Health » Overview

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

Sixth Salzburg Question launches on World Population Day
Sixth Salzburg Question launches on World Population Day
Oscar Tollast 
People around the world are being asked to consider a new talking point as part of a global discussion on end of life care. Earlier today, the sixth question in the Salzburg Questions series was launched to coincide with World Population Day. The online series has been engaging people in conversation on Twitter since February 20 about issues surrounding palliative care. July’s question is, “How and what do you measure to ensure quality palliative & EOL care?” Richard Harding, reader in palliative care and director of global programmes and partnerships at Cicely Saunders Institute, King’s College London, marked the start of a discussion with a blog entry. Each question in the Salzburg Questions series is launched on an international day of observation and led by people with expertise in the field of palliative care. These people were involved in a Salzburg Global session in December: Rethinking Care Toward the End of Life. To keep track of the conversations taking place, participants are asked to use the #allmylifeQs hashtag. At the time of writing, the #allmylifeQs hashtag has generated more than 8.65 million impressions on Twitter. There have been 2,551 tweets involving 500 participants from around the world. Salzburg Global is encouraging as many Fellows as possible to join in with this conversation today and for the rest of the month.  People are also encouraged to write blogs, which could be hosted on ehospice; the European Association for Palliative Care (EAPC) blog; Palliverse; and the International Association for Hospice and Palliative Care (IAHPC) newsletter. Vlogs are also welcome and should be sent to katie.witcombe@kcl.ac.uk so they can be posted to a dedicated YouTube channel. Please join in the conversation and remember to use the hashtag #allmylifeQs. 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 discussions 20 February 2017 - World Day of Social Justice - Why aren't countries accountable to commitment on #EOL care for vulnerable people? - Agnes Binagwaho 20 March 2017 - World Happiness Day - Is dying well as important as living well? - Lynna Chandra 07 April 2017 - World Health Day - How have you prepared for your death? - Suresh Kumar 15 May 2017 - World Family Day - Will caring for your dying loved one bankrupt you emotionally and financially? - Sheila Payne 20 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 Luyirika 11 July 2017 - World Population Day - How and what do you measure to ensure quality palliative & EOL care? - Richard Harding 28 September 2017 - International Right to Know Day - Doctors, Nurses, do you want to die the way your patients die? - Bruce Chernof 14 October 2017 - World Hospice and Palliative Care Day - Do you know how to access #palliative care when you need it? - Stephen Connor 10 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  
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145 countries signed the 1951 UN Refugee Convention - Why do refugees have limited access to quality health care and end-of-life care?
145 countries signed the 1951 UN Refugee Convention - Why do refugees have limited access to quality health care and end-of-life care?
Dr Emmanuel Luyirika and Shelley Enarson 
This article first appeared on the EAPC blog, which will continue to publish more posts on the Salzburg Question series. It refers to the fifth Salzburg Question: One hundred and forty-five countries signed the 1951 Refugee Convention - Why do refugees have limited access to quality health care and end-of-life care? Continuing the Salzburg Questions series that encourages a global discussion about the key issues affecting palliative care. On World Refugee Day today, 20 June, Dr Emmanuel Luyirika, Executive Director, and Shelley Enarson, Communications Consultant, both of the African Palliative Care Association, explore the fourth question in the Salzburg Questions that asks why refugees have limited access to quality health care and end-of-life care. The refugee crisis is reaching epidemic proportions globally with cross-border migration from countries in the Middle East, North and West Africa – especially Syria, Libya, Afghanistan, Nigeria, Gambia – and other refugees from the region entering Europe. In Africa, the situation is no better. During the month of May, Uganda received 2,000 refugees daily from South Sudan, and currently hosts about 1.2 million refugees from across the continent – making it the third highest refugee host country in the world. This is happening in a country where the health system already falls short of meeting the needs of its citizens, with palliative care coverage still low. Other refugee host countries are facing similar challenges across Europe, Africa, Asia, and South America, as well as other regions of the world. Influxes of refugees in some of the lesser-developed regions, such as Africa, are transitioning to neighbouring countries where healthcare systems are not well developed and are struggling to meet the need of their national citizens. The addition of refugee populations stretches these systems to near-breaking points within a context of already limited resources allocated to health services. Refugees often find it easier to move to less developed countries because of limited immigration controls. More developed countries with more robust health systems are often more stringent in allowing in refugees, which keeps most refugee resettlement within lesser-developed countries. This exposes refugees to healthcare services that are often not able to offer comprehensive care, including palliative care. As a way of solving this problem, the UNHCR (UN Refugee Agency) donor countries and organisations working in refugee situations should ensure that palliative care is included in all emergency responses to limit the suffering that refugees with palliative care needs experience. Core to palliative care inclusion in emergency response services is a move towards the inclusion of palliative care into the Sphere Handbook, which serves as the gold standard for complex humanitarian emergency interventions. This Humanitarian Charter is regarded by implementing agencies, as well as bilateral and multilateral donors, as the “ethical and legal backdrop to protection principles” of refugees and other vulnerable populations (The Sphere Project, p. 6). The inclusion of palliative care is included in a first phase of open online public consultation until 30 June 2017. An inclusion of palliative care into the Sphere Standards could ideally lead to a broader allocation of palliative care funding as a mainstreamed priority in complex humanitarian emergencies globally. Such a move would not only lead to an expansion of palliative care services as part of UHC objectives, it would also ensure its services and ethos impacts communities in situations of dire need, with lesser infringement on resource strapped health systems.
