Presentation for the Associação de Estudantes da Escola Nacional de Saúde Pública da Universidade NOVA de Lisboa (AEENSP_NOVA) April 20th 2021 210420 long version middleton j aeensp

1. Professor John Middleton
President, Association of Schools of Public Health in the
European Region
Planning for an outbreak of health

2. What is ASPHER ?
The Association of Schools of Public Health in the European Region
(ASPHER) is the key independent European organisation dedicated to
strengthening the role of public health by improving education and
training of public health professionals for both practice and research.
We have 120 member schools of public health in Europe and
associates globally.
We are developing our partnerships with sister public health
organisations in America, Africa, Asia, Australasia and the Arab
world

3. Public health is :
The science and art of promoting health and wellbeing,
preventing disease and prolonging life through the organised
efforts of society
Acheson 1988, after Winslow 1920, WHO 1948

4. What is public health?
The public’s health
And
The public system, services and profession

5. The public’s health
There’s never been a
better, or more
necessary, time to be
in public health

6. 6
23/04/2021
The public’s health: global burden
of disease, corporate anti-health
interest,

7. Globally, mortality rates have decreased across all age groups over the
past five decades, with the largest improvements occurring among
children younger than 5 years. However, at the national level,
considerable heterogeneity remains in terms of both level and rate of
changes in age-specific mortality; increases in mortality for certain age
groups occurred in some locations.
Countries have saved more lives over the past decade, especially among
children under age 5, but persistent health problems, such as obesity,
conflict, and mental illness, comprise a “triad of troubles,” and prevent
people from living long, healthy lives.
Total deaths in children younger than 5 years decreased from 1970 to
2016, and slower decreases occurred at ages 5–24 years. By contrast,
numbers of adult deaths increased in each 5-year age bracket above the
age of 25 years.
Global burden of disease study, 2017

8. Global burden of disease deaths- Portugal

9. Burden of disease attributable to 20 leading risk factors in 2010
expressed as a percentage of global disability-adjusted life-years
Global Burden of Disease Group. www.thelancet.com 2012 380 2245
Diet ≈ 40%

10. These 10 Corporations Control Almost Everything We Eat

11. http://www.bmj.com/content/358/bmj.j4443?sso=

12. 12
23/04/2021
Violence, conflict and public
health at home and abroad

13. The epidemiology of violence
Evidence-based violence prevention: a life course
approach
Asset based community development
Primary, secondary &tertiary prevention role of the
public health community as primary preventers of violent conflict,
through healthy public policies and tackling major social inequalities in
health; and as early reactors, mitigaters and responders to violence.
New public mental health approaches
A role for public health in conflict resolution with
aid agencies, political scientists, theologians and international lawyers
A role for public health educational bodies
A leadership and partnership role for public
health
www.fph.org.uk/uploads/Violence%20report.pdf
Areas of action for the public health
community in preventing violence

14. Interconnectedness:
conflict over natural
resources: oil, water

15. Interconnectness: Loss of agricultural land through global
warming, crop failure, food riots, Arab Spring, Syrian war

16. 16
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Planetary health: environment, loss of
biodiversity, food and ecosystems balance,
climate change.

17. A role for our climate
change special
interest group

19. •
19
23/04/2021

20. 20
23/04/2021

24. Coccolithophore (diatom): Produces 50% of the
world’s oxygen
Algal blooms photosynthesising off
south west coast of Wales

25. Climate
breakdown
is here
now!- 1 fire

26. • Climate breakdown is
here now!- 2 floods
Indonesia
floods
Climate
breakdown is here
now!- 2 floods

27. Climate
breakdown
is here
now!- 3
marine life
extinction

29. 23/04/2021 29

30. Austerity kills
Climate breakdown
Service cuts
Brexiting health
A manifesto for health, J Middleton November 28th 2019

