European Foundation Centre:

1
Towards a European Global Health Strategy

• European Foundation Centre
• Europe in the World
• Dr Graham Lister
• The Nuffield Trust
• 3th November 2004

2
Why global health?

• Health issues that affect populations
• across barriers of space, time and culture
• Global infectious disease threats
• Influenza, SARS, Measles, antibiotic misuse
• Global health impact of trade and lifestyle
• Depression, heart disease, cancer, diabetes
• Threat to the health of the globe
• Pollution, global warming, loss of resources
• Threat to human security and development
• The greatest challenge to our generation

3
The Nuffield Trust and global health

• 1999 Global Health a local issue
• 18 papers on trade, aid, knowledge, travel,
  culture.
• Centre for Global Change and Health at LSHTM
• 2000 UK partnership for global health
• Information and ICT for global health
• Globalisation and womens health
• Making Globalisation Work for the Poor
• 2001 www.ukglobalhealth.org
• 650 articles, reports, links, news items
• 2002 Health and Foreign Policy
• Global health and security
• 2003 UK strategy for global health
• Health as a global public good
• 2004 Global health networking
• USA, Canada, Commonwealth
• Netherlands, Germany, Eire, Australia, India

4
The Global Health Agenda

• Fair trade
• Poor countries loss to subsidies gt aid
• Better aid
• Poor country debt paymentsgt development aid
• Fair migration
• Losses of health workers gt health aid workers
• Investment for health
• 70 jobs from investment womens burden
• Sharing knowledge
• 10 of research 90 of health problems
• Building a global civil society
• 700 million tourist arrivals how much
  understanding?
• Health as a global public good
• Their health today Our health tomorrow

5
Trade

• Agricultural subsidies
• Geneva agreement
• 20 reduction in subsidies
• Action on cotton and sugar
• 2006 EU to phase out subsidies on
• tobacco, cotton and olive oil
• Access to medicines
• Doha agreement
• Import generics
• For national emergency
• Other actions
• AIDS triple therapy 1500 to 150
• EU orphan drug and Priority Medicines
• Partnerships and progress in Malaria, HIV/AIDS,
  TB

6
Aid

• 1969 Pearson Comm UN 1 target (0.7 ODA)
• Pre AIDS, oil crisis, debt crisis, climate change
  
• Denmark, Sweden, Netherlands, Luxembourggt 0.7
• Ireland 2007, Finland 2010, France 212, UK 2013
• EDF ODA 55 aid /65 of grant aid
• But only 42 to least developed countries
• High percentage of tied aid and conditionality
• Much of aid ends up paying for debts
• 2004 UNDP rethink aid and global public goods
• 0.7 aid 0.3 global public goods
• Health as a global public good
• 2005 UK proposals for International Finance
  Facility
• Vaccination pilot programme

7
Migration of health workers

• Migration of health workers to EU
• Commonwealth code - WHA call for action
• UK recruits 5,000 doctors, and 12,500 nurse
• Migration of health workers within EU
• 300 doctors left Hungary 150 left Estonia
• Remittances
• About twice the level of aid
• It cost 14 to remit 100
• Remittances do not return to the health sector
• Solutions are complex
• Need to balance rights and responsibilities
• EU to train for its own needs
• Need to compensate for training costs

8
Investment for health

• FDI 7x aid produces jobs, prosperity, health
• But can result in
• Polluting industries
• Unacceptable child labour and womens conditions
• Increases in unhealthy products tobacco, alcohol,
  cola
• Working with MNCs
• Global health award
• Partnerships for health
• Working on MNCs
• Health impact assessment
• Training for health leaders in poor countries
• Exchange to raise consumer awareness

9
Sharing knowledge

• Health Information and the Internet - eHealth
  Information Plan
• Potential applications to global health but
• Need to create infrastructure and skills
• Research networks
• Kanakaskis global health research networks
• Europe and Developing Country Trials Partnership
• Protecting health in Europe
• Action on MNC companies
• A port health strategy for Europe
• Improved health surveillance

10
Building a global civil society

• Three linked policy issues
• Environmental protection
• Global health
• Human security
• Raising awareness
• Medical and other students
• People to people links for health
• Twinning for health organisations
• Health of immigrant groups in Europe
• Roma health
• Health links of Diaspora communities

11
Why do we need an EU strategy for global health?

• Is global health just an aid strategy?
• A global public good?
• And a defining moral challenge?
• Is there an alternative?
• US strategy for global health?
• Is this an issue for the EU or member states?
• Does it involve common values and interests?
• Does it relate to trade and security?
• Does EU already have an unstated strategy?

12
Solidarity and global health

• Global health requires integrated response
• Government foreign policy, aid, trade and health
• Private sector pharma and global companies
• Research sector academic and commercial
• Voluntary sector NGOs, patients and public
• Need national strategies for global health
• And EU wide strategic process to address issues
  where European action is necessary.

13
Why should the EFC lead

• Foundations can provide bridges between
• Europe and developing countries
• Government, business, academic civil society
• EFC can be a keystone for government, business,
  academic and civil society action
• EFC can create a European approach to global
  health
• Potential for enormous benefits from initiative
• To support this we propose to establish a
  European Council for Global Health.
• www.ukglobalhealth.org

14
Aims of the ECGH

• Develop awareness and action at EU (EC and EP),
  government, civil society and the business world
  of the relevance of global health to long term
  health and security of everyone.
• Build partnerships and aim to create consensus on
  a joint integrative European approach to global
  health based on European values solidarity,
  health as a human right, secularism, in member
  states of the EU (national councils on global
  health) and at the European level.
• Support and inform the policy process towards
  making Global Health an integral part of the
  external objectives of the EU social, economic
  and foreign policy, in the form of a European
  strategy for global health make a real
  difference in how Europe approaches global health
  issues this is more than development policy
• Strengthen and monitor European commitments to
  global agreements such as International Health
  regulations, Doha, International Framework
  Convention on Tobacco Control and where
  appropriate initiate such agreements through
  European Channels
• Support and inform the policy process towards
  making Global Health an integral part of the
  internal objectives of the EU raise awareness
  of the impact of globalization on health issues
  and impacts within Europe due to the increased
  movement of people, goods and services, for
  example migrant health, movement of health and
  medical professionals, port health strategy
• Support and build global partnerships for
  dialogue and action with other parts of the world
  from developed and developing world
• Make EFC- ECGH a significant force in global
  health development
• Raise European citizens awareness of the
  relevance of global health issues to their
  everyday lives