PLAYING WITH THE TRUMP CARD: HEALTH HAS CHAMPIONS TO STAY THE GAME

In the wake of a surprising election result in favor of Donald Trump, David Stuckler, Martin McKee, Richard Horton, Michael Moore and various public health leaders from all around the world, discussed the potential impact of the election on health at the 9th European Public Health Conference.

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At the meeting, Richard Horton, editor of The Lancet, challenged health leaders to develop a public health manifesto in the period prior to the swearing-in of the President-elect. Of particular interest to public health professionals during Trump's campaign was his pledge to fully repeal the Affordable Care Act, which provided over 15 million people, who would otherwise be excluded, access to treatment. He has since stated that he plans to keep some parts of the law intact, but his proposals are still worrying to those who support the principle of universal healthcare. The European Public Health Association and World Federation of Public Health Associations have committed to writing the manifesto, which will be published in The Lancet, and to ensure that Trump promotes public health during his time in office.


LETTER TO DR. JUAN MANUEL SANTOS, PRESIDENT OF THE REPUBLIC OF COLOMBIA

On 11th November 2016, the World Federation of Public Health Associations, along with the 'Asociación Colombiana de Salud Pública', wrote a letter to Dr. Santos, President of the Republic of Colombia, congratulating him for being awarding the Nobel Prize for Peace.

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Dr. Santos has demonstrated to the world that a process of peace-making can be embarked upon even when the situation seems to be blocked from all sides. His actions have provided a signal of hope to all the regions of the world where the majority of people look so desperately for an end to war. In war and civil unrest people cannot live fulfilled happy lives, and even the basic human right to health cannot be achieved. It was for this reason that the WFPHA, in the name of over 100 member organizations representing a wide range of public health professions, chose to take the opportunity to recognize Dr. Santos' achievements.

The Office of the High Commission for Peace of Colombia has subsequently sent a letter to Michael Moore, WFPHA President, thanking the WFPHA for its gesture of support and solidarity. In the letter, it was recognized that the international community is essential to end the conflict and help unite Colombians.


WHO FRAMEWORK CONVENTION ON TOBACCO CONTROL

The seventh session of the Conference of the Parties (COP7) to the WHO Framework Convention on Tobacco Control (FCTC) was held in Delhi on 7-12 November 2016.

The Conference delivered several significant decisions that will shape the international treaty for the next two years and beyond, including decisions which enhance implementation of areas linked to development, human rights as well as public health. The decisions will address the consequences of the on-going tobacco epidemic, which is expected to kill 1 billion people in the 21st Century unless measures are taken. The Parties to the Convention voiced their concerns over the tobacco industry's continued attempts to infiltrate and manipulate the workings of the Convention and decision-making. The Head of the Convention Secretariat, Dr. Vera Luiza da Costa e Silva, told delegates: “The long hours of debate and planning has produced a strong roadmap for global tobacco control for the next two years, when COP meets again. Despite all the hard work by the Parties it is sad to see tobacco industry interests, yet again, being promoted. It is determined to undermine and distract us from our goal – to fight against the tobacco epidemic that not only damages health and kills people, but also impoverishes those living in low- to middle- income countries.”

The WFPHA was represented by Valeska Carvalho Figueiredo and Silvana Rubana Turci, from the Tobacco and Health Studies Center of the National School of Public Health of the Oswaldo Cruz Foundation (CETAB). At COP7, Valeska and Silvana had the opportunity to present during the side events two important public health actions that CETAB develops, in collaboration with the implementation of the Framework Convention on Tobacco Control. During the side event, 'Healthier and Environment-friendly Alternatives to Tobacco Cultivation', they presented a proposal for the development of a comprehensive health care protocol for farmers who grow tobacco. This protocol will be useful for monitoring workers' health and the environmental consequences of tobacco. In addition, during the side event 'Preventing Tobacco Industry Interference: What's new? And What's Next?', they presented the Brazilian Observatory on Tobacco Industry Strategies, to contribute to the Secretariat's project of development an observatory in each of the BRICS countries (Brazil, Russia, India, China, and South Africa).


