PUBLIC HEALTH IN A FLAT WORLD A Singaporean’s Perspective
THOMAS FRIEDMAN n n Pulitzer Prize winner Bestseller released in 2005 Focus on trade and commerce Opportunities and challenges of GLOBALIZATION
GLOBALIZATION n n Not just a geopolitical policy It is a phenomenon Confluence of new technologies “…it presents 2 contradictory faces – new technologies, greater wealth and rising living standards for millions of people; and at the same time, new instabilities, new risks, new uncertainties…” Renato Ruggiero (1998) Former DG, WTO
DG, WHO Dr Margaret Chan Singapore 2007 “Globalization has helped spread a costly epidemic of chronic diseases to the developing world. Consumer behaviors the world over are being shaped by global forces of production, trade, marketing and distribution. In the developing world, a strong national asset – the healthy diet and physical activity associated with rural farming – is being lost. ”
The MASS Effect n n Mass travel Mass production Mass communications Mass transfer of risks, including harmful lifestyles
GLOBAL HEALTH n n The original idea of International Health – flow of information and resources from developed to developing countries Global Health emphasizes the interdependence of countries and organizations on universal concerns
What we need…. . n n A new vision A research intensive culture An innovative healthcare delivery strategy A “global public policy”
The cost of a PANDEMIC n n World Bank estimates loss of $800 bn worldwide, and greatest cause will arise from uncoordinated efforts to avoid infection (2005) “It is also an issue of self-interest; can the world afford to leave vast populations vulnerable to the high morbidity and mortality that inevitably accompany pandemics? Is it not in our collective best interest to strive for more equitable protection? ” DG WHO (2007)
n n n n 1) 2) 3) 4) 5) 6) 7) 8) Eradicate extreme poverty and hunger* Achieve universal primary education Promote gender equality & empower women Reduce child mortality* Improve maternal health* Combat HIV/AIDS, malaria, and others* Ensure environmental sustainability* Develop global partnership for development* * Health-related as identified by WHO
An assessment by the DG, WHO (2008): n “For many priority diseases, trends such as globalization and urbanization have introduced a commonality to health problems seen in every part of the world. Among the health-related MDGs, there appears to be difficulty in reducing maternal mortality. The causes are broad and closely linked to social and economic factors. There is no single pill, bednet or vaccine that can guarantee results. Clearly, the problem of weak health systems includes the shortage of human resources as well as issues of infrastructure and financing. ”
Contributions of PH Professionals n Handling the Information Explosion “The world of 2020 will be a global knowledge village of 8 bn people…” Using the skills of health, information and risk assessment as well as communications – to guide public action
Contributions of PH Professionals n Creating New Knowledge Promoting Evidence-based Healthcare Developing competence in population -based research, using the latest biomedical tools with rigorous study designs
What do we do in such times n n “. . it is a bottomless pit of panic and despair. ” We will have to do more with less – evidence-based cost-effective health care.
Public Health in Asia n n n We have issues in public housing, environmental sanitation, infectious disease control, health promotion, innovations in healthcare & financing Combining local experience with an international perspective “…the health and well-being of people around the world depend critically on the performance of the health systems that serve them. ”
Our role in capacity-building n n n Training is key New areas of concern: obesity, bioterrorism, flu-pandemic Plugging the “gaps” in management Developing core skills in PH Making a significant contribution by equipping and encouraging a professional worker with a broad understanding of health issues and the skills to deal with disease prevention, health promotion and the delivery of health services
CONCLUSION n n THINK BIG: Challenge of a borderless world ACT SMART: Show competence in a focused manner Our future in a flat world
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