Public Health between global challenges and subsidiarity Experience from the Public Health Agency. Michel Pletschette,MD Head of Scientific Department

Transcription

1 Public Health between global challenges and subsidiarity Experience from the Public Health Agency Michel Pletschette,MD Head of Scientific Department

2 What is PHEA : dedicated programme management structure : grants, meetings, tenders :40 M /y 37 persons, located in Luxembourg Set standards in technical quality, dissemination and policy feed back Mandate is to eliminate discretionary elements in the management process: no political role

3 Challenges 3rd Public Health revolution: transition of theoretical model of health from biology to social sciences but health remains vulnerable:what hygiene and chronic disease treatment has acquired needs to be kept and developed

4 Challenges Only 20% of mortality reduction due to clinical care : importance of social determinants! Health management becomes knowledge management at individual and collective levels: Importance of peer processes, dialogue and scientific basis: reviews, evaluation etc.

5 Health Challenges and EU Action Health information and Health Portal Interactions with WHO Pharmaceutical Forum Pharmaceutical and Medical Device Safety Citizens want more control Globalisation New Technology and Innovation Health investments through Structural Funds etc Capacity building Expanding EU: growing health gaps Migration & Cross Border Healthcare Health Services Initiative Ageing Population Projects funded Cross-sectoral work Climate Change, Pandemic and Bioterrorism Threats Lifestyle Related Diseases ECDC Health Security Committee White paper on Nutrition Communication on Alcohol Tobacco control strategy

6 Subsidiarity A way of working together No substitute for balanced decision making Major role in helping to implement common programmes:solidarity Prerequisite of learning to work together is coherent with evolving nature of health as a social product

7 Health and Development - Globally 80 Mexico Spain France Italy Japan life expectancy, China India Nigeria Russia Indonesia Pakistan Bangladesh Gabon Namibia Brazil South Africa Argentina Korea Equatorial Guinea UK Germany USA 40 Botswana 0 10,000 20,000 30,000 40,000 gdp per capita, 2000, current PPP $

8 Principles for EU Strategy 1 a Value-Driven approach *Health as a Fundamental Right *Engaging with Citizens, improving information and data, equity, solidarity, etc... 2 Health is Wealth *HLY in the Lisbon Agenda *Recognising the economic benefits of costeffective health investments, capacity building 3 Health in All Policies *Bilateral work with (e.g.) Regional Policy on Health Investments, Employment on healthy workplaces, Enterprise on innovation *Encouraging new partnerships at all levels 4 Global Health *Strengthening EU s voice on global stage *Tackling shared issues such as pandemic, climate change

9 EU has academic competences but do we have capabilities

10 Country Public health publications, 2000 BE NZ CH NO DK ES FI IT FR NL SE DE A U CA A CNZ UK EU15 EU25 EUR28 US W ld P ublica tions pe r ye a r

11 How will Health programme work Health threats Health infomation ( data for change) Health promotion via action on determinants ( poor health as a result of organisational failures: access, literacy, poor choices)

12 Basis is: How can we network succesfully? complementarity of competences, task distribution commensurate with capabilities, trust and communication Multidisciplinarity Avoidance of expediencies Planning

13 How to organise? EU inter-country perspective : Often extrapolation of national experiences: pitfalls: different perceptions, different priorities, different methods, sources of knowledge Need for common evaluations

14 EU intra-country experience Extrapolation from EU cooperation onto regional levels: global differs from uniform trend to give regions more responsibility in health : demographic and policy factors( organisation of care ) driving forces but also limitations in public health:capabilities are never universal need for competence centers development :role for national strcutures?

15 2008 country participation vs AU BE BG CY CZ DE DK ES FI FR GB GR HR HU IE IS IT LT LU LV MT NL NO PL PT RO SE SI SK TR

16 Associated partners in countries 2008 vs AU BE BG CY CZ DE DK EE ES FI FR GB GR HR HU IE IS IT LI LT LU LV MT NL NO PL PT RO SE SI SK TR

17 Recommendation for funding per MS

18 Popularity of the argument or fragmentation of the efforts or efficient EU wide networkingfrom earlier and other pogrammes

19 More efforts needed for dissemiation Number of proposals by dissemination means www, website conference reports other publications others meeting flyers, brochure and lef... training material media scientific publication newsletter network workshops CD roms, videotapes, DVD database press conference not identified electronic newsletter seminar

20 Dissemination needs needs a defined defined universe Target groups DG SANCO And other DG of EC National Health Policy makers Public Health professionals Academic Sector in PH Health NGOs The health- Related private sector Population at large Non health professionals Means of dissemination www Conferences & meetings Information days Publications Flyers and brochures newsletter Training materials Other Contents of dissemination General information on current public health topics Evidence in public health and health care Policy and practice recommendations Theoretical approaches In public health PHEA (Evaluation and execution level) Project coordinators (Operative level) EC-DG SANCO (Policy level) Feedback PH knowledge Feedback

21 Successful project writing and management good practice experience Know risks of failure Failure of collaborate as a partnership e.g., low participation, differences of opinion on strategy, partner drop-out Failure to ensure quality of deliverables Benefits of applying Big challenge, but it is worth it, even if unsuccessful Good exercise in considering the project idea from different perspectives Your network develops Getting started Contact your NFP and national/regional/local grants office, they can give you good advice and be helpful Read the EU documents carefully Failure to get ethical approval e.g., for the collection of epidemiological data Failure to secure own contribution Delays Minimise risks of failure Plan project describing activities to achieve objectives Detailed plan for work packages (dissemination, evaluation plan) Use logical frameworks as a tool for planning Take good care of the partnerships partnership synergy does not come by itself requires time, communication and a clear management/network structure Carefully follow up the planned activities define realistic milestones and indicators Key role of coordinator Tasks: Maintaining contact between all partners and PHEA Ensuring completion of work packages; Handling financial matters Methods: Project mailing list & personal s, phone conversations Guidelines for work packages; Cooperation with package leaders Project meetings Challenges: Different working cultures; divergent organisational structures; Problems of enforcing compliance with deadlines Challenges in management Financial aspects Financial records kept to include all expenses for different work packages and for whole project Strong financial input from the coordinator essential Technical aspects Need to cover very different aspects of the project requires broad technical expertise Management aspects Managing the partnership communication and leadership Organisational capacity to keep track of deliverables Exchange information with PHEA Make a time plan, and stick to it. Start early. Contact possible partners. Do not include partners who do not follow the time table or who do not keep to agreements made What makes a good proposal Relevant to policy context and EU added value Appropriate technical approach; efficient management Logical structure (specific objectives, activities, outcomes & deliverables Budget: realistic and balanced between work packages and partners Reasonable number of partners representing diversity of MS