Wednesday, November 15, 2006

Each October Europe’s health policy community withdraws to two small towns in the Austrian Alps. The annual European Health Policy Forum alternates between the neighbouring towns of Bad Gastein and Bad Hofgastein, in the beautiful setting of Salzburger Land.
After an epic session last year, in which I gave six presentations, I sort of regained some control this time, with only three presentations but also facilitation of two workshops. Of course, while the formal sessions are always valuable, the real benefit of going is the amount of work that you can do outside them, catching up with what is happening and developing collaborative activities.
One of my talks was in a session on pandemic preparedness. There were some really great presentations, for example by Zsuzsanna Jakab, new director of the newly established European Centre for Disease Prevention and Control and from David Heymann, who heads the infectious disease team at the WHO. With my collague Rifat Atun, I had been looking at the situation in those parts of the world that lie outside the formal system of surveillance – the bits that are not independent countries but are de facto not part of anywhere else. In the present situation, what is striking is how many of them lie under the migratory routes of birds. They include those places that never quite managed to get sorted out at the end of the USSR, such as the Trans Dneistr Republic, a break away part of Moldova, as well as various places in the Caucasus. Others are Western Sahara, Palestine, and Northern Cyprus. Then there is Taiwan, which differs from the rest because it has a highly developed health system but its ability to interact with the global surveillance system is seriously constrained by its ambiguous relationship with China. Some time ago we obtained details of a secret memorandum negotiated by the WHO and China that at least made it possible for communication with Taiwan to take place (although no-one shared it with the Taiwanese) but it contains ludicrous restrictions such as requiring that communications be faxed because to write “Taiwan” on a letter would imply recognition of its independence!
However, much else was discussed, including the need to do something about alcohol in Europe. Regulations arising from European single market have forced some countries to dismantle their carefully though out alcohol policies. An example is Finland, which has had to dismantle restrictions on sales outlets. The result – a massive increase in deaths from cirrhosis. The European Commission is proposing a strategy that would allow governments to take some very limited steps to address this problem but it is clear that the alcohol industry is engaging in highly dubious tactics to block it. More later….