36. 36
23/04/2021
The COVID-19 pandemic

37. John Middleton [lecture title]
[date]
Global governance
for health

40. 23/04/2021 40

41. 23/04/2021 41

43. 23/04/2021 43

44. 23/04/2021 44

45. 23/04/2021 45
ASPHER COVID-19 task force
Members in 30 countries
Actions:
• Reports on testing
• Masks
• Inequalities
• Second wave and winter planning
• How to count illness
• Basic terms of inequalities in health
• Herd immunity
• Five vaccination statements including the latest
Vaccine internationalism, vaccine passports and
vaccine diplomacy
https://www.aspher.org
/covid-19-task-
force.html

46. 23/04/2021 46
ASPHER COVID-19 task force
Actions :
Public health service functions :
• Contracts with European Health surveillance centre
ECDC for reviewing competencies in infectious
diseases, and vaccinology.
• Young professionals training and project work
• A survey of the work of our member schools in the
pandemic
• Surveys of actions by our schools in delivering teaching,
in person or remotely
• Papers on the erosion of public health
• Support statements for the role of WHO
https://www.aspher.org
/covid-19-task-
force.html

47. John Middleton [lecture title]
[date]
https://www.aspher.org/d
ownload/413/aspher_stat
ement_on_the_strategic_
use_of_masks.pdf

48. John Middleton [lecture title]
[date]
https://www.aspher.or
g/download/421/asph
er_statement_on_the_
covid-19_testing.pdf

50. The new
Global
Network for
Academic
Public
Health- and
our
statement
regarding
the role of
WHO
https://s3.amazonaws.com/ASPPH_Media_Files/Docs/Global+Network+WHO+Statement.pdf

52. Vaccination

54. Planning for an outbreak of
health:
ASPHER’s next project : we
want your ideas

55. Planning for an outbreak of
health:
The public health system,
services and profession

56. https://epha.org/public-
health-must-be-
strengthened-for-a-
healthy-post-covid-world/
Global governance for health

57. John Middleton:Planning for an outbreak of health

59. John Middleton:Planning for an outbreak of health

60. John Middleton:Planning for an outbreak of health
Renew the mandate of the UN and
WHO in globsal health governance
The new Treaty for pandemic
preparedness
Governance
Transparency and information
sharing
Resources and capacity
New continental/WHO regional
structures with response capacity
Ceded authority to supranational
structures

61. John Middleton: Planning for an outbreak of health
Planning for an
outbreak of health:
The public’s health

62. John Middleton [lecture title]
[date]
Upsides
of
lockdown
1 :
Decline in
air
pollution

63. Upsides in
lockdown 2:
interest in
more active
travel

64. uild back
etter?

65. ‘Build back’ ?
Working practices and relationships ?
Reducing inequalities? Minorities?
Vulnerable groups? Women? Older
people?

66. John Middleton:Planning for an outbreak of health
https://www.health.org.uk/sites/default/files/upl
oad/publications/2020/Build-back-fairer-the-
COVID-19-Marmot-review.pdf
Build back
Fairer?

67. John Middleton:Planning for an outbreak of health
Build back
Fairer?
The richest billionaires could
give $139,300,000,000 away
and still be as rich as they
were in 2020. These
billionaires could end global
hunger for about $300 billion.
A fraction of their overall
wealth.

68. ‘Build
back’?

69. ‘Build back’ ?

70. ‘Build back’ ?

71. ‘Build back’ ?

72. ‘Build back’ ?
To what austerity, poverty and
unfairness? Environmental squalor and
health and wealth for some?
Plan for an outbreak of health….

73. William Beveridge designed a welfare state
for the UK in the deepest point of the
Second World War.
‘We should regard want,
idleness , ignorance, squalor
and disease as enemies of us
all. That is the meaning of a
social conscience; that we
refuse to make our separate
peace with evil.’

74. Thank you
John Middleton,
President
Association of Schools of Public Health
In the European Region
John.middleton@aspher.org