• Public health – enemies of the people?

• Poor need not = unhealthy, making the world fairer through policies on eating, chronic disease and trade

• How to eliminate HIV and hepatitis B and C by 2030

• Is President Trump’s stand on free trade agreements good for public health

• We’re getting fatter and sicker

• Self-governance and health for Indigenous peoples

Monday 3 April 2017, Melbourne Convention Centre

Researchers at the 15^th World Congress on Public Health available for interview from Monday 3 April

More at www.wcph2017.com/media.php and @wcph2017 on Twitter.
Contact Niall on 0417-131-977, niall@scienceinpublic.com.au or Tanya on 0404-083-863 for interviews

‘Enemies of the people’: public health in the era of populist politics and media – Martin McKee, past president European Public Health Association

Public health has transformed the world. We have longer and healthier lives. Roads, work, food are all safer. So why are populist politicians and media portraying public health leaders as ‘enemies of the people’ asks Martin McKee.

They are rejecting scientific evidence and replacing it with fake news. Public health has a duty to speak truth to power. It can also help explain the rise of these forces including evidence that declining health was the strongest predictor of the shift in votes to Donald Trump. But public health is not always on the side of the angels, especially in 1930s Germany.

We are living in dangerous times, with some of the leading countries in the world led by politicians who are both dangerous and grossly incompetent. Yet there is hope. We have been here before. We must ensure that this time public health is on the right side.

Martin McKee is Professor of European Public Health at the London School of Hygiene and Tropical Medicine. He’s speaking at 10.30 in The Plenary. More below.

The poorest 20 per cent of Australians are most likely to be unhealthy – we can change that

“The world is an inherently unfair place—and that has consequences for your health,” says Professor Sharon Friel from ANU.

Beyond simple bugs and broken bones, health problems are also influenced by the circumstances in which people are born, grow, live, work, and age. Australian National University researcher Sharon Friel wants to break these ‘social determinants of health’. She will share a case study of how national policies can encourage healthy and equitable eating, helping to prevent chronic disease; explain how international trade agreements can have health consequences, and discuss a vision for a fair; sustainable and healthy world.

Sharon has advised the WHO and the Rockefeller Foundation on health equity.

The fifth of Australia’s adult population in the lowest socioeconomic status bracket is also the group most likely to be regular smokers, to do little or no exercise, to be overweight and to have high blood pressure. Could it be due to poorer access to healthy food? Or living in car-dependent outer suburbs that don’t encourage walking?

Sharon Friel is speaking at 11 am in The Plenary. More below

How to eliminate HIV and hepatitis B and C

Blood-borne diseases kill millions of people globally every year. The World Health Organization has set targets to end the HIV, hepatitis B and hepatitis C epidemics by 2030 and there is a real possibility of achieving these goals.  Margaret Hellard from the Burnet Institute will lead a World Leadership Dialogue exploring what we need to do to end these diseases—and it will take more than drugs.

“It is vitally important that we take a multipronged approach if we are going to end the epidemics of HIV, hepatitis B and hepatitis C. We need prevention –  safe sex education and access to pre-exposure prophylaxis to prevent HIV transmission, access to clean injecting equipment and opioid substitution therapy.  We need to ensure that the “birth dose” of hepatitis B vaccine is given to all babies globally within 24 hours of birth. We need simple, affordable blood tests.  We need to ensure equity of access to treatment.  Finally, we need research for cures and vaccines.”

1.30 pm, more below.

Creating systems to prevent chronic diseases – Andrew Wilson, Australian Partnership Prevention Centre

Chronic diseases kill more than 38 million people a year and are the leading cause of premature death and disability in Australia. Despite all our efforts to encourage people to live more healthily, we’re getting fatter and sicker. Andrew Wilson will lead the World Leaders Dialogue session ‘Exploring systems approaches to chronic disease prevention’, with presentations and discussion with international and national leaders in health policy and research in new ways to tackle this wicked problem. 4 pm.

