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Salzburg Global Seminar has long been a leading forum for the exchange of ideas on issues in health and health care affecting countries throughout the world. At these meetings agendas have been re-set affecting policy and practice in crucial areas, such as patient safety and the engagement of patients in medical decision making. In 2010, Salzburg Global Seminar launched a multi-year series of seminars to crystallize new approaches to global health and health care in the face of emerging challenges affecting us now and set to continue on through the coming generation.


Interviews and coverage from our Health programs

Irene Higginson - What future research is needed to improve care for people with advanced illness & towards the end of life
Irene Higginson - What future research is needed to improve care for people with advanced illness & towards the end of life
Irene Higginson 
This article first appeared on the EAPC blog, which will continue to publish more posts on the Salzburg Question series. It refers to the ninth Salzburg Question: What future research is needed to improve care for people with advanced illness & towards the end of life. Irene Higginson, Professor of Palliative Care & Policy and Director of the Cicely Saunders Institute, King’s College London, explains why research is so important, and what people can do to support it. Palliative care puts the person before the disease. (View our video here). Our role is to look after the whole person and those close to them, and this means assessing and offering the very best in therapies, treatment and care, to help people live well despite their illness as well as controlling symptoms at the end of life. The person-centred approach does not mean that we have it right yet; it should mean striving to improve what we do. As a doctor trained dually in palliative medicine and public health medicine, I have long been concerned that the treatments, therapies and services that we can offer patients and families need to improve. In the future, I want to be providing patients and families with better treatments, therapies and care, especially in the hard to manage areas. Research needs to test and discover better treatments for the many complex physical problems and symptoms that people have, such as breathlessness, fatigue, frailty, pain and nausea, as well as for emotional, social and spiritual issues. There is a need for research into better ways to support those who currently miss out on the best in palliative care, especially those groups that form part of growing populations (such as older people with multiple morbidity) who are most likely to require palliative care in the future. We also need to be realistic. Health and social care resources are constrained in many countries, so we need research into solutions that are cost-effective. Research into better services is also vital, as services are a key component to influencing quality of life for people. Those close to the patient often provide so much, and research into ways to support them is urgently needed. We work closely with our Patient and Public Involvement (PPI) group, whose feedback and insights enable us to steer our research according to the needs and concerns of the people who will directly benefit from advances in palliative care practice and provision. Pam Smith, one of our PPI members, describes her reasons for becoming involved in the work of the Institute: “Without ongoing research into palliative care, the lives of the people suffering from advanced illness, and also the lives of their carers, will never be improved. A compassionate society cares about the people who live in it!” Scientific discovery takes time to progress. Palliative care has had some major successes over the years, but now we need to be thinking about what people will need in five to ten years’ time, and what research, investment, workforce and capacity are required to deliver this. So with this #allmylifeQs, I am asking all of you who read this to speak to four other people today about why you think that research is important, and what you can do to support it.
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Ninth Salzburg Question to Launch on World Science Day for Peace and Development
Irene Higginson, the director of Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, speaking at Salzburg Global
Ninth Salzburg Question to Launch on World Science Day for Peace and Development
Salzburg Global Seminar 
An online conversation about end of life care will continue on Friday when the ninth Salzburg Question is launched.The last question in the series will ask people to consider what future research is needed to improve care for people with advanced illnesses and those toward the end of their lives.The Salzburg Questions series started earlier this year on February 20 and has engaged people from all around the world. Those who have been participating in the discussion have been using the #allmylifeQs hashtag. Between the launch of the series and November 10, the hashtag received more than 10 million impressions on Twitter and was used in more than 3,300 tweets.The launch of the ninth question will coincide with World Science Day for Peace and Development. November's question is - What future research is needed to improve care for people w advanced illness & towards the end of life?Irene Higginson, the director of Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, will help lead the discussion.  