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Fifth Salzburg Question launches on World Refugee Day
Fifth Salzburg Question launches on World Refugee Day
Oscar Tollast 
An online conversation on care toward the end of life has asked participants to consider the standard of care available to refugees. Earlier today, the fifth question in the Salzburg Question series was launched to coincide with World Refugee Day. The online series has been engaging people in conversation since February 20 about issues surrounding palliative care. Participants have been using the #allmylifeQs hashtag to connect with one another. June's question is, "145 countries signed the 1951 UN Refugee Convention - why do refugees have limited access to quality health care and #EOL care?" Emmanuel Luyirika, executive director of the African Palliative Care Association (APCA), has helped launch the discussion. Each question in the Salzburg Questions series is launched on an international day of observation and led by people with expertise in the field of palliative care. These people were involved in a Salzburg Global session in December: Rethinking Care Toward the End of Life. May's question was launched by Sheila Payne, an influential leader in promoting multidisciplinary work in palliative care. She asked, “Will caring for your dying loved one bankrupt you emotionally and financially?” In response to this question, Payne summarized her thoughts in a post for the EAPC blog. At the time of writing, the #allmylifeQs hashtag has generated more than 8.3 million impressions on Twitter. There have been 2,416 tweets involving 475 participants from across the world. Salzburg Global is encouraging as many Fellows as possible to join in with this conversation today and for the rest of the month.  People are also encouraged to write blogs, which could be hosted on ehospice; the European Association for Palliative Care (EAPC) blog; Palliverse; and the International Association for Hospice and Palliative Care (IAHPC) newsletter. Vlogs are also welcome and should be sent to katie.witcombe@kcl.ac.uk so they can be posted to a dedicated YouTube channel. Please join in the conversation and remember to use the hashtag #allmylifeQs. 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 discussions 20 February 2017 - World Day of Social Justice - Why aren't countries accountable to commitment on #EOL care for vulnerable people? - Agnes Binagwaho 20 March 2017 - World Happiness Day - Is dying well as important as living well? - Lynna Chandra 07 April 2017 - World Health Day - How have you prepared for your death? - Suresh Kumar 15 May 2017 - World Family Day - Will caring for your dying loved one bankrupt you emotionally and financially? - Sheila Payne 20 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 Luyirika 17 July 2017 - World Population Day - How and what do you measure to ensure palliative & EOL care? - Richard Harding 28 September 2017 - International Right to Know Day - Doctors, Nurses, do you want to die the way your patients die? - Bruce Chernof 14 October 2017 - World Hospice and Palliative Care Day - Do you know how to access #palliative care when you need it? - Stephen Connor 10 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
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Fellows of The Child in the City - Health, Parks and Play launch Salzburg Statement
Fellows of The Child in the City - Health, Parks and Play launch Salzburg Statement
Salzburg Global Seminar 
Salzburg Global Fellows have called on leaders to ensure all children enjoy the right to safe, free play in a nature-rich space within a 10-minute walk from home. The call to action was included in a Salzburg Statement published as a result of discussions at Session 574 - The Child in the City: Health, Parks and Play. It was the third session of the Parks for the Planet Forum, which was supported by Parks Canada and Korea National Park. The Forum is held in partnership with the International Union for Conservation of Nature (IUCN). It advances work to implement the Promise of Sydney and the Sustainable Development Goals. During a five-day program held in March, 52 experts in urban planning, childhood development, conservation, environmental policy, and health considered how green spaces could better meet the needs, and be accessible for, children. Participants asked themselves what the benefits of these spaces were and how they could be maximized. They considered the implications for urban planning, design and management if the needs of the child were placed at the center. On the final day of the program, participants agreed a small working group would build on the ideas shared by producing a statement outlining a shared set of principles and recommendations. The Salzburg Statement on The Child in the City: Health, Parks and Play recommends several policies, practices and investments. It also contains eight actions which can transform cities for children. These eight actions are: Ensure children of all ages, backgrounds, income, and abilities have equitable access to nature and play regularly and in meaningful ways to promote good health and wellbeing.Embed nature in everyday places used by children, such as schools, backyards, parks, playgrounds and city streets, to make the city into a natural outdoor