PREFACEPublic health challenges develop over time and vary across countries. Society changes as do population health threats, and public health systems accordingly attempt to adapt to change. As reflected in ASPHER's activities, public health training programmes must reflect these continuously developing changes in a dynamic way. From time to time all organisations need to revise their mission statements and the ethical context for their activities as part of the process of adaptation to change.Theodore Tulchinsky, together with Christopher Birt, Ramune Kalediene and Andre Meijer, members of the ASPHER Executive Board, prepared this Working Paper. They take a wide perspective and context for ASPHER's mission, addressing the ethics, values, vision and aims of the organisation, including some early targets for its activities.The Executive Board approved this Working Paper, under development for more than a year, as a basis for continuing discussion, so enabling the possibility for members to agree formally upon ASPHER's values, vision, mission and aims. The first opportunity for such discussion will offer itself at the Annual Conference in Valencia at the end of October this year.Suresnes, 2 October 2007Anders FoldspangPresident - ASPHERPREAMBLEThe peoples of Europe have benefited greatly from the startling successes of modern public health of the 19th and 20th centuries, which has brought sanitation, environmental and occupational health, vaccination, control of infectious diseases, safer and healthier foods, healthier mothers and babies, family planning, declining mortality from coronary heart disease and stroke, as well as from motor-vehicle crashes, and recognition of tobacco use as a major health hazard. The result is increased longevity, with improved health standards and quality of life for the peoples of the industrialized countries. But this improvement is far from uniform for all population groups and countries across Europe, with many countries in post-Soviet transition and other poor and developing countries still suffering from low health standards; in many such countries the New Public Health remains a novel and challenging concept.Public health developed on the basis of, and continues to rely upon, a wide spectrum of available social, legislative as well as biomedical and environmental interventions. Health promotion is incorporated within this increasing scope of public health, and it addresses complex public health problems that are largely influenced by social conditions as well as by individual and group knowledge, attitudes, practices, and behaviours. This complex of causation and of intervention approaches applies in prevention and control of HIV, cardiovascular diseases, motor vehicle injury, mental health, threatened pandemics, and terrorism, as well as in communicable diseases and in many other health problems facing individuals, groups and communities. European schools of Public Health, and ASPHER as their association, have a continuing role in promoting new public health policies as dictated by changing epidemiology and as enabled by new technologies.The ethical base of public health in Europe developed in the context of the 19th and early 20th century successes, and was codified following lessons learned from the corruption by dark forces, using eugenics theories to justify the killing hundreds of thousands of helpless individuals, genocide and the Holocaust, with the killing of millions in efficient systems of mass murder. The threats of genocide, ethnic cleansing and terrorism have departed from neither the European nor the world stages, and the utmost degree of vigilance is required to prevent their recurrence. As in the case of war, these constitute grave threats to public health and international human rights. The lessons learned from the 20th century tragedies help us today to address increasingly complex ethical issues in public health, by balancing the rights of the individual with those of the community. …
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