Селин, в этом меня не обвинял даже Мегабит.
|
Селин, в этом меня не обвинял даже Мегабит.
На смёпках с 1 Израильской
Хочу переделать мир. Кто со мной?
Между прочим, когда ты рассказываешь мне о каких-то событиях из твоей жизни, я слышу только одну сторону. И тоже могу предположить, что ты каким-то образом приукрасила события. Нет, не наврала, но пересказала расставив свои акценты.
На смёпках с 1 Израильской
Хочу переделать мир. Кто со мной?
А вот она!
http://earth-chronicles.ru/news/2013-01-27-38416
На Всемирном форуме в Давосе рассматривали вопросы принудительной эвтаназии и борьбы с инопланетянам
Помимо экономических вопросов, в повестке дня Всемирного экономического форума в Давосе значатся такие темы, как неконтролируемое использование геоинженерных технологий, медицинское вмешательство в мозг человека, существование внеземных цивилизаций и продление человеческой жизни
Дискуссионная панель, которая так и называется "Х-фактор", подготовлена при поддержке общенаучного журнала "Природа" (Nature). Помимо традиционных тем - искусственное изменение климата, электронное управление лесными пожарами и развитие геоинженерии - к списку тем "Х-фактора" добавились риски искусственного продления человеческой жизни, искусственное увеличение когнитивных возможностей человека, а также угрозы, исходящие от внеземных цивилизаций.
По мнению ученых, в ближайшее время у человечества появятся медицинские препараты, которые смогут провоцировать у людей супер-способности. Поскольку сейчас ученые всего мира работают над созданием лекарств против таких заболеваний, как болезнь Альцгеймера и шизофрения, то вполне вероятно, что в ближайшем будущем появятся новые препараты по стимулированию мозговой деятельности у обычных людей. Сейчас уже существуют психостимуляторы "Риталин" и модафинил, которые активизируют когнитивную деятельность мозга человека. Но, несмотря на то, что все эти препараты создаются исключительно для людей с умственными заболеваниями, нельзя исключать, что они будут использованы здоровыми людьми, чтобы лучше запоминать информацию и показывать высокие результаты на работе или в учебе.
К тому же ученые соглашаются, что развитие супер-способностей человека возможно при помощи высокотехнологичных электронных устройств. Проведенные опыты показали, что улучшить работу мозга и память можно с помощью вживленных в человеческий организм электронных датчиков. Но такой метод технологически сложен и вряд ли будет доступен обычному человеку, в отличие от медицинских препаратов. Тем не менее ученые считают, что через десять лет нейробиология выйдет на новый уровень, тогда внутримозговые электронные датчики и сенсоры будут повсеместно распространены. Но тут ученые задаются вопросом, будет ли этически правильно делить общество на тех, кто может себе позволить улучшить работу мозга или нет, должны ли подобные препараты поступить в свободную продажу и нужна ли для этого законодательная база.
К тому же велик риск, что подобного рода разработки попадут в плохие руки и будут использоваться в корыстных целях. Воздействуя на нейромедиаторную систему мозга, они не только увеличивают человеческую память и активизируют работу мозга, но также влияют на психологическое состояние человека, делая его управляемым и уязвимым к программированию на определенные задачи. К тому же подобная технология позволяет стирать память, что может нанести непоправимый урон мозговой деятельности человека. Ученые опасаются, что препараты и технологии по увеличению когнитивной работы мозга могут попасть в распоряжение криминальных группировок или террористических организаций, которые будут использовать их против человечества.
Другая тема - возросшие проблемы из-за увеличения продолжительности жизни. Новейшие медицинские разработки позволили продлить жизнь человека на 35%. С одной стороны, это хорошо, но с другой стороны, возникает большое число проблем, например, финансовые затраты на социальные выплаты и перенаселение планеты.
Специалисты считают, что единственное решение этих проблем - принудительная эвтаназия долгожителей. Сторонники такого метода считают, что благодаря развитию медицинских технологий даже самые слабые и болезненные люди могут прожить до 90 или 100 лет. А это может привести к резкому увеличению населения планеты, к тому же это противоречит закону природы, где выживают сильнейшие. Поэтому для сокращения численности населения долгожителей стоит использовать эвтаназию, считают эксперты.
И наконец, самая неоднозначная тема дискуссии – существование внеземных цивилизаций. Многие мировые лидеры не раз делали заявления о существовании инопланетян. Так, в декабре 2012 года премьер-министр России Дмитрий Медведев в интервью журналистам пошутил на тему существования инопланетян. "Сколько их [инопланетян] среди нас я рассказывать не буду, поскольку это может вызвать панику", - шутливо заметил Медведев. Но на этом интерес к теме о существовании внеземных цивилизаций не закончился, о чем свидетельствует соответствующая дискуссия в повестке дня на форуме в Давосе.
Эксперты форума соглашаются, что в результате освоения космоса в конечном итоге человечество обнаружит существование внеземной цивилизации и откроет новые планеты. "Вероятно, через десять лет мы узнаем, что Земля не единственная планета Вселенной, на которой есть жизнь", - считают участники форума. В результате, эксперты призывают мировое сообщество готовиться к встрече с внеземной цивилизацией и оценить вероятные угрозы такой встречи. Также возникнет необходимость создания специальных служб по обнаружению внепланетных и внеземных цивилизаций, которые помогут предупредить угрозу, исходящую из космоса.
Тем не менее эксперты соглашаются, что даже если внеземная цивилизация будет обнаружена, это не сильно изменит человеческую жизнь. Несмотря на то, что это открытие станет сенсацией года, вряд ли оно моментально повлияет на жизнь на Земле. Но в долгосрочной перспективе подобное открытие изменит психологическое и философское сознание человека. "Даже открытие возможного зачатка жизни на другой планете вызовет разговоры о возможном существовании жизни во Вселенной, что в свою очередь подорвет основы философии и религии", - считают эксперты форума.
На смёпках с 1 Израильской
Хочу переделать мир. Кто со мной?
Charter for Healthy
Living
January 2013
A report from the World Economic Forum’s Healthy Living Initiative
Prepared in collaboration with Bain & Company
© World Economic Forum
2013 - All rights reserved.
No part of this publication may be reproduced or transmitted in any form or by any means,
including photocopying and recording, or by any information storage and retrieval system.
The views expressed are those of certain participants in the discussion and do not necessarily
reflect the views of all participants or of the World Economic Forum.
REF11012013
3
Charter for Healthy Living
Contents
Preface
4
Executive summary
5
Charter for Healthy Living
6
Health and Well-being: Fundamental
Socio-economic Pillars of our societies
9
Multistakeholder Action: The Only Way to
Create System-level Change
13
Charter for Healthy Living will Deliver
Multistakeholder Action
18
Appendices
20
Contributors
21
References
The World Economic Forum is pleased to present the Charter
for Healthy Living, which is the outcome of a 12-month process
engaging governments, businesses and civil society around the
world.
The Charter’s main goal is to bring together public, private and
civil society actors to deliver concrete multistakeholder actions
that enable individuals, families and communities worldwide to
lead healthy and active lives. To progress towards this goal, the
Charter outlines specific focus areas for multistakeholder action,
provides principles for building a shared mindset, leverages each
stakeholder’s core competencies and stresses the importance of
continuously monitoring and evaluating the actions implemented.