BANNING NUCLEAR WEAPONS IS CRUCIAL FOR GLOBAL HEALTH

Before this year ends, the United Nations general assembly can take a decisive step toward ending one of the most urgent threats to public health and human survival in the world today. UN member states can and must mandate negotiations on a new treaty that prohibits nuclear weapons.
The dangers posed by these weapons are utterly unacceptable, and the only sure way to prevent an unthinkable catastrophe is to eliminate them completely. That is not only possible, it’s essential and long overdue.
A single nuclear weapon can destroy a city and kill most of its people, making it impossible to provide meaningful aid to the survivors. A nuclear war could kill many more people in an hour than were killed during the entire Second World War.
Nuclear detonations in cities would ignite massive fires with extreme and long-lasting environmental consequences, disrupting the Earth’s climate and agricultural productivity. Less than 1% of the nuclear weapons in the world today could cause a nuclear famine with the potential to put two billion people at risk of starvation.
The thousands of nuclear weapons in the countries with the largest arsenals alone could bring about nuclear winter, with the prospect of destroying the essential ecosystems on which life depends and thereby threatening human extinction.
Nuclear weapons release intense ionising radiation that jeopardises any immediate survivors; causes acute and long-term illnesses, including cancers, that are often deadly; and leaves a legacy of genetic and intergenerational health harm.
A nuclear war has an extremely high likelihood of creating refugee crisis orders of magnitude larger than the one we seem unable to cope with today. Nuclear weapons eradicate the physical and social infrastructure required for recovery from conflict.
Earlier this year, our federations, the main bodies representing millions of physicians, nurses, and public health professionals around the world, presented these facts to a special UN working group on nuclear disarmament. The International Red Cross/Red Crescent and UN agencies charged with responding to humanitarian disasters warned that health professionals and relief workers would be unable to mount any meaningful response to the consequences of a nuclear conflict.
One hundred and twenty-seven states have said with common voice that their security is directly threatened by the 15,000 nuclear weapons that exist in the arsenals of nine countries, and they are demanding that these weapons be prohibited and abolished. They have lost patience with the refusal of the nuclear-armed states to fulfill their obligation to disarm. Moreover, they rightly see the massive and expensive nuclear re-armament programs underway in these states as confirming their bad faith and recklessly endangering our collective security.
The working group recommended – by a majority of more than three to one – that the general assembly mandate negotiations, to start next year, on a treaty to prohibit nuclear weapons. A ban treaty will create a new and explicit legal, moral and political norm – comparable to the treaty prohibitions that already apply to chemical and biological weapons, antipersonnel landmines, and cluster munitions.
A ban treaty will close a legal gap with regard to nuclear weapons by making it unequivocal that no state has a legitimate claim to possess, build, test, deploy, use, or threaten to use them.
A minority – the nuclear-armed states and those claiming to rely on their nuclear weapons – object to a ban treaty because they believe that nuclear weapons make them more secure. In fact, these weapons, whose use has the potential to destroy human civilisation, are the greatest threat to the security of everyone, including the nations that possess them.
An evidence-based understanding of what nuclear weapons actually do invalidates all arguments for continued possession of these weapons by anyone, and requires that they urgently be prohibited and eliminated as the only course of action commensurate with the existential danger they pose. The working group has sent this clear message to the general assembly, where governments must now muster the courage to act on behalf of humanity’s future.
Banning and eliminating nuclear weapons is a high global health priority. The general assembly has the opportunity to move us towards this critical goal. It must not fail to act.