classroom.Involve children in designing and planning natural spaces for recreation, education, inspiration and health, to give them ownership and pride in their local communities, schools and parksBuild curiosity, wonder, and care for nature in children (for example by greening school grounds and involving children with community gardens). Protect natural features across cityscapes and create an equitably distributed network of accessible green and nature-rich spaces that all generations can reach on foot.Connect cities with the broader ecosystems in which they are embedded, creating corridors for people, plants and animals to move safely across the city and into its surroundings.Establish more urban conservation areas to increase access to nature and connect cities to the broader protected area networkWork together through cross sectoral and multi-level partnerships to build an inclusive culture of health in cities. View the Salzburg Statement on the Child in the City: Health, Parks and Play on Issuu
Download the Salzburg Statement in full by clicking here The Salzburg Global program The Child in the City: Health, Parks and Play is part of the multi-year Parks for the Planet Forum, a series held in partnership with the IUCN and Huffington Foundation. The session is being supported by Parks Canada and Korea National Park. It is being sponsored by the W.K. Kellogg Foundation. More information on the session can be found here: www.salzburgglobal.org/go/574 - You can follow all the discussions on Twitter by following the hashtag #SGSparks
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Sheila Payne - Will caring for your loved one bankrupt you emotionally and financially?
Sheila Payne - Will caring for your loved one bankrupt you emotionally and financially?
Sheila Payne 
This article first appeared on the EAPC blog, which will continue to publish more posts on the Salzburg Question series. It refers to the fourth Salzburg Question: Will caring for your dying loved one bankrupt you emotionally and financially?To mark the International Day of Families today (15 May 2017), Sheila Payne, Emeritus Professor, International Observatory on End of Life Care, Lancaster University, UK, launches the fourth of the Salzburg Global Seminar questions. Palliative care interventions have historically neglected the essential role played by family and friends in supporting people near the end of life. This is surprising since virtually all of us will at some point in our lives be, albeit unwillingly, witnesses to the final illnesses and deaths of close family members. This is therefore a common, shared global experience. But will caring for your loved one bankrupt you emotionally and financially?The answer to this question probably lies in a number of factors including your personal resilience and resources, the network of social and emotional support available to you in your extended family, community and faith group, and in the health, social care and welfare system that your country provides. For most families, facing the loss of a family member is a distressing time but is mitigated by adequate resources and support systems. However, for those with inadequate social support or networks – perhaps because they are refugees, are older people or poor, or live in countries where health care or health insurance is too expensive, or social care is not available – then facing a loved one’s end of life can be literately devastating.What can you do?There has been a growing acknowledgement of the emotional impact of witnessing the decline and death of a close relative. This is usually labelled as ‘carer burden’, which includes both the emotional impact and also the caregiving tasks involved in supporting a dying person. There are now many ‘tools’ that attempt to measure this ‘burden’ and even a few that recognise that caregiving can have both positive and negative elements. Palliative care professionals can ensure that the emotional and support needs of families are regularly assessed and addressed, before a crisis is reached.What has perhaps received less attention is the financial impact of having a dying family member within one’s family. Evidence from the USA and Australia suggests that illness and medical debts are a major reason for bankruptcies. A recent analysis of out-of-pocket expenses in the last year of life for older people in 13 European countries indicates that they ranged from two per cent to 25 per cent of median household income (Penders et al 2017). Once again, routine assessment of economic circumstances and the need for welfare support should be included within palliative care.Finally, as an international palliative care community could we be doing more to highlight the often hidden impact of the final illness on the emotional and financial welfare of family members? After the death, as we receive their gratitude and thanks for the palliative care that we provided for their loved one, do we stop to ask how they are managing? Can we be more proactive in highlighting their needs to governments and policy makers?Reference Penders YWH, Rietjens J, Albers G, Croezen S, van den Block L. Differences in out-of-pocket healthcare in the last year of life of older people in 13 European countries Palliative Medicine 2017, 31(1) 42-52 doi: 10.117/0269216316647206.