Self-governance and health for indigenous peoples of Canada, Australia, New Zealand and the USA

While the Indigenous cultures in the four countries are different in some obvious and critical ways, they also share key commonalities in their colonial heritages and challenges in addressing development needs.  Through collaboration and sharing of new thinking and innovative processes Indigenous peoples can address their contemporary needs and aspirations. Michelle will draw on case studies that show how investment in cultural based models of government will create diverse and effective Indigenous Nations and communities.

Michelle Deshong is a global leader in governance. She’s completing a PhD at James Cook University in Townsville and draws her connection to the Kuku Yulanji Nation. 11.30 in The Plenary. More below.

Other speakers/topics/stats from day one, Monday, at the World Congress on Public Health

• Medicine is a social science and politics is nothing more but medicine on a grand scale. What does that mean in 2017? Dr Ilona Kickbusch, Global Health Centre, Geneva, 12 noon, The Plenary
• What can we learn from past global pandemics to be ready for the next one? – Raina Macintyre, UNSW
• Sex after 65: Sexual activity and physical tenderness in older adults – Rosanne Freak-Poli, Monash University
• Are celebrities bad for your health? Stars in food and beverage advertising – Vivica Kraak, Virginia Tech
• Up, Up and Away with Superhero Foods: Developing nutrition resources for school aged children – Jennifer Tartaglia, Foodbank WA
• Stopping mothers, children and adolescents dying young (six million preventable young deaths last year), Judy Lewis, University of Connecticut
• Could Trump’s withdrawal from the Trans Pacific Partnership be good for public health? Deborah Gleeson, LaTrobe University

The 15^th World Congress on Public Health is on from 3 to 7 April at the Melbourne Convention and Exhibition Centre.

@WCPH2017 #WCPH2017

Media contacts

• Niall Byrne 0417 131 977 niall@scienceinpublic.com.au
• Tanya Ha 0404 083 863 tanya@scienceinpublic.com.au
• Ellie Michaelides 0404 809 789

Background/abstracts

“Enemies of the people?” public health in the era of populist politics, Martin McKee

Contact details: European Public health, London School of Hygiene and Tropical Medicine, Martin.McKee@lshtm.ac.uk, social media: @martinmckee

Abstract:

Professor of European Public Health, London School of Hygiene and Tropical Medicine

Past President, European Public Health Association

In “An enemy of the people”, the Norwegian playwright Henrik Ibsen describes how Dr Stockmann, the municipal doctor in a small town, has discovered that the public baths, which bring in much-needed revenue to the town, are contaminated. He must choose whether to remain silent or to speak out and alienate the vast majority of the townspeople. He speaks out and, in the final scene, he is evicted from his home, whose windows have just been smashed by the crowds. Yet he sticks to his principles, declaring that “the strongest man is he who stands alone”.

The term “enemy of the people” has been used rather a lot in recent months. In the United Kingdom, the Daily Mail, one of the most widely read tabloid newspapers, used it to refer to three High Court judges who dared to point out that the government must seek the approval of Parliament for the greatest constitutional change in half a century. In the United States, Donald Trump uses it frequently in his attacks on the mainstream media. Earlier the twentieth century, both Stalin and the Nazis used it to describe those whose lives they deemed expendable. Given this history, should we regard the term as an insult or an accolade?

Public health has a duty to speak truth to power. It uses epidemiology to make the invisible visible, drawing connections that reveal otherwise unseen patterns of disease, describing hidden inequalities within society, and giving voice to those who are marginalised or oppressed. In the prevailing climate in many countries, this places public health professionals firmly within the category of enemies of the people.

This presentation will ask what public health can do at a time when populist politicians are in the ascendant in many countries. They are rejecting scientific evidence and replacing it with fake news. They are sowing divisions in our society, employing the long-established tactic of divide and rule.

