After apparently going missing in action, the Measuring What Matters framework turned up in Geneva this week, courtesy of Health Minister Mark Butler at the 77th World Health Assembly. The column this week brings wide-ranging updates from #WHA77 and other global health developments.
It links to a discussion on a primary healthcare dichotomy whereby “the political and financial prioritisation of specialist care and hospital services despite the overwhelming population need and policy emphasis on front-line community care, for which generalist skills are crucial”, to a paper urging a precautionary public health response on smartphones, social media, and teenage mental health, and to a publication outlining an Indigenous strengths-based theoretical framework.
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The quotable?
The world stands on the edge of a precipice. The foundations of international law and multilateral cooperation are at serious risk of collapse due to cumulative failures of political leadership. We face the most perilous moment since the Second World War.”
77th World Health Assembly
For some time now Croakey contributors have been asking, ‘whatever happened to the Albanese Government’s Measuring What Matters framework?’, as the Treasurer has gone noticeably quiet on concepts such as wellbeing budgets.
However, Health Minister Mark Butler was waving the flag for the framework at the 77th World Health Assembly in Geneva this week, as indicated by the photos below featuring Professor Mariana Mazzucato, who chaired the World Health Organization’s Council on the Economics of Health for All.
Mazzucato argues that “rather than pursuing economic growth regardless of the consequences, we should orient economic activity toward the goals of human health and well-being, and toward ensuring a healthy and sustainable environment”.
But how can a Health Minister transform economic policy? While in Geneva, Butler was due to participate in a WHA77 Strategic Roundtable on related topics, so perhaps he will have more to say about this upon his return.
According to a media statement before WHA, Butler planned to engage ministerial counterparts and health experts on pressing domestic health issues such as digital health, primary care reforms, youth mental health, nicotine dependency, and rheumatic heart disease.
The WHA was also a chance to wave the flag for Australia’s efforts on vaping regulation on the eve of World No Tobacco Day on 31 May, which this year is focussed on protecting children from tobacco industry interference.
In a related statement, the WHO’s Regional Director Saia Ma’u Piukala said the WHO urges Member States in the Western Pacific Region to either ban or stringently regulate e-cigarettes as part of a comprehensive tobacco control strategy, and said “Australia’s leadership in tobacco control is both commendable and inspiring”.
Minister Butler chaired a roundtable discussion with other Health Ministers and senior foreign health officials, to discuss countries’ shared challenges and successes in taking action on vaping, including legislation now before the Australian Senate, which is due to come into effect on 1 July 2024.
“The world is watching, and the passage of our vaping legislation is being followed with great interest by other governments around the world,” Butler said in a statement.
Other issues at the WHA included climate and health, as previously reported by Croakey, social participation and community engagement in healthcare, social media’s impact upon young people, decolonising public health practices, and pandemic preparation and prevention.
Some key points from the WHO Director-General’s Address to the 77th World Health Assembly
- Tobacco use is declining in 150 countries, and there are now 19 million fewer smokers globally than there were two years ago.
- More than 90 countries increased their tobacco excise tax between 2020 and 2022.
- Last year, another 13 countries passed or implemented best-practice policies to eliminate transfat from their food supply. Almost half the world’s population is now protected by such policies, compared with just seven percent in 2018, when we launched the WHO call for action.
- 28 countries increased taxes on alcohol, tobacco or sugary drinks.
- Over the past decade, 45 countries have reduced road traffic deaths by at least 30 percent, and 10 have achieved a reduction of 50 percent or more.
- WHO has launched a Commission on Social Connection to highlight the impact of social isolation and advise me and the world on how to address it.
- Globally two billion people face financial hardship due to out-of-pocket health spending, and half the world’s population is not fully covered by essential health services. This is staggering.
- Last year, WHO verified 1,510 attacks on healthcare in 19 countries, with 749 deaths and more than 1,200 injuries.
Recommended reading
Croakey readers interested in the connections between public health, democracy, trust, disinformation, toxic news and information systems and the rise of populism may find the perspectives below useful.
The Elders warn that failures of political leadership risk collapse of international order
“At the conclusion of their board meeting in São Paulo, The Elders today call on world leaders to uphold international law and prioritise multilateral cooperation to build a better world for current and future generations.
The world stands on the edge of a precipice. The foundations of international law and multilateral cooperation are at serious risk of collapse due to cumulative failures of political leadership. We face the most perilous moment since the Second World War.
The United Nations and other institutions created to promote the stability and accountability that come through the rule of law are under attack. The growing climate of impunity for states and leaders, who show no respect for the principles on which they were founded, may take us to a point of no return.
The principles of the UN Charter risk being subsumed by aggressive nationalism and great power rivalry. This is not in any state’s long-term interest, given the existential threats to humanity that can only be tackled by global cooperation within a framework of agreed rules….”
The Berlin Summit Declaration – Winning back the people
“Liberal democracies are today confronted with a wave of popular distrust in their ability to serve the majority of their citizens and solve the multiple crises that threaten our future. This threatens to lead us into a world of dangerous populist policies exploiting the anger without addressing the real risks, ranging from climate change to unbearable inequalities, or major global conflicts. To avert major damages to humanity and the planet, we must urgently get to the root causes of people’s resentment.
