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Offline: Russia pitches for global health
Comment
Offline: Russia pitches for global health
Reuters
Corbis
The audience at the World Trade Centre in Moscow last Thursday knew that a “high-level dignitary” was expected. Security was tight and tense. Each of us was scrutinised carefully (in long and bad-tempered queues) by Russian police. The programme for this first global ministerial conference on healthy lifestyles and non-communicable disease (NCD) control was to begin at 9 am with opening speeches, followed by a high-level panel of ministers discussing what they planned to do about a growing crisis that is now killing 36 million people each year. The mysterious celebrity was to arrive by 11.30 am. But the day started as it finished—late. The opening was delayed. The high-level panel was rescheduled. Time (and quite a lot of it) passed. The purpose of the conference was to get 90 ministers and 155 national delegations excited about NCDs, committed enough to go home and do something about them. By midday, they were looking bewildered. The conference had ground to a halt before it had properly begun. Just as we all wondered why we were here at all, a commotion. Margaret Chan, WHO’s DirectorGeneral, together with Tatiana Golikova (Russia’s Minister of Health and Social Development), strode into the hall with Vladimir Vladimirovich Putin. The Ministers jumped up, sat down again, took out their cameras, and began snapping photographs like tourists who had just glimpsed a Hollywood star. The conference was underway. *
Mary Evans Picture Library
Contrary to his public reputation, Putin was utterly charming. He praised health care as “the most important field” and claimed Russia was making “much progress”. His government was pouring billions of roubles into the health system. Despite severe economic conditions, “it’s wrong when people say we can discard social programmes”. “I don’t know a more noble mission, a more noble profession”, he concluded, “than that of a medical doctor”. Unlike politicians, who are justifiably “objects of criticism”, “we always count on you”. The morning had been frustrating and poorly organised. But Putin was undeniably worth waiting for. *
Photolibrary
One of the greatest of all Russian intellectuals, Alexander Herzen (born in Moscow in 1812), wrote that “History is the autobiography of a madman.” By which I think 1556
he meant that there were no simple solutions to the world’s complex problems. That is certainly the case for NCDs. One reason for getting ministers together was to ask scientists to step out of the way and invite political leaders to start leading. But the panel of ministers from South Africa, India, Saudi Arabia, the US, China, and Russia showed all too eloquently why WHO, and those of us joining forces with WHO (The Lancet included), need to recalibrate our strategy for getting heart disease, stroke, cancer, and diabetes, among other conditions, on the agendas of Presidents and Prime Ministers at the UN General Assembly in New York this coming September. Although 80% of NCD deaths take place in low and middle-income countries, the fact is that for the 50 or so poorest countries in the world an unfinished litany of problems remains—infectious diseases, maternal and childhood illnesses, and unchecked population growth. NCDs come bottom of this list. If we are to make any progress at all in getting NCDs noticed, we’ll have to show how their prevention and treatment can easily be integrated into existing health programmes that are already struggling in health systems starved of cash and capacity. Another big vertical initiative is not what countries want or need. This points to an uncomfortable truth—we in the health community have not made an effective business case for NCDs. Deaths alone are not enough. We need to show why NCDs matter—and they do—for economic stability as well as poverty reduction. The macroeconomic case for action is lacking: an urgent gap to fill between now and September. * Still, one of the most optimistic conclusions I took from this meeting of ministers was that Russia has launched itself into global health. Is it too hopeful to believe that Russia sees health as a sphere where it can demonstrate its positive contribution to global affairs? Vladimir Putin committed Russia to “enhance cooperation” with WHO. With Russia holding the Winter Olympics in 2014 and the World Cup in 2018, the country is already on a trajectory towards greater global recognition. Putin’s extended hand for health should be grasped. Richard Horton [email protected]
www.thelancet.com Vol 377 May 7, 2011
Offline: Russia pitches for global health
Reuters
Corbis
The audience at the World Trade Centre in Moscow last Thursday knew that a “high-level dignitary” was expected. Security was tight and tense. Each of us was scrutinised carefully (in long and bad-tempered queues) by Russian police. The programme for this first global ministerial conference on healthy lifestyles and non-communicable disease (NCD) control was to begin at 9 am with opening speeches, followed by a high-level panel of ministers discussing what they planned to do about a growing crisis that is now killing 36 million people each year. The mysterious celebrity was to arrive by 11.30 am. But the day started as it finished—late. The opening was delayed. The high-level panel was rescheduled. Time (and quite a lot of it) passed. The purpose of the conference was to get 90 ministers and 155 national delegations excited about NCDs, committed enough to go home and do something about them. By midday, they were looking bewildered. The conference had ground to a halt before it had properly begun. Just as we all wondered why we were here at all, a commotion. Margaret Chan, WHO’s DirectorGeneral, together with Tatiana Golikova (Russia’s Minister of Health and Social Development), strode into the hall with Vladimir Vladimirovich Putin. The Ministers jumped up, sat down again, took out their cameras, and began snapping photographs like tourists who had just glimpsed a Hollywood star. The conference was underway. *
Mary Evans Picture Library
Contrary to his public reputation, Putin was utterly charming. He praised health care as “the most important field” and claimed Russia was making “much progress”. His government was pouring billions of roubles into the health system. Despite severe economic conditions, “it’s wrong when people say we can discard social programmes”. “I don’t know a more noble mission, a more noble profession”, he concluded, “than that of a medical doctor”. Unlike politicians, who are justifiably “objects of criticism”, “we always count on you”. The morning had been frustrating and poorly organised. But Putin was undeniably worth waiting for. *
Photolibrary
One of the greatest of all Russian intellectuals, Alexander Herzen (born in Moscow in 1812), wrote that “History is the autobiography of a madman.” By which I think 1556
he meant that there were no simple solutions to the world’s complex problems. That is certainly the case for NCDs. One reason for getting ministers together was to ask scientists to step out of the way and invite political leaders to start leading. But the panel of ministers from South Africa, India, Saudi Arabia, the US, China, and Russia showed all too eloquently why WHO, and those of us joining forces with WHO (The Lancet included), need to recalibrate our strategy for getting heart disease, stroke, cancer, and diabetes, among other conditions, on the agendas of Presidents and Prime Ministers at the UN General Assembly in New York this coming September. Although 80% of NCD deaths take place in low and middle-income countries, the fact is that for the 50 or so poorest countries in the world an unfinished litany of problems remains—infectious diseases, maternal and childhood illnesses, and unchecked population growth. NCDs come bottom of this list. If we are to make any progress at all in getting NCDs noticed, we’ll have to show how their prevention and treatment can easily be integrated into existing health programmes that are already struggling in health systems starved of cash and capacity. Another big vertical initiative is not what countries want or need. This points to an uncomfortable truth—we in the health community have not made an effective business case for NCDs. Deaths alone are not enough. We need to show why NCDs matter—and they do—for economic stability as well as poverty reduction. The macroeconomic case for action is lacking: an urgent gap to fill between now and September. * Still, one of the most optimistic conclusions I took from this meeting of ministers was that Russia has launched itself into global health. Is it too hopeful to believe that Russia sees health as a sphere where it can demonstrate its positive contribution to global affairs? Vladimir Putin committed Russia to “enhance cooperation” with WHO. With Russia holding the Winter Olympics in 2014 and the World Cup in 2018, the country is already on a trajectory towards greater global recognition. Putin’s extended hand for health should be grasped. Richard Horton [email protected]
www.thelancet.com Vol 377 May 7, 2011