The Salzburg Questions series has nine questions on matters involving palliative care. Each month, different individuals and institutions at the heart of the debate have shared a different question coinciding with an international day.These individuals and institutions were involved in Session 562 - Rethinking Care: Toward the End of Life. Other Salzburg Global Fellows who have led discussions so far include Agnes Binagwaho, Lynna Chandra, Suresh Kumar, Sheila Payne, Emmanuel Luyirika, Richard Harding, Bruce Chernof, and Stephen Connor. Salzburg Global Fellows are encouraged to take part in the conversation on Twitter on the day and afterward. They can also take part by sharing blog posts around each question.Blog platforms could include ehospice, the EAPC blog, Palliverse, and the IAHPC Newsletter.Participants on Twitter have already linked to research, podcasts, and papers during their discussions.If you hold a debate, workshop or Q&A event on a Salzburg Question, please film it so it can be uploaded to a dedicated YouTube channel. Send your video to katie.witcombe@kcl.ac.uk.A Twitter list of Salzburg Global Health Fellows has been created. If you would like to be added to this list, please let us know by subscribing or contacting us on Twitter at @SalzburgGlobal. List of dates, questions, and people leading discussions20 February 2017 - World Day of Social Justice - Why aren't countries accountable to commitment on #EOL care for vulnerable people? - Agnes Binagwaho20 March 2017 - World Happiness Day - Is dying well as important as living well? - Lynna Chandra07 April 2017 - World Health Day - How have you prepared for your death? - Suresh Kumar15 May 2017 - World Family Day - Will caring for your dying loved one bankrupt you emotionally and financially? - Sheila Payne20 June 2017 - World Refugee Day - 145 countries signed bit.ly/2ah31bH why do refugees have limited access to quality health care and #EOL care? - Emmanuel Luyirika11 July 2017 - World Population Day - How and what do you measure to ensure quality palliative & EOL care? - Richard Harding28 September 2017 - International Right to Know Day - Doctors, Nurses, do you want to die the way your patients die? - Bruce Chernof13 October 2017 - World Hospice and Palliative Care Day* - Do you know how to access #palliative care when you need it? - Stephen Connor10 November 2017 - World Science Day for Peace and Development - What future research is needed to improve care for people w advanced illness & towards the end of life? - Irene Higginson*This year's World Hospice and Palliative Care Day is taking place on Saturday, October 14. We will launch the question the day before to generate more discussion.
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Chochoe Devaporihartakula – A clean and green Asia needs compliance and transparency
Unhealthy levels of air pollution affect the lives of millions living in Asian mega-cities like Shangai, pictured, writes Chochoe Devaporihartakula
Chochoe Devaporihartakula – A clean and green Asia needs compliance and transparency
Chochoe Devaporihartakula 
Devaporihartakula will be a participant at the upcoming session in the series The Asia We Want: Building Community Through Regional Cooperation. All participants were invited to share their own vision for “the Asia we want.” Urbanization is increasingly perceived as a serious issue that threatens to undermine recent advances towards sustainable development in Asia. Currently, 48 percent of the population in Asia is living in urban areas and is expected to grow to 64 percent by 2050 according to the United Nations. The highest rate of urban population growth is predicted to take place in Asia and Africa, which will have significant consequences on natural resources, energy consumption, greenhouse gas emissions and climate change, while air pollution levels attributable to urban development already far exceed World Health Organization (WHO) standards and are likely to rise substantially in the coming decades. While other regions are exposed to unhealthy levels of air pollution, Asia accounts for the largest share of ambient PM2.5 and is responsible for millions of deaths. In Southeast Asia, urban air pollution is ranked among the highest in the world with many cities showing pollution levels five to 10 times above WHO limits. Those of us who live in Southeast Asia’s mega-cities know that air pollution is a problem. But the public is only now beginning to learn just how dangerous this problem has become. A recent study by the University of Chicago found that air pollution is shortening the lives of Vietnamese citizens by 1.16 years. Earlier this year, Harvard University and Greenpeace estimated that air pollution from the region’s coal-fired power plants could be killing 20,000 people per year. It is often the poor who suffer disproportionately from environmental health risks associated with air pollution effects. The Asia we want can only be made clean and green by ensuring the effectiveness of environmental compliance and increasing transparency and accountability of all stakeholders. Every country has limited resources that must be