The Forum’s overall strategy for global health addresses two major
gaps: 1) enabling healthy and productive lives and access to care,
and 2) making health and healthcare an investment for economic
development and growth. Implementing the Charter for Healthy
Living addresses the first gap. To address the second gap – the
dimensions of supply and demand for health from a systems
perspective – the Forum has also facilitated strategic discussions
and country-specific workshops on how health systems could be
organized in the future to achieve sustainability.
As part of the Charter’s development, the Forum engaged over
150 leaders of government, business, civil society, international
organizations and academia in multistakeholder consultations
held in Mexico, the United States, Switzerland, Thailand and India.
Nearly 30 one-on-one executive-level interviews were conducted
with cross-sector global leaders. Through this process, the Forum
catalysed excitement in Mexico and India, which are now moving
forward with implementing collaborative actions.
An outstanding group of Forum partners and constituents
contributed tremendous leadership, technical expertise and
extensive time to this initiative through their engagement in the
Working Group and the High-level Steering Board. These advisory
groups are included in this report.
The report aims to introduce the Charter to a broader audience. It
carries the message that many public and private stakeholders are
aligned with the goal of collaborative Healthy Living actions. It also
highlights the widespread conviction among all the leaders involved
that multistakeholder efforts are the key to transforming the current
health landscape, in which non-communicable diseases are a main
source of mortality, morbidity and lost economic output.
The Forum welcomes this shared belief and is committed to
providing a neutral platform for developing and implementing such
multistakeholder actions in the coming months. I hope this Charter
will encourage many other stakeholders to initiate or participate
in joint actions to achieve our shared goal of healthy and active
individuals, families and communities worldwide.
Robert Greenhill
Managing Director
and Chief Business
Officer
World Economic
Forum
4
Charter for Healthy Living
Health defines an individual’s quality of life and impacts his
or her social and economic development, but modern-day
lifestyles challenge our health and Healthy Living. The decline in
Healthy Living has resulted in an increase in non-communicable
diseases (NCDs) – namely cardiovascular disease, cancer, type
2 diabetes, chronic obstructive pulmonary disorder and mental ill
health – which cause immense human suffering and even death.
Economically, NCDs will cause an estimated cumulative output
loss of US$ 47 trillion over the next two decades.
What if we could change the trend of Healthy Living and create
a community in which total well-being is enabled, supported and
rewarded?
In reality, encouraging Healthy Living will be challenging. Many
interconnected drivers of Healthy Living interact with each other
through a complicated network. For example, diet and access to
professional preventative and diagnostic care are highly influenced
by an individual’s environment and income. Effectively addressing
Healthy Living in a sustainable and systemic way requires
combining stakeholder efforts to enable conducive environments
for Healthy Living and drive long-term behaviour changes.
At the World Economic Forum Annual Meeting 2012 in Davos-
Klosters, global leaders called for more multistakeholder and
cross-sector action to prevent NCDs. Specifically, leaders called
for a Charter to bring together stakeholders for collaborative action
to enable Healthy Living. The Charter was developed through
extensive consultation with representatives from government,
business and civil society, and defines the mutually agreed critical
elements of success:
1.
Stakeholders take joint, concrete, economically sensible
and evidence-based multistakeholder action to promote
Healthy Living and NCD prevention and control, in which all
stakeholders leverage their core competencies to:
−
Build awareness for Healthy Living and NCD prevention and
control
−
Improve the availability of (and access to) products and
services
−
Create innovative incentives and supportive environments
−
Invest in professional capacity building
−
Advance knowledge through science and research.
Executive Summary
Healthy Living involves creating and
maintaining health: a state of complete
physical, mental and social well-being - not
merely the absence of disease or infirmity
2.
Multiple stakeholders work together effectively, transparently
and respectfully.
3.
All organizations advance their own approach to Healthy Living.
4.
Healthy Living actions are regularly monitored and evaluated.
In the coming years, the Charter will facilitate multistakeholder
action to change the course of Healthy Living. With the
commitment to monitoring, evaluation and continuous learning,
the quality and impact of multistakeholder action for Healthy
Living will set a new standard and improve the lives of millions of
people around the world. Together, stakeholders can deliver lasting
change and real health outcomes.
The Forum has begun engaging stakeholders and will continue to
on-board additional representatives in the coming months. The
Forum is seeking additional stakeholder support and opportunities
to translate the Charter into action and would like to invite all
stakeholders and sectors to embark on this journey towards
Healthy Living.
5
Charter for Healthy Living
Charter for Healthy Living
- v1.0
Committing to multistakeholder action
Health and well-being are fundamental socio-economic pillars of
all societies. Health is a basic human right and a driver of social
and economic development. While gains have been made in
worldwide health, the leading cause of death today, and for the
foreseeable future, is the rise of NCDs. NCDs challenge our social
and economic prosperity; they are expected to cause a cumulative
global output loss of US$ 47 trillion over the next two decades.
There is a moral imperative to maintain and improve the health of
societies around the world.
The time to act is now.
Healthy Living involves creating and maintaining health: a state of
complete physical, mental and social well-being – not merely the
absence of disease or infirmity. The roots of Healthy Living are
multilayered, influenced by social and environmental determinants
as well as specific risky behaviours – especially tobacco use,
unhealthy diets, harmful use of alcohol and physical inactivity. The
lack of access to basic prevention, treatment and care further
inhibits Healthy Living. All these factors are interconnected and
influence everyday decisions.
Given this complexity and interdependency, it is clear that enabling
Healthy Living is not just a health agenda, but an imperative
for all of society. To have a sustained impact, all stakeholders
should work together to build environments in which healthy
choices are the easiest choices. As acknowledged by the UN
General Assembly, all stakeholders have an important role to
play in NCD prevention and control. However, there is a clear
need to strengthen coordination across multiple stakeholders to
improve the effectiveness and impact of these efforts. The power
of concerted joint action can achieve more than the sum of its
individual components; a multistakeholder and cross-sectoral
approach is the only way to facilitate the required system-level
change.
The Vision:
−
Invest in professional capacity building
within health and
all other related sectors in order to
train the future cadre
of leaders in
Healthy Living and to serve the health-related
needs of individuals, families and communities
−
Advance knowledge through science and research
; develop
collaborative and innovative research programmes that
address the fundamental drivers of Healthy Living
2.
Multiple stakeholders work together effectively,
transparently and respectfully to:
−
Build a shared mindset and joint ownership, find common
ground, and commit to open and honest communication
and mutual trust, while building collaborative bridges and
aligning jointly defined goals
−
Recognize shared objectives and the need for a unified
community, acknowledging the specific roles and
responsibilities of each stakeholder
, all of whom bring
unique strengths and capabilities to the collaborative work:
−
Public sector
– creates supportive environments that
facilitate Healthy Living and multistakeholder action
through effective international governance, national and
local governments; use appropriate mechanisms that
enhance coherent policy-making to promote health
across ministries and agencies
−
Private sector
– builds and adapts commercial models to
support Healthy Living; creates innovative approaches to
increase the access, affordability and quality of products
and services and leverages existing networks and
organizational capabilities for multistakeholder actions
−
Civil society, including academia
–
advocates for Healthy
Living through specific outreach programmes and
grassroots mobilization; conducts research, generates
and disseminates new knowledge, and supports
monitoring activities, particularly those related to the
effectiveness and impact of multistakeholder actions
3.