Ira Helfand and Tilman Ruff are co-presidents of International Physicians for the Prevention of Nuclear War; Sir Michael Marmot is president of the World Medical Association; Frances Hughes is CEO of the International Council of Nurses; Michael Moore is president of the World Federation of Public Health Associations.
From The Guardian


GLOBAL HEALTH LEADERS IDENTIFY TOP PRIORITY FOR NEXT WHO DIRECTOR-GENERAL

WASHINGTON (October 13, 2016) – What should be the highest priority for the next World Health Organization Director-General in the face of mounting health challenges and a shortage of funding?

Global health leaders from across the world say “the answer lies within the WHO’s main constitutional pillar, the right of everyone to the highest attainable standard of health.”
Writing in The Lancet Global Health published Oct. 13, the global health leaders from all corners of the world say the next WHO Director-General should make the human right to health their “highest priority,” with the Framework Convention on Global Health (FCGH) as “the centerpiece of this endeavor.”
The FCGH is a proposed treaty that would be based in the right to health and aimed at national and global health equality.
The article comes, as the campaigning for the next WHO Director-General gets underway, just days after the WHO announced the candidates for the upcoming election of the next head of the world’s health agency, which will take place in a two-step process next January and May.
The health leaders describe the FCGH as a tool that “would reform global governance for health to enhance accountability, transparency, and civil society participation and protect the right to health in trade, investment, climate change, and other international regimes.”
They write, “It would usher in a new era of global health with justice—vast improvements in health outcomes, equitably distributed.”
Lawrence Gostin, of the O’Neill Institute for National and Global Health Law at Georgetown University in Washington, DC, says the proposed global health treaty “is founded in the recognition that global health justice today requires global cooperation.” Yet, he says, “Systems for global cooperation today are deeply deficient, from inadequate funding and accountability to other international regimes undercutting health. For example, agreements on trade and intellectual property impede access to essential vaccines and medicines.”
“Meanwhile, extreme marginalization and health disparities within countries persists, often leaving poor and excluded populations with far worse health outcomes than their better off neighbors,” Gostin says.
The Lancet Global Health article further explains how the FCGH could advance health accountability, including through national health accountability strategies and a global health accountability framework.
The authors say the treaty could enhance equity, including through “standards on disaggregated data, non-discrimination, equitable resource distribution, and pro-poor pathways to meet health targets.” And it could improve global governance for health, including through a domestic and global health financing framework, which would for the first time set health finance benchmarks for all countries, and right to health impact assessments and public participation to ensure that international agreements respect the right to health.
The authors also emphasize the responsibility of all sectors for the right to health.
The health leaders point to another reason that the next WHO Director-General should prioritize the FCGH, observing that the “FCGH would reinvigorate WHO’s global health leadership,” and “become the platform for reforming WHO as a rights-based 21st century institution, with badly-needed reforms, such as community participation, new priorities favouring social determinants of health, and a culture of transparency and accountability.”

In addition to Gostin, other authors of the article include
Eric A. Friedman, JD, O'Neill Institute for National and Global Health Law, Georgetown University Law Center; Paulo Buss, MD, MPH, FIOCRUZ Center for Global Health, Rio de Janeiro, Brazil, National Academy of Science, Rio de Janeiro, Brazil; Mushtaque Chowdhury, MSc, PhD, BRAC, Dhaka, Bangladesh, James P. Grant School of Public Health, BRAC University, Dhaka, Bangladesh; Anand Grover, BSc, LLB, Lawyers Collective, New Delhi, India; Mark Heywood, SECTION27, Johannesburg, South Africa; Churnrurtai Kanchanachitra, PhD, Institute for Population and Social Research, Mahidol University, Phuthamonthon, Thailand; Gabriel Leung, MD, MPH, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China; Judith Mackay, MB ChB, Vital Strategies, Hong Kong Office, China, Asian Consultancy on Tobacco Control, Hong Kong, China; Precious Matsoso, BPharm, LLM, National Department of Health, Pretoria, South Africa; Sigrun Møgedal, MD, Norwegian Knowledge Centre for the Health Services, Oslo, Norway; Joia S. Mukherjee, MD, MPH, Partners In Health, Boston, MA, USA, Division of Global Health Equity, Brigham and Women’s Hospital, Boston, MA, USA, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA; Francis Omaswa, MB ChB, MMed, FRCS, African Centre for Global Health and Social Transformation, Kampala, Uganda; Joy Phumaphi, MSc, African Leaders Malaria Alliance, Dar-es-Salaam, Tanzania; K. Srinath Reddy, MD, DM, MSc, Public Health Foundation of India, New Delhi, India; Mirta Roses Periago, MD, MPH, Global Network for Neglected Tropical Diseases, BuenosAires, Argentina; Oyewale Tomori, DVM, PhD, Nigerian Academy of Science, Lagos, Nigeria; Miriam Were, MB ChB, MPH, Dr PH. Moi University, Kenya; and Debrework Zewdie, PhD, CUNY School of Public Health and Public Policy, New York, NY, USA.