It will first argue that public health can contribute to an understanding of how these forces have become so powerful, tracing their origins to the deep-seated inequalities in societies, including evidence that declining health was the strongest predictor of the shift in votes to Donald Trump. It will look at historical comparisons from Europe in the twentieth century.

Second, it will look at the consequences for health, domestically and internationally of these politicians, drawing in particular on recent analyses of the impact of those promoted by Donald Trump and the consequences of Brexit.

Finally, it will look to the lessons of history, recalling how public health has not always been on the side of the angels, including its complicity with authoritarian regimes in the 1930s.

We are living in dangerous times, with some of the leading countries in the world led by politicians who are both dangerous and grossly incompetent. Yet there is hope. We have been here before. We must ensure that this time public health is on the right side.

Martin McKee is Professor of European Public Health at the London School of Hygiene and Tropical Medicine where he founded the European Centre on Health of Societies in Transition (ECOHOST), a WHO Collaborating Centre. He is also Research Director of the European Observatory on Health Systems and Policies and Past President of the European Public Health Association. He trained in medicine and public health and has written extensively on health and health policy, with a particular focus on countries undergoing political and social transition.

You may also wish to refer to the profile of Martin McKee published in the Lancet in 2013

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)60748-5/fulltext?elsca1=ETOC-LANCET&elsca2=email&elsca3=E24A35F

Why where you live and what you earn matters for health, Sharon Friel

The world is an inherently unfair place—and that has consequences for your health.

Beyond simple bugs and broken bones, health problems are also influenced by the circumstances in which people are born, grow, live, work, and age. Australian National University researcher Sharon Friel is an expert in these ‘social determinants of health’.

The fifth of Australia’s adult population in the lowest socioeconomic status bracket is also the group most likely to be regular smokers, to do little or no exercise, to be overweight and to have high blood pressure. Could it be due to poorer access to healthy food? Or living in car-dependent outer suburbs that don’t encourage walking?

Sharon will share a case study of how national policies can encourage healthy and equitable eating, helping to prevent chronic disease; explain how international trade agreements can have health consequences, and discuss a vision for a fair; sustainable and healthy world.

Plenery: We are at a pivotal juncture in recorded human history. The confluence of global environmental degradation, social inequities and civil unrest, and the continuing and often widening inequities in health outcomes between and within nations, shines a light on some fundamental ruptures in society as we know it and poses questions of justice and equity. Generally, it is known what must be done to ensure a fairer, more sustainable and healthier world. Imagine a time when we have redistributive macroeconomic and social policies; intolerance of bigotry; inclusive societies that welcome difference. Conditions of life that support, nurture and enable everyone, regardless of their sex, postcode, age or colour to flourish, but all done with the lightest of environmental touches. Pursuit of such a vision requires changing the status quo. It means redressing the inequities in power, money and resources and in daily living conditions. This is not straightforward given that many people and institutions benefit from the status quo. Pursuit of a fairer, more sustainable and healthier world is a governance challenge, taking place in many rooms, at many levels, and using many processes. The shifting political sands at the turn of 2016 provide an opportunity to harness the global despair and desire for a different society. The opportunity is now for governance for health equity.