All organizations advance their own approach to Healthy
Living,
playing a leadership role within
all sectors and peer
groups and:
−
Leverage core capabilities to promote and enable Healthy
Living, building on existing stakeholder Healthy Living efforts
−
Ensure high priority and appropriate resource allocation to
Healthy Living actions
−
Promote Healthy Living for employees and their families
4.
Healthy Living actions are regularly monitored and
evaluated to:
−
Ensure the independent, transparent and regular monitoring
of processes, outputs and outcomes through jointly defined
metrics, leveraging existing enablers where appropriate
−
Create effective feedback loops to ensure that actions and
impact are continuously improved upon
−
Share successful
high-impact, evidence-based Healthy
Living solutions and relevant non-proprietary data with the
broader community to help them learn from the collective
experience
Multistakeholder efforts can make major contributions to achieve
the global target of a 25% reduction in premature mortality from
NCDs by 2025. The Forum invites all stakeholders to share this
vision with us and engage on this journey of multistakeholder
action for Healthy Living.
Public, private and civil society stakeholders
working together to deliver a global paradigm
shift towards Healthy Living, creating
conducive environments and supporting
healthy, active lifestyles at individual,
community and societal levels
5
Charter for Healthy Living
A global paradigm shift towards healthy living will happen
when:
1.
Stakeholders take joint, concrete, and evidence-based
multistakeholder action to promote Healthy Living and
prevent and control NCDs. Taking actions that make
economic sense for overall society, stakeholders leverage
their core competencies to:
−
Build awareness for Healthy Living and NCD prevention
and control
by proactively supporting and implementing
health literacy campaigns, effectively marketing activities
and harnessing social media to empower decision-making,
especially within vulnerable groups
−
Improve availability of (and access to) products and
services
that support the promotion and maintenance of
Healthy Living, including the innovation and renovation of
necessary products and services
−
Create innovative incentives and supportive environments
–
aimed at individuals, communities and businesses
–
to
make healthier choices easier and sustainable
6
Charter for Healthy Living
Health and Well-being: Fundamental Socio-economic Pillars
of our societies
“The enjoyment of the highest attainable standard of health is
one of the fundamental rights of every human being without the
distinction of race, religion, political belief, economic or social
condition” (WHO, 194. With the ratification of the World Health
Organization’s constitution in 1948, governments have had a
strong mandate to support the health of their populations. At the
time, health was defined as “a state of complete physical, mental
and social well-being and not merely the absence of disease or
infirmity”, yet today, health is still too often associated only with
reacting to and treating disease.
Healthy Living involves creating and maintaining heath; it is
important because it defines individuals’ and societies’ quality of
life and has a major impact on social and economic development.
Instead of thinking about health as merely the absence of disease,
what if health could be
widely
recognized more broadly as an
optimal state of well-being? Imagine a community in which “great
health” is as important as the level of education or social status,
or where health education is as important as mathematics. In this
community, the total well-being of individuals and families would
be recognized as a priority and thus appreciated and rewarded.
Making this vision a reality will require a new way of thinking about
health – a mindset that makes “better health” prestigious and
aspirational and gives health and wellness a brand that encourages
positive behaviour (Anderson et al., 2011). Society needs to
facilitate a conversation about promoting and creating sustainable
health.
Global Healthy Living faces many challenges
For most societies, the factors that promote Healthy Living
have changed over time as social and environmental trends
have evolved and created new opportunities and challenges for
modern living. In reality, the components of Healthy Living are
highly interconnected and influence everyday decisions. Medicine
has helped treat or prevent common communicable diseases,
and access to information, professional medical advice and new
technology has helped rural and remote communities better
manage their health. However, some of the same technology has
redefined the term “social networks” during this period, and the
urban lifestyle has negatively affected levels of physical activity.
More recently, economic uncertainty has placed many families, and
even entire countries, under enormous levels of stress.
In its simplest form, three main elements influence Healthy Living:
changing global megatrends, increasing prevalence of risk factors
and rising social pressures (Figure 1).
Changing global megatrends
The global population is ageing. By 2050, 22% of the
world’s population will be over 60 years of age, compared
to 11% today (UN, 2012). The implications for Healthy Living
are evidenced by the disproportionally higher healthcare
expenditure for older age groups (OECD, 2006). Ageing, as a
megatrend, also increases the likelihood of other barriers to
Healthy Living. For example, physiological risk factors such as
obesity tend to increase with age, and typically peak at age
60-70 (Sassi et al., 2009). Certain social pressures – such as
poverty and social exclusion – also affect Healthy Living in
ageing communities (UN, 2011a).
Urbanization is another megatrend that has major implications
for Healthy Living. Urbanization encourages passive forms of
transport and thus increases physical inactivity (WHO, 2010a),
which is one of the most significant risk factors for Healthy
Living (WHO, 2012a). Rapid urbanization, particularly in low-
and middle-income countries, can also lead to greater social
pressures such as inadequate housing and limited access
to basic health infrastructure. In addition, urban air pollution
accounts for 1.2 million deaths per year (WHO, 2012a).
Figure 1. Three major barriers to Healthy Living
Source:
World Economic Forum, Bain & Company
1
MU
N
Healthy
Living
-
Poverty
and
relative
position
within
social
gradient
-
Disadvantages during early life
-
Social
exclusion
-
Rising stress levels
-
Shift in work-life balance
-
Limited access to health services and infrastructure
-
Rising
unemployment
-I
nadequate
housing
Physiological
risk
factors
-
Raised
blood pressure
-
Obesity
-
Hyperglycaemia
-
Hypercholesterolaemia
Behavioural
risk
factors
-T
obacco
use
-
Physical
inactivity
-
Harmful
use
of
alcohol
-
Unhealthy
diets
Environmental
risk
factors
-
Unhygeinic
conditions
-
Urban
outdoor air
pollution
•
Environmental
hazard
s
&
climate
change
•
Growing
middle
class
in
emerging
markets
•
Intensifying
competition
for finite
resources
•
Ageing
population
•
Rapid
unplanned
urbanization
•
Economic
instability
Growing prevalence of
risk factors
Rising
social pressures
Changing
global megatrends
B
C
A
A
13
Charter for Healthy Living
Charter for Healthy Living will Deliver Multistakeholder Action
+ 150 leaders consulted
From public sector, private sector and civil
society
30 one-on-one executive-level
interviews
With global leaders representing all stake
-
holders
Multistakeholder dialogues
in Puerto Vallarta, New York,
Bangkok, Geneva and NCR-Delhi
Facilitating collaborative relationships for
health between stakeholders and sectors
The Charter allows stakeholders to
collectively move from dialogue to action.
Therefore it has an enormous potential to
unlock the power and impact of
multistakeholder collaborations.
