Wednesday, 24 June 2015

A reality dream or austerity nightmare?

In a recent dream I asked Winnie [Winston Churchill] why at Yalta he pulled Greece out of the Soviet Block and placed it in the West. The answer then was clear. In today’s reality of feathering one’s own nest in the relevant comfort of hidden obscurity, it takes a determined effort to push away troublesome questions such as is the international community interested only in Greek real estate, it’s islands and natural wealth or is Europe hell bent on bringing Greece to its knees?

At such times it is useful to recall that ‘treating facts with imagination is one thing, but to imagine them is another’. It is also useful to recall that as the complexity of any problem space grows [here read Greek debt and humanitarian disaster], so does the probability that the outcome of a decision taken, may prove counterintuitive and sometimes destructive.

Expert pronouncements coming from economists on the need for an economic agreement and from public health on the demise of population wellbeing are equally alarming. The humanitarian crisis no doubt is sliding fast from the political agenda while a GREXIT or an “accidental” exit from the euro-zone rise as distinct possibilities.

If the current government is pressured to side step its own red lines not only would it be antidemocratic it would be deceivingly counterintuitive. Failure to reach a reasonable agreement with its creditors may act as a stimulus to a large and long lasting transient instability. Acting together, the sequel may make the Defkalion flood to seem like a spillover from a coffee cup. Can the gods remain silent knowing that a child born today will have a lower life expectancy than its parents while tomorrow it may be worse than in the developed world? In a battle with the Titans the outcome of negotiation should result in equal status, appropriate development and social progress. By compensating Greece for wartime damages, Germany could bring normalcy back to Europe.

An agreement dictated by an economically oriented Europe certainly will have adverse effects on population health. “Take it or leave it” is a toxic concoction that will cause further social inequality. Expecting the weaker side to make more concessions than Europe is also a prescription for continuing disaster. An agreement that is equivalent to an accentuated extension of the Memorandum with additional austerity is no solution. Bailout funds that help defray liabilities incurred should not be an option. It is a carrot with most of the carotene never reaching its target.

Greece must strengthen its weak systems and institutions and prepare the nation to respond to emerging disasters including a sudden onset one like the big bang postulated by economists as well as dealing with the ongoing creeping health disaster. It must promote meritocracy, enable the hierarchy to work and ensure that knowledgeable voices are heard. A scientific culture must be developed, populism constrained and division avoided. Balance in Greece can be restored if both negotiating parties focus on an agenda that emphasizes a more social Europe and a better regulated Greece. 13 distinguished economists and all Greek, argue that the Government should sign a modest deal with Europe and without required structural changes, here and now. Otherwise, the nation will take the path to chaos through bankruptcy and the Drachma’s return. I would add that if the “13” can incorporate humanitarian disaster relief into their proposal then it could be the basis for an intermediate agreement.

Two things seem certain; the size of the Greek debt is unsustainable and Europe without Greece is unimaginable. If this is understood and accepted within the principle of solidarity then debt restructuring must contain the elements of a substantial trim, a reasonable time line and better thought out elements for real-time preparedness to emerging disasters.

My reading is that the Greek people want an agreement that will improve their daily life and confer fiscal stability on Greece, within a united Europe. Not just any agreement will do! To paraphrase Churchill, let us brace ourselves for what might be the grimmest hour in the hope that it will turn out to be the finest.

Professor Dr. Jeffrey Levett
22/6/2015 Belgrade
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Saturday, 13 June 2015

Greece Succeeds in European Public Health! : What will happen now?

"It is regrettable that here where the goddess Hygiene flourished, no attention is paid to the science of public health" Constantine Savas [1907] who in 1905, proposed the establishment of a School of Public Health.

The Association of Schools of Public Health in the European Region [ASPHER, Brussels] with a unanimous and Greek-friendly decision chose Athens to celebrate its 50th Anniversary on the European stage in May 2016. Witness to the decision in Jerusalem were representatives of the World Health Organization, the European CDC, the World Federation of Associations of Health, the African Association as well as important personalities from Alma Ata, Australia, Canada, America and other important Institutions.

The Celebration for public health will be conducted by the National School of Public Health [NSPH, formerly Athens School of Hygiene] under the aegis of the Hellenic Ministry of Health. The School is a founding member of the Association [1966], which once again, demonstrated its special consideration for the "Hellenic School", recognizing not only its uniqueness in Greece but its important role in Europe and in the Balkans.

