Why Health is Public: Insights from the 17th National Health Conference in Brazil

The 17th National Health Conference takes place in Brasilia from July 2–5. The Executive Director of the WFPHA, Prof. Bettina Borisch, takes part in this event.

The Conference gathers 6,000 participants and is one of the country’s most important on public health. The main theme of the Conference is “Defend the Single Health System (SUS), Life and Democracy – Tomorrow Will be Another Day”. To understand, the SUS is the Brazilian health care system that is public and offers Universal Health Coverage to all Brazilians.

The Conference is organized by the National Health Council (CNS) and the Brazilian Ministry of Health. Health Councils exist at the municipal, state, and federal levels. Delegates to these councils are patients, academics, health professionals, and minority groups. They are elected to represent the needs of the population concerning “their” health care system. This is a democratic representation that links citizens, users, to their health care system. Over four days, panel discussions, debates, and working groups are held to come to final resolutions. Prof. Borisch points out that “this is a great and sometimes difficult way for citizens to have real participation and ownership in their health care system. There is a strong will in the audience to defend the SUS. It seemed to me that the will was even stronger now that there was a change in government away from the previous right-wing, neoliberal president. It was also felt that the intimate link that exists between a healthy life for all and democracy was understood.”

Prof. Borisch also points out that “such a process is not without difficulties, but health has to be a public affair, an affair of all. Everywhere we have to find ways to render health public, it is the finest task of public health professionals. Health and disease are very individual, and so we will have to embrace the diversity of demands of groups, minorities, and subgroups without, at the same time, guaranteeing the right to health to all.”

“The Conference was a showcase of all these aspects. A vibrant and multicolored crowd that, with all their voices and wishes, transmitted the feeling that health in Brazil is a public affair. We could all learn from Brazil as to how render health an active part of our democracies,” she mentions. Or to cite Health Minister Nísia Trindade Lima, who speaks at the Conference: “One of the first acts of the Ministry of Health was a meeting with the CNS to bring back social participation”.

The Conference takes place every four years. It is an important space for dialogue between government and society for the construction of public health policies.

Global Public Health Policies: Public Health Associations’ Perspectives

The definition of advocacy may exhibit slight variations across different disciplines. According to the World Health Organization (WHO), health advocacy is a combination of social actions designed to gain political commitment, policy support, social acceptance, and systems support for a particular goal or program. Advocacy is identified as one of the core functions of public health and is a key tool for achieving the Sustainable Development Goals (SDGs).

Within global public health, advocacy involves the engagement of diverse stakeholders in decision-making to improve population health. National public health associations and international non-governmental organizations (NGOs) play a vital role in advocating, advising decision-makers, guiding initiatives, and raising citizens’ awareness. Advocacy initiatives and campaigns, joint position statements, resolutions, and internal policies are recognized as the main tools used to influence policy in public health advocacy.

In a recent study by the researchers of the WFPHA, they investigated the focus of public health advocacy carried out by national public health associations over 4 years, between 2018 and 2021, to identify strengths and gaps in national and international advocacy and highlight areas where policy development could be strengthened. 12 national public health associations, including Ethiopia, Cameroon, South Africa, Nigeria, Canada, the United States of America (USA), Brazil, Spain, France, the United Kingdom (UK), Australia, and New Zealand, participated in their study, and a total of 220 policy documents were analyzed.

According to the study, the largest number of policy documents came from high-income countries and dealt with environmental health and communicable diseases, including COVID-19, with, however, important differences among regions. In the African region, public health advocacy focused mainly on strengthening health systems; Europe and South America were mostly concerned with communicable diseases and pandemic management; and North America and the Western Pacific regions focused primarily on climate change. In all regions, limited attention was paid to international health and health as a human right.

The study revealed that public health associations are active advocates for several public health issues. However, more effort should be devoted to implementing a more international and intersectoral approach, rooted in health as a human right.

According to the study, better use of resources and evidence to design health interventions, easy accessibility of data for policy and decision-makers, improved funding mechanisms, and citizen awareness are needed to strengthen the advocacy process.

The study recommended that in the future, advocacy efforts could involve more academics, journalists, and influencers, who would collaborate with national public health associations and professionals, as a single voice of civil society.