Julio Frenk
, Dean, Harvard School of Public Health
A group of inspired stakeholders called for a global Charter
At the World Economic Forum Annual Meeting 2012 in Davos-
Klosters, world leaders called for a coordinated response to the
Healthy Living challenge in the form of a Global Charter for Healthy
Living. The Charter aims to provide a unifying framework that will
bring together the different stakeholders to help them agree on a
common goal and highlight the importance of independent and
transparent monitoring.
With this mandate, the Forum consulted with government and
business leaders, as well as thought leaders from academia and
civil society, over the last 12 months. Leveraging existing Forum
regional sessions and creating specific meetings where necessary,
there was an extensive consultation about the Charter’s vision and
components. The Forum also established formal advisory panels
(see Contributors) to provide strategic guidance and technical input
as required.
The vision unites multiple stakeholders
Multistakeholder action is at the core of the Charter for Healthy
Living. World leaders from all stakeholder groups unanimously
called for more cross-sectoral and multistakeholder collaborations
to implement solutions for Healthy Living.
Leaders also called
for translating dialogue into
real
action with tangible health
outcomes. As captured in the Charter’s vision, this will require a
comprehensive approach to Healthy Living action – enabling both
conducive environments and encouraging individual behaviour
change.
−
Creating conducive environments
is important to support
individuals, families and communities in their daily lives and
to be healthy in the long term. For some, enjoying public
recreational space is not possible because it’s not safe or the
necessary infrastructure does not exist. For others, healthy and
affordable food options are simply not available. In 2003 the
UK government was concerned about the health implications
of the salt content in processed food products. Over the
next seven years, the government focused on reducing salt
consumption through an industry-wide reformulation initiative
(See Insert 1 for more details).
−
Individual behaviour change
is particularly hard to achieve in
the Healthy Living context. Many people around the world
know what they would like to change (e.g. lose weight or
stop smoking) but find it very hard to do so. In South Africa,
Discovery introduced a multistakeholder, health-focused
incentive programme to help encourage its members to invest
in prevention and early diagnosis to ultimately create long-term
behaviour changes (see Insert 2 for more details).
Insert 3: News-Heartfile Public Awareness Campaign
Promoting effective Healthy Living interventions in low-resource communities
Established in 1998, Heartfile is an NGO with a focus on policy analysis and innovative solutions for improving health systems in
Pakistan. The News-Heartfile public awareness campaign was launched in partnership with
The News International
, the largest-
circulating English newspaper in Pakistan, which reaches over 2.5 million readers every day. The partnership yielded 259 health and
Healthy Living-related articles in weekly instalments over a period of 130 consecutive weeks during the period February 1999 to
March 2006. The specific topics varied, but included stress and stress management, diabetes, hypercholesterolaemia, cholesterol,
depression and the harmful use of alcohol. Interim research suggested that the knowledge and attitudes of the readership base had
improved as a result of the News-Heartfile public awareness campaign (Nishtar, 2004). The sample population of a post-intervention
evaluation revealed that 93% of readers remembered having seen the News-Heartfile articles, and 87% of this group reported that the
articles significantly supplemented their knowledge about diet, with comparative rates for physical activity and smoking at 77%
and
85%, respectively. Although self-reported, the rate of behaviour change was impressive – 40% claimed some dietary changes, 39%
made changes in their levels of physical activity and 8% reduced their tobacco use.
According to research, the average cost per article was US$ 169, suggesting a highly cost-effective approach, particularly in a low-
resource setting. This multistakeholder approach, in which Heartfile and
The News International
were able to leverage their core
competencies, provided important health outcomes.
14
Charter for Healthy Living
(from left to right, top down) Margaret Hamburg, Commissioner, US Food and Drug Administration; Omar Ishrak, Chairman and CEO, Medtronic; Paul Bulcke, CEO, Nestle;
Margaret Chan, Director General, World Health Organization; Rob Flaherty, CEO, Ketchum; Muhammad Ali Pate, Minister of State for Health of Nigeria; Enrique T. Ona, Minister
of Health, Government of Philippines; Kenro Oshidari, Regional Director for Asia, United Nations World Food Programme; Malvinder Singh, Chairman, Fortis Healthcare; Helene
D. Gayle, President and CEO, CARE USA; Chris Viehbacher, CEO, Sanofi; Gunilla Carlsson, Minister for International Development Cooperation of Sweden;Pablo Kuri Morales,
Subsecretary of Prevention and Health Promotion of Mexico; Alexandre F Jetzer, Member Emeritus of the Board of Directors, Novartis International.
16
Charter for Healthy Living
Table 1: Five types of multistakeholder action identified within the Charter
Multistakeholder
action
Typical stakeholder
action
Potential multistakeholder action
Build awareness for
Healthy Living and
NCD prevention
and control
A teacher talks about the
importance of a healthy
diet and physical activity
in class
A multistakeholder school initiative implements an integrated school policy with
the following initiatives:
−
National Curriculum is changed to include more physical education
−
An online game on Healthy Living is developed through a consortium of
companies and disseminated through schools’ activities
−
School menu is changed; partner companies sponsor healthy food options
Improve availability
of (and access
to) products and
services
A local health body offers
a single free diabetes
screening event in
pharmacies
A multistakeholder initiative to enable regular diabetes screening and ensure
follow-up with diagnosed patients:
−
A local healthcare chain aligns with local governments to pool resources
and infrastructure for regular screening events and targets newly diagnosed
diabetes patients
−
An awareness campaign is implemented through social media, print, TV,
billboards, SMS, etc.
−
A telecom company provides SMS to alert all users of the diabetes
screening activities
−
Employers provide time and transportation to allow employees to take
advantage of screening service
Create innovative
incentives and
supportive
environments
A health insurer and
health provider team
up to offer discounted
prices in weight loss
programmes
A multistakeholder initiative is set up to provide a full set of incentives for healthy
weight:
−
A consortium, including retailers, restaurants and coffee shops, coordinates
purchasing efforts so they can offer cheaper healthier foods
−
Municipalities work closely with recreational community centres to offer
physical activity opportunities
−
Health providers and insurers align on incentives that reward health-
promoting behaviours
−
Municipalities require a mandatory health impact assessment as part of
urban policy design
−
A consortium of NGOs develops a “health recommended label” that
recognizes healthier products
Invest in
professional
capacity building
A university offers an
executive programme on
health promotion
The government, academia, civil society and private sector work together to:
−
Assess the needs of the regional and national workforce to support
multistakeholder collaborations for health
−
Develop a joint programme for knowledge transfer across stakeholders
−
Pool resources for national-level delivery of training
Advance knowledge
through science
and research
Government publishes
standards and health
recommendations
Multistakeholder action, including academia, patient advocacy groups, private
sector and the government, creates resources for public use:
−
Jointly build a database of best practices on Healthy Living
−
Incentives for monitoring and evaluating activities and programmes
−
Incentives for stakeholders who share their data (e.g. positions on technical
or implementation boards, staff exchange programmes)
17
Charter for Healthy Living
The Charter will catalyse concrete action
Health and Healthy Living are the world’s greatest political and
social challenges. Stakeholders need to use the Charter for
Healthy Living to act decisively to address Healthy Living and allow
health to become a driver of economic growth. In the coming
years, the Healthy Living initiative will facilitate multistakeholder
actions for which there is clear support from all stakeholders.
