1. Europe Health Report 2005 (1). Noncommunicable diseases are the main cause of the burden of disease on the European Region, and communicable diseases are an additional burden on other countries, caused by poverty and underfunded health services.

2. Europe Health Report (2) Action should be taken to implement well-known, comprehensive interventions to tackle the seven leading risk factors: tobacco alcohol high blood pressure high cholesterol overweight low fruit and vegetable intake and physical inactivity.

3. Europe Health Report (3) Reducing the seven risk factors would largely prevent the seven leading conditions: ischaemic heart disease depressive disorders cerebrovascular disease alcohol-use disorders chronic pulmonary disease lung cancer road traffic injuries.

4. Europe Health Report (4) The European health report 2005 has a special focus on children's health, because health in childhood determines health throughout life and into the next generation. Differences exist between the patterns of ill health in children and in adults, and wide differences in the causes and rates of illness and death in children exist between countries.

5. European Health Report (5) This shows the need for complementary health and social policies on adults and children. The report identifies poverty and socioeconomic inequality as the greatest threats to children's health. The report calls for renewed effort in protection and promotion of child health. Investing in children's health is investing in the future.

6. Why a People’s Health Movement ? Health for all by 2000 ? The end of Primary Health Care ? A large number of the world pop´n is still lacking access to water, sanitation, basic health care, education and shelter. Public health services are inadequate Health budgets are too small Social justice or market ?

7. The first People´s Health Assembly 1500 health activists from 57 countries met in Savar, Bangladesh, for the first People´s Health Assembly The People´s Health Charter: –An expression of common concern –A vision for a healthier and just world –A call for action Country PHM chapters

8. People´s Health Movement WHO advocacy Women and health War, disaster and aid Poverty and AIDS Private-Public Partnerships Trade and health Environmental degradation and health Disability Social, cultural and religious dimensions of health

9. Globalisation and health Big business promoting unhealthy consumption Worldbank limits public sector health expenditure Nature and biological properties are patented by multinationals TRIPS turns medicines into commodities instead of tools for health interventions

21. The root causes of ill health are: Poverty Inequity, and also gender imbalance Social disintegration and violence Lack of human rights and respect for human dignity Environmental degradation Lack of good governance

25. The health sector crisis

26. The health crisis in developing countries Ministries of Health with too little capacity Health expenditure too low Health worker crisis Infra-structure lacking AIDS What happened to Primary Health Care ? Health for all ?

27. Health worker crisis

32. Health care systems and approaches to health care Value driven (quality or coverage ) Biomedical priorities Primary health care District health model system New Public Management Global Public Private Initiatives (GPPIs)

33. PHC is since undermined by: Macro-economic factors Health system reforms and privitization/commercialization of health care services Selective health care and verticalization of programmes Selective and efficiency-driven Cost- Effectiveness Analysis

34. An estimated 30,000 children still die every day mainly from preventable and easily treatable causes.

35. Health care systems are collapsing in many African countries and in war-ravaged countries as Afghanistan and Iraq.

37. Life expectancy is falling in most african countries and in former sovjet union countries.

38. Global Public Private Initiatives Global Fund for HIV/AIDS, TB and Malaria PEPFAR Stop TB Initiative GAVI Polio Eradication Roll back malaria A total of 80 GPPIs challenging expertise, capacity and resources from Ministries of Health in developing countries

39. GPPIs Accountable to whom ? Bill and Melinda Gates Foundation Pharmaceutical companies The poor ?

41. Are churches concerned ? Should churches be concerned ? Do the churches have a voice ? What is the message of the churches ? Where is the CMC ?

42. Did the People´s Health Movement take the place of the former CMC ?

43. Christian Medical Commission People´s Health Movement

44. CMC has a different role than PHM Different dimensions in health Not only justice, but also compassion Values are not rigid Institutional responsibility

45. Vision Health is central to development and reflects the norms and values of the society in which we partake. -Development implies improvement in living conditions and quality of life for all members of society -The health of people is an indicator of the soundness of developmental policies

46. The past and future role of a CMC: Affirming the special role of churches and christian health agencies in health&development Applying and transferring public health logic, systems and expertise to CBOs Advocacy, participating in networks Linking religious and humanitarian values such as equity, human rights, justice, sustainability, inclusion to health & development policies and practices

47. Future themes ? Sexual and reproductive health HIV/AIDS Essential drug policies Health, healing and wholeness Christian health agencies and networks Disability, mental health and home care Health care financing Health care management and PME

48. Agenda for a CMC Churches and health Missiology, health and healing Health for all, now ! advocacy for health rights advocacy for social policies for health AIDS: access to prevention and treatment for all! Valuing,revitalising, expanding the health worker force Theological training in conflict mediation, counselling and healing....... Etc.

49. Basic needs, basic rights

50. Towards a healthy future for all.

51. Thank you. Prepared for the Ecumencial Study Consultation on ´The Global Health Situation and the Mission of the Churches in the 21st Century´, Breklum. September 2005 Christina de Vries.