The School aims to repeat the success of the 14th General Assembly [GA] of the Association [1992]. The GA took place in the Plaka, in the Goulandri-Horn Foundation beneath the Acropolis and next to the Tower of the Winds. It was accompanied both by Greek wines and music of Mimis Plessas. Mimis provided inspiring insights into Greek music and a recital for human rights and public health. The GA was the recipient of valuable support and contributions from Mrs. Niki Goulandri who provided the visitors with a marvelous museum experience. Dimitri Horn accompanied Mimis Plessas who was introduced as the Laurence Olivier of Greece. Informative high-level talks were given by Academician George Merikas on Greek Mythology and by Anna Psarouda Benaki on educational culture, former minister, Speaker of Parliament and Transparency International. A Forum on Public Health in the Balkans was conducted with participants from the entire region.

International institutions present were the World Health Organization [Copenhagen and Geneva], the European Union [DGV and XIII], the Rockefeller Foundation and the University of Peace of the United Nations. In 1992, the Assembly had the support of the George Sourlas former Minister of Health and Speaker of Parliament and Marietta Gianakou, former Minister of Health and EuroMP.

The Hellenic School was founded by Prime Minister Eleftherios Venizelos with the involvement of important personalities such as Apostolos Doxiadis, [who diagnosed Spanish flu in Greece], and Alexander Pappas [personal physician of the Prime Minister]. Its aims then and now are to strengthen Greek scientific culture by developing postgraduate programmes for engineers, doctors, nurses, public health specialists and managers of health and social services within an autonomous institution. It cultivated research and a link to the international community within a framework of the League of Nations and the Rockefeller Foundation.

As a consequence, Greece set in motion a short-lived but effective revolution in public health. It resulted in the eradication of malaria, the control of tuberculosis and dramatic gains in longevity and a steep of drop in child mortality. The ultimate outcome was national development, the emergence of Greece as a modern state and its entry into the league of developed nations.

The School has often been referred to as the Greek Lighthouse of public health with a beam that never failed, although it was dimmed during the Colonel’s dictatorship. On one visit to the School the Minister of Health dismissed the professor and took over of a class in a dictatorial style.

When first launched, the School was considered elitist and unnecessary by a large part of academia. When Constantine Karamanlis made it’s rejuvenation a priority on his return from exile in France [1974] the academic world delayed its reopening and continues to stymie its function. Few politicians have understood the needs for a School of Public Health and even fewer have been willing to do something about it. Over its nine decades the School has remained a lighthouse, but often it was more like a boat tossed in a political storm.

The shipping news of today is that the NSPH has scored a significant success for Greece . Today refugees are an enormous challenge Greek public health and the situation in Syria is not without risk to Greece, which is ill prepared to respond to emerging disasters. A Greek child born today will have a lower life expectancy than a child born in the developed world, a result of the ongoing humanitarian crisis.

It should not be forgotten that at the time of its birth, the health of the Greek population was worse than the health of the people in Brazil and that Greece was overwhelmed with an influx of more than a million refugees from Asia Minor and totally shut down for months as a result of a pandemic of dengue fever that came from Syria.

The celebration of ASPHER in Athens [2016] will act as a catalyst for the improvement of the NSPH and to constrain the humanitarian health disaster, an unprecedented affair. A unique event to pay tribute to the Association of Schools of Public Health in the European Region at 50 will be conducted by a unique School, the NSPH. It needs the support of the official Greek authorities and all those who recognize the dangers ahead.

Surely, the celebration of ASPHER in Athens will trigger achievements as in the days of Eleftherios Venizelos when the School was first inaugurated and those of Constantine Karamanlis when he rejuvenated it after the dark days of dictatorship.

Professor Dr. Jeffrey Levett
National School of Public Health, Greece and European Center for Peace and Development, Serbia
jeffrey.levett@gmail.com




It is envisaged that the under development program CELEBRATING ASPHER’s FIRST HALF CENTURY, ATHENS 25-27 MAY 2016 will include aspects of patient human rights, human security and health diplomacy. Under discussion is a project on public health as a tool for resilience building and human security.
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