European Public Health Community Research Articles

2.C. Round table: A Pandemic Treaty to deliver global health equity: negotiating under a ticking clock

Abstract Access to medical countermeasures (vaccines, therapeutics, diagnostics), fair resource allocation and a global health framework to counter future pandemics are to be provided for by the Pandemic Treaty, intensely debated in the Intergovernmental Negotiating Body (INB) over the past two years. The final negotiations round began under tremendous pressure (Apr 29, 2024), with dissonance on structural treaty elements and a ticking clock to finalise the text at the World Health Assembly (end of May 2024). At a time of shifting geopolitical powers, in a year of elections across the world, war in Europe and rising defence expenditure, countries are reluctant to commit; the draft postpones key decisions, proposing to establish two intergovernmental working groups for instruments on One Health and prevention, and on a Pathogen Access and Benefits (PABS), with technology transfer and capacity-building remain largely unaddressed, despite COVID-19 lessons. With EU and G7 countries holding to their positions on surveillance, financing, and intellectual property (IP), negotiations will continue. A more critical question remains: will the Treaty’s be adequate and timely enough to meet the challenges of inevitable future pandemics? Will it deliver the global framework of its foundational purpose of equity and justice? This RT aims to inform and involve the European public health community, continuing the series of activities embarked upon at the beginning of the pandemic, empowering its members for evidence-informed advocacy and concerted action. Following a brief presentation on the Treaty’s key provisions, each panel member will deliver a brief (2-3 min) intervention based on core expertise, with two rounds of panel questions/statements to follow, and with an interactive element to prioritise and submit questions. The first elaborating on the current provisions, linking them to the key expertise of panel members, i.e., international and EU law, public health law, One Health and infectious disease control, global health policies, technology transfer, fair pricing and access to countermeasures. The second examining what can be achieved via evidence-informed advocacy, and with a special focus on the role of the European public health community. Has it been well represented so far in negotiations? Should it be more involved? Is it well equipped to provide expert advice to Europe’s policymakers? Is there complementarity in relation to Europe’s Global Health Strategy (GHS) and national global health plans? Finally, the role of WHO will be briefly debated. How can sovereignty be safeguarded without compromising implementation? What is the role of transparency and sound governance to remain in line with national and EU laws and priorities? The last five minutes of this RT will be used to consolidate messages and share plans to inform future formal EUPHA positioning in negotiations. Key messages • Pandemic accord deliberation has have taken place under extreme urgency and geopolitical pressure. The European public health community must be informed and engaged for EU and country-level advocacy. • At a time of permacrisis, the adoption of a global framework for fair resouce allocation, access to medical countermeasures,and to strengthen health systems for future pandemics is urgently needed. Speakers/Panelists Sujitha Subramanian University of Liverpool, Liverpool, UK Dimitra Lingri European Healthcare Fraud and Corruption Network, Brussels, Belgium Debjani Muller HTAi, Edmonton, Canada Ricardo Mexia National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal Bettina Borisch WFPHA, Geneva, Switzerland

The European Public Health Community is mourning Richard Horst Noack.

The European Public Health Community is mourning Richard Horst Noack.

The best laid plans?: international governance perspectives in AMR national action plans in Europe.

There is a broad consensus in the European public health community that international collaboration and coordination are key in the fight against antimicrobial resistance (AMR). Yet, while experts typically testify the importance of cross-national learning and a coordinated effort to reduce the spread of multi-resistant bacteria, there are mixed views about how that is best realized in practice, particularly on the dichotomy between horizontal and vertical activities. National action plans (NAP) from all EU member states were systematically overviewed by two independent researchers. We followed a fixed procedure for locating a broad and comparable content on the international dimensions, and letting these vary on scales. We find that countries adhere to four different strategies for international coordination, varying between 'high' and 'low' on values of vertical and horizontal activities. Most countries spend none or very little space to discuss international activities, while some countries use their NAPs to outline their aspiration for taking leading roles in the international struggle. Moreover, in line with previous research, we find that many countries directly mimic the Global Action Plan, but also that a large share of countries describe independent arrangements in their international strategies. European countries recognize AMR and its inherent international governance challenge differently in their NAPs, which may have implications for coordinated action to address the issue.