Letter in support of FCGH
Complementing the article in Lancet Global Health, a letter to the WHO Director-General nominees in support of the FCGH has been signed by many of the Lancet authors and others global health experts, including Paul Farmer, of Partners In Health and Harvard University.
Dozens of leading global and regional health, humanitarian, and human rights organizations also joined the letter. These include
Action for Global Health (a European network), AMREF Health, the Asian-Pacific Resource and Research Centre for Women, BRAC (the world’s largest NGO), CARE International, the Global Health Council, Handicap International, the Helen Keller Foundation, the International Council of AIDS Service Organizations, the International Network of Women Against Tobacco, the International Rescue Committee, the International Union Against Tuberculosis and Lung Disease, Oxfam International, REPOAC (Network of West and Central African NGO National Platforms), WaterAid, and the World Federation of Public Health Associations. Demonstrating local support for the FCGH, major national health and human rights organizations, including from countries in Africa, Asia, the Americas, and Europe, also endorsed the letter.

For more information, please contact Karen Teber


INTRODUCTION OF TOBACCO PLAIN PACKAGING IN NEW ZEALAND

WFPHA and PHAA support the Government of New Zealand on its plans to introduce tobacco plain packaging in the country

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Since 2013, following the lead of Australia, the Government of New Zealand has been working on the promotion of a new regulatory scheme to introduce plain packaging of tobacco products. On May 31, 2016, the New Zealand Ministry of Health released draft regulations that would implement the Smoke-Free Environments (Tobacco Plain Packaging) Amendment Bill, which is currently being considered by the Parliament (Standardised Tobacco Products and Packaging Draft Regulations; Smoke-Free Environments-Tobacco Plain Packaging- Amendment BillGovernment Bill186-2). The Ministry has lead a consultation with the public on the proposed requirements for standardized tobacco products and packages set forth in the draft regulations. The consultation document gives an overview of the exposure draft regulations.

The World Federation of Public Health Associations and the Public Health Association of Australia have congratulated the New Zealand Government on its plans to introduce tobacco plain packaging and strongly support the proposed approach.

With the enactment of the Tobacco Plain Packaging Act in 2011, Australia was the first country in the world to request and obtain tobacco products to be sold in plain packaging. The aim of the policy was to induce smokers to quit, while preventing potential smokers from getting addicted.
Plain packaging refers to the standardization of the number of cigarette sticks in each pack, of their dimension and of the cigarette pack design (namely the pack size and colour, the position, font and dimension of the brand name, the visibility of the health warnings). In particular, it has been shown that the harmonized features of peer packs can significantly harm the promotional strategies of tobacco companies and make smoking less attractive to young people. Despite the legal actions promoted by major tobacco companies against the Australian Government, peer reviewd research and independent evaluation have clearly shown the effectiveness of plain cigarette packaging regulations both in the short and in the long run.


