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H20: putting health on the global agenda

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What an astonishing collection of nations was represented at the recent meeting of the Group of 20!

Argentina, Australia, Brazil, Canada, China, France, Germany, India, Indonesia, Italy, Japan, Republic of Korea, Mexico, Russia, Saudi Arabia, South Africa, Turkey, the United Kingdom, the United States and the European Union.  Spain, New Zealand, Myanmar were guests this year. Was this World Cup of economics?

G20 members account for two-thirds of the world’s population, 85 per cent of global gross domestic product and over 75 per cent of global trade.

The meeting was the culmination of months of off-stage manoeuvring and discussion among the stage hands and extras as they choreographed the presentations and prepared cosmetics for the principals.

Growth was the topic – how to increase global activity by 2 per cent a year. No-one wants another GFC, so discussions about how to maintain economic momentum are vital.

As with meetings of the UN and with similar cultural festivals, there were side-shows, fringe gatherings and protests in Brisbane.

As the G20 website says, the G20 also regularly engages with non-government sectors: “Engagement groups from business (B20), civil society (C20 – led by Tim Costello), labour (L20), think tanks (T20) and youth (Y20) held major events during the year, the outcomes of which contributed to the deliberations of G20 leaders”.

H20, held in Melbourne by the federal AMA, the Victorian AMA and the World Medical Association (WMA), was a belated attempt to put health issues on the G20 agenda.

H20 was attended by about 150 delegates from across Australia and from the member countries of the World Medical Association, together with public health and environmental groups and medical students.

While the concerns of attendees were disparate, there was unity around six themes:

  • how do we make health care a sustainable enterprise? 
  • How can we do better at advocating for health and health care as vital for economic development? 
  • How do we show that investing in health is exactly that, and not a sunk cost?
  • How do we confront the perpetual downward pressure of unfair disadvantage and social inequality on health, and rescue the health and well-being of humanity from its position low down the priority list in many countries? 
  • How do we contribute to the push towards responsible conservative behaviour in the light of climate change and its long-term effects on health?   
  • How do we keep health workers safe in dangerous and insecure places?

These questions assail us in Australia and beyond, and speakers at the Summit from around the world highlighted the urgency of action from all of us on a number of fronts, including communicable and non-communicable disease control and management, clinical practice and public health, through advocacy and involvement in service provision and representation. 

There is always a serious risk with events such as these that, in laying bare the massive global challenges we confront, those attending head home feeling depressed and disempowered.

This need not be so, because we as a medical profession have great strength, credibility and skill to address all of the six principal concerns listed above.

So how should we go about it? What should we do?

Here are some practical ideas about things we can do today that will go toward addressing these great global challenges:

  • advocate for international action and support for organisations committed to action on these challenges, such as the International Red Cross, OXFAM, Médecine sans frontières and UNICEF;
  • take an interest in upstream causes of ill health like poor diets, smoking, excessive drinking and poor urban design, and support the efforts of those such as the AMA working for reforms like tighter regulation of alcohol marketing and labelling practices;
  • support efforts to achieve integrated care for those with chronic illnesses.  Linking all modalities of care from hospital to the community is the ambition of many health services internationally, and Australia can pioneer the way to do this best;
  • support efforts to establish national, state and local prevention programs.  By working with agencies such as the National Heart Foundation, cancer councils and the prevention arms of health departments, we can help in finding the most effective ways to prevent the major illnesses afflicting much of the world today (obesity, diabetes, heart disease and stroke) and act as a guide for other countries that are facing the same problems; and
  • keep an eye open for preventive opportunities in the clinical setting.  Much prevention occurs in the clinical setting. We have done well in Australia in helping, through clinical care, to prevent complications of diabetes, stabilise the risk of heart disease, immunise and screen. These have paid off well. The world needs examples of clinical service that contribute to prevention.