 10 E-mail: frazzica@infoservizi.it
Professor Deborah Hennessy 12, The Close – Union Road Bridge Canterbury, Kent, CT4 5NJ
United Kingdom
Tel. No.: +44 1 227 831 842 Fax No.: +44 1 227 831 842
E-mail: deb.hennessy@btinternet.com
Professor Clyde Hertzman
Director, Population Health Program Canadian Institute for Advanced Research Department of Health Care and Epidemiology Faculty of Medicine
University of British Columbia
5804 Fairview Avenue, Mather Building V6T 1Z3 Vancouver BC, Canada
Tel. No.: +1 604 822 3002 Fax No.: +1 604 822 4994
E-mail: hertzman@interchange.ubc.ca clyde.hertzman@ubc.ca
Professor Klaus Hurrelmann
Director, WHO Collaborating Centre for Child and Adolescent Health Promotion
School of Public Health University of Bielefeld
PF 100 131 - Universitätsstr. 25 D-33615 Bielefeld, Germany
Tel. No.: +49 521 106 3834 Fax No.: +49 521 106 2987
E-mail: Klaus.Hurrelmann@post.uni-bielefeld.de
Dr Maksut Kulzhanov
Dean, Kazakhstan School of Public Health 19a Utepov str.
480060 Almaty, Kazakhstan
Tel. No.: +7 (3272) 491819 Fax No.: +7 (3272) 491 766 E-mail: mkk_ksph@nursat.kz
Dr Joan-Ramon Laporte
Director, WHO Collaborating Centre for
Research and Training in Pharmacoepidemiology Department of Pharmacology and Psychiatry Universitat Autonoma de Barcelona
Ciutat Sanitària de la Vall d’Hebron E-08035 Barcelona, Spain
Tel. No.: +34 93 428 3029 Fax No.: +34 93 428 5112 E-mail: jrl@icf.uab.es
Dr Ruhsara Maharramova Head, Treatment Department
Institute of Tuberculosis and Lung Diseases 4, Kicik Deniz kuc.
370014 Baku, Azerbaijan
Fax No.: +994 12 930 711
E-mail: through: fma@who.baku.az
Professor Tilek S. Meimanaliev Minister of Health
Ministry of Health of Kyrgyzstan Moskovskaya 148
Bishkek 720405, Kyrgyzstan
Tel. No.: +996 312228697 Fax No.: +996 312228424
E-mail: through: almaz@who.elcat.kg
Professor Zafer Öztek (Secretary of the Congress) President
Society of Public Health Specialists of Turkey Medical Faculty, Department of Public Health Hacettepe University
School of Medicine Ankara, Turkey
Tel. No.: +90 312 324 3975 Fax No.: +90 312 311 0072 E-mail: zoztek@hotmail.com
Professor Albrecht Reith
The Norwegian Radium Hospital and Institute for Cancer Research
Montebello
0310 Oslo, Norway
Tel. No.: +47 22 93 47 17 Fax No.: +47 22 93 56 27
E-mail: Albrecht.reith@labmed.uio.no
Dr Serdar B. Savas
57 Ada, Marolya 3/15, D:20 81120 Atasehir
Istanbul, Turkey
Tel. No.: +90 (216) 455 17 36 Fax No.: +90 (533) 331 56 74 E-mail: fsavas@hotmail.com
Dr Tourgeldy S. Sharmanov Director
WHO Collaborating Centre for Nutrition Institute of Regional Problems of Nutrition Klochkova 66
KZ-480008 Almaty, Kazakhstan
Tel. No.: +7 3272 42 92 03 Fax No.: +7 3272 42 92 03 E-mail: tsharmanov@nursat.kz
Dr Igor Sheiman
Director, Boston University
Legal and Regulatory Health Reform Project 13, Sadovaya-Samotechnaya Ul.