EXTRAJUDICIAL KILLINGS IN THE PHILIPPINES

An open letter from the civil society calls on UN drug control agencies to take urgent action

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A few weeks have passed since Mr. Rodrigo Duterte was inaugurated as the new President of the Philippines, during an official ceremony where he confirmed his “uncompromising adherence to due process and the rule of law” and assured that “the Republic of the Philippines will honour treaties and international obligations”.
Mr. Duterte won the presidential elections on 9th May, following the withdrawal of his main opponents and thanks to an electoral campaign based on the commitment to end crime and corruption in the country within six months. Despite the absence of any clear policy detail, his blunt promises won him the support of millions of Filipinos weary of ineffective governments, which let Mr. Duterte win the presidency by a clear margin.
However, since his election, the new President has made several public statements which explicitly contradict his stated intentions to comply with the Philippines’ human rights obligations. For instance, he repeatedly incited also ordinary citizens to the extrajudicial killings of people suspected of using, dealing and supplying drugs.
Moreover, Duterte has been suspected of playing a role in many of the hundreds of killings of alleged drug dealers that have been taking place all around the country since he won the election.
Such a critical issue requires the planning and implementation of urgent advocacy actions aiming to promote a human rights-based approach to drug control.
For this purpose, the International Drug Policy Consortium (IDPC) has recently prepared an open letter to the UN Office on Drugs and Crime (UNODC) and the International Narcotics Control Board (INCB), to call both bodies to condemn the killings and to put pressure on President Duterte to end his bloody war on drugs.

Together with many NGOs to whom the letter was submitted, the World Federation of Public Health Associations has expressed its support by signing the call.


CIVIL SOCIETY GROUPS SAY NO TO INVESTORS SUING STATES IN RCEP

WFPHA supports the statement against the introduction of ISDS in RCEP countries

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The Regional Comprehensive Economic Partnership (RCEP) is being negotiated in secret by 16 countries and a leaked copy of its investment chapter includes proposals to allow foreign investors to sue governments at an international tribunal.
If the proposals are accepted, this investor-to-state dispute settlement (ISDS) will allow foreign investors to sue RCEP governments if they regulate in ways that may harm the foreign investors' interests, even if the regulation is aimed at safeguarding the public interest of that countries.
The application of the ISDS in the past has entailed considerable challenges to health, environment, financial regulation and many other fields, and has obliged even the governments of some of the least developed countries to pay huge fees to the "damaged" investors. These de facto limitations of sovereignty and of the governments’ ability to rule have led many countries (both inside and outside RCEP) to question their support to any investment protection provision (including ISDS) in bilateral investment treaties (BITs) and free trade agreement (FTA) investment chapters.
Various United Nations (UN) human rights bodies have also stated their serious concerns about ISDS. According to 10 UN Special Rapporteurs/Independent Experts on human rights, the ISDS cases clearly demonstrate how "the regulatory function of many States and their ability to legislate in the public interest have been put at risk". They also called for enhanced transparency during the negotiations of FTAs through the publication of the negotiating texts and the possibility for any stakeholder to participate in the negotiation process.
On August 5th, the Fourth Ministerial Meeting of the RCEP was held in Vientiane, Laos, and was attended by the Ministers of Commerce from 16 sides including the ten countries of ASEA, China, Australia, India, Japan, Korea and New Zealand. Given the need to finish the negotiations before the end of 2016, the Ministers stressed the importance of reaching an agreement, according to the RCEP Negotiation Guidelines and Objectives and in view of the 14th round of negotiations to be held from August 10th to 19th in Ho Chi Minh City, Vietnam. In this context, many of the RCEP civil society organisations are trying to push the RCEP countries to reject the introduction of ISDS in the agreements.

The World Federation of Public Health Associations gave its support to the statement against the introduction of ISDS in RCEP countries, being it consistent with its 2016 Resolution on international trade agreements and public health.


