The WFPHA’s Walter Ricciardi, and EUPHA’s Iveta Nagyova and Dineke Zeegers Paget discuss the major achievements of the recent virtual World Congress on Public Health 2020
Three years ago, the World Federation of Public Health Associations (WFPHA) decided to organise their World Congress on Public Health in Rome, Italy. Both the European Public Health Association (EUPHA) and the Italian Society of Hygiene, Preventive Medicine and Public Health (SItI) were invited as co-organisers of this big global public health event. After a short discussion, it was decided that the theme of the World Congress would be: ‘Public health for the future of humanity: analysis, advocacy and action’, to highlight the importance of health as well as the importance of collaborating together to achieve health for all. The theme set public health at the centre of current critical topics including climate change, threats to water and food supply, overburdened health systems, and a dangerous increase in leading politicians rejecting evidence as the basis for policy.
The planning of the Congress was going smoothly until COVID-19 hit the world and in May 2020, it soon became clear that an on-site in-person congress was no longer possible, especially as we – public health professionals – do not want to be responsible for spreading the pandemic further. It was therefore decided that this World Congress would be fully virtual.
A global reach
This helped in enlarging the main objective of this Congress: to reach the public health community worldwide to discuss public health issues that influence the health of all people. By adapting the format of the conference and thereby the format of the programme, we managed to establish a programme on all topics touching on health that was available for all time zones around the world and therefore to all public health professionals worldwide. We also managed to get influential public health champions from all over the world to take part in our plenary sessions, such as Martin McKee, Richard Horton, Chris Murray, and Hans Kluge, as well as experts in other fields such as Jan Beagle (from the International Law and Development Organisation) and Summer May Finlay (a Yorta Yorta woman, a Lecturer at the University of Wollongong, and a Research Assistant at the University of Canberra, who discussed the rights of indigenous people Australia).
The programme allowed participants to learn from a magnitude of public health fields and to hone their skills to be able to advocate, counter fake news, and stand up for human rights. We also managed to secure a large number of participants (3,750 delegates from 125 countries) including representatives from research, policy, training, and practice. Patient organisations actively participated in the programme while architects organised a pre-conference. We could say that going virtual allowed the entire global public health community to come together.
In line with this, the plenary programmes aimed to provide the global health community with tools and evidence to be able to challenge and hold to account those with the power to make a difference. The eight plenary sessions addressed issues such as what happened to enlightenment, discussing the impact of fake news and providing skills to counteract this. We also looked at a survival strategy for Earth and moving out of our silos, where speakers from different backgrounds reflected on working together on interdisciplinary topics. The plenary sessions included the need for public health leadership to make the world healthier, and the impact of digitalisation in terms of both reducing and widening health inequalities. A special point of attention was given to the public health workforce and their new role to be the agents of change and initiators of making the difference.
A parallel programme of 260 workshops and short presentation sessions was divided into 12 Congress Tracks to guide attendees through the vast number of sessions. A special track was introduced on the latest developments in COVID-19.
All in all, over the course of five days the global public health community, including professionals touching on public health, discussed issues of global concern including: the COVID-19 pandemic; the (public) health workforce; climate change; heightened health inequalities; vulnerable groups; and the health of refugees, migrants, and ethnic minorities. So, what will happen after this five-day hype? Will things change? Will we continue our strive for health for all? We argue that yes, we will most certainly continue to do our utmost to make change happen!
A call for solidarity
One of the outcomes of the World Congress was the Congress Statement (1), which was devised by the WFPHA, EUPHA, SItI, and the UK Faculty for Public Health to strengthen the event’s impact. The statement emphasised the need to work in solidarity around the world, working for the common good and betterment of humankind. And this was in reference not only to the public health community, but being deliberately collaborative with all relevant sectors and making sure the evidence is presented in a compelling story to convince policymakers to make the right choice. The statement calls for ‘an investment in public health and care services and for collaboration together as citizens of one planet to deliver the 2030 Sustainable Development Goals, all of which have implications for our health and wellbeing’. It was signed by 53 national and international organisations from 32 countries.
EUPHA is planning to publish short reports on six of the 12 tracks to increase the impact of the Congress beyond the congress dates. These short reports will be written by the so-called ‘EUPHA fellows’; young public health professionals and students who were selected to play a more active part in the Congress and in return received some mentoring sessions with key people in public health. This is the third year that EUPHA fellows have been organised by our network for young professionals and students, EUPHAnxt.
A human face
EUPHA also invited its 26 theme-specific sections to organise events/activities around the Congress. The EUPHA Health workforce research section (EUPHA-HWR) managed to organise a supplement to the European Journal of Public Health (EJPH) (2) entitled ‘The Health Labour Market and the ‘Human Face’ of the Health Workforce: Analysis, Advocacy and Action’. This Supplement seeks to bring a ‘human face’ to health labour market analysis and to strengthen a public health approach in the health workforce debate. Inspired by EUPHA’s strategy of ‘analysis, advocacy and action’, new empirical results on health labour markets are presented, as well as advocating tips for the health workforce as the ‘heart and soul’ of healthcare systems and policy recommendations towards a resilient future health workforce that is more sensitive to the individual behind every healthcare worker are given.