Follow the science: The European public health community confronts the first wave of the COVID‐19 pandemic

AbstractThis paper argues that “following the science” is not always the best strategy. It does so by examining the first phase of the coronavirus disease 2019 (COVID‐19) pandemic in three countries: Denmark, the Netherlands, and Sweden. All three countries possessed highly respected infectious disease agencies with wide stakeholder involvement. Despite this, Danish, Dutch, and Swedish public health agencies underplayed the threat of the COVID‐19 virus, discouraged intrusive mitigation measures, and were slow to admit their mistakes. Countries that trusted their national agencies, specifically the Netherlands and Sweden, witnessed higher mortality. By contrast, the Danish government marginalized its epidemiologists and suppressed the spread of the virus. The paper thus demonstrates the limits of trusting national scientific expertise, even when properly embedded within social networks, during periods of heightened uncertainty.

Workshop: Bridging the health divide across the Mediterranean: an agenda for public health research and polic

Abstract Objectives Develop 3-4 areas for intensified collaboration The Mediterranean region has a rich history and is home to some of the earliest civilisations. Today, the Mediterranean is often in the news as a result of tragic events and unrest including conflict and loss of lives at sea. Political meetings such as the South EU summit of Southern European leaders and the 5 + 5 EuroMed are useful events to highlight the priority policy issues of this region. Yet, health has rarely been at the forefront of the political agenda for the Mediterranean. The migrant crisis comes as a timely reminder that there exists a full continent on the other side of this sea and border countries from Africa, themselves in active processes of reform and change, should be seen as neighbours with whom the European public health community needs to collaborate. The purpose of this workshop is to shine a light on the health divide across the Mediterranean, to highlight key epidemiological, health systems and global health governance issues of priority to the region. It aims to stimulate an initial discussion for a public health research and policy focus on the Mediterranean region which could eventually lead to a call for action and a programme of activities at international level. Our neighbours share with us several public health challenges, from financing of health systems, epidemiological transition toward NCD diseases, environment and life style risks, human resources for health challenges and migrant issues from other parts of the continent. Marseille, as the conference location, provides a unique opportunity to debate and exchange with the three Maghreb countries facing the southern border of Europe. Key messages Maghreb health systems are in transition, all three rather different, but rather close to some European and EU health systems regarding financing, priorities, social and regional inequalities in access to health services, aging and NCD growth pressure. How can they become a part and contribute to the very active European Public Health analysis and benchmarks on optimizing health systems performance? Part of the health crisis regarding migrants in Europe is also an issue for health care systems in Maghreb countries. Are there ways to collaborate, to implement real collaborative and joint actions? Maghreb countries face a very specific crisis because of European policies of attracting health professionals: the brain drain is a significant issue, endangering the capacity of the Maghreb health systems. Do we foresee solutions to it? Maghreb countries face the same transition as Europe toward chronic diseases’ increased burden due to global changes in lifestyles and exposure to globalized health risks, But also thanks to improved health care and longer life expectancies. Fighting an increase in some risk factors can only be global or regional, with joint actions in need of forgetting the presence of the sea. Chronic disease is also an issue for international organizations: for example, such discussion could bring the three WHO regional officers involved around the Mediterranean Sea closer.

Four Italian experiences on vaccination policies: results and lessons.

In 2018 the Council of Europe adopted a Recommendation on strengthened cooperation against vaccine preventable diseases. Among EU Member States, Italy has a long-lasting tradition of immunization policies implemented in the context of the National Health Service over the last forty years. We identify, report and critically appraise four immunization strategies implemented in Italy in recent years and quantitatively assess their impact on coverage rates and other selected indicators. First: the regional law that suspended mandatory vaccination in the Veneto Region in 2007 to stimulate a proactive approach to vaccine uptake was not successful. Second: a strengthened political commitment started in 2014 brought to the release of an innovative and updated National Immunization Prevention Plan and to encouraging increase in vaccine confidence and vaccination uptake. Third: the success of social media influencers is exemplified by the case of Roberto Burioni, professor of microbiology, who in 2015 started a personal social media campaign to contrast anti-vaccinists. Fourth: The new 2017 Italian law extending mandatory vaccinations has successfully impacted on vaccine coverage which increased by more than 1% and 4% for polio and MMR vaccines, respectively, in the first six months since its entering into force, and has continued to raise in 2018. Our data and real-life case studies offer to the broader European public health community a solid basis for discussion and ground to evaluate similar polices implemented in different European settings, with the common goal to share best practices and promote the culture of immunization.