FRAMEWORK CONVENTION ON GLOBAL HEALTH

The WFPHA signs a call to promote support to the FCGH by the WHO and the UN

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Preventable and treatable injuries and diseases are on the decline, but still condemning many millions to avoidable death and illnesses in sub-Saharan Africa, the Indian subcontinent, and other impoverished areas of the world. By one measure, health inequities are at the root of nearly 20 million deaths. These inequalities are replicated within countries, both high-and low-income ones. Those who are poor, disabled or belong to socially disadvantaged minorities are far less likely to access quality health care and have their fundamental survival needs met, and consequently, their life expectancy is shorter. Despite the codification of the right to the highest attainable standard of physical and mental health by multiple international Treaties and national Constitutions, yet large gaps exist between commitments and reality, and immense health inequities persist across the globe. In this context, the Framework Convention on Global Health (FCGH), whose drafting is currently underway, could create a right-to-health governance framework based on the post-2015 Sustainable Development Goals. Recognising the potential impact of the FCGH, UN Secretary-General Ban Ki-Moon in person issued the following call to action in his report preceding the June 2016 High-Level Meeting on Ending AIDS: “I further encourage the international community to consider and recognize the value of a comprehensive framework convention on global health”. The FCGH would help ensure that health goals and targets in the 2030 Agenda for Sustainable Development are successfully implemented, by trying to fill the existing gaps in accountability, governance, financing and human rights protection. In particular, the FCGH would develop a set of concrete actions to address four persisting global health shortcomings: weak accountability, inadequate funding, discrimination against disadvantaged minorities and the risk for national and international governance to harm global health (two major examples are the intellectual property rules impeding access to medicines and the recent international trade and investment treaties that may reduce the Governments' ability to rule). Inspired by recent Treaty precedents such as the WHO Framework Convention on Tobacco Control (FCTC) and the Paris Agreement, and combining some elements of these models, the FCGH may become an innovative 21st century instrument for 21st century governance. Among the supporters of the FCGH there are many institutional and partnership actors, together with leading health and human rights organisations and networks. In order to win the support of the next WHO Director General and next UN Secretary General, two sign-on letters have been delivered to the candidated for each election calling upon them to support the FCGH.

The World Federation of Public Health Associations agreed to sign the call, thus giving its support to the initiative.

For further information about the Framework Convention on Global Health, please click here.
An exhaustive summary of the FCGH background, goals and intended actions can be found here.


WFPHA ENGAGEMENT ON MIGRANT HEALTH

The WFPHA and European Public Health Association (EUPHA) have jointly developed a statement on the refugees’ crisis. The statement has been presented at the European Public Health Conference in Milan on October 15th 2015.

The WFPHA and EUPHA:

  • Endorse the WHO’s call for a systematic public health response and UNHCR’s demand for the immediate creation of logistic facilities to deal with the needs of asylum-seekers in their transit from countries of origin to refuge in European countries.
  • Call for the implementation of essential public health measures that include emergency services, access to care during pregnancy and childbirth, vaccination against communicable diseases, paediatric facilities, medication and care for chronic conditions, as well as mental and social health intervention.
  • Demand that special attention is paid to gender-based violence including rape and reproductive health issues.
  • Emphasize that as a region with resources and democratic traditions, the European Union has a responsibility to behave in a way that is exemplary and to provide a model of good practice in order to manage the refugee crisis with generosity and solidarity.
  • Request the public health associations involved (in the countries of origin, transit and wherever the refugees settle) to share knowledge, information and advocacy tools in order to strengthen their influence in favour of refugee health and wellbeing.
  • Invite public health associations to collaborate with institutions and NGOs by sharing their knowledge and experience. Such activities include offering relevant surveillance information and training on the public health aspects of the crisis to health-care workers providing medical care for refugees.
  • Encourage public health associations to advocate through mass media and other methods of influence for the protection and promotion of the human rights of the refugees as well as those of the host communities. Advocacy actions should also contribute to the provision of accurate information on health risks as well as fair consideration of refugees in order to avoid any discrimination and stigma.

    To read the statement, click here.
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M. Asnake (WFPHA president) and M. Moore (WFPHA VP/president-elect) presenting the statement at the Press Conference.
 
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