High-Level Symposium on Health Policy & Personalized Medicine for Cancer: Projecting Europe-China Collaboration in the Global Arena – A Report

Integrating China in the International Consortium for Personalized Medicine (IC2PerMed) project aims to foster collaboration between the European Union (EU) and China in the field of personalized medicine research, innovations, and policies. IC2PerMed, a Coordination and Support Action under the Horizon 2020 funding program, seeks to offer policymakers key solutions for harmonizing the approach to personalized medicine globally.

The IC2PerMed project is reaching its final phase successfully, with a recent High-Level Symposium on personalized medicine focusing on presenting the project’s outcomes and discussing its implementation at national and international levels. The symposium emphasized the potential adoption of personalized medicine in cancer and beyond, with a particular emphasis on China and Europe.

The healthcare system faces challenges in providing accurate and timely care for cancer patients. Digital health and artificial intelligence can play a significant role in improving patient health. However, progress in personalized medicine has been limited, and only a small percentage of cancer patients receive individualized care. The lack of support and insufficient allocation of resources hinder the implementation of personalized medicine in the EU.

China has recognized the challenges it faces in healthcare and aims to comprehensively address long-term health issues. The country has launched major personalized medicine projects, focusing on disease prevention, treatment, and rehabilitation. Personalized medicine is a strategic priority under China’s 13th Five-Year Plan, with significant investment in technological innovation and scientific advancements.

Collaboration between local governments and public health systems is crucial for the introduction of personalized medicine, and it should be seen as part of prevention efforts and cost-saving measures. However, challenges such as data sharing, regulatory pathways, ethical considerations, and training need to be addressed. Increasing health insurance supply, fostering international cooperation, and supporting research funds and scientist exchange programs are important steps.

While progress has been made, challenges such as limited resources, regulatory issues, and disparities persist. The implementation of personalized medicine requires collaboration, adequate training, and a focus on affordability and equity.

IC2PerMed: Roadmap

Integrating China in the International Consortium for Personalized Medicine (IC2PerMed) project aims to support the European Union (EU)-China collaboration over the developments of personalized medicine research, innovations, and policies through the International Consortium for Personalized Medicine (ICPerMed) initiative, providing people with access to personalized, smart, and inclusive healthcare solutions in the near future.

Over the past 4 years, the IC2PerMed project has developed a roadmap that aims to promote consistent approaches to personalized medicine research, development, innovation, and policies between the People’s Republic of China and the EU.

The roadmap proposes, through the actions listed below, items to deepen and promote alignment and creation of a common ground for European and Chinese collaborations on personalized medicine.

Improving: Empowered and Responsible Citizens

• Health Literacy
• Research
• Public Trust
• Ethical Challenges

Promoting: Trained and Up-to-Date Healthcare Workforce

• Education and Ethics
• Collaborations
• Policies

Fostering: Healthcare Systems’ Sustainability

• Resources
• Ethical, Legal, and Social Implications (ELSI) and Costs
• Evaluation
• Networks

Bringing: Innovation to Market

• Cost Effectiveness
• Needs Assessments
• Principles and Guidelines
• Perspectives

Adopting: Big Data and ICT Solutions

• Data Exchange
• Privacy, Security, and Trust
• Standards

Fostering: Research funding

• Patient Needs
• Value Chain
• Synergies

Translating: Basic Clinical Research and Beyond

• Omics Sciences
• Data and Standards
• Collaborations

The roadmap was presented during the High-Level Symposium on Health Policy and Personalized Medicine for Cancer: Projecting Europe-China Collaboration in the Global Arena, organized by the WFPHA in Geneva, Switzerland, on May 26, 2023.

Promoting Oral Health for Refugees: A Call to Action

The scale of global forced displacement is increasing worldwide as a result of persecution, armed conflict, generalized violence, natural disasters, famine, and economic changes. Refugees are one of the most vulnerable and marginalized populations globally, facing significant challenges in accessing health care, including oral health care.

Like all people, refugees are entitled to access health care, including oral health care, as guaranteed by the International Covenant on Economic, Social, and Cultural Rights. This right is further reinforced by the 1951 Refugee Convention and its 1967 Protocol, which require countries to ensure that such care is provided without discrimination and on the same basis as nationals.

