Case Study for THET August 2017 E-bulletin: Global Health – Thoughts and Actions from the UK
In an ever increasingly connected world, global health has both direct and indirect impacts on human health and the well-being of the planet. Local health threats can quickly become global, and global emergencies can be felt on local levels, with the sustainability of systems being pushed to their limits. Social, environmental and economic imbalances often impact those who are most disadvantaged, perpetuating inequalities within and between countries.
Wales has a long and rich history of being an outward looking nation (figure 1), whilst ensuring coherence with UK foreign affairs, international development legislation and policies, benefits to the Welsh population in the spirit of mutual respect, learning and support have been created. Notably demonstrated through the Welsh Governments’ commitment to the ‘Wales for Africa’ programme, which was launched in 2006, the programme has allowed many NHS Wales professionals to take part in international activity in lower- and middle-income country settings with grant funding through Hub Cymru Africa and the additional flexibility that NHS Wales staff are granted regarding the freedom to apply for one week of paid leave to better enable them to partake in such activity.
As a result of Welsh Governments’ document ‘Health Within and Beyond Welsh Boarders: An Enabling Framework for International Health Engagement’ (2012), the pan-Wales body the ‘International Health Coordination Centre’ (IHCC), part of Public Health Wales, was established. This enabled the development of an NHS Wales pledge to implement the Charter for International Health Partnerships in Wales in 2014.The commitment ensures Welsh NHS bodies are working to the four founding principles of the Charter; to improve organisational responsibility, reciprocal partnership working, good practice and sound governance procedures.
More recently, Wales has adopted a unique and innovative approach to addressing social, environmental, economic and cultural well-being challenges through the Well-Being of Future Generations (Wales) Act 2015 (the Act), which was developed in tandem with Agenda 2030. The Act places a statutory duty on public bodies, striving to achieve a common vision through the implementation of seven well-being goals, one of which is a ‘globally responsible Wales’ (figure 2).
Within this enabling environment, Public Health Wales has made a distinctive and varied contribution to the global health agenda, building on Wales’ rich history, international collaborations and expertise highlighted through its recently launched a long-term 10-year strategy International Health Strategy, ‘Nationally Focused, Globally Responsible’. It has a vision to become a globally responsible, world leading and inspiring public health agency, achieving a healthier, happier and fairer Wales. The strategy has three priorities and six strategic objectives to support the successful delivery of Public Health Wales’ national role, strategic priorities and well-being objectives, capitalising on international learning, innovation and research, to achieve the maximum benefit for public health policy and practice in Wales. We will also work across the NHS to develop a globally responsible workforce and support an enabling, outward looking organisational environment, with our partners and networks world-wide to strengthen Public Health Wales’ contribution to global health security and sustainable development. Organisationally we are working in collaboration with over 60 international agencies (figure 3), and examples of activity are highlighted in case studies 1 and 2.
Case Study 1: Collaboration with the Commonwealth Secretariat
Public Health Wales provides guidance on policy making, technical assistance and advisory services to members of the Commonwealth Secretariat, which works to achieve sustainable, inclusive and equitable growth. It promotes democracy, the rule of law, human rights, good governance and social and economic development. Public Health Wales has been working with the Commonwealth Secretariat on the development of guidance and policy documents, such as a Health Protection Policy and planning Toolkit and a Policy Toolkit for Preventing Interpersonal, Collective and Extremist Violence.
The purpose of the toolkit is to provide a comprehensive and practical resource for policy makers and planners responsible for strengthening regional, sub-national and global health protection as part of the overall health system. It is based on the Systems Framework for Health Policy, Commonwealth Secretariat 2016, endorsed by the Commonwealth Secretariat and is presented as the suggested framework for use across the 52 member countries, to be tailored to need identified in-country, thus enabling and empowering the coordination and organisation of individual health protection services. The tool-kit has been field-tested in Sierra Leone, providing important insights into the post-Ebola strategic planning, and a recent evaluation has demonstrated its value as a complement to the WHO Joint External Evaluation Tool.
To promote the Commonwealth Peace Building initiative, the Commonwealth Secretariat partnered with Public Health Wales to develop a policy toolkit ‘Preventing Violence, Promoting Peace – A policy tool kit for addressing interpersonal, collective and extremist violence’. The toolkit summarises evidence on the prevention of all types of violence and violent behaviours, including interpersonal violence, child maltreatment, intimate partner violence, sexual violence, elder abuse and youth violence, collective violence, including war and gang violence, and violent extremism. It focuses largely on how to prevent individuals and groups from developing violent behaviours and explores the economic benefits of this approach rather than the costly process of dealing with violence and its consequences.
Case Study 2: Multi-National Study Visit to Explore Welsh Approaches to Sustainable Development and Health Equity
Hosted by Public Health Wales in collaboration with EuroHealthNet and the WHO Regions for Health Network, the study visit brought together 21 delegates from 16 countries. The aim of the visit was to provide an opportunity to share good practice and practical approaches to linking the health and sustainable development agenda across strategic and operational contexts. Through Welsh examples and the implementation of the Well-being of Future Generations (Wales) Act 2015, as well as experience from other European regions, the study visit enhanced understanding and suggested possible approaches to translate the 2030 Agenda and other European priorities into effective action. The visit was supported by the EU programme for Employment and Social Innovation, and WHO Euro.
Policy, Research and International Development, Public Health Wales