Reflections from theme rapporteurs

Rapporteurs gave summaries of major themes of the conference: What’s the Story? What’s the exciting research question? What does this mean for business? What does this mean for young people?

What’s the story?

Jeff Kittay, Graduate School of Journalism, Columbia University

Having a strong lead story will engage the media, in the same way that the ‘dead parrot’ has raised awareness about avian flu in the United Kingdom. School lunches are a particularly good example – the issue is easily communicable and demonstrates a practical way in which control can be exerted over the risk factors for chronic disease.

Jeff’s personal favourite vignette of the week was the example given by Sir Liam Donaldson in one of the opening sessions – the primary care trust in Leeds (UK) that partnered with a local credit union. 1,700 patients opened accounts, escaping from a cycle of debt – £1.4 million was saved in debt-interest payments to loan sharks. It is an example of treating health as part of a whole-lifestyle approach.

Suggestions:

The extent of OxHA’s remit and the vocabulary that it uses deserve more careful thought.

  • Exactly what diseases are being addressed and why?
  • Is ‘chronic’ really the most appropriate phrase? Would ‘avoidable diseases’ or ‘diseases of choice’ be more appropriate?
  • Consider the negative connotations of ‘diet’ – language that suggests restraint, rather than suggesting good nutrition.
  • The OxHA message should start with the big picture: half of all the deaths in the world are due to four diseases, which are themselves due to just three risk factors.

OxHA needs to work on its message and put effort into a public-information campaign, being careful to test the messages in a culturally sensitive way.

Following Steve Bodhaine’s presentation, our self-assuredness needs to be punctured. We tend to think that if we are happy in our social relationships then we are healthy – but this sort of social well-being is not sufficient for genuine health. A public-information campaign could focus on how to achieve real good health, focusing on ‘uncool self-destructive behaviour’, and showing up the complacency into which people tend to slip.

Having a strong lead story will engage the media, in the same way that the ‘dead parrot’ has raised awareness about avian flu in the United Kingdom. School lunches are a particularly good example – the issue is easily communicable and demonstrates a practical way in which control can be exerted over the risk factors for chronic disease.

What is the exciting research question?

Barry Kistnasamy, Nelson Mandela School of Medicine, Durban

Research is important – ‘If it’s not measured, it can’t be managed’ – but, although there is more research that can be done, there is already sufficient data out there, ready to use. What is needed is people and organisations who can translate the research into a useable form – how to move beyond adding years to life, by adding life to years.

Taking the research forward may not be the responsibility of academics – instead, activists are needed to move the agenda forward. This is particularly important as society and the media are more likely to take notice of a ‘champion’ of a cause.

How about in the sense of announcing and promoting advances in research?  He could see a role for identifying what we (now) know and being sure that other understand the implications.

Suggestions:

  • OxHA could take a lead in announcing and promoting advances in research as they happen. OxHA could have a role in identifying the relevant implications of new research data, and ensuring that these implications are fully appreciated by a wide audience.
  • OxHA could also begin to adapt the existing research for local, practical use.
  • OxHA could develop a ‘hit squad’ – people who can address influential bodies such as the World Trade Organisation. For example, free trade agreements in the past have focused on crisis drugs (anti-retrovirals, for example), rather than on chronic-disease drugs. There is much awareness-raising to be done in this area.
What does this mean for business?

Prerequisites for an effective alliance between the international business and the global public health communities

Natalya Fedorova, Woodrow Wilson Associates

The support and involvement of international business is vitally important to the mission of OxHA.  Much stronger representation and involvement of major business is essential and needs to be obtained reasonably quickly.  But how to get it?

1. The accumulation of clinical and epidemiological evidence to date  has been impressive. Going forward, much more time and energy now needs to be spent on action planning and action.  In order to attract significant business involvement we will have to demonstrate that the hand on the tiller has passed from those involved primarily with collecting and analysing data to those who are experienced change agents with proven track records in making major changes happen.

2. We need to develop very clear proposals with which to approach business, spelling out what exactly needs to be done, by whom, by when, and what the realistic and specific costs and benefits of doing so are compared with not doing so.

3.  We need to consider carefully how and with what attitudinal assumptions we actually engage senior management of the international business community.  We need to keep in mind that the leaders of these corporations are well informed and knowledgeable about most public health problems.

4. Corporations generally do not think that business in general has a special obligation to solve the problems of global public health.

5. It is not a good strategy, for many reasons, to presume to tell  business what is in its short-term or medium-term best economic interests.  They usually have a very complex agenda, and from the outside it is very difficult to judge their pressures and priorities.

6.  We must reach out to business in a very collaborative way. In those instances where business reaches out and engages with us, we must welcome it warmly.

What does this mean for young people?

Hala Khalaf, author of author of ‘Young Voices: Life with Diabetes’ (Jordan)

Hala made the point that apathy among young people – as chronic diseases are something far in the future – can be a major problem.
There were two videos made by the young people who attended the conference – one lampooning the amount of food on offer at Yale and conference guests’ attitude towards it, and one presenting the experience of attending the conference from the point of view of the youth panellists.

Suggestion:

  • OxHA needs to package its message in a way that is appealing and makes a healthy lifestyle relevant to young people.
Discussion on the rapporteurs’ reflections

A shadow element of much that has been said during the meeting has been on finance. There is a need for a new system of finance, as well as a new approach to the health system.

A further suggestion was to study campaigns by environmentalists and the tax schemes that have been used in the past to regulate behaviour.

There were comments reinforcing the opinions of the rapporteurs – notably:

  • businesses, particularly insurance companies, want to see action, rather than research;
  • OxHA’s message must be very crisp, and state very clearly exactly what it is that the organisation does.