used effectively to foster greater compliance with the law and improved protection for people and the environment. National governments, city officials, local communities, and regional cooperation through networks such as the Asian Environmental Compliance and Enforcement Network (AECEN) must collaborate to make sure steps are taken in order to regulate and monitor pollution sources at the very early stage. This would ensure fewer polluting sources, reduced health impacts, more efficient economic growth, and greater economic returns to the country. Most Asian countries currently lack advanced technology used for pollution monitoring. Therefore, proper mechanisms such as prioritizing high risk threats through regulations, incentive programs to motivate compliance, and advanced technology for more accurate and less expensive monitoring can help all countries leap forward in the effectiveness of their compliance and enforcement efforts. Dealing with air pollution is a global challenge but the good news is that during the first Asia-Pacific Ministerial Summit on the Environment held in Bangkok in September 2017, 30 countries in Asia-Pacific committed to move towards a clean and green Asia-Pacific with highlights on the urgency of addressing environmental health risks associated with pollution and promoting resource efficiency measures and practices. Let’s hope and see if this initiative can really lead to sustainable urban development and nature-based solutions – and not just another commitment that is left on the shelf. Chochoe Devaporihartakula is the program manager for the Institute for Global Environmental Strategies (IGES) and the Training Event Specialist for the Regional Resource Center for Asia and the Pacific at the Asian Institute of Technology (AIT). Session 591 - The Asia We Want: Building Community Through Regional Cooperation I - A Clean and Green Asia - is the first session of a new multi-year series held in partnership with the Japan Foundation. For more information on the Session, please click here. To keep up to date with the conversations taking place during the session on social media, follow #SGSasia.
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Sandeep Choudhury – “The Asia we want should be one based on equitable growth and not the disparity we see today between the rich and the poor”
The growth of emerging Asian economies should be achieved in a sustainable manner, writes Choudhury. Image: Flickr/Selamat Made
Sandeep Choudhury – “The Asia we want should be one based on equitable growth and not the disparity we see today between the rich and the poor”
Sandeep Choudhury 
Choudhury will be a participant at the upcoming session in the series The Asia We Want: Building Community Through Regional Cooperation. All participants were invited to share their own vision for “the Asia we want.” Two thirds of the world’s poor live in Asia. More than 850 million lack access to safe drinking water and over two billion lack access to improved sanitation. Energy demand is set to double in the coming years. Education and women’s issues remains a big concern. Already we see large parts of South East Asia and South Asia ravaged by hurricanes and floods, which has led to millions being displaced. There are other areas with droughts and food security to deal with. Ethnic and political violence has led to the creation of millions of refugees, which compounds the problem further. Set against this backdrop, it is imperative that we understand the localization of problems and come up with solutions that are inclusive as well as bottom up. Communities need to be engaged, and not in superficial ways. Time is of the essence and the bureaucracy across governments needs to streamlined for quicker delivery. The Asia we want is a coming together of modern technology to deliver last mile development as well as draw upon the ethos and traditions of the olden days. Frugal consumption patterns and community living was the norm in Asia, before massive industrialization and population growth spurred millions to migrate and clog the cities of Asia, as well as drive up unsustainable consumption and poverty levels. Asia is comprised of agrarian economies in large parts, and it would be ideal if we could go back to days of clean and sustainable land use practices. The Asia we want should be one based on equitable growth and not the disparity we see today between the rich and the poor. While the emerging economies in Asia are growing and energy demands set to rise, it is important that this growth is achieved in a sustainable manner and not the same way that we witnessed the developed world grow though the 20th century. We have to learn from our mistakes and take this next growth cycle in Asia as an opportunity to grow in a manner which is not detrimental to our existence in the future. Sandeep is a co-founder at VNV Advisory Services, responsible for the initiation and development of the climate change expertise. Session 591 - The Asia We Want: Building Community Through Regional Cooperation I - A Clean and Green Asia - is the first session of a new multi-year series held in partnership with the Japan Foundation. For more information on the Session, please click here. To keep up to date with the conversations taking place during the session on social media, follow #SGSasia.