There is ample evidence today that this distrust is not only, but to a large extent, driven by the widely shared experience of a real or perceived loss of control over one’s own livelihood and the trajectory of societal changes. This sense of powerlessness has been triggered by shocks stemming from globalization and technological shifts, now amplified by climate change, AI and the inflation shock. And, decades of poorly managed globalization, overconfidence in the self-regulation of markets and austerity have hollowed out the ability of governments to respond to such crises effectively.
Winning back the people’s trust means rebuilding these capacities. We do not pretend to have definitive answers. However, it seems crucial to re-design or strengthen policies based on some of the fundamental lessons we can draw from what has caused such levels of distrust…”
Maria Ressa’s speech at the 2024 Harvard commencement ceremony
“You’re standing on the rubble of the world that was, recognise it. I said this in the Nobel lecture: an atom bomb exploded in our information ecosystem because social media turned our world upside down, spreading lies, faster than facts, while amplifying fear and anger, fueling hatred. By design. For profit.
Whether it’s the AI of social media or generative AI, we don’t have integrity of information, we don’t have integrity of facts…
And here’s three sentences I’ve said over and over. Without facts, you can’t have truth. Without truth, you can’t have trust. Without these three, we have no shared reality, no rule of law, no democracy. We can’t begin to solve existential problems like climate change.
…In 2023, the global democracy index fell to its lowest level ever. Today, 71 percent of the world lives under autocratic rule. We are electing illiberal leaders democratically. And once in power, these autocrats not only crush institutions in their countries, but form alliances and create Kleptocracy, Inc.
And it’s not just the tech companies that abdicated responsibility for protecting us, it’s also democratic governments like the United States. Tech is the least regulated industry around the world.
So let me end by reminding you: we are standing on the rubble of the world that was, and we, you, must have the courage, the foresight to imagine – and create the world as it should be: more compassionate, more equal, more sustainable. ”
Other global health matters
The Lancet: Political economy dichotomy in primary health care: bridging the gap between reality and necessity
“The first dichotomy lies in the political and financial prioritisation of specialist care and hospital services despite the overwhelming population need and policy emphasis on front-line community care, for which generalist skills are crucial.
…The second dichotomy relates to investments that take pro-poor approaches for primary health care, aiming to reduce poverty-related disparities. However, an emphasis on “the poor” has contributed to a distorted perception of PHC as inferior care for impoverished individuals or low-income areas.”
Last week’s ICYMI reported on a new review showing benefits of mask-wearing. Read more from some of the authors – at Professor Deborah Lupton’s blog, and at The Conversation UK: Masks work, our comprehensive review has found.
Public health
BMJ: Smartphones, social media, and teenage mental health
#AusPol
Read more: These authors argue that people living in the regions will benefit less than in those in South East Queensland, given the limited demand for public transport, and the lesser provision of services. Free or heavily discounted public transport can be a good idea, they say, but it’s best when targeted at the most disadvantaged. (Croakey notes that many issues are not covered in this article, such as the climate and health benefits of encouraging public transport use.)
Albanese Government must take historic opportunity and adopt Human Rights Act after inquiry recommendation
A coalition of 104 civil society organisations have welcomed the Parliamentary Joint Committee on Human Rights call for an Australian Human Rights Act as an important step forward towards a fairer, more compassionate Australia. Australia is the only western liberal democracy without a legislated Human Rights Act or similar in our laws. A Human Rights Act will mean governments must consider people’s human rights when creating new laws and policies, and delivering services – like aged care, Medicare, disability services, and education funding. A Human Rights Act would provide a basic safeguard so people could also take action and seek justice if their rights are violated.
2017 report, Service delivery in remote and discrete Aboriginal and Torres Strait Islander communities
First Nations health news
An Indigenous Strengths-based Theoretical Framework
The author Dr Jacob Prehn writes: “A strengths-based approach must supersede the deficit discourse that continues to be a defining feature of how social workers, allied health professionals, researchers, and policymakers interact with Indigenous Australians.”
The LIME Good Practice Case Studies Resources showcase examples of good practice in Indigenous medical and health education from schools and specialist colleges across Australia and Aotearoa/New Zealand.
Appointments and awards
Lowitja Institute welcomes Paul Stewart as new chief executive officer
Lowitja Institute announced the appointment of Mr Paul Stewart as its new chief executive officer to lead Australia’s only national Aboriginal and Torres Strait Islander community controlled health research institute.
A proud Taungurung man with connections to Central Victoria, Mr Stewart replaces Adjunct Professor Janine Mohamed who led the organisation for six years.
Mr Stewart has longstanding ties to the Institute from his early career in Aboriginal and Torres Strait Islander health research, and more recently held the positions of deputy CEO and interim CEO.
His career spans over 20 years with experience in leadership roles across a range of sectors including Aboriginal and Torres Strait Islander health, sport, government and education, both locally and internationally.
#CroakeyREAD
National Indigenous Times. Eugenicists, Racists, Nazis: A new truth-telling book from the University of Melbourne examines the institution’s relationship with Indigenous people.
Events upcoming