World Leadership Dialogue: It is almost ten years since the global Commission on Social Determinants of Health (CSDH) reported to the WHO. The CSDH assembled evidence on what could be done to achieve better and more fairly distributed health worldwide through action on the social determinants. The three major conclusions and associated recommendations of the CSDH were that i) inequities in the daily circumstances in which people are born, grow, live, work and age affect health inequities within and between countries; ii) the conditions of daily life are influenced by inequities in ‘structural drivers’ of power, money and resources; and iii) there is a need to expand the knowledge base on the social determinants of health, evaluate action taken and develop a workforce that is trained in addressing the social determinants of health.  The CSDH involved a large orchestra of key change-agents and policy actors in many different types of institutions across the world. Commissioners guided the work of the CSDH. With their experience they brought an understanding of realpolitik in different geo-political, institutional and socio-cultural contexts and depth of knowledge relating to health equity. Leading academic institutions globally formed networks of research around thematic areas. The CSDH learnt about the process of policy development and implementation from the experience of countries through policy-makers and practitioners. Civil society organizations contributed learning on how to effect social change through community engagement and advocacy and added grass-roots analysis of the impact of social determinants. The structure of the CSDH was deliberately designed to create a shared ownership of the issues and knowledge, thereby encouraging adaptation and implementation of the recommendations and ongoing pursuit of health equity.  In this session we will explore from different policy actors perspectives, if and how the momentum and evidence that was generated by the CSDH has affected action on the social determinants at the global level and within countries and institutions. The aim of the session is to identify the types of action that have been taken to address health inequity; the forms of governance that helped pursue a health equity agenda, and what the future challenges and opportunities are for action on the social determinants of health equity.

Sharon Friel is Professor of Health Equity and Director of the School of Regulation and Global Governance (RegNet), Australian National University. She is also Director of the Menzies Centre for Health Policy ANU. She is a Fellow of the Academy of Social Sciences Australia, an ANU Public Policy Fellow and an Australian Council of Social Services (ACOSS) Policy Advisor. She is Co-Director of the NHMRC Centre for Research Excellence in the Social Determinants of Health Equity. She held an inaugural Australian Research Council Future Fellowship to investigate the interface between health equity, food systems and climate change, based at the National Centre for Epidemiology and Population Health, ANU. Between 2005 and 2008 she was the Head of the Scientific Secretariat (University College London) of the World Health Organisation Commission on Social Determinants of Health. Her current interests are in the political economy of health; policy, governance and regulation in relation to the social determinants of health inequities, including trade and investment, food systems, and climate change.

Eliminating HIV, hepatitis C and hepatitis B by 2030 – Margaret Hellard, Burnet Institute

 

Blood-borne diseases (HIV, hepatitis B and hepatitis C) kill millions of people globally every year. The World Health Organization has set targets to end the HIV, hepatitis B and hepatitis C epidemics by 2030 and there is a real possibility of achieving these goals.  Margaret Hellard and colleagues will reveal what we need to do to end these diseases—and it will take more than drugs.

Hepatitis B

More than 248 million people (3.8% of the world’s population) are chronically infected with HBV, with an estimated 700,000 deaths caused by hepatitis B in 2015.  This is a disease that can be prevented by a simple highly effective vaccine. Treatment is also available that can stop people with chronic hepatitis B infection developing severe liver disease and dying from their infection.

Hepatitis C

An estimated 80 million people (globally, 1.1%) are chronically infected with hepatitis C virus (HCV), resulting in nearly 500,000 deaths in 2015.  One of the most remarkable breakthroughs in medicine science has occurred in the past few years with the development of direct acting antiviral agents (DAAs) that can  cure for hepatitis C.  DAAs are highly effective (over 95% cure rates), requires only one to two tablets for 8 to 12 weeks for most people and have few side effects.  In Australia the federal government made these remarkable new treatments available to everyone with chronic hepatitis C from the first of March 2016.  In the first year it was estimated that over 40,000 Australians received DAA treatment. However in many places globally – DAAs are not available for all.  Over the next few years a key task globally is to ensure these highly effective treatments can be made available to everyone with hepatitis C infection.

HIV

About one million people die each year as a consequence of HIV, the disease that’s claimed more than 35 million lives so far.  In Australia, as in many developed countries the group at greatest risk of HIV infection is gay and bisexual men.  In other countries, particularly parts of the African continent, young women are at highest risk of HIV infection.  In other regions, such as Eastern Europe, people who inject drugs are at high risk of HIV because they are unable to access safe and clean injecting equipment. Similar to hepatitis B, there are highly effective treatments for HIV that keep people well, and reduce the chance of them spreading the infection to others.  Unfortunately as with hepatitis B and hepatitis C there are many people in the world who are not yet on treatment.