Ethics in public health: call for shared moral public health literacy

Public Health (PH) in Europe has become much more vocal about its moral understandings since 1992. The rising awareness that PH issues were inseparable from issues of human rights and social justice almost self-evidently directed the agenda of EUPHA and the European Public Health (EPH)-conferences. Problems of cultural and behavioural change, and environmental issues on a global scale were also added. The Section Ethics in PH invited the EPH community to join in 'arm chair thinking': coming together at conferences not only to share the 'how' and 'what' of PH research, practices and policies but also the 'why'. Time has been reserved to genuinely discuss what moral values are at stake in the work of PH and to actively develop a moral language and framework for PH Ethics. The challenge for the next decades is to find ways to involve the general public in the cultivation of a shared moral PH literacy.

Identification of Delivery Models for the Provision of Predictive Genetic Testing in Europe: Protocol for a Multicentre Qualitative Study and a Systematic Review of the Literature

The appropriate application of genomic technologies in healthcare is surrounded by many concerns. In particular, there is a lack of evidence on what constitutes an optimal genetic service delivery model, which depends on the type of genetic test and healthcare context considered. The present project aims to identify, classify, and evaluate delivery models for the provision of predictive genetic testing in Europe and in selected Anglophone extra-European countries (the USA, Canada, Australia, and New Zealand). It also sets out to survey the European public health community's readiness to incorporate public health genomics into their practice. The project consists of (i) a systematic review of published literature and selected country websites, (ii) structured interviews with health experts on the genetic service delivery models in their respective countries, and (iii) a survey of European Public Health Association (EUPHA) members' knowledge and attitudes toward genomics applications in clinical practice. The inclusion criteria for the systematic review are that articles be published in the period 2000-2015; be in English or Italian; and be from European countries or from Canada, the USA, Australia, or New Zealand. Additional policy documents will be retrieved from represented countries' government-affiliated websites. The results of the research will be disseminated through the EUPHA network, the Italian Network for Genomics in Public Health (GENISAP), and seminars and workshops. The transfer of genomic technologies from research to clinical application is influenced not only by several factors inherent to research goals and delivery of healthcare but also by external and commercial interests that may cause the premature introduction of genetic tests in the public and private sectors. Furthermore, current genetic services are delivered without a standardized set of process and outcome measures, which makes the evaluation of healthcare services difficult. The present study will identify and classify delivery models and, subsequently, establish which are appropriate for the provision of predictive genetic testing in Europe by comparing sets of process and outcome measures. In this way, the study will provide a basis for future recommendations to decision makers involved in the financing, delivery, and consumption of genetic services.

Help! Where is the European public health community?

The Commission of the European Communities has produced a white paper on health strategy for Europe, which was adopted in June 2007. It can be accessed electronically1 and commented upon...

PROMOTING THE PUBLIC'S HEALTH—Reorienting health policies, linking health promotion and health care. Conclusions drawn from the 2005 EUPHA conference in Graz

The 13th European Conference on Public Health held from 10 to 12 November 2005 in Graz attracted some 900 public health researchers, policy experts and practitioners from all continents. A conference book1 highlighting the outcomes of what turned out to be a highly stimulating scientific meeting is going to be published by mid-November 2006. The annual EUPHA conferences seem to have a great potential to promote the professional discourse of the international public health community, though their contribution to the development of the field has never been assessed. This book is intended as a contribution to this discourse, as a part of the international public health process, and one that the readers will hopefully also find interesting and informative from the scientific point of view. Conference books are inherently a difficult genre. The editors of the Graz conference book have attempted to avoid publishing a conference report of merely a series of plenary speeches and oral presentations. Their aim was to capture the general spirit of the conference, summarize the main scientific content and communicate innovative ideas and visions for the future. The Graz conference addressed three broad questions: From the 5 plenary sessions, the 60 parallel sessions and over 200 posters it was concluded that the European Public Health community shares a fairly strong value and knowledge base related to the determinants of public health which, however, varies markedly between countries. Yet, in most countries there is a serious need to invest in capacity building, foremost in relevant …

European Public Health Association

EUPHA's sister association in the multidisciplinary field of public health, the Association of Schools of Public Health in the European Region, is celebrating its 40th anniversary. ASPHER has served the European public health community during a period of dramatic and demanding change—unprecedented expansion, increasing complexity and growing unity as well as diversity. ASPHER has contributed to the development of a European public health. As this year's president of EUPHA I am honoured to thank and congratulate our ASPHER colleagues and friends very warmly. The two Associations share responsibility for capacity building in European public health and for providing the European public health community and the general public with a clear vision and perspective of the public's health. Both ASPHER and EUPHA share responsibility for developing two of the most basic resources for public health capacities in the 21th century. ASPHER's raison d'etre and mission is to advice and assist academic institutions to offer high-quality education and training programmes for public health professionals working in policy development, practice and research. EUPHA's remit, on the other hand, is to guide and support the development of an adequate knowledge base serving the needs both of policy and practice through multidisciplinary research. Both associations will serve the European public health best if their share a common value and knowledge base grounded in sound research and scientific discourse. During the last years public health leaders, scientists and practitioners have entered a debate on the values and principles guiding policy making, scientific research and organisational practice.1 It centres on value-related themes such as health and health improvement, equity and social justice, social cohesion and solidarity, responsiveness to health and disease-related needs, acceptability and efficiency of health services, governance and financial sustainability. We have learned that the values and principles underlying these themes tend to be …