To help stakeholders initiate and manage multistakeholder action
for Healthy Living, the Forum and PAHO, in collaboration with Bain
& Company, have also developed a “Toolkit for Multistakeholder
Action”. The Toolkit is based on a simple six-block framework to
help collaborations structure their work. It provides step-by-step
guidelines, hands-on templates and case studies to illustrate
solutions to the core challenges of multistakeholder action (for
more details, see Appendix B).
To date, the Toolkit has been shared with representatives from all
stakeholder groups, and two opportunities for multistakeholder
action have been catalysed in Mexico and India. Interested
stakeholders are currently scoping and preparing needs
assessments to better understand the requirements for action, and
the process will move forward in 2013.
Figure 5: Six building blocks for multistakeholder action as described in the Toolkit for Multistakeholder Action
Source:
World Economic Forum, Bain & Company
To ensure progress on these diseases, we
need enlightened self-interest and
enlightened leadership. Not taking action
is morally unacceptable and economically
unsustainable.
Margaret Chan
, Director General, World Health Organization
Be part of the paradigm shift towards Healthy Living
Taking real action will require enlightened leadership that balances
short-term realities and long-term Healthy Living goals. Every
stakeholder – public sector, private sector and civil society – has an
essential role to play in creating sustainable changes to promote
Healthy Living.
In 2012, the Forum began engaging stakeholders, and in 2013 will
seek additional support and opportunities to translate the Charter
into action. The Forum would like to invite all stakeholders and
sectors to engage in our Healthy Living dialogues and embark on
this journey towards Healthy Living.
4
MU
N
Understand
Align
and
Design
Mobilize
Build
and
Train
Deliver
Evaluate
and
Sustain
2
3
4
5
6
1
-W
hat is the objective of the joint action?
-W
hat exactly are we going to do?
-W
hat is our concept?
-
How do we measure
outcomes?
-
How do we ensure lasting
impact?
-W
hat is our common vision and ambition?
-
How do we start the collaboration?
-W
ho is providing the resources?
-W
ho should be involved?
-W
hat is the stakeholder
value proposition?
-
How do we secure active
engagement?
-W
hat is our local Healthy Living situation?
-W
hich interventions are in place?
-W
hat can we learn from others?
-W
hat is our
workplan
?
-W
hat are the key implementation risks?
-
How do we communicate our successes?
18
Charter for Healthy Living
Appendix A: Examples of contributions to Healthy Living by
non-health sectors
Sector
Why and how can the sector contribute to Healthy Living?
Agriculture
The agriculture sector can be a powerful ally for Healthy Living through the promotion of healthy diets.
Aligning policies and activities, such as nutrition education, school and rooftop gardens, or promoting
urban and peri-urban agricultural projects has a huge potential to increase the consumption of fresh fruits
and vegetables and improve the quality of dietary patterns while also representing a source of income for
families. Furthermore, developing innovative ways to bring the direct and indirect outputs of the agriculture
industry directly to consumers presents a win-win situation; the industry would have increased demand,
and thus increased profit, and a larger proportion of populations would practise healthy diets. Partnerships
across non-health industries can also contribute to Healthy Living: the agriculture and the restaurant/
catering industries could, through successful collaboration, provide healthier affordable menu options.
Education and
communication
Education and communication are important to build health literacy and strengthen the population-
level knowledge on the links between everyday behaviours and health. In particular, education and
communication play important roles at all levels of Healthy Living action, from prevention to risk factor
response to healthcare treatment and rehabilitation. Aligning these sectors is particularly important for the
development of clear, accurate and consistent messages. Early education makes Healthy Living and its
values a natural part of our social culture. Social and mass media campaigns are effective and cost-efficient
methods of increasing awareness on specific risk factors and promoting health-conducive behaviours.
Accurate education in schools, communities and the workplace on health behaviours and their potential
benefits could lead to a population-level reduction in Healthy Living risk factors. Communication strategies
remind us of the need for health maintenance, and partnering with the communication sector presents
innovative opportunities to cost-effectively encourage rehabilitation and treatment through SMS and e-mail.
Infrastructure,
urban planning and
transportation
Urban planning, e.g. through community and street designs that incorporate parks, wide sidewalks and
bike lanes, can make physical activity safer and more pleasant and thus incentivize communities to be
more active with tremendous health benefits (Anderson et al., 2011). Transportation can, with traffic-
calming measures (e.g. speed bumps) and efficient public systems, also encourage physical activity and
environmental sustainability. When working in coordination with one another, the infrastructure, urban
planning and transportation sectors have the potential to logistically increase the availability of healthy
products and ease access to quality health promotion and care services.
Labour systems
Workplace health promotion programmes can promote healthy behaviours through incentives such as
workplace health screenings, promoting smoke-free workspaces or by providing healthy food options.
Employers benefit from these programmes through increased employee productivity, improved corporate
image and reduced healthcare costs. At a larger system level, healthy labour systems imply secure and
sustainable employment, which significantly impacts the well-being and health of a population. Without
secure employment, people are unable to financially support healthy diets or have sufficient time to practice
physical activity; with insufficient structures for stress management, they may pursue risky behaviours such
as the harmful use of alcohol.
Producers and
retailers
As the sector that the population perhaps most frequently comes in contact with, producers and retailers
can uniquely affect the health of a population simply through the availability and pricing of its products. Price
promotion strategies, product placement and point-of-sale information can positively influence patterns
of in-store consumer behaviour by encouraging healthier choices and healthy activities. Without healthy
food options to buy or physical activity paraphernalia, consumers can’t practice healthy diets or lifestyles.
Without access to affordable medication or health equipment, individuals are unable to proactively manage
their health.
Social welfare
systems
The illness and disability imposed by NCDs threaten the stability and sustainability of health and social
protection systems. Social issues such as poverty, employment, home and physical security have indirect,
yet powerful, implications for the capacity to practice healthy behaviours. Populations vulnerable to these
social issues will find it particularly challenging to implement health maintenance and response behaviours.
Coordinating with social welfare systems increases the available healthy options for these individuals in a
realistic form and at an affordable cost. Moreover, once individuals are affected by a chronic condition, their
ability to work can be severely reduced, while their need for social welfare support increases. Therefore
it is in the interest of these systems to maintain the population with the highest level of health possible,
especially working-age individuals in the labour force and ageing groups in their retirement years.
Trade
Trade agreements can impact the price, availability and access of foods, beverages, technologies, drugs
and other products. Hence, trade can play a key role in influencing the health environment. Information
exchange between trade and other sectors can contribute to a better alignment of trade agreements and
international policies with potential health outcomes.
19
Charter for Healthy Living
Appendix B: Toolkit for Joint Action
The idea to develop a “Toolkit for Multistakeholder Action” to
support Healthy Living initiatives was developed at the World
Economic Forum on Latin America in April 2012. The event held
in Puerto Vallarta, Mexico gathered high-level decision-makers
from the public and private sectors to share success stories of
joint action in the region, discuss key challenges and opportunities
for multistakeholder collaboration, and develop the “Charter for
Healthy Living”. During the discussions in Mexico, it became clear
that implementing joint actions at the local level can be challenging.
