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

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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Dr Stephen Connor - Do you know how to access palliative care when you need it?
As part of the Salzburg Questions Twitter campaign, people were asked, "Do you how to access palliative care when you need it?"
Dr Stephen Connor - Do you know how to access palliative care when you need it?
Stephen Connor 

This article first appeared on the EAPC blog, which will continue to publish more posts on the Salzburg Question series. It refers to the eighth Salzburg Question: Do you know how to access palliative care when you need it?

Dr Stephen Connor, Executive Director of the Worldwide Hospice Palliative Care Alliance, London England, explores the eighth question in the Salzburg Questions series, that encourages a global discussion about the key issues affecting palliative care.

The benefits of palliative care, and particularly early palliative care, for life-limiting illness, have been demonstrated but do most people know how to access palliative care when they need it?

The data suggest not. The World Health Organization and WHPCA Global Atlas of Palliative Care at the End of Life reports that while 40 million people need palliative care annually, including 20 million at the end of life, only 14 per cent of that need is being met at the end of life, and less than 10 per cent overall. Less than one per cent of children who need it are receiving palliative care.

In only 20 countries is palliative care well integrated into the healthcare system, while 78 per cent of those needing palliative care live in low- and middle-income countries with weak health systems.

The theme of this year’s World Hospice and Palliative Care Day is: Universal Health Coverage and Palliative Care: Don’t leave those suffering behind!

This draws attention to the fact that palliative care is an essential and needed service and a defining feature of Universal Health Coverage It is impossible to have Universal Health Coverage (UHC) without universal coverage of palliative care.

So what exactly does UHC entail? Universal Health Coverage means that: ALL people can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship.

Food distribution programme by WHPCA partner, the Centre for Palliative Care, in Korail slum, Dhaka, Bangladesh.

Central to UHC is a focus on equity: ALL people must be able to access these services. Equally important is the provision that seeking these services must not expose people and families to financial hardship or force them into poverty through paying for expensive treatments, travel to services or through loss of income by the person who is ill or their carers.

The sub-themes of World Hospice and Palliative Care Day are: Count, Care and Cost. These speak to the three dimensions that must be taken into account to realise UHC including palliative care: Political and population (count) – Who needs palliative care and who is covered?; Health services (care) – Which services are covered?; and Economics and financial protection (cost) – Who will pay for palliative care as part of UHC and how will they do this?

UHC is a target under Sustainable Development Goal (SDG) #3: Good Health and Wellbeing. There is currently great political momentum around the SDGs.

It is essential to keep palliative care at the forefront of these discussions so that as UHC is realised, anyone who needs palliative care will know what it is, how it could help, and how they or their loved ones could access it if they need it.

Do you know how to access palliative care when you need it?

Tweet your answer to #allmylifeQs.

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Eighth Salzburg Question to be launched ahead of World Hospice and Palliative Care Day
Stephen Connor speaking at Session 562 - Rethinking Care: Toward the End of Life.
Eighth Salzburg Question to be launched ahead of World Hospice and Palliative Care Day
Salzburg Global Seminar 

People around the world will be tested on their knowledge of how to access palliative care as part of the next Salzburg Question.

The eighth question in the Twitter series will be launched on Friday, October 13, the day before World Hospice and Palliative Care Day.

The Salzburg Questions series started earlier this year to kick-start an online conversation about end of life care.

The campaign has connected people from all around the world and has resulted in significant discussion online.

Those who have participated in the conversation so far have been using the #allmylifeQs hashtag.

Between the launch of the series on February 20 and October 9, the hashtag had received 9.63 million impressions and was used in more than 2,800 tweets.

The eighth question in the series is being released ahead of World Hospice and Palliative Care Day.

October’s question is – Do you know how to access palliative care when you need it?

Stephen Connor, executive director of the Worldwide Hospice Palliative Care Alliance, 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, and Bruce Chernof.

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 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

13 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

*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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Bruce Chernof - When the time comes to tell our story, what will we see?
Bruce Chernof - When the time comes to tell our story, what will we see?
Bruce Chernof 

This article first appeared on the EAPC blog, which will continue to publish more posts on the Salzburg Question series. It refers to the seventh Salzburg Question: Doctors, nurses; do you want to die the way your patients die?

Today, on International Right to Know Day (28 September) Dr Bruce Chernof, President and Chief Executive Officer of The SCAN Foundation, California, USA, explores the seventh question in the Salzburg Questions that asks: Doctors, nurses; do you want to die the way your patients die?

Around the world, healthcare providers are trained to be objective, rational, and clinical at the bedside. Long white coat, white dress, white smock, maybe a white hat – they are just signifiers, tropes, costumes in a performance, where we are the ‘good guys’ here to right wrongs and cure the sick. And of course, following the Hippocratic Oath: ‘First, do no harm.’ So this is what we do, day in, day out, with dedication and compassion, but always through that dispassionate clinical lens. Until . . .

When the tables are turned, and the provider is the patient, what seemed like an uplifting virtuous drama reads much more like a comedy, or worse, a tragedy. It is time for all healthcare providers to take a deep, introspective look at our practice. Are we caring for the whole person or simply going about the business of treating patients? Despite all of our progress to transform healthcare delivery to make it more holistic, it remains utterly biased toward the antiseptic and technical aspects of treating patients. Healthcare prioritizes safety and cure above all else, yet in our own lives we are far more likely to prioritize autonomy, dignity, and happiness. We have an enormous number of technical measures to track the quality of medical services, yet almost no measures for quality of compassion or respect. All healthcare providers secretly pray for quality of life for ourselves, balanced with technical quality of care. So here is the little secret I have learned over three decades: all our patients want the exact same thing.

We need to break the bonds both of incrementalism and lofty strategic planning that seem to be the brick walls and iron bars that serve as our stage’s proscenium and backdrop. Endless, minute Plan-Do-Study-Act cycles, policy reforms for one more new payment code, or dramatic 10-year global targets may be part of the solution, but these are not the answer.

We need to commit to delivering care to every person and every family exactly as we would want to be treated. For as we all know, autonomy and dignity are not delivered through the sharp prick of an IV catheter or a light blue gown that doesn’t quite close completely at the back. When the time comes to tell our story, what will we see? Virtuous drama with an uplifting ending? Comedy of errors? Or simple tragedy? The choice is ours.

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