Office 32
103437 Moscow, Russian Federation
Tel. No.: +7095 737 9484 or 209 58 06 Fax No.: +7095 737 9485
E-mail: igor.sheim@g23.relcom.ru or igor@sheyman.msk.ru
Dr Raymond Xerri
Director, Health Policy and Planning Department of Health
‘Palazzo Castellania’
15, Merchants Street Valletta, Malta
Tel. No.: +356 24 30 06 Fax No.: +356 24 60 00 E-mail: ray.xerri@magnet.mt
Dr Mikhrinisso Yuldasheva
Health Care Reform Project of Tajikistan Ministry of Health of Tajikistan
Shevchenko 69
Dushanbe 25, Tajikistan
Fax No.: +992 37 22 15 507
E-mail: through: whotjk@tajnet.com
World Health Organization Regional Office for Europe
Scherfigsvej 8, 2100 Copenhagen Ø, Denmark Dr Marc Danzon
Regional Director
Tel. No.: +45 39 17 17 17 Fax No.: +45 39 17 18 18 E-mail: mda@who.dk Dr Richard Alderslade
Regional Adviser
Evidence on Health Needs and Interventions
Tel. No.: +45 39 17 14 55 Fax No.: +45 39 17 18 18 E-mail: ral@who.dk Dr Assia Brandrup-Lukanow
Regional Adviser Gender Mainstreaming
Tel. No.: +45 39 17 14 26 Fax No.: +45 39 17 18 18 E-mail: abr@who.dk Ms Ainna Fawcett-Henesy
Regional Adviser Nursing and Midwifery
Tel. No.: +45 39 17 13 55 Fax No.: +45 39 17 18 18 E-mail: afa@who.dk Dr Gülin F. Gedik
Project Officer for CARNET countries
Tel. No.: +45 39 17 15 59 Fax No.: +45 39 17 18 70 E-mail: gge@who.dk Dr Elke Jakubowski
Associate Professional Officer
European Observatory on Health Care Systems
Tel. No.: +45 39 17 12 25 Fax No.: +45 39 17 18 70 E-mail: elj@who.dk Mr Kees de Joncheere
Regional Adviser Pharmaceuticals
Tel. No.: +45 39 17 14 32 Fax No.: +45 39 17 18 18 E-mail: cjo@who.dk Dr Rusudan Klimiashvili
WHO Liaison Officer, Georgia
Tel. No.: +995 32 37 60 23 Fax No.: +995 32 99 80 73 E-mail: whologe@access.sanet.ge Mr Bekir Metin
WHO Liaison Officer, Turkey
Tel. No.: +90 312 428 40 31 Fax No.: +90 312 467 70 28 E-mail: whotur@dominet.in.com.tr Dr Alena Petráková
WHO Liaison Officer, Czech Republic
Tel. No.: +420 2 24972486 Fax No.: +420 2 2491 4830 E-mail: wholocz@who.cz
Ms Francesca Racioppi Short-term Professional Transport
ECEH Rome Division
Tel. No.: +39 06 48 77 545 Fax No.: +39 06 48 77 599 E-mail: frr@who.it
Ms Karen Taksøe-Vester Programme Assistant
Tel. No.: +45 39 17 15 39 Fax No.: +45 39 17 18 70 E-mail: ktv@who.dk Dr Erio Ziglio
Regional Adviser
Health Promotion and Investment for Health
Tel. No.: +45 39 17 15 24 Fax No.: +45 39 17 18 18 E-mail: ezi@who.dk Dr Herbert Zöllner (Co-secretary of the Congress)
Regional Adviser Economics for Health
Tel. No.: +45 39 17 13 47 Fax No.: +45 39 17 18 70 E-mail: hzt@who.dk
WHO headquarters
20, avenue Appia, 1211 Geneva 27, Switzerland Dr Alessandro Loretti
Coordinator
Emergency Health Intelligence and Capacity Building
Tel. No.: +41 22 791 27 52 Fax No.: +41 22 791 48 44 E-mail: lorettia@who.ch
