Global Health Diplomacy: Promoting Multisectoral actions in Health Literacy United Nations ECOSOC Annual Ministerial Review Beijing, China April 2009 Scott C. Ratzan, MD, MPA Vice President, Global Health Government Affairs & Policy Johnson & Johnson

The extension to all peoples of the benefits of medical, psychological and related knowledge is essential to the fullest attainment of health. World Health Organization Preamble to the Constitution Our Goal: Health for the public good

Developing Health Literacy

Informed opinion and active cooperation on the part of the public are of the utmost importance in the improvement of health of the people. World Health Organization Preamble to the Constitution The Opportunity to Advance Health: Health Literacy for the public good

Apply our evidence-based approach to Health Literacy Over 14 years of research in the peer reviewed Journal of Health Communication had measurable outcomes with communication affecting: –Knowledge –Attitudes –Awareness –Practices –Perceptions –Intentions –Behavior change, and –Social Change

Health Literacy Framework

- Health Literacy Health Literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. Ratzan and Parker, NLM/NIH Current Bibliographies of Medicine, 2000 USDHHS, Healthy People 2010 Institute of Medicine, 2006 Ratzan ( ) 2000 (USDHHS)

Measure Health Literacy A broad set of factor that empower and facilitate health what gets measured gets done Incorporate health literacy with measurable items Link to global, regional and national efforts to measure health quality, disparities, and cost

Health Literacy – A potential scorecard 1.What do we do to stay healthy? –Key areas and numbers: immunizations, blood levels (glucose, cholesterol), weight, blood pressure, etc. 2.If we are sick, how can we get better? –Can you do quality self care; screening? –Do you rely on the system for health decisions 3.If we are living with illness, how do we get effective medical care? –Knowledge, information and practice ; 3.

Consideration of Pediatric health literacy Most children and their caregivers [could] benefit from a set of health literacy skills adequate to meet common preventive needs (e.g nutrition, development, home safety, vision and lead screening, immunizations.) AND common acute health needs (e.g. Fever, dehydration, upper respiratory tract infections, sexually transmitted infections) Source: Benard Dreyer, American Academy of Pediatrics, 2009 [ ] 2009

Not an Easy Task for Asia Pacific

An Illustrative Health Literacy Scorecard : Asia Pacific 1.What do we do to stay healthy? –Key areas and numbers: body mass index in range, minerals/salt, immunizations, weight, blood pressure, etc. –Do I or my family/friends smoke cigarettes? 2.If we are sick, how can we get better? –Can I recognize and understand signs/symptoms? –When do I seek a health service worker advise? 3.If we are living with illness, how do we get effective medical care? –Knowledge, information and practice 1. / 1. / 1.

Can we develop an approach for health literacy?

CONCLUSION.. Efforts to impact health literacy requires multisectoral actions A Health Literate citizen and world Medical sector and research institutions Academic institutions, physician associations, individual doctors Testing and patient diagnosis Appropriate treatment and care Disease management -hospital and pharmaceutical firms Research -epidemiology -scientific and clinical -social International health associations and organizations (UN, WHO, World Economic Forum, etc) International standard setting -guidelines, protocols -best practice Technical assistance Funding International coalition building Private sector Funding, individuals Corp. employee engagement - education and financial support Corp in-kind support Innovation and creativity Foundations, NGOs Financial support Grass roots intervention -initiate and sustain community action Lobbying and advising government Service delivery Mass media and mobile technologies Press outlets (TV, Radio, Newspaper, Magazine) Telecom outlets ( Message boards, SMS etc.) Public forum and information -data dissemination -public feedback and discussion Government Health Ministry, Public Health Officials, State and local governments Legislation and policy Direct funding

Possible engagement with the United Nations and health literacy WHCA Monograph (September 2009) ECOSOC Meeting on Promoting Health Literacy (Beijing, April 2009) + ECOSOC Meeting on NCDs in the Middle-East (Qatar, May 2009) + ECOSOC High Level Segment on Global Health (Geneva, 6-8 July 2009) UN General Assembly High Level Discussion on Health (New York,June 2009) ECOSOC Outcome Report at General Assembly for action under provisions of a resolution on Global Health and Foreign Policy (September 2009)

Advancing health literacy on multiple levels is ideal for health diplomacy later this year Health is, I believe, a fruitful – and a friendly – arena for foreign diplomacy. Health operates as a key driver of economic and social progress. Health contributes to stability and is a foundation of prosperity

A little impatience will spoil great plans, or Patience is a virtue. * the Analects of Confucius * Thank You!

APPENDIX/BACKUPS

The overall goal of Public Health Care in China (Excerpt from Opinions of the CPC Central Committee and the State Council on Deepening the Health Care System Reform) emphasize the combination of prevention, treatment and rehabilitation By 2011, the basic public health services shall have been available far and wide And by 2020, the health level of the people shall be further enhanced.

Establishing the basic health care system covering urban and rural residents (Excerpt from Opinions of the CPC Central Committee and the State Council on Deepening the Health Care System Reform) Efforts should be made to strengthen health promotion and education. Health care institutions, government agencies, schools, communities, enterprises, etc. shall massively carry out health education, take full advantage of various media, strengthen the dissemination of medical and health knowledge, advocate healthy and civilized lifestyle, promote rational nutrition among the public, and enhance the health awareness and self-care ability of the people.

Establishing practical and shared health care information system (Excerpt from Opinions of the CPC Central Committee and the State Council on Deepening the Health Care System Reform) Establishing and improving health care legal system Efforts should be made to improve the health legislation. Quicken the promotion of the basic health care legislation, specify the rights and obligations of government, society and residents in terms of enhancing health to ensure that everyone is entitled to the basic health care services.