EU and Greek Institutions: Competences and Autonomy for Health

Professor Jeffrey Levett
The European Union {EU} with its set of reasonable but incomplete instruments and institutions still has enormous promise. Locked however, in an economically oriented posture, it remains centrally focused and continues to relegate social values to a secondary category. To live up to its original vision a reorientation is necessary. Unfortunately, in its dealing with its black sheep problem it has thrown away a unique opportunity. Slowly if not deliberately it is being transformed from an association of equal membership status countries, into a polarized assembly of lenders [creditors] and borrowers [debtors] with a predominance of power vested in one member. As a result, its competitive development globally and perhaps its survival as a unique geographical space are both at risk.

Besides failing to deal with population health issues related to the Greek debt crisis, the EU has been slow in engaging the Balkans. It is failing also with respect to the Ukraine and Syria and their potential effects on Europe and with respect to health. To become more globally competitive the EU needs to mend its gates to health while ensuring security, which necessitates a strengthening of its external and internal sanitary shields. The very big question of immigration with its significant public health and human security issues still needs tackling.

Locked in an inadequately recognized and poorly understood humanitarian crisis with a still growing and unsustainable debt, Greece will probably experience a worsening health situation resulting from population vulnerability. So far population resilience has acted as a brake. To reverse the tide of well recognized health demise Greek institutions must be mended, the influence of party politics reduced and their competences strengthened. In a situation of limited institutional governance and transparency, no one is ever responsible. When it comes to “who done it”, blame runs away like water from a duck's back while the overused use of the word shame carries little currency. Bridge agreements in thin air and bridges going nowhere certainly need explanation.

How can we explain the reckless burden of borrowed money by Greece to a backdrop of low and limited productivity? How can we understand persistent viewpoint that AUSTERITY is an economic engine for societal development? Surely these concerns demand some form of elucidation?

Austerity should be clearly recognized as a manmade fiscal hazard for population health that fits nicely into models of disaster management. It is not an economic stimulant for development. To ensure national development the enormous potential for creativity in Greece, with its well educated population should be deployed in new ways to reduce the cumulative destruction [1980-2014] and to build upon all positive gains as a result of action or from the postponement of action by government. The oft sited outcome differences between Greece and some other countries [Ireland, Italy, Spain, and Portugal] are simply a matter of governance. Differences might reflect non-colonizing, colonized and colonizing histories. The significant differences probably reflect the degree of effectiveness of institutions, behavior of political bodies and the level of societal openness.

Although Greek infrastructure building benefited from EU funding it was significantly side tracked and diverted in various ways while contributing to the Greek deficit, which got underway as a result of favoritism and vote buying. It was given a boost by the Athens Olympics. Government perpetuated deficit growth policies while the following one sustained and/or augmented it and consequently the incoming government assumed a larger burden of unresolved problems. politicians simply pushed the day of reckoning back while exchanging blame with the previous one. The day of reckoning arrived earlier this year. supposedly the awaited “agreement” would improve the conditions of the Greek population several months down the road. No such improvement has yet emerged.

The recent AGREEMENT dictated by Europe and accepted by the Greek parliament provides a few short gasps of relief but no real breathing space. It seems to extend the current austerity measures so detrimental to health. It remains unclear whether its specific components have any capacity to promote Greek national development or rein in growing health damage. Nevertheless, development can not come without it. It can neither come about without the deployment of its well educated work force, annulment of behaviours holding back the neighbour or punishing its very best nor without making a significant strike against unemployment.

Can the Greek government ensure the application of specific measures their monitoring and the evaluation of progress together with the promotion of a scientific culture? Can the Greek government now put forward plausible and sustainable solutions to its national problems? Can Greece pull itself out of its state of opacity and make competence count? Can Greece extricate itself from population demise?

Cracks in the health status of the Greek public continue to deepen and broaden. Children born today can expect a lower material quality of living and a shorter life span than their parents. This ongoing humanitarian crisis in Greece will probably accentuate before it improves as monthly gains shrink [salary, pension, and allowances] and costs for basic needs grow [food, shelter, electricity, water, and telephone/internet]. Consequently, social inequality will grow and “freedoms from want and freedom from fear” will slowly evaporate. No one can be certain where the current situation will lead. For it to lead somewhere meaningful it needs institutional autonomy with competent fully supported staffs and personnel, free to act within an improving scientific culture and vigorously supported by the intellectual elite.

Today, Greece needs humanitarian aid from the EU, a merger between primary health care and public health, reinforcement of health sector governance and new policy considerations. It is necessary to strengthen interdisciplinary education for public health emphasizing competences. R/D must be funded. Preparedness for health development and disaster management must be improved by calling upon the good offices of the WHO. In a therapeutic spirit, the EU must work closer with to ensure the effective application of WHO Health 2020 strategy and strengthen European connectedness through SEE Growth 2020 strategy.

So far a GREXIT has been bypassed but not yet avoided, while austerity continues its ruination of the social fabric of Greece. An economy passing through disaster like Greece needs a different reorganizational tool box than those available in more efficient societies with well designed plans to arrange needs, obligations and sustain economic status. This tool box is within the purview of the EU.

On a successful note, Greece in 2016 will host the half century celebration of the unique activities on the European stage of public health by the Association of Schools of Public Health in the European Region [ASPHER]. It will be conducted by the National School of Public Health, whose work in public health helped push Greece into the league of advanced nations. On a suggestive note, Greece should also take a more comprehensive part in the work of the South Eastern Europe Health Network [SEEHN]. After all Israel is a member while Greece is not.

On a cautionary note two additional, recurrent and ongoing upheavals in Greece must be mentioned. The first, forest fires, underscore, once again, the need for disaster management development with risk of future damage minimized, prevention and mitigation at the core of the recovery process and within a mindset and framework of real societal development. Secondly, the shirking of accountability for the ongoing crisis must be addressed. As Satan avoids incense, the main actors for the gigantic Greek problem space avoid their responsibility; this contains the seeds for yet another Greek tragedy. In the avoidance process the responsible agents seem hell bent on taking out other eyes.

Greek politicians can learn much from the way Germany repented and came to terms with its past after WWII. It was part of a process from which Germany benefited tremendously from the humanity of the world. While the two sins are in no way comparable the principle of evaluation and accountability should become common ground. Greece can also benefit from Germany’s market needs in the Balkans, a region where it still has a unique advantage. In health that opportunity has been charted by the National School of Public Health. It should not be forgotten that the Balkans have been termed the first and last Europe.


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