Participants concluded that the Charter should be supplemented
by a set of operational guidelines for multistakeholder
collaborations.
The guidelines – called “Multistakeholder Collaboration for Healthy
Living - Toolkit for Joint Action” – were developed over the
following months. The toolkit is structured as a pragmatic, hands-
on guide that aims to serve as a resource for successfully planning,
managing and sustaining joint action for Healthy Living. It consists
of:
−
A report that provides guidance about how to successfully plan
and manage the six building blocks for multistakeholder action
(Figure 5)
−
An Annex with more than 30 templates that can be used
by Healthy Living project teams to prepare for key project
meetings and milestones
The toolkit is available in a version 1.0 and will be refined and
updated as more experience with multistakeholder action for
Healthy Living is accumulated.
The toolkit is structured around six building blocks:
1.
Understand
“Understand” is a situational analysis that provides the foundation
for relevant and coordinated Healthy Living action. It starts with
a guide on how to assess the local Healthy Living challenge
and local healthcare infrastructure. Teams working on a specific
initiative may choose to conduct only a brief or highly focused
analysis, but obtaining a shared “big picture” view of local Healthy
Living challenges is strongly recommended. The building block
also includes a tool to map the local interventions landscape
and guidance on how to learn from other initiatives to prevent
“reinventing the wheel”. Finally, it provides a framework to identify
priority areas for joint action so that resources can be used
effectively.
2.
Align and Design
This building block describes how to develop a solid and culturally
adapted concept for Healthy Living action and how to identify
the right set of stakeholders to deliver the action. It starts with a
framework for concept design that addresses both basic elements
(e.g. location and target group) but also differentiates components
that specify how to achieve behaviour change, mobilize
communities and integrate innovative elements. It also includes
frameworks to identify the right set of stakeholders from the public
sector, private sector and civil society and articulate the rationale
for participation and potential value added by each stakeholder
type.
3.
Mobilize
“Mobilize” provides guidance on how to bring multiple partners
together and align them with a common vision and shared values.
It starts with a pragmatic checklist for a successful “kick-off”
meeting for the initial working group. This building block describes
how to define a common vision and provides an example of a value
statement specific to multistakeholder collaborations for Healthy
Living. Finally, it provides a framework to help select partners with
the best “fit” with the collaboration and offers advice on how to get
them on board.
4.
Build and Train
“Build and Train” offers practical tools on how to effectively set
up and manage a multistakeholder collaboration. It starts with
a framework to define the governance structure and roles and
responsibilities. It then introduces the “championship spine”
concept, which can greatly accelerate momentum within the
collaboration and beyond. This building block also addresses
collaboration agreements and offers templates to define resource
mechanisms and benefit sharing. Finally, it offers a way to handle
conflicts of interest and suggests a training plan that incorporates
both trainings to ensure effective collaboration and operational
trainings to implement the Healthy Living action.
5.
Deliver
This building block is about “how to get it done” – how to
effectively manage the collaboration throughout a joint action. It
suggests a milestone-based approach for the joint action and
provides a checklist for go/no go decisions. It also includes
pragmatic templates for day-to-day project management and
provides advice on internal communication. Finally, it introduces
the RAPID
®
methodology to ensure effective decision-making in
complex settings.
6.
Evaluate and Sustain
The final building block provides guidance on how to ensure a
lasting impact on Healthy Living – a great challenge for many
collaborations. It suggests a menu of metrics that can be used to
track outcomes, covering awareness and knowledge, behavioural
changes, physical changes and ultimately NCD prevalence and
mortality. It also offers tools to identify and manage implementation
risks and check the “health” of the collaboration. Finally, it provides
a checklist of success factors to sustain the collaboration and
a framework to capture learnings and share them with other
collaborations.
The Toolkit for Multistakeholder Action
provides pragmatic guidance for
stakeholders, focusing in the most
important aspects of multistakeholder
collaboration. It puts aside the typical
project management frameworks and
presents concepts that everyone can
understand.
Pablo Kuri Morales
, Subsecretary of Prevention and Health
Promotion of Mexico
20
Charter for Healthy Living
Contributors
The members listed below contributed leadership, technical expertise and extensive time to the Charter for Healthy Living through their
engagement in the Working Group and the High-level Steering Board.
High-level Steering Board
Co-Chairs
Paul Bulcke
, Chief Executive Officer, Nestlé
Christopher Viehbacher
, Chief Executive Officer, Sanofi
Salman Amin
, Executive President and Chief Marketing Officer, Pepsi Co
Rob Flaherty
, Chief Executive Officer, Ketchum
Julio Frenk
, Dean, Harvard School Public Health
Adrian Gore
, Chief Executive Officer, Discovery Holdings
Robert Greenhill
,
Managing Director and Chief Business Officer, World Economic Forum
George Halvorson
, Chairman and Chief Executive Officer, Kaiser Permanente
Margaret Hamburg
, Commissioner, USA Food and Drugs Administration
Lonny Reisman
, Chief Medical Officer, Aetna
Martin Seychell
, Deputy Director General DG SANCO, European Commission
Josette Sheeran
, Vice-Chairman and Member of the Managing Board, World Economic Forum
Daljit Singh
, President, Fortis Healthcare
Paul Stoffels
, Worldwide Chairman, Pharmaceuticals, Johnson & Johnson
Jean-François van Boxmeer
, Chairman of the Executive Board and CEO, Heineken
Working Group
Ray Baxter
, President, Kaiser Permanente International and Senior Vice-President, Community Benefit, Research and Health Policy, Kaiser
Permanente
Martin Bernhardt
, Vice President Relations with International Institutions, Sanofi
Michael Goltzman
, Vice-President, International Government Relations and Public Affairs, The Coca Cola Company
James Hospedales
, Coordinator Chronic Disease Prevention and Control, Pan American Health Organization
Pablo Kuri Morales
, Subsecretary of Prevention and Health Promotion, Secretariat of Health of Mexico
Petra Laux
, Head Global Public & Government Affairs, Novartis International
Peter Lurie
, Senior Advisor, Office of the Commissioner, Food and Drugs Administration, US
Conor McKechnie
, Director, Global Public Affairs, GE Healthcare
Johanna Ralston
, Chief Executive Officer, World Heart Federation/ NCD Alliance
Scott Ratzan
, Vice-President, Global Health, Government Affairs and Policy, Johnson & Johnson
Janet Voute
, Vice President Public Affairs, Nestle
Derek Yach
, Senior Vice-President, The Vitality Group Inc
Paul Boykas
, Vice-President, Global Public Policy and Government Affairs, PepsiCo Inc
This report has been prepared by the World Economic Forum with the support of Bain and Company
World Economic Forum
Eva Jané-Llopis
, Director, Head of Health Programmes
Vanessa Candeias
, Senior Project Manager Healthy Living
Rosemary Harrison
, Project Manager, Healthy Living, Secondee from Bain & Company
YoungJoo Kang
, Intern, Healthy Living
Bain & Company
Norbert Hueltenschmidt
, Director, Global Head of Healthcare, Bain & Company
Iris Danke
, Manager, Bain & Company, Switzerland
21
Charter for Healthy Living
References
Asaria, P, Chisholm, D., Mathers, C et al. Chronic Disease Prevention: Health Effects and Financial Costs of Strategies to Reduce Salt
Intake and Control Tobacco Use. In
The
Lancet
, 2007, 370:2044-2053.