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Xixi Chen – We need integrated, collaborative and bottom-up leadership to build a cleaner and greener Asia
Businesses and communities need support in setting their goals to reduce emissions, writes Xixi Chen
Xixi Chen – We need integrated, collaborative and bottom-up leadership to build a cleaner and greener Asia
Xixi Chen 
Chen will be a participant at the upcoming session in the series The Asia We Want: Building Community Through Regional Cooperation. All participants were invited to share their own vision for “the Asia we want.” 2015 saw the historic successful deal of the Paris Agreement, which symbolized the unanimous determination from nearly 200 countries to fight against climate change and emphasized the climate leadership of the collaboration among all countries. But 2017 has seen this leadership transformed, if not demolished. On June 1, 2017, the new administration of the United States announced that the country will withdraw from the Paris Agreement. It was a big setback for the green community. However, four days later, the CEO of Unilever made the announcement saying “we are still in,” followed by thousands of city mayors, business CEOs, and non-profit organization leaders. The decision of the president of the US did not change or stop the joint effort from a cross-section communities of the country and beyond to help reduce carbon emissions. This new rising leadership on climate change and sustainability, is different from the top-down national-level leadership we are used to seeing – it is a stronger integrated force, incorporating all kinds of bottom-up community-level efforts working together. To build a cleaner and greener Asia, this is the new leadership we need and it can help bridge us into the long-term future in the face of inevitable short-term political unitability and uncertainties in many different parts of the world. This new force of leadership on climate requires strong and effective collaboration on community level, letting leaders from cities, businesses, investors, colleges and universities, local communities, to come and work together toward the same goal: providing fresh air, clean water, safe food, affordable energy, and a healthy environment to everyone in Asia – and the world. As the Chinese philosopher Lao Tzu said “a journey of thousand miles begins with a single step.” Helping businesses and communities set their own big and achievable science-based goals on emissions reduction and sustainability is that crucial first step. Once we have the goals, we will need to overcome the communication barrier and build high-quality conversations to help us move forward together because Asian countries are so diverse in cultures and languages and the social and economic developments are uneven. Using advanced technologies to build the best-practice sharing platform can help strengthen the collaboration among our communities; if there is an innovative transportation solution in one city, how can we effectively share the solution with other cities? Regional high-impact initiatives need to be applauded and encouraged, and the resources and tools that can help maximize the impacts should be replicated and shared across industries and regions with lower cost and higher accessibility. Undoubtedly, market-based policies and innovative financing mechanisms will also help accelerate the collaboration and scale up positive results because the best environmental solutions are always strong business cases too. This is not an easy pathway and there is a lot of work need to be done along the road. But the future looks more promising and exciting because a future Asia with better networked and collaborative communities will be not only cleaner and greener, but also more resilient and prosperous. Xixi Chen is a manager at the Environmental Defense Fund based in New York with focuses on clean energy, green supply chain, and corporate partnerships. Session 591 - The Asia We Want: Building Community Through Regional Cooperation I - A Clean and Green Asia - is the first session of a new multi-year series held in partnership with the Japan Foundation. For more information on the Session, please click here. To keep up to date with the conversations taking place during the session on social media, follow #SGSasia.
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Wilson John Barbon – Disasters are not natural phenomena but are the result of human and social conditions
Natural disasters, including the possible eruption of Mt. Agung in Bali, are first and for most social development issues, writes Wilson John Barbon
Wilson John Barbon – Disasters are not natural phenomena but are the result of human and social conditions
Wilson John Barbon 
Barbon will be a participant at the upcoming session in the series The Asia We Want: Building Community Through Regional Cooperation. All participants were invited to share their vision for “the Asia we want.” The imminent eruption of Mt. Agung in the tourist island of Bali, Indonesia has filled the news in Asia. A number of countries have already issued travel warnings for the island. But despite all of these warnings, I still flew into Bali at the beginning of October together with the hundreds of tourists. It seems like despite all the ominous news both (real and fake) in social media, Bali still enjoys 95 percent occupancy. I was in Bali to facilitate two events related to disaster risk reduction (DRR); namely a two-day orientation on community-managed DRR for a number of local community-based organizations (CBO) from Timor Leste; and a learning conference on the role of local leadership in building disaster resilience in Indonesia and Timor Leste. I thought to myself this is an opportune time to talk about disaster resilience of local communities within the shadows of a possible eruption of Mt. Agung. On the first day of my interaction with CBO leaders from Timor Leste, I had just two key messages for them about