2012-10-03 14:15:34 - Among the profound implications of globalisation are those for health problems and systems. What were once diseases whose reach was only regional, are now able – thanks to air travel – to have drastic consequences within hours, breaking out thousands of miles away at the other end of the world. Moreover, with changing life-styles “diseases of civilisation”, such as diabetes and high blood, are on the increase, above all in poor countries. It follows that global health must also become central to EU foreign policy, experts told the European Health Forum Gastein. Cooperation with stakeholders such as India and China would become increasingly significant, they said.

Bad Hofgastein, 3 October 2012 – „Globalisation is rapidly changing health and health systems, with no end in sight to this process,” said Prof Dr Thomas Krafft (Department for International Health, University of Maastricht). “The distinction between domestic and international health problems is becoming less and less important.“ The spread of infectious diseases around the globe was an example of just how powerful the impact of globalisation on health systems was, he said. But non-transferable, so-called “diseases of civilisation” which accompanied the lifestyle of prosperous countries were also spreading to poorer or rapidly-developing regions, and becoming a growing health problem, too. „The globalisation of health and disease requires completely new public health strategies,“ Professor Krafft argued during an event jointly-organised

by the Platform Global Health Europe and Maastricht University at the European Health Forum Gastein (EHFG).

He went on: „Moreover, the problems posed by climate change and by fundamental alternations in our natural environment, as well as the monitoring, detection, and prevention of health risks posed by emerging or recurring infectious diseases, are challenges that can only be solved jointly. It is clearly in Europe's fundamental interests to work together, and a particularly relevant area that needs to be addressed by a common European foreign and health policy.“

As a result of its population density, highly dynamic trade in commodities, increased migration and travel, and the ever-more intensive link-up with the rest of the world, Asia, and especially the rapidly growing economies of China and India, were often in the spotlight. „The outbreaks of SARS and avian flu are just two striking examples of the importance of close and comprehensive cooperation between European institutions and their Asian partners,” said Prof Krafft. “These partnerships need to be systematically developed and maintained so that they can take the strain when crises occur, and operate with as little friction as possible.”

Exporting unhealthy behaviour to other countries and regions

It was not only communicable diseases (infectious diseases) which were increasingly becoming global problems, said Prof Krafft. Increasingly, non-infectious diseases like diabetes, hypertension, and cardiovascular disease, along with the risks associated with them, such as obesity and tobacco-smoking, had long since taken on epidemic proportions, not just in developed countries. And they had also become widespread for a long time even in countries with low or moderate incomes.

„It is precisely in such countries that lifestyle is changing rapidly, with negative effects on health,“ said Prof Dr Ilona Kickbusch, director of the Global Health Programme at the prestigious Graduate Institute of International and Development Studies in Geneva. „The global marketing strategies of global companies, for instance in the tobacco and food sector, are also helping to export from our part of the world to other countries and regions behaviour which is injurious to people's health.“

That fact also made it highly complex to steer health policy issues on an international scale, she said: there were entirely new, formerly unheard-of challenges. Global health had long ago ceased to be the exclusive domain of governments. Many trans-national players, such as industrial enterprises and NGOs, were growing in influence and importance.

Important EU role

„Since we have to face global problems together, we also need common global solutions,“ said Prof Krafft. „In the EU there is now a general understanding that Europe has to adopt a significant role and promote global management strategies on the issue of global health, as it did in developing international strategies on climate change. The publication of the Council Conclusions on the EU Role in Global Health is an important milestone in this respect.“

That the EU and its Member States were going beyond mere declarations of intent was also reflected in the creation of a separate Division for Global Issues in the European External Service. In the context of global challenges to health policy and to European healthcare systems an approach, it was more than usually crucial to adopt a perspective which cut through the different sectors. It was not just health policy which had a decisive impact on health; that was just as much the case for European foreign, trade, and finance policy.

Rapidly developing economies as major global players in the health sector

But it was not only Europe which had to assume greater responsibility for global health problems, Prof Krafft argued. Important industrialized and developing economies like Brazil, Russia, India, and China would have an enhanced role in future. “Thanks to their very size and population, such countries already play an important role in global health issues. If they improve their national health and set up the internationally required early warning systems they will make a significant contribution to global health. So it is in the interests of the international community to support these countries in taking up their responsibilities for global health.“ Prof Krafft said that especially China and India recognised that they were global players in some areas of health: „In recent years both countries have hugely expanded their health research infrastructure. That means they are not just contributing to global knowledge, but have also registered large numbers of patents, above all in the areas of health technology, pharmacology, and health IT.“

China had drawn conclusions from the outbreak of SARS in 2003. This hit, and briefly paralysed, a country largely unprepared for the epidemic. Action had since been taken to develop an exemplary nationwide reporting system for outbreaks of disease. India was trying out the latest communication technology in an effort to make up for lost time in health surveillance and to skip several technological generations. „This is another area in which a number of important opportunities for close professional and technological partnership with Europe suggest themselves,“ said Prof Krafft.

„Reverse innovation“ or „trickle-up innovation“ was the concept that defined research collaboration with the EU, he said. It described innovation processes in major industrialized and developing economies which issued in less capital-intensive technologies better-adapted to local needs, the innovations then spreading to the more developed world. „We are convinced that there are great possibilities in this area for working together to improve global health,“ said Prof Krafft.

Successful EU cooperation with UNICEF

But in other respects too the EU played a crucial role in matters of global health, since it was the largest international donor in development policy, and particularly cooperation in health development, he said. „For example, EU cooperation has greatly contributed to the work of UNICEF in significantly reducing female genital mutilation and the number of child marriages.“ In the years 2008 - 2012 the EU had made a total of nearly 4m Euros available to UNICEF for these purposes.

Professional dialogue and exchanging experiences at Gastein

This year's Global Health Forum in the framework of the EHFG brings together senior representatives of European institutions and research organizations and their Indian and Chinese partners. This dialogue of professionals included discussion of the pre-conditions and basis for closer cooperation between specialized services in monitoring and controlling infectious diseases, as well as the role of EU foreign policy. „This dialogue also offers the opportunity to learn from the extensive experience of our Asian partners,“ said Prof Krafft.

The EHFG is the most important conference on health care policy in the European Union. In this its 15th year, the EHFG attracts more than 600 decision-makers from 45 countries to discuss major topics on the future of the European health care system from 3 to 6 October 2012.

Please find photos of the European Health Forum Gastein using this link: www.ehfg.org/940.html.

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