LUNEDÌ 8 MARZO 2021
Presidente Aisppd Onlus
Tributo alla Giornata internazionale della Donna
Monday 8th March 2021
The IX International Day of Awareness and Prevention of Women Diseases
Tribute to International Women's Day
PREVENZIONE DEI TUMORI GINECOLOGICI
Prevention of gynecologic cancer
UNIVERSITÀ DEL PIEMONTE ORIENTALE
University of Piedmont Italy
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SENSIBILIZZAZIONE E PREVENZIONE DELLE MALATTIE VANTAGGI E BENEFICI SOCIALI SANITARI ED ECONOMICI
Diseases awareness and prevention Social health and economic benefits
OMS Organizzazione Mondiale della Sanità
WHO World Health Organization
RANIERI GUERRA Direttore generale vicario
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Diseases awareness and prevention: social, health and economic benefits.
This celebration comes one year after the first clinical signs of the SARS-CoV-2 pandemic, which has overwhelmed the health systems of every country in the world, after circulating undetected in our communities, as we now know, for at least three months before the identification of the first cases. We are in a world that now has 120 million cases, and many more who went undiagnosed, with a number of deaths exceeding 2.5 million, but also with over 250 million vaccines already injected.
The epidemiology and dynamics of the virus we are fighting are now much better known, but our systems still flounder in search of definitive, effective and sustainable solutions. We have learned that epidemics are not fought in hospital wards, but in communities, in our living, learning, work and leisure environments. Primary health care including the public health essential components is key for the response, but we have unfortunately dismantled the health prevention architecture in the past few years.
Simple actions of common life quickly led to the spread of the virus, which makes use of human mobility in our connected and globalized world to enter our homes and upset our system of social and economic relations. We will never return to the world before and now it is up to us to invent something different and less intrusive in the planetary health paradigm, underlining how we are not only interconnected with each other, but also with the world around us. Everything is interconnected: the public health toolkit addresses the main determinants of health and diseases, which go well beyond the health sector, protecting the most marginal, fragile and vulnerable of our communities, anywhere in the world. The 2030 sustainable development goals are moving towards these scenarios, being signed by all the UN member states. Italy has translated the SDGs system into such initiatives as the gender budget, the green budget and the promises of the new government to invest the large volumes of financial resources made available into public goods, not surprisingly defined as ´next generation´. We still have a lot to do to amend the current COVIDF-19 vaccine policy, stigmatized also by the Pope, as well as by my Organization, which has made vaccination democracy and access to basic services its flagship message, transferred to the world leaders during the next weeks of the Italian presidency of the G20.
We are now paying for the progressive divestment that has led an advanced healthcare system like ours - in any case among the best in the world - to rely on large copayment schemes, with a massive shortage of personnel due to the combined effect of retirement and the persistent block of turn-over. All these factors contributed to the progressive and selective impoverishment of the preventive sector, where the budget, never adequate, had been lowered since 2016 to well below 4% of the total public financing. Despite this, cancer screening campaigns had been launched, with several vaccine innovations and protective strategies for the early ages and the elderly.
While we all know that prevention is the most productive investment that we can adopt, at the same time we must recognize that prevention is not cheap, and needs major resources, such as the 110 billion euros needed to improve contaminated sites of national interest.
Another key issue is the disruption of essential medical services suffered during the pandemic mainly by those who would be in major need as they cannot afford accessing alternative services. One neglected area above all is mental health, despite the evidence of need by first line care givers, by school children and teachers, suffering from the closures and lockdowns imposed to safeguard our communities and fragile individuals.
16 trillion USD have been lost so far due to the pandemic: the disaggregation of this loss shows clearly that less than half comes from decreased productivity, while health and medical costs are exorbitant and due to increase in the future when today´s asymptomatic individuals may show clinical consequences of the virus encounter. The situation is also less than manageable with traditional control measures, due to the infodemia that feeds hate campaigns with fake news and disorienting information especially from the anarchic social media world. The youngsters are a specific target for health education, promotion and prevention, as they need special semantics and opinion leaders´ orientation that go beyond the traditional public system capacity and competence.
In no way the world will be able to heal leaving someone behind and vaccinating only elites: 10% of the global GDP was already invested in the health sector worldwide before the pandemic. This is enough money to support the reconstruction of our systems if we invest differently and target the main health determinants, such as pollution, obesity, the lack of physical exercise, tobacco and alcohol consumption, food. The cost of compromised health due to those factors is incredibly high and can be recovered massively to rebuild the preventive architecture. Having a solid prevention system means also the capacity to prepare and respond to epidemics in the best possible way, as the current situation must have taught us now.
Today is also a special day and we must take this opportunity to address specific and dramatic problems such violence against women, sadly increased massively during the closures, but also the lack of women in strategic and command positions, where the world needs their creativity and their empathy to let us move ahead and recover, amending the inequities and vulnerabilities that still constrain our societies.
BARACK H. OBAMA
PROF. ANDREA PAPADIA