www.thelancet.com Vol 381 April 13, 2013
Offline: The Stockholm syndrome
“How many ‘global health’ conferences are needed each year?” So asked Gabriel Scally, justly perplexed about why the Swedish Medical Society was holding Global Health beyond 2015 last week. It might be easier to ask who isn’t holding a global health conference these days.
But the meeting in Stockholm was different. As Umeå Global Health quickly shot back (on Twitter), “this is a public engagement with global health, not another high-level meeting”. And so it proved to be. Ministers in the Swedish Government spoke to a mostly non-medical audience—1400 people with an average age well below 40 years. They were joined by policy makers, diplomats, funders, scientists, students, activists, and businessmen and women. Why? First, to broaden the conversation about global health. The OECD reported last week that international aid fell by 4% in 2012, after a 2% fall in 2011.
The public in donor countries not unreasonably ask, at a time of fi nancial austerity, whether their tax contributions might be better spent on more urgent domestic priorities.
Second, although non-Scandinavians think of Sweden, Norway, and Denmark as leaders in social welfare and aid spending, some local experts take a diff erent view.
Olle Stendahl (a Linköping professor and a Board member of the Swedish Research Council) argued that these golden years have long passed. So the conference asked whether it was “time to reposition Scandinavia in global health”. Finally, what about the role of young people?
On the first objective, the conference succeeded handsomely. Thanks to the imaginative and tenacious leadership of Peter Friberg, the Swedish Society of Medicine’s industrious President, particular emphasis was put on three still neglected dimensions of global health — climate change, inequalities, and non-communicable diseases. Attention did not necessarily mean consensus.
Although conventional thinking now sees climate change as a serious threat to public health, that view has dissenters. The most vocal critic was Hans Rosling, a man who has done more than anyone to make global health a household phrase. He called those who made the link between health and climate change “liars”. It’s a strong word. What he means is that the biggest threat to global health is extreme poverty, not climate change, and it is extreme poverty that should be our overriding priority.
Rosling does not deny the importance of climate change. On the contrary, he simply says that it is a development,not a health, issue. The arguments were passionate, won applause on both sides, and remained unresolved.
What about the role of Sweden in global health? Perhaps Swedes do feel they have fallen behind. But Sweden is surely a global leader in health. Anders Nordström is Sweden’s Ambassador for Global Health, one of only a handful in the world. His position has allowed Sweden to punch well above its weight in global health diplomacy.
Individuals such as Hans Rosling, Johan Rockström, and Mariam Claeson have extended Sweden’s infl uence well beyond the country’s shores. The Swedish International Development Cooperation Agency has long been admired as a development partner. The University of Umeå has carved out an utterly distinctive position as an academic centre in global health. And now the Swedish Society of Medicine is bringing the country’s previously aloof medical community to the centre of global health discussion. Of course, there is always more that can be done (defending a welfare model that is under constant attack, encouraging even deeper international engagement). And to that end, Peter Friberg is leading a team to write a Stockholm Declaration, an opportunity to develop a renewed vision for Sweden in global health.
They do so from a base that is the envy of many nations.
The last word should go to the young professionals in Stockholm. “Stop global whining”, urged Renzo Guinto from the Philippines. In his inspirational address at a workshop the day after the conference, he described the first reading assignment his medical school class was given. A biochemistry textbook? No. It was the 1978 Alma Ata declaration, one of the most visionary documents in the history of health. Imagine if the values of Alma Ata were in the hearts and minds of every health professional, from day one of their education. It is just possible we might not be facing quite so many seemingly intractable predicaments in global health today.
www.thelancet.com Vol 381 April 13, 2013
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