1. Global health challengesPolicies and priorities PROF. SCOTT C. RATZAN, MD, MPA, MA Vice President, Pharmaceuticals and Global Health Government Affairs, Europe Johnson & Johnson and Editor-in-Chief, Journal of Health Communication: International Perspectives

2. Agenda • Welcome – tour de table – What is the biggest challenge in your country, region or globally in health? • Global health realities and challenges • Group discussion on communication issues and priorities • Presentation by each group on their ideas

3. What is health? [Health] is ‘what we, as a society, do collectively to assure the conditions in which people can be healthy.’ Institute of Medicine, 1988

4. What contributes to health? • poverty • inequality • human rights • conflict/war • housing • pathogens • leisure • pollution • employment • education • food • epidemiology • surveillance • detection • immunizations • payment • pharmaceuticals • patient counselling • treatment Health system Environmental influences Human behavior & lifestyle Culture, beliefs, attitudes, values, networks, social norms, empowerment

5. How is health policy developed? POLITICAL (multilateral orgs., reimbursement, transparency…) ECONOMIC (trade, innovation, tech. assessment…) Public Sector Private Sector The patient LEGAL (patent protection, access…) ADMIN (access to the market, length of processes…)

6. How is policy developed?What about evidence-based policy-making? • Epidemiology • Economics • Trends in the absence of action • Health and quality of life outcomes Where are ethical principles to guide decision making?

7. Priorities for global health are highly contested. • G8 Okinawa (2000): AIDS, malaria, and tuberculosis • G8 Gleneagles (2005): Africa • Gates Foundation: vaccines; infectious diseases; technology rich solutions for developing country problems • Media: Avian Flu, SARS, “killer diseases” • Business: infections, productivity • United Nations: Millennium Development Goals • US Government: HIV/Aids; health related security issues Source: Derek Yach, Director of Global Health, Rockefeller Foundation

8. Source: Ratzan, S. Filerman, G. and LeSar, J, Attaining Global Health: Challenges and Opportunities Population Bulletin, 2000.

9. Global Challenges: Ideas for Health Competence • Individual • health literate • appropriate demand • participants • System • supply • quality • access POLICY CLIENT • Environment • community participation • policies • social norms

10. How to get there: A science based approach can make a difference • Adds VALUE from the intervention • Bases decisions on SOUND SCIENCE and EVIDENCE • Develops opportune OPINION LEADERSHIP • Involves Policymakers, Physicians, Patients and the Public inPARTNERSHIP

11. Our Goal: Health for the public good “Informed opinion and active cooperation on the part of the public are of the utmost importance in the improvement of health of the people.” World Health Organization Preamble to the Constitution

12. Breakout session • What should the priorities be in your country, region or globally in health? • Which are the communication activities and for which audiences?

13. BACK UP SLIDES if necessary post breakout

14. Dramatic progress on several fronts over the last decade • New funding for R&D; targeted programs (Global Fund, GAVI, PDPs……) • High level political interest for a restricted set of health issues • New products for malaria, TB, AIDS and others in the pipeline

15. BUT: still neglecting the basics at country level • Health systems supported by national funds • Health professionals • Surveillance systems • Health leadership • Prevention and public health • Major causes of suffering-not death: mental health

16. acute childhood infections maternal deaths Simple technologies Rapid impact Controlled by health services Within the medical sector and the health department chronic, life long infectious and non-infectious diseases Complex interventions Decades before impacts Main levers outside health service control Multiple stakeholders and all government Old and new agendas for global health