Oral health is an integral part of overall health and well-being. However, oral health and access to oral health care for refugee populations remain areas of concern. The FDI World Dental Federation, Framework Convention on Global Health Alliance, Sustainable Health Equity Movement, and World Federation of Public Health Associations believe that access to oral health care is a fundamental human right and recognize that oral health is an integral part of overall health and well-being. They urge policymakers, healthcare providers, and international and national organizations to:

1. Include oral health as a part of current and future refugee health strategies and priorities, including for pregnant women, mothers, and young children,
2. Promote the importance of oral health and the rights of refugees among both healthcare and non-healthcare staff who encounter refugees to raise awareness of refugees’ right to health, including oral health, and
3. Ensure equitable access to essential oral health services for refugees as an integral component of primary and antenatal care and as a matter of their rights, in partnerships with national and local dental and health organizations.

IC2PerMed: Healthcare Professionals’ Education and Citizens’ Empowerment in Personalized Medicine

Technological and medical advancements have played a significant role in fostering personalized medicine. Nonetheless, for successful implementation of personalized medicine, it is crucial that all stakeholders involved, including healthcare professionals, citizens, and policymakers, achieve adequate health literacy. The Integrating China in the International Consortium for Personalized Medicine (IC2PerMed) project addresses this matter by highlighting the need to educate healthcare professionals and empower citizens. In an article published by the researchers of the IC2PerMed project, of which the WFPHA is a partner, they sought to identify the priority areas of intervention for healthcare professionals’ education and curricula and the engagement and empowerment of citizens and patients.

The article identified 17 priorities, of which 7 were related to health professionals’ education and curricula, whereas 10 focused on citizen and patient awareness and empowerment.

7 Priorities on Health Professionals’ Education and Curricula

• Foster research aimed at identifying the most effective methods to improve healthcare professionals’ literacy and expertise in the field of personalized medicine.
• Strengthen healthcare professionals’ ethics.
• Improve healthcare professionals’ knowledge of ethical, legal, social, and economic issues related to personalized medicine.
• Improve healthcare professionals’ communication skills to inform and empower citizens and patients in the field of personalized medicine.
• Foster multidisciplinary collaborations between different healthcare professionals and stakeholders in personalized medicine-related practices.
• Establish collaborations/partnerships among institutions/countries aiming at improving healthcare professionals’ literacy and expertise in the field of personalized medicine.
• Include healthcare professionals’ health literacy in personalized medicine as an emerging priority in national governmental strategies, policies, and plans.

10 Priorities on Citizen and Patient Awareness and Empowerment

• Promote and support citizens’/patients’ engagement in self-management of health and disease.
• Improve populations’ health literacy and skills as a prerequisite for better citizens’ and patients’ engagement and empowerment in the field of personalized medicine.
• Improve citizens’ and patients’ digital literacy and skills, considering the role of digital tools in supporting the engagement of citizens in personalized medicine.
• Foster needs-assessment research in the field of citizens’ and patients’ education related to personalized medicine.
• Foster research activities aimed at identifying effective methods to improve citizens’ and patients’ literacy and engagement in the field of personalized medicine.
• Improve healthcare professionals’ genomic literacy as a prerequisite for effective citizens’ and patients’ engagement in the field of personalized medicine.
• Strengthen communication and enhance communication activities in the field of personalized medicine.
• Promote public trust in scientific research, public organizations, and private institutions, given their importance in advancing personalized medicine-related research and technology.
• Foster collaborations/partnerships between different institutions/countries aiming to improve citizens’ and patients’ literacy and empowerment in the field of personalized medicine.
• Consider ethical, legal, social, and economic challenges for citizens’ and patients’ engagement in the field of personalized medicine.

According to the article, the identified priorities emphasized the importance of education and health literacy, multidisciplinary and international collaboration, public trust, and consideration of ethical, legal, and social issues. The article highlighted the relevance of the involvement of stakeholders in informing decision-makers, developing appropriate national plans, strategies, and policies, and ensuring the adequate implementation of personalized medicine in health systems.

The IC2PerMed project aims to support the EU-China collaboration over the developments of personalized medicine research, innovations, and policies through the International Consortium for Personalized Medicine (ICPerMed) initiative, providing people with access to personalized, smart, and inclusive healthcare solutions in the near future.