 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Ellen E. Rosskam, PhD, MPH, Senior Work Security Specialist, InFocus Programme on Socio-Economic Security, International Labour Office, 4, route des Morillons, Geneva, 1211, Switzerland, 41-22-799-8815, Rosskam@ilo.org
Health care systems in countries around the world are liberalizing, with various levers used to open markets to what is predominantly an American model of health care provision. National public health systems are not the vision of the liberalized model, nor is universal access to care. Privatised systems exclude significant segments of populations from access to health care, with most people unable to pay for medical treatment and medicines. In some countries, only fee-for-service hospitals may have available the necessary medicines to treat contagious, debilitating, and potentially fatal diseases, such as tuberculosis. From Africa and Asia, to eastern Europe, many public health systems are in decline, lacking in human resources and capital investment. Infectious diseases such as SARS, tuberculosis, and AIDS have gained media attention in relation to population health. But those working in the health systems are also at high risk, lacking protection from exposures, often working in conditions where the spread of infection cannot be contained. Last year alone in Ukraine, for example, there were 30,000 new cases of tuberculosis. One thousand of these cases were among health care workers.
Providing healthcare is an onerous burden in many countries, with salaries unpaid, training forgone, benefits neglected, leave cancelled. In eastern Europe, such conditions led to a sharp increase in morbidity and mortality in the 1990s. However, health care workers are dedicated professionals, working with a sense of duty and pride, often subjected to degrading, humiliating working conditions. The physical environments of many workplaces are deplorable, often dangerous.
Health care workers are being asked to make enormous changes today, often without being consulted or even properly informed. Incessant pressure to cut budgets drastically in many developing countries has taken preference over planning the best way to provide health services for everybody in a fair way, on an efficient, accessible and sustainable basis. Now is the time to do better, and to ensure that the workers labouring to provide decent health services are treated with respect and dignity. Policy recommendations to reverse current trends include a public health approach, emphasising prevention and universal access to health care, increasing investment in health care systems, and involving health workers’ voice in policy and decision-making.
Learning Objectives:
Keywords: International Public Health, Eastern Europe
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.