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Fourth Salzburg Question looks at emotional and financial toll of losing a loved one
Fourth Salzburg Question looks at emotional and financial toll of losing a loved one
Oscar Tollast 
An online conversation on care toward the end of life will switch its focus to the emotional, and financial toll suffered by the family and friends of a dying loved one.People taking part in the Salzburg Questions series will be posed a new question on this subject on Monday, May 15, which coincides with the International Day of Families.The Salzburg Questions series has engaged people in conversation on Twitter since February 20 with discussions related to palliative care. People taking part in the discussion use the hashtag #allmylifeQs.May’s question is, “Will caring for your dying loved one bankrupt you emotionally and financially?” Sheila Payne, an influential leader in promoting multidisciplinary work in palliative care, will help launch the discussion.Each question in the Salzburg Questions series is launched on an international day of observation and led by people with expertise in the field of palliative care. These people were involved in a Salzburg Global session in December: Rethinking Care Toward the End of Life.April’s question was launched by Dr. Suresh Kumar, a palliative care physician and health activist. He asked, “How have you prepared for your death?” This question led to several interesting responses, which Dr. Kumar summarized in a blog post for the European Association for Palliative Care (EAPC).At the time of writing, the #allmylifeQs hashtag has generated more than 7.5 million impressions on Twitter. There have been 1,895 tweets posted involving 367 participants from across the world. Salzburg Global is encouraging as many Fellows as possible to join in with this conversation on the day, beforehand, and afterward. People are also encouraged to write blogs, which could be hosted on ehospice; the European Association for Palliative Care (EAPC) blog; Palliverse; and the International Association for Hospice and Palliative Care (IAHPC) newsletter. Vlogs are also welcome and should be sent to katie.witcombe@kcl.ac.uk so they can be posted to a dedicated YouTube channel.Please join in the conversation on Monday, which coincides with the International Day of Families, and remember to use the hashtag #allmylifeQs. 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 discussions 20 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 Luyirika17 July 2017 - World Population Day - How and what do you measure to ensure 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 Chernof14 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 with advanced illness & towards the end of life? - Irene Higginson
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Sir Harry Burns – “It would be a mistake to think the health care system on its own can tackle the determinants of health”
Sir Harry Burns – “It would be a mistake to think the health care system on its own can tackle the determinants of health”
Nicole Bogart 
Members of the inaugural meeting of the Sciana network have spent days contemplating the challenges facing the health and health care systems of today, and of the future. But when theorising solutions to  these challenges, Sir Harry Burns, professor of global public health at the University of Strathclyde,  Scotland, stresses the importance of not falling victim to the belief that one grand scheme is the solution.“The way in which to change a  complex system isn’t through a  grand plan – it’s through people  examining problems, coming up with  solutions, testing those solutions, and spreading learning,” Burns says.Burns’ focus is on how societies can create overall “wellness” for  its citizens, where health is a state of physical, mental and social wellbeing, not just the absence of illness. But this approach, he explains, is one based on a series of  complex systems coming together.“It would be a mistake to think that  the health care system on its own can tackle the determinants of  health,” he says. “First of all, the  health care system tends to focus on illness, whereas wellness goes  hand-in-hand with treating illness in terms of creating a society where wellbeing is the aim.”He continues: “A society with lots of wellbeing isn’t just a society where  health is good, it’s a society where  education attainment is good, where people are engaged, where there  is a high level of social cohesion,” noting there is scientific evidence indicating this process begins with children and young people.“Children who experience difficult in  early life through parental absence,  through mental illness of parents, through poverty, will often find it  harder to learn, to behave correctly  in stressful situations,” he says. “As a result they’re more likely to  fail. So giving support to families who find themselves in difficult  circumstances is the basis of a  wellbeing society. But it doesn’t stop, it continues through life.”After spending just three days with members of Sciana, the health leaders network, Burns, whose  involvement will continue with the  network in the coming months as a senior ambassador, says he has  gained a greater insight into the way  different health care systems are financed, and how that financing  determines their functionality and  ability to change.“What I’ve heard in some systems  is finance doesn’t seem to be a  huge problem, therefore what’s the  incentive for change? Whereas in  the UK system our government has decided there is a limited amount of  money for health care, [so] we are  forced to discover new, more efficient  ways of delivering care, which is why  we focus on wellbeing as a way of  reducing the need for care.”
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