First Meeting of the Governing Board of Indian Council of Medical Research School of Public Health, Address, 27 July 2007, Chandigarh, India.

Address By Dr Samlee Plianbangchang Regional Director, WHO South-East Asia At First Meeting of the Governing Board of Indian Council of Medical Research School of Public Health Chandigarh, India 27 July 2007 First Meeting of the Governing Board of Indian Council of Medical Research School of Public Health 27 July 2007 Chandigarh, India Address By DR SAMLEE PLIANBANGCHANG REGIONAL DIRECTOR, WHO SOUTH-EAST ASIA Chairman, Dr V.I. Mathan; Professor K.K. Talwar; Professor Rajesh Kumar; Professor M.D. Gupte; Distinguished Members of the Board; Ladies and gentlemen: At the outset, I would like to thank the organizers of the meeting for inviting me to be here. I would also like to congratulate the Indian Council of Medical Research and the Postgraduate Institute of Medical Education and Research, Chandigarh, for their foresight in establishing this and other Schools of Public Health. These steps mark yet another milestone in improving and further developing public health education and research in India. All of us agree that our public health systems need to be strengthened. And for this, we need strong public health education and research. Therefore, this and other such Schools of Public Health will contribute significantly to education and research in modern public health in India. 2 The principle of classic public health is valid even today. However, due to environmental, demographic, ecological and societal changes, we are presently facing new challenges in public health. Global warming with its profound implication on health; emergence of new diseases like SARS and avian influenza; re-emerging diseases like tuberculosis and malaria, and the double burden of communicable diseases and non communicable diseases, coupled with rapid globalization and liberalization of international trade, are the situations that call for new public health strategies and approaches. Therefore, public health systems need to be critically reviewed. The short educational courses that this institute has already embarked on are important. These will form the basis for development of courses at the masters and higher-degree levels. Subjects of epidemiology, health management and health promotion are among the core disciplines of public health. The policy and strategic guidance of this distinguished Governing Board will go a long way forward in enabling this and other Schools of Public Health to contribute to the strengthening of public health systems and infrastructures in India. One may ask as to why public health systems and infrastructures need to be strengthened. At the same time, we must accept that in this part of the world, public health has never been given adequate attention. Our public health infrastructures have never been appropriately developed to tackle health challenges of the entire population. That is part of the reason why we have faced frequent outbreaks of communicable diseases, like dengue fever, Chikungunya, malaria and many more. In fact, diseases once put under control have re-emerged, like tuberculosis. And we are facing imminent devastation from new infectious agents like avian influenza. At the same time, we are yet to effectively tackle the unrelenting spread of HIV/AIDS. These and many more of such diseases need public health interventions for their effective prevention and control. The aim to attain health for all people everywhere can be achieved through reaching the unreached in order to ensure equity and social justice in access to and utilization of quality health care and services. It is here that public health measures and interventions become imperative indeed. Health for all will not be achieved without public health interventions through primary health care approach. In this connection, it must be realized that community-based health workforce constitutes the backbone for the efforts to attain health for all. Community-based 3 health workforce includes all types of community health workers and community health volunteers. These people are also another category of public health practitioners who serve the population at community and grassroots levels. Community-based health workforce needs particular attention in its development and strengthening through institutional support - the support that comes from various education and research institutions, including Schools of Public Health. And, the support from public health professionals and public health specialists produced by these Schools of Public Health. Furthermore, in today’s health development, we are emphasizing the reduction of disease burden. This is in addition to just prolonging life by preventing death and disability through institutional care and services. Reducing the disease burden can be effectively achieved only through primary prevention - prevention that focuses on health risks and determinants and which needs public health measures aimed at health promotion and disease prevention. Reduction of the disease burden can also lead to poverty reduction, especially at family and community levels. With strong institutional back-up support, public health can base its work primarily in family, community and the entire population. For public health interventions to be effective, the back-up support of education and research institutions is really indispensable. And to be effective, public health work in this context must link with the higher levels of care: primary, secondary and tertiary, through functional referral systems. Furthermore, public