The Global Society on Migration, Ethnicity, Race and Health
The EUPHA Migrant and ethnic minority health section (EUPHA-MEM) was active throughout the year to establish the Global Society on Migration, Ethnicity, Race and Health (3). This new society was launched during the first day of the Congress. The Global Society is an actual and virtual meeting point for individual members and affiliated organisations working to protect and improve the health of all, regardless of ethnic background or place of origin. It provides opportunities to exchange information and ideas and promote beneficial change across the world. In EUPHA-MEM’s March 2020 call for action (4), the specific needs for immigrants and ethnic minorities in the context of COVID-19 were clearly addressed and these needs can be seen as essential in any healthcare service for these vulnerable groups.
Future challenges in public health include the lessons we are learning from COVID-19:
- Health inequalities continue to be a ‘chronic disease’. COVID-19 has clearly shown that health inequalities not only continue to exist, but also increase in times of crises. Sir Michael Marmot highlighted that COVID-19 is exposing and amplifying existing inequities (5). Health inequalities are based on origin, income, health status, and genomics, and we need an overall response, together with non-health related sectors, to tackle these
- Strong health systems. If COVID-19 has shown us anything, it is that our health systems dealing with these emergencies need to be strong. And yet, all too often, budget cuts hinder the sustainability of strong health systems;
- A well-trained health workforce. EUPHA-HWR highlighted this best: “What is needed the most are healthcare systems that take care of the health and wellbeing of their staff, and societies willing to pay them in a fair and gender-equitable manner.” (6) Life-long learning is required and new topics like advocacy must be included in all medical schools and schools of public health;
- Health promotion and behavioural change remain essential action points to reduce chronic conditions. Behaviour plays an important role in health promotion and its change has enormous potential to prevent or modify the course of diseases. The association between strategies of health promotion and behavioural change could have a positive impact on the health and wellbeing of the population; and
- The environment has enormous consequences on individual health and should thus remain a priority. We should therefore collaborate with partners around the world and from different disciplines to ensure that the climate emergency is effectively dealt with.
The triple A rating
In 2020, EUPHA adopted a new strategy based on achieving a triple A rating for public health in Europe. The triple A rating is based on the title of the World Congress: analysis, advocacy, action. EUPHA’s mission for 2020-2025 is to enable everyone in Europe to achieve the highest possible level of health by providing independent and authoritative Analysis of the evidence, combined with targeted Advocacy to achieve co-ordinated Action by all key stakeholders. This vision clearly builds on the commitments of our governments and international agencies to achieve the health-related Sustainable Development Goals. It recognises the importance of placing Health in all policies and it draws on the Vienna Declaration (7) to embrace the entire range of health determinants, including the biological, social, environmental, occupational, behavioural, political, and commercial, the health care system, and everything that influences the health of our planet.
WFPHA’s strategy is also oriented in this direction. In particular, there is an urgent need to invest in public health and care services and to work together as citizens of one planet to deliver the 2030 SDGs, all of which have implications for our health and wellbeing. WFPHA, together with EUPHA and the public health community throughout the world, are united and eager to support policymakers, individuals, and communities to face this important challenge.
WFPHA is at the forefront of ensuring that everyone has fair access to medicines and vaccines. In this context, WFPHA will make a huge effort to ensure access to COVID vaccination for all, not forgetting populations in low income settings. Moreover, the COVID-19 pandemic will have far-reaching and long-term global consequences beyond the spread of the disease itself with economic, political, cultural, and social implications. Far-sighted plans and sustainable funding mechanisms are of the utmost importance to manage and recover from the pandemic. Guaranteeing equitable access to COVID-19 vaccination is the first step.
To face these challenges, it will be necessary to continue to implement our paradigm: strong leadership, evidence-based medicine, and value-based medicine, which are the pillars of modern healthcare and are necessary to guide political choices and decisions.
EUPHA and WFPHA are very pleased to hear that the new president of the European Union, Dr Ursula von de Leyen, emphasised the need for a European health union in her first State of the Union speech on 16 September 2020. (8) She said: “For me, it is crystal clear – we need to build a stronger European Health Union. And to start making this a reality, we must now draw the first lessons from the health crisis. We need to make our new EU4Health programme future proof. This is why I had proposed to increase funding and I am grateful that this Parliament is ready to fight for more funding and remedy the cuts made by the European Council.” With this positive support, the European and global public health community are ready to address the future challenges in public health.
1) https://wcph2020.com/16th-world-congress-statement-88, last accessed 16 November 2020
published 24 March 2020
6) ‘Health labour markets and the ‘human face’ of the health workforce: resilience beyond the COVID-19 pandemic’, E Kuhlmann, G Dussault, M Wismar, European Journal of Public Health, Volume 30, Issue Supplement_4, September 2020, https://doi.org/10.1093/eurpub/ckaa122
State of the Union address to the European Parliament, 16 September 2020
European Public Health Association
Dineke Zeegers Paget
European Public Health Association
Director European Public Health Conference
+31 30 2729 709
President, World Federation of Public Health Associations
Please note, this article will also appear in the fourth edition of our new quarterly publication.