building people’s resilience against disasters and climate change. The first message I always teach is: disasters are not natural phenomena. They are the result of human and social conditions. In the parlance of disaster risk reduction, we differentiate hazards from disasters. Hazards are the events (both natural and human acts) that have the potential to create serious disruption in the way of life of people and their communities. These disruptions we refer to as disasters. How people are affected is a result of human and social conditions. Then the second message I teach is: resilience building starts with changing the mindsets of individual people. It’s about shifting to a new way of looking at our development challenges. A resilience mindset is having the ability to be aware of and to understand the hazards that we are exposed to; it is about having the ability to calibrate one’s exposure and vulnerability to these hazards; and finally, it is the ability to determine and act on building coping capacities to better survive and bounce back quickly from these hazards. Therefore, building community resilience is a process of capacity development. Resilience cannot be just handed over to communities. Communities, through their local leadership, have to build their own resilience. I call on development players to shift towards a mindset that disasters are social development issues; that individuals and communities have the ability to choose whether they will be a disaster victim or a survivor. Secondly, I call on local communities that they should continue to organize, mobilize and innovate to address the social, economic and political root causes of disaster risks. And I believe local leadership plays a big role. While Mt. Agung looms in the backdrop of our event in Bali, I hope that the voices we gathered and the relationships built among local leaders will start the ripple towards building a more resilient Asia. Wilson John Barbon is currently the Country Program Coordinator for Myanmar tasked with leading the establishment of the International Institute of Rural Reconstruction (IIRR) presence in Myanmar.  Session 591 - The Asia We Want: Building Community Through Regional Cooperation I - A Clean and Green Asia - is the first session of a new multi-year series held in partnership with the Japan Foundation. For more information on the Session, please click here. To keep up to date with the conversations taking place during the session on social media, follow #SGSasia.
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Marifrance Avila – “For us to achieve the Asia that we want, we need to start with achieving the country that we want”
Marifrance Avila – “For us to achieve the Asia that we want, we need to start with achieving the country that we want”
Marifrance R. Avila 
Avila will be a participant at the upcoming session in the series The Asia We Want: Building Community Through Regional Cooperation. All participants were invited to share their vision for “the Asia we want.” The Philippines is an archipelagic country endowed with both mineral and natural resources that have the potential to meet the basic needs of the people and to support a far more prosperous and equitable society – if it were not for the historical confluence of different factors: a legacy of colonial plunder and its current-day forms, the inability to address the roots of the worsening global climate crisis, and the failure of governance to address the ecological and socio-economic realities of our times. This is not only a reflection of my own country but more of a picture of the Asia we are. Asia is a rich continent not only of its natural resources but of its people and its culture. The Asia we dream of is a haven of cultural integration, a venue for intellectual discourse, a place of economic progress, climate resilience and a green Asia. However, this vision is not something we can achieve in a blink of an eye. This involves hard work, dedication, and collaboration. In my country, we are keen to address issues of the environment. In Makati City, for example, we make sure that economic advancement does not derail our efforts to protect the environment we live in. Makati, as a highly-urbanized city, focuses on managing its greenhouse gas (GHG) emissions. The GHG Management Plan allows the city government to analyze the emissions produced within its geographic boundary and to identify appropriate climate change mitigation options through policies and programs. Using the inventory report as a backbone for a scientific baseline analysis of trends in GHG emissions, the plan serves as Makati City’s blueprint for climate change actions. This is just one of the initiatives that we can impart to our neighboring countries in Asia. For us to achieve the Asia that we want, we need to start with achieving the country that we want. We need to make sure that where we live is a sanctuary not just for its people and culture, but also for our floras and faunas; a country where people are sensitive not only to their own needs but also to the needs of their surroundings. As Barry Commoner said: “The first Law of Ecology: Everything is connected to everything else.” We are but one in this world, interconnected and intertwined. What we do in our own country will ripple and multiply. This is how we can realize the country we dream of – and the Asia we want. Marifrance R. Avila is currently the focal person for both climate change and water and the pollution section of the pollution control and regulation division of the city of Makati, the Philippines. Session 591 - The Asia We Want: Building Community Through Regional Cooperation I - A Clean and Green Asia - is the first session of a new multi-year series held in partnership with the Japan Foundation. For more information on the Session, please click here. To keep up to date with the conversations taking place during the session on social media, follow #SGSasia.
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