President's column: Looking back at the 13th EUPHA conference Graz 10–12 November 2005

Close to 800 public health researchers, practitioners and policy experts from 55 countries and all five continents participated in this year's conference of the European Public Health Association, entitled ‘Promoting the Public's Health—Reorienting health policies, linking health promotion and health care’. One key question guided the organizers: How can we, the European public health community, build effective capacities for sustained population-wide health improvement in our own countries and in a changing Europe? 1 The Graz conference presented eight keynote lectures and the traditional Ferenc Bojan Memorial lecture, 60 parallel workshops or oral sessions with over 460 presentations and about 200 poster presentations, beside a full-day pre-conference and numerous meetings of EUPHA sections, associations, and working parties. Looking back at the 13th EUPHA conference three preliminary conclusions can be drawn: 1. European public health is getting stronger both in the fields of scientific research and knowledge-based practice. This trend was already apparent in the previous EUPHA conferences in Dresden, Rome, and Oslo, and evidently confirmed in Graz it. 2. EUPHA's 10 Statements on the Future of Public Health in Europe2 express a balanced vision and clear directions for linking research, policy, and practice. Future public health can only be achieved if the whole society invests in it. Public health should form an integral part of the political agenda in all sectors. Public health research remains a solid basis for the development of public health practice and policy. Public health research should focus on the needs of policy and practice. Researchers should learn how to interact with politicians and practitioners. 3. Adequate public health capacity requires a solid knowledge base. Public health knowledge is the basic resource or ability to solve a wide range of health care and health promotion problems. To further develop public health according to the directions expressed in the 10 …

Jeff Koons and the celebration of banality: impressions from Oslo

The annual conferences of the European Public Health Association are a good opportunity to look around in the old continent. I vividly remember the Dresden conference in 2002, which brought the European public health community to a city reflecting the great and tragic history of Germany. Some of that history, and its effects on German public health, can be experienced first hand in Dresden's famous Deutsches Hygiene Museum.1 Last year's conference was in Oslo, a city whose heated pavements melt the snow below shoppers' feet, effectively symbolizing the high standards of living in Norway and other Scandinavian countries. This time, I used my spare time to see the Jeff Koons retrospective exhibition in Oslo's Astrup Fearnley Museum of Modern Art. Far from being typically Norwegian, the … * Correspondence: J.P. Mackenbach, Department of Public Health, Erasmus MC, University Medical Center Rotterdam, PO Box 1738, 3000 DR Rotterdam, The Netherlands, Email: j.mackenbach{at}erasmusmc.nl

Editorial. An agenda for public health research in Europe

In some senses, the end of 1997 marks a transition for the journal. Per-Gunnar Svensson, who founded the journal in 1990, is retiring as editor-in-chief on his appointment as Director General of the International Hospital Federation in London. Per-Gunnar combined the vision of a specifically European journal of public health with the energy, enthusiasm, and sheer hard work necessary to make that vision a reality. In doing so, he has contributed enormously to the sense of a European public health community. As the journal moves into a new phase, we want to build on Per-Gunnar's achievements. In an increasingly interdependent world, in which many of the threats to the health of our populations are global, such as climate change, the trans-national tobacco industry, and emerging infectious diseases, we will continue to support the development of a global public health agenda. In the previous paper, Gro Harlem Brundtland sets out clearly why we need to be concerned about these issues, wherever we live, which bespeaks our goal of developing the pan-European identity of the journal further. This year we have seen an increase in coverage of research that has a specifically European dimension, an example being the recent supplement on cross-border health care and, in future, we hope that the journal becomes the first place that people look for this type of research. We believe that the journal is uniquely placed to contribute to the dissemination of research where a European dimension provides real added value.

A report by a working party 1975. Council of Europe European Public Health Community. Abuse of medicines. III. General recommendations.

A report by a working party 1975. Council of Europe European Public Health Community. Abuse of medicines. III. General recommendations.