health interventions should be developed and implemented in the context of local ecological, environmental and epidemiological factors. A public health system is part and parcel of a country’s governance. The concrete foundation of Public Health should therefore be built within the country’s socioeconomic, cultural and political framework. Public health work is multidisciplinary and multisectoral in nature. Therefore, we need to keep in mind that it will not be possible for the health sector alone to successfully pursue the ultimate purpose of public health - to reach the unreached everywhere for the attainment of the goal of health equity and social justice, and to ensure that health becomes a fundamental right of everyone. This is how we can reach the goal of health for all, through the efforts of all people, all disciplines and all sectors. Public health measures will have to ensure the involvement of citizens from all walks of life in health development at various levels - personal, family, community and national. Moreover, public health interventions have to pay special attention to care and services for special groups of 4 population, particularly those who are poor, underserved, underprivileged, marginalized and vulnerable. The subject of public health is not new to us. Public health systems and infrastructures have been in place for a long time in this country. Therefore, the strategy to strengthen public health in India has to start from what are existing. Since India is a very big country but with very few public health institutions at the moment, there is a need to have more. This is the justification for establishing a number of Schools of Public Health in India, including this one. The world has changed a lot during the recent decades. Approaches to health development have also undergone a change. Moreover, changes are taking place in various aspects of health situations. Therefore, in order for public health to be relevant to today’s health development, the measures and interventions involved have to be critically reviewed and reoriented. We have to revisit our public health approaches with the view to ensure their efficiency and effectiveness in today’s health situations. Teaching of, and research in, Public health at various institutions will have to play a leading role in moving forward towards modern public health. This is how we can meet today’s health needs of the population at all levels, everywhere. In the process of such development, effective coordination and cooperation among concerned institutions must be ensured. We really need a strong network of public health institutions in India. At the same time, we have to campaign for greater interest, attention and commitment from governments, at both Central and state levels. Without the government’s firm will and commitment it will not be easy to move forward towards strong public health systems for the country. In addition, we should bear in mind that whatever efforts we put in today for strengthening public health infrastructures will help us achieve sustainable development in the long term. In this context, therefore, what we are doing must be institutionalized, and what is achieved from our development efforts must be sustained as part of national systems. This is one of our challenges in this very important exercise. The WHO South-East Asia Region has always accorded high priority to public health education, practice and research. In this regard, I would like to mention that a Regional 5 Conference on Public Health Education in the South-East Asia Region in the 21st Century was held in Calcutta in 1999, which led to the Calcutta Declaration. The Declaration has been used as the basis for WHO to support Member States in the Region in their efforts to strengthen Public Health. In 2004, Public Health Initiative was launched by WHO Regional Office for South-East Asia with the view to accelerate the development and strengthening of public health education and research in the Region. As a result, a network of South-East Asia Public Health Education Institutions was formed. The primary purpose of the network is to promote cooperation in public health education, training and research among concerned and related institutions, not only in the South-East Asia Region, but in other regions of WHO as well. The network which meets annually will be holding its next meeting at the Indian Institute of Health Management Research in Jaipur in September this year. I hope that all Schools of Public Health in India will attend the meeting and join the network. As I said, WHO, in South-East Asia Region, accords high priority to supporting the development and strengthening of public health in Member States. We in WHO therefore look forward to a close and productive working relationship with all Schools of Public Health in India. I am sure with unwavering determination and commitment of the Indian Council of Medical Research and Postgraduate Institute of Medical Education and Research, Chandigarh, all Schools of Public Health in India will steadily grow into full-fledged Institutions for public health education and research, to serve not only this country, but also the international community. Finally, ladies and gentlemen, I wish the distinguished Board Members all success in their noble tasks in the area of public health, and in their efforts to strengthen public health education, training and research in India. We, in WHO, look forward with optimism to the day when schools of public health in India can contribute productively to the attainment of health for all in the country. Thank you.