Report from the 9th World Health Summit 2017 in Berlin, 15th-17th of October
A political update: What’s going on in mainstream Health Policies?
By Nora Laubstein
About 2000 participants attended the three day World Health Summit (WHS) in Berlin under the patronage of Angela Merkel, Emmanuel Macron and German Health Minister Herman Gröhe. The presidency for this year was held by Helene Boisjoly, University of Montreal and WHS-founding President Detlev Ganten, Charite-University. Both are partners of the M8-Alliance, a 2009 founded network of 20 global Academic Health Centers, Universities and National Academies.
The WHS is one of the world`s most prominent strategic forums for global health and includes “Academia”, “Civil Society”, “Private Sector” and “Policy Makers”. The WHS brings together stakeholders from the following fields: Health Policy in the G7/G20, Global Health Security, Healthy and Resilient Cities, Vaccine Research and Development, Strengthening Innovation and Health Systems and Big Data for Health Governance. More information about the WHS-Foundation GmbH can be found under www.worldhealthsummit.org ↗
Within forty-six panel-discussions and workshops the speakers, their guests and the audience tackled all relevant and current global health from an academic point of view. WS No7 (Defining an EU Global Health Strategy) mentioned the history of the European Union`s increasing role in the Public Health area. This role began with Maastricht and an action plan in 1997, continued in 2008 with the first EU Global Health plan and then offered the 2010`s principles for foreign policy “Health in all policies” by the EU-Council. In July 2017 the Agenda 2030, including “Sustainable Development Goals (SDG)” was adopted. The European Union has only an observer-status in the WHO (World Health Organization) and is not able to vote. The EU representative for WHO-related matters comes from the Commission’s General Directory DG-Sante.
Since the topic Sustainable Development Goals was a part of all panel-discussions and some of the workshops, it is helpful to have a clear understanding about this term: Formally called “Millennium Health Goals/MHG” (adopted by the WHO-Definition based only on diseases), the WHO member states were not fully satisfied and in 2015 changed it to “Sustainable Development Goals”. SDG now also includes human rights, equality, global justice and governance. Meanwhile “Health” was put in the center of all policies by the WHO, just in opposite to the EU-White paper from President Juncker, who mentioned “Health” only beside other topics. Panel Chair Ilona Kickbusch, director of the Global Health Center, clearly outlined new and upcoming challenges for the SDGs: The new challenges (war, migrants, inequality and poverty), and the political contest and the incredibly strong industrial drivers (consumption, tobacco, etc.). She pointed out that there must be decisions, political choices, partnerships and a stronger focus on the people.
The following obstacles were identified and addressed through concrete actions: The exit strategy when a project is finished was discussed. This is a crucial time to make sure progress is not dismantled during the exit process from project. In this context “voluntary work” was positioned in opposition to “sustainable work”…because of “voluntary work” does not mean an ongoing work. Also the engagements of “Private Partnerships” have changed in the last five years. Justin Mc Carthy from PFIZER Inc. spoke about the great success of the vaccination program of over 500 million children in Africa, which happened in only five years.
The NCD-sector (Non-communicable diseases) however, is also harmed by the private sector – such was discussed under the topic: “Individual choices vs. political choices”. This should be regulated with taxes etc. by the policies. One bitter remark was stated by Elhadj As Sy, General Secretary of the Red Cross: “How could something become sustainable when we are faced with more and more cases of emergency”? Things are getting worse, not better. There is almost no confidence in public structures for building-up sustainable circumstances.
One other topic was, “Precision Medicine and Population Health”. Since 2015 a precision medicine initiative was proclaimed by Barack Obama. The mission behind it is to enable a new era of medicine. This is done through research, technology and policies that empower patients, researchers and providers to work together toward development of individualized treatments. This panel-discussion included all forms of “person-centered”, “individual” and “precision” aspects. Examples are: Mono-Clonally Anti-bodies, Biomarkers (PTMs=Human biomedical proteins), biological aspects, re-definition of cancer (biological background?) and all high quality patient`s data. Also concrete practical problems were discussed, like: Could we use randomized studies any longer? 30% of all receipts were not used in pharmacy, and 50% of all medicaments for NCDs were used in a wrong way…
A very vital discussion happened in the Digital Health- panel. In his introducing speech Salif Samake, Ministry of Health in Mali, claimed that the SDGs need a Public partnership that will focus on putting the patient front and center. Digital Health means technology in Health Care. It should be Health system-orientated and support home-based health and literacy. Also “universal health coverage/UHC” (= e.g. taxes, insurance, economics, etc.) should be included. There are 4,8 billion mobile phones globally by now. Inside the hospitals communication without papers and “real-time-diagnostics” has become reality. But what skills are needed for implementing Digital Health? The solution proposed was data-collectors, coordinating capacity, trainees for development and strategies and academic tools.
A big problem today is when a grant ends. Once the money is finished, the project ends. So here must be a change of thinking: The money must help the whole system! It should be easy and not too academic. This leads to sustainable systems with a permanent need of resources…
Michael Adelhardt, from the GIZ Germany, stated that until now there are only a few positive outcomes of all investments. What would be necessary for showing success? The potential is here but it needs to be documented. WE should keep in mind that eg. Telemedicine in a hospital used by doctors could be a locally specific tool, but a national program will take some years. Because technology is only a tool, the conclusion of the panel was to start with questions like: What is the vision? How can we use the amount of data better? The panel stated that without bigger goals or a framework Digital Health does not work. Remark from the audience: Digital Health should be used for empowering the people. So it has the power to change governments! More about the WHS under: www.worldhealthsummit.org ↗
The title “Science-Innovation-Policies” shows exactly the list of importance. The Opening Ceremony highlighted a strong, nearly religious belief in research and science. Nobel laureate Roger D. Kornberg mentioned the fabulous progress of medicine as a science over the last one hundred years; he spoke of former times, when mankind used blood-letting, leeches and the four humors. Werner Baumann, CEO of Bayer AG voted for evidence-based science, not for any “emotional feelings” or some kind of “science-fiction”. The fusion with Monsanto… for him this presents part of a holistic approach to agriculture, environment and health.
The speech of the current German Minister of Health, Herman Gröhe, was an politically charged and up-to-date. He stated that Germany will support the WHO with thirty-five million Euros next year and will be part of the WHO-Board. Private Partnership with the industry and Evidence-based research would also be supported by the German government.
The term “innovation” used here means “Industry=Private Partnership”. La Roche Holding Ltd. Has taken a stake in the field of fighting against Antimicrobial Resistance (AMR). New antibiotics as well as an increase in the quantity of current antibiotics are now in production.
There was not a single word about Complementary and Alternative, Traditional or Integrative Medicine. Only at the coffee-break was there a short chat with the EU-representative in the WHO, who asked: “What about Homeopathy? Are you still representing Homeopathy in your organization?”