 

“We have highly effective antiviral treatments for HIV, hepatitis B and hepatitis C  that can either stop people getting sick from their infection or in the case of hepatitis C and DAAs can cure people of their infection.  For hepatitis B there is also a highly effective vaccine.” says Margaret.  However a key problem  is that many people are still not aware they are at risk of infection from a blood borne virus, are not getting tested for the infection or do not have access to the treatments or vaccines.  “It is vitally important that we take a multipronged approach if we are going to end the epidemics of HIV, hepatitis B and hepatitis C – this includes prevention –  safe sex education and access to PrEP (pre exposure prophylaxsis) to prevent HIV transmission, access to clean injecting equipment and opioid substitution therapy for people who inject drugs to reduce their risk of all three infections.  Also we need to ensure that the “birth dose” of hepatitis B vaccine is given to all babies globally in 24 hours of birth to reduce the transmission of hepatitis B infection.  We need simple, affordable blood tests so we can scale up programs to test if people have an infection – first this helps them get timely access to treatment to keep them well and second it means they can modify behaviours, reducing the chance of infecting others and their infection progressing.  We need to ensure equity of access to treatment.  Finally, we need support for research to develop cures for hepatitis B and HIV and effective vaccines for hepatitis C and HIV.”

Margaret has recently  been appointed co-chair of the WHO Strategic and Technical Advisory Committee on HIV and Viral Hepatitis (STAC). The Committee, is an amalgamation of separate WHO HIV and viral hepatitis committees, recognising the two conditions are linked and the need for a cohesive approach if we are to achieve the 2030 elimination targets.

Margaret will lead the World Leadership Dialogue session ‘HIV, Hepatitis C and Hepatitis B elimination by 2030’ to discuss how we can eliminate these blood-borne diseases.

Self-governance and health for Indigenous peoples, Michelle Deshong

Abstract

Indigenous peoples across the world face challenges in the interrelated areas of self-determination, governance and economic development.  This is certainly true of the CANZUS (Canada, Australia, New Zealand and USA).  While the Indigenous cultures in the four countries are different in some obvious and critical ways, they also share key commonalities in their colonial heritages and challenges in addressing development needs.  Through collaboration and sharing of new thinking and innovative processes Indigenous peoples can address their contemporary needs and aspirations. The Australian Indigenous Governance Institute is building on this work internationally and providing an opportunity to supporting Indigenous nations within Australia to pursue and exercise their right to self-determination and economic development though strong self-governance.  The Institute is working to foster future research, development and the sharing of best practice models and resources from Australian and Internationally. The presentation will draw on a number of case studies from the health and community sector that showcase best practice models of governance  and how future investment in cultural based models of government will create diverse and effective Indigenous Nations/communities, leading to future sustainability and success.

Profile

Michelle Deshong lives in Townsville, North Queensland and draws her connection to the Kuku Yulanji nation. She has completed a BA with First Class Honours in Political Science and Indigenous studies and is working on her PhD at James Cook University. Michelle has worked in both the Government and NGO sectors, and has held many senior leadership roles. From 2001-2010 Michelle was the Director of the Australian Indigenous Leadership Centre and in 2001 she was awarded ACT Aboriginal Person of the year. She currently holds a number of directorship roles in the Not for Profit sector. In 2013 Michelle was named in the Australian Financial Review/Westpac 100 Women of Influence Awards.

Michelle has extensive experience in areas of leadership, governance and politics. She has a strong commitment to human rights and has also been an NGO representative on many occasions at the United Nations forums on the Commission on the Status of Women and Convention on the Elimination of Discrimination against Women. She has a strong background in gender equality and works to ensure that the voices of Indigenous women are represented at all levels. Michelle is currently undertaking research in the USA and Canada as part of her Fulbright scholarship to develop strategies for Nation building and gender equality. She was also named as the 2015 National NAIDOC Scholar of the Year.