International cooperation is difficult but necessary to address global health issues. It requires overcoming barriers between nations like language and wealth differences, and between individuals with differing worldviews. Cooperation is achievable through open dialogue to reconcile different interests and find equitable, win-win solutions. Global forums could further cooperation by debating and designing reforms to reduce misleading health information.

1. International Cooperation Dr Peter R Mansfield OAM BMBS GP Director, Healthy Skepticism Inc

2. 2 “What is simple is false, but what is not is useless.” - Paul Valery

3. A system problem “Put a good person in a bad system, and the system wins, no contest.” - W. Edward Demings 3

4. Complain or walk away Barlow J, Møller C. A complaint is a gift. Using customer feedback as a strategic tool. Berrett-Koehler Publishers. San Francisco 1996 “When customers feel dissatisfied with products and services, they have two options: they can say something or they can walk away. If they walk away, they give organizations virtually no opportunity to fix their dissatisfaction.

5. A complaint is a gift Complaining customers are still talking with us, giving us an opportunity to return them to a state of satisfaction so they will be more likely to buy from us again. So as much as we might not like to receive negative feedback, customers who complain are giving us a gift.”

6. Global problems require global cooperation

7. Healthy Skepticism Inc Main aim: To improve health by reducing harm from misleading health information Everyone who supports our aims is welcome to become a HS member

8. Selling vs. marketing Kotler P, Armstrong G. Principles of Marketing 8th Edn. Prentice Hall NJ 1999

9. If you want to go fast go alone, if you want to go far go together

10. Diffusion of innovation

11. Barriers to cooperation between nations Language Culture Time zone Unequal wealth

12. Barriers to cooperation between people World view / tolerance levels Externalities Unquestioned assumptions illusion of control Communication preferences Under/Over-confidence, Optimism/Pessimism

13. Barriers to cooperation between people Oversimplification of others’ views Acceptance of responsibility Expectation levels Width of focus

14. The blind people and the elephant

15. Balance information and action Paulo Freire

16. Group stages Situational leadership Forming Storming Norming Performing Telling Selling Participating Delegating Tuckman – Hersey and Blanchard

18. Actor-Network Theory Translation = innovators try to create a forum Stages: Problematisation Interessement Enrolment Mobilization of allies

19. Effectiveness “effectiveness at enrolling others to one’s projects is a more important determinant of the effective exercise of power than resources possessed. Those who exercise the greatest power are those who enrol many others with more resources and authority than themselves, and, more importantly, those who enrol others who are even better at enrolling others than themselves.” Braithwaite J, Drahos P. Global business regulation. Cambridge University Press 2000

20. How to achieve cooperation re hotel keys

21. 21 Regulatory pyramid Cause of non-compliance Regulatory response Unable Remove Profit seeking Costs Education / Restorative justice Lacks understanding Notification Lacks knowledge but virtuous Modified from Braithwaite J. Restorative Justice and Responsive regulation. Oxford: Oxford University Press 2002

23. Win - Lose Dr Alfredo Bengzon, former Minister of Health for the Philippines, First International Conference on Improving the Use of Medicines, Chiang Mai 1997 “Considering the wide variety of stakeholders involved and the wide variety of their interests, it seems inevitable that there will be winners and losers. Yet that is exactly what we must avoid, because, like the systems of the human body, the systems of the body politic remain deeply connected, even as their interests appear to be at cross-purposes.

24. Win - Win What we must instead strive for is therefore a win-win situation, one where all positions are advanced, not necessarily equally so, but certainly equitably so. Through open, honest, thoughtful and productive development dialogue, we must direct our efforts at reconciling private gain with public good, professional pride with patient welfare, science with value. Only this objective will sustain the interest of the whole.”

25. Guardian vs. Trader ethics Jane Jacobs. Systems of Survival: A Dialogue on the Moral Foundations of Commerce and Politics 1992

26. Guardian Trader Shun trading Exert prowess Be obedient and disciplined Adhere to tradition Respect hierarchy Be loyal Take vengeance Deceive for the sake of the task Shun force Compete Be efficient Be open to inventiveness and novelty Use initiative and enterprise Come to voluntary agreements Respect contracts Dissent for the sake of the task

27. Guardian Trader Make rich use of leisure Be ostentatious Dispense largesse Be exclusive Show fortitude Be fatalistic Treasure honor Be industrious Be thrifty Invest for productive purposes Collaborate easily with strangers and aliens Promote comfort and convenience Be optimistic Be honest

29. Groupthink Daniel Goleman. Vital Lies Simple Truths. The psychology of self-deception. 1985 Bloomsbury London 1997 The impulse to obscure dark facts, we have seen, comes from the need to preserve the integrity of the self, whether individual or shared. A group may implicitly demand of its members that they sacrifice the truth to preserve an illusion.

30. Strangers are a threat Thus the stranger stands as a potential threat to the members of a group, even though he may threaten them only with the truth. For if that truth is of the sort that undermines shared illusions, to speak it is to betray the group.

31. Strangers are an opportunity Still the truth-teller may fill the quintessential modern need. We live in an age when information has taken on an import unparalleled in history; sound information have become the most prized of commodities. In the realm of information, truth is the best of goods.

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33. Conclusion: International cooperation is difficult and slow but is achievable and necessary. Recommendation: Further development of cooperative global forums to debate, design and promote reforms addressing the causes of misleading health information.