Anderson, P, Harrison, O, Cooper, C. et al. Incentives for Health. In
Journal of Health Communication
, 2011, 16(2):107-133.
Bloom, D E, Cafiero E, Jané-Llopis E et al.
The Global Economic Burden of Non-communicable Diseases
. Geneva: World Economic
Forum, 2011.
http://www3.weforum.org/docs/WEF_Harvard_HE_GlobalEconomicBurdenNonCommunicable Diseases_2011.pdf
,
a
ccessed December 2012
Boles, O, Halsey, Y.
Many Healthy Returns: The Business of Tackling Non-communicable Diseases (NCDs)
. London: The International
Business Leaders Forum, 2011.
Buse, K, Harmer, A M. Seven Habits of Highly Effective Global Public-Private Health Partnerships: Practice and Potential. In
Soc Sci Med
,
2007, 64:259-271.
Collaborating for Health,
Incentives that Create Healthy Behaviour
(2011).
http://www.c3health.org/wp-content/uploads/2011/08/Craig-
Nossel-seminar-FINAL-20110817.pdf;
a
ccessed December 2012
Donkin, A, Goldblatt, P, Lynch, K. Inequalities in Life Expectancy by Social Class, 1972-1999. In
Health Statistics Quarterly
, 2002, 15:5-
15.
Food Standards Agency,
UK Salt Reduction Initiatives
(London, 2012).
http://www.food.gov.uk/multimedia/pdfs/saltreductioninitiatives.pdf ,
a
ccessed December 2012
Hospedales, C J, Jané-Llopis, E. A Multistakeholder Platform to Promote Health. In
Journal of Health Communication
, 2011, 16(2):191-
200.
Jayasinghe, S, Jayasinghe, S. The Prevention of Global Chronic Disease and Academia: Another Key Area? In
American Journal Public
Health
, 2011, 101(11):2005-2006.
Kivimäki, M, Virtanen, M, Elovainio, M et al.
Work Stress in the Aetiology of Coronary Heart Disease – A Meta-analysis. In
Scandinavian
Journal of Work and Environmental Health
, 2006, 32:431-442.
Lim, S, Gaziano, T A, Gakidou, E et al. Prevention of Cardiovascular Disease in High-risk Individuals in Low-income and Middle-income
Countries: Health Effects and Costs. In
The
Lancet
, 2007, 307:2152-2157.
Marmot, M.
The Status Syndrome: How Your Social Standing Affects Your Health and Life Expectancy
. London: Bloomsbury, 2004.
Nishtar, S, Farugui, A M, Mattu, M A et al. The National Action Plan for the Prevention and Control of Non-communicable Diseases and
Health Promotion in Pakistan Cardiovascular diseases. In
Journal of the Pakistan Medical Association
, 2004, 54(3):S14-S25.
Nishtar, S, Jané-Llopis, E. A Global Coordinating Platform for Noncommunicable Diseases. In
Journal of Health Communication
, 2011,
16(2):201-205.
Organisation for Economic Co-operation and Development,
Projecting OECD Health and Long-term Case Expenditure: What are the
Main Drivers?
Economics Department Working Papers No. 477 (Paris, 2006).
www.
oecd
.org/data
oecd
/57/7/36085940.pdf,
a
ccessed
December 2012
Patel, D N, Lambert E V, da Silva, R, et al.
The Association between Medical Costs and Participation in the Vitality Health Promotion
Program among 948,974 Members of a South African Health Insurance Company. In
American Journal of Health Promotion,
2010,
24(3):199-204.
Sassi, F, Devaux M, Cecchini, M et al.
The Obesity Epidemic: Analysis of Past and Projected Future Trends in Selected OECD Countries
,
OECD Health Working Papers, No. 45. Paris: OECD Publishing, 2009.
Stansfeld, S, Candy, B. Psychosocial Work Environment and Mental Health – A Meta-analytic Review. In
Scandinavian Journal of Work
and Environmental Health
, 2006, 32:443-462.
UK Department of Health.
Report on Dietary Sodium Intakes
(London, 2012).
United Nations Department of Economic and Social Affairs Population Division,
Population Ageing and Development
(New York, 2012).
http://www.un.org/esa/population/publications/2012PopAgeingDev_Chart/2012AgeingWallchart.html,
a
ccessed December 2012
22
Charter for Healthy Living
United Nations Department of Economic and Social Affairs,
Current Status of the Social Situation, Well-Being, Participation in
Development and Rights of Older Persons Worldwide
(New York, 2011a).
http://www.un.org/esa/socdev/ageing/documents/
publications/current-status-older-persons.pdf,
a
ccessed December 2012
United Nations General Assembly,
Political Declaration of the High-level Meeting of the General Assembly on the Prevention and Control
of Non-communicable Diseases
(New York, 2011b).
http://www.un.org/ga/search/view_doc.asp?symbol=A/66/L.1,
a
ccessed December
2012
Wen, C P, Wu, X. Stressing Harms of Physical Inactivity to Promote Exercise. In
The
Lancet
, 2012, 380:4-5.
World Bank,
Effective Responses to Non-communicable Diseases: Embracing Action Beyond the Health Sector
(Washington, 2011).
http://siteresources.worldbank.org/HEALTHNUTRITIONANDPOPULATION/Resources/281627-1095698140167/
EffectiveResponsestoNCDs.pdf,
a
ccessed December 2012
World Health Organization,
Constitution of the World Health Organization
(Geneva, 194.
http://www.who.int/governance/eb/who_
constitution_en.pdf,
a
ccessed December 2012
World Health Organization,
Social Determinants of Health: The Solid Facts
. 2
nd
Edition (Geneva, 2003).
http://www.euro.who.int/__data/
assets/pdf_file/0005/98438/e81384.pdf,
a
ccessed December 2012
World Health Organization,
Preventing Chronic Disease: A Vital Investment
(Geneva, 2005).
http://www.who.int/chp/chronic_disease_
report/en/,
a
ccessed December 2012
World Health Organization,
2008-2013 Action Plan for the Global Strategy for the Prevention and Control of Noncommunicable Diseases
(Geneva, 2008b).
http://www.who.int/nmh/publications/9789241597418/en/,
a
ccessed December 2012
World Health Organization,
The Global Burden of Disease: 2004
(Geneva: 2008a).
http://www.who.int/healthinfo/global_burden_
disease/2004_report_update/en/index.html,
a
ccessed December 2012
World Health Organization and Commission on Social Determinants of Health,
Closing the Gap in Generation Health Equality through
Action on the Social Determinates of Health
. Comission on Social Determinatnes of Health Final Report (Geneva, 200.
http://www.who.
int/social_determinants/thecommission/finalreport/en/index.html,
a
ccessed December 2012
World Health Organization,
Interventions on Diet and Physical Activity: What Works
(Geneva, 2009).
http://www.who.int/
dietphysicalactivity/whatworks/en/,
a
ccessed December 2012
World Health Organization,
Global Recommendations on Physical Activity for Health
(Geneva, 2010a).
http://whqlibdoc.who.int/
publications/2010/9789241599979_eng.pdf,
a
ccessed December 2012
World Health Organization,
Global Status Report on Noncommunicable Diseases 2010
(Geneva, 2010b).
www.who.int/nmh/publications/
ncd_
report
_full_en.pdf,
a
ccessed December 2012
World Health Organization,
Noncommunicable Diseases Country Profiles 2011
(Geneva, 2011a).
http://www.who.int/gho/en/,
a
ccessed
December 2012
World Health Organization,
Global Health Observatory
(GHO) (Geneva, 2011b).
World Health Organization,
Intersectoral Action on Health: A Path for Policy-makers to Implement Effective and Sustainable Intersectoral
Action on Health
(Geneva, 2011c).
http://www.who.int/nmh/publications/ncds_policy_makers_to_implement_intersectoral_acti on.pdf,
a
ccessed December 2012
World Health Organization,
Scaling Up Action Against Noncommunicable Diseases: How Much Will it Cost
? (Geneva, 2011d).
http://
www.who.int/nmh/publications/cost_of_inaction/en/,
a
ccessed December 2012
World Health Organization,
Global Health Risks: Mortality and burden of disease attributable to selected major risks.
(Geneva, 2012a).
http://www.who.int/healthinfo/global_burden_disease/GlobalHealthRisks_report_full.pdf,
a
ccessed December 2012
World Health Organization,
Prevention and Control of Noncommunicable Diseases: Follow-up to the High-level Meeting of the United
Nations General Assembly on the Prevention and Control of Non-communicable Diseases
(Geneva, 2012b).
http://apps.who.int/gb/
ebwha/pdf_files/WHA65/A65_54-en.pdf,
a
ccessed December 2012
World Health Organization,
Prevention and Control of Noncommunicable Diseases. Options and a Timeline for Strengthening and
Facilitating Multisectoral Action for the Prevention and Control of Noncommunicable Diseases through Partnership
(Geneva, 2012c).
http://apps.who.int/gb/ebwha/pdf_files/WHA65/A65_7-en.pdf,
a
ccessed December 2012
World Health Organization,
A draft comprehensive global monitoring framework, including indicators, and a set of voluntary global targets
for the prevention and control of noncommunicable diseases
(Geneva, 2012d).
http://www.who.int/entity/nmh/events/2012/discussion_
paper3.pdf,
a
ccessed December 2012
На смёпках с 1 Израильской
Хочу переделать мир. Кто со мной?
Друзья!
Спешу поделиться с вами своим открытием. С большой долей уверенности могу заявить, что я нашел откуда выплыла эта статейка.
На Давосском Форуме проходила маленькая сессия, организованная Федерацией Швейцарских Католических Церквей. На ней священники поднимали несколько вопросов, правомерность которых они оспаривают. Среди них присутствовал вопрос о правомерности использования эвтаназии, как средства улучшения качества жизни членов семьи больного. При этом они использовали словосочетание "паллиативная помощь больным и их семьям". "Паллиативная помощь" - новое для меня слово и я полез изучать его значение. Кто не засох мозгами, советую поинтересоваться этим значением.
Видимо, какой-то дебил, который побоялся подписаться даже псевдонимом, и состряпал эту статейку. Осталось выяснить точную дату этой сессии и всё "завяжется".
P.S
Уважаемый Пумяух, а Вас не смутили формулировочки типа "долгожительство противоречит законам природы и закону о выживании сильнейшего" из уст "экспертов" Давосского Форума?
И, где, так вами любимые правозащитники? Чего они молчат? Наверное и они любят котлетки из старичков.
Паллиативная помощь (от фр. palliatif от лат. pallium — покрывало, плащ) — это подход, позволяющий улучшить качество жизни пациентов и их семей, столкнувшихся с проблемами угрожающего жизни заболевания, путем предотвращения и облегчения страданий благодаря раннему выявлению, тщательной оценке и лечению боли и других физических симптомов, а также оказанию психосоциальной и духовной поддержки пациенту и его близким[1] .
Термин «паллиативный» происходит от латинского «pallium», что имеет значение «маски» или «плаща». Это определяет содержание и философию паллиативной помощи: сглаживание — смягчение проявлений неизлечимой болезни и/или укрытие плащом — создание покрова для защиты тех, кто остался «в холоде и без защиты».
Цели и задачи паллиативной помощи
Содержание
Паллиативная помощь:
- облегчает боль и другие доставляющие беспокойство симптомы;
- утверждает жизнь и относится к умиранию как к естественному процессу;
- не стремится ни ускорить, ни отдалить наступление смерти;
- включает психологические и духовные аспекты помощи пациентам;
- предлагает пациентам систему поддержки, чтобы они могли жить насколько возможно активно до самой смерти;
- предлагает систему поддержки близким пациента во время его болезни, а также в период тяжелой утраты;
- использует мультидисциплинарный командный подход для удовлетворения потребностей пациентов и их родственников, в том числе в период тяжелой утраты, если возникает в этом необходимость;
- повышает качество жизни и может также положительно повлиять на течение болезни;
- применима на ранних стадиях заболевания в сочетании с другими методами лечения, направленными на продление жизни, например с химиотерапией, радиационной терапией, ВААРТ.
- включает проведение исследований с целью лучшего понимания и лечения доставляющих беспокойство клинических симптомов и осложнений[1].
Цели и задачи паллиативной помощи:
- Адекватное обезболивание и купирование других тягостных симптомов.
- Психологическая поддержка больного и ухаживающих за ним родственников.
- Выработка отношения к смерти как к закономерному этапу пути человека.
- Удовлетворение духовных потребностей больного и его близких.
- Решение социальных и юридических, этических вопросов, которые возникают в связи с тяжёлой болезнью и приближением смерти человека[2].
Паллиативная медицина
Паллиативная медицина — раздел медицины, задачами которого является использование методов и достижений современной медицинской науки для проведения лечебных процедур и манипуляций, призванных облегчить состояние больного, когда возможности радикального лечения уже исчерпаны (паллиативные операции по поводу неоперабельного рака, обезболивание, купирование тягостных симптомов).
Паллиативная помощь отличается от паллиативной медицины и включает в себя последнюю.
Последний раз редактировалось Белая Хризантема**; 21.03.2013 в 16:27.
Надеюсь данная статья удовлетворит любопытных.
Последний раз редактировалось Белая Хризантема**; 21.03.2013 в 16:34.
Это реклама фонда? А на вашем форуме можно рекламировать частные фонды? У меня есть свой список. Можно?
Эту тему просматривают: 1 (пользователей: 0 , гостей: 1)
И как мы все понимаем, что быстрый и хороший хостинг стоит денег.
Никакой обязаловки. Всё добровольно. Работаем до пока не свалимся Принимаем: BTС: BC1QACDJYGDDCSA00RP8ZWH3JG5SLL7CLSQNLVGZ5D LTС: LTC1QUN2ASDJUFP0ARCTGVVPU8CD970MJGW32N8RHEY Список поступлений от почётных добровольцев «Простые» переводы в Россию из-за границы - ЖОПА !!! Спасибо за это ... |
18+ |