The role the International Federation may play in front of the actual health challenges
Statement by Dr Freddy Pedersen, Chairman of the International Federation Health & Community Services Commission, President of the Danish Red Cross, to the 7th Conference of European Health Ministers, Oslo.
12 June 2003



Mr. Chairman,
Distinguished Ministers,
Ladies and gentlemen,

The International Federation of Red Cross and Red Crescent Societies welcomes the opportunity to bring to this Conference of European Health Ministers, the experience of millions of members and volunteers working around Europe to improve the health of vulnerable people.

The profound transformations that have taken place in Europe over the past decade, have given its peoples hope for a better future for themselves and their children. At the same time, transformation has produced significant economic and social change, and increased vulnerability for large numbers of individual men, women and children.

This has become visible through new forms of xenophobia and discrimination, new health problems and problems of separated families.
The Red Cross Red Crescent can testify to the efforts and achievement in improving the public health of many communities around the region.

However, in spite of the progress made, health inequities across and within countries continue to be unbearably high. This reflects that health messages, commodities, the tools and the infrastructure are not reaching those most in need. New ways of doing business are required. This is a point which was recognized by the G8 Heads of Government at their meeting in Evian from 1-3 June, but there is a need for much more work on the detail of what must be done if we are to make a real impact.

We believe that only public health interventions that successfully mobilize civil society will be able to reach the poorest of the poor and bring sustainable public health improvements that can narrow the growing equity gap.

European Red Cross Red Crescent Societies have much to offer in this respect. As an independent auxiliary to public health authorities, our National Red Cross and Red Crescent Societies bring to the table large volunteer networks, a well-respected emblem and the proven ability to mobilize the power of humanity and bring additional resources to the community level. As a neutral, impartial and trusted humanitarian organization, the Red Cross Red Crescent can help bridge the gap between the formal health system and vulnerable communities. This is a significant addition to the mandate and the technical capacity that ministries, WHO and others have.

The European Red Cross and Red Crescent National Societies assembled in Berlin in April 2002 to determine priorities for the coming four years. I would like to bring to your attention a number of pressing concerns that need to be addressed and where the value of partnering with Red Cross Red Crescent Societies can become clearer.

Tuberculosis

In 1993, the World Health Organization (WHO) declared TB a worldwide disaster, threatening millions of lives all over the world. Asian and sub-Saharan Africa are the hardest hit, but Eastern Europe has recently seen a major increase in the incidence and deaths related to TB after many years of steady decline. An estimated 75 per cent of people with TB are between the ages of 15-44, which is seriously damaging socio-economic development. The growing epidemic of HIV and the threat of drug-resistant TB, are rapidly narrowing the chances to control TB in Europe.

WHO, national health authorities and other agencies are working in TB control in an integrated manner. Red Cross and Red Crescent support to TB programmes –working with ministries of health and others– is making a significant contribution by raising awareness on TB and HIV among the general population, by providing social assistance, care and treatment supervision to the most vulnerable TB patients and by greatly reducing dropout rates. In a few areas the Red Cross is also helping strengthen ties between civil and penal sectors of TB services for improved living conditions in overcrowded prisons and guaranteed access to TB treatment for prisoners, as well as legal and prison reform, as prerequisites for successfully fighting TB in penal institutions.

HIV and AIDS

Some parts of the European continent are experiencing the fastest-growing rate of HIV/AIDS in the world. Injecting drug users (IDUs) are at particular risk, and are overwhelmingly young men. The major challenges in prevention and control of HIV/AIDS vary in different parts of Europe. In Eastern Europe and Central Asia, reduction of HIV transmission through IDUs has become a public health priority, while efforts to prevent HIV transmission through sex, blood transfusion or mother-to-child need to be strengthened. No sub-region is guaranteed that the epidemic will not grow. Access to clean injecting material, substitute drugs and adequate social work are ways of reaching out to IDUs.

The International Federation is working in close partnership with the European Network of People living with HIV/AIDS (ENP+) within the framework provided by National AIDS Control Plans. Two particular areas where I would like to highlight the value we are adding value include:
a) acting against stigma and discrimination of PLWHA, and
b) advocating for, and/or implementing harm reduction strategies that include outreach to IDUs, access to clean injecting material and substitute drugs programmes.

[In some ways linked to the above, the third area I would like to highlight is the problem of]

International migration, discrimination and health

All European National Societies are committed to bring particular attention to the needs of those whom migration has placed in special jeopardy: people living in the shadow of illegality, people excluded from health care access by definitions which discriminate against them and, most of all, the children whose futures are threatened by such discrimination.

We reaffirm the entitlement of every individual to enjoy basic human rights in accordance with international law… and these rights must be extended to all new arrivals in our countries, regardless of their legal status. We want to ensure that those affected by HIV/AIDS, tuberculosis and other infectious diseases are able, freely, to access appropriate care. We want to extend our assistance and protection to all those in need of it, in accordance with international humanitarian law, human rights law, tolerance and human dignity.

Every human being has the right to health, regardless of his or her personal legal status. Every government has an obligation to secure access to basic rights by all persons on their territory, regardless of why the individual is present.

None of these issues has easy solutions. All of them imply engaging with hard to reach highly vulnerable groups. It is in covering this last mile, that civil society partners like the Red Cross Red Crescent can prove most useful and cost-effective. Let me reassure you that wherever ministries of health and UN organizations are willing to team up with the Red Cross Red Crescent you will see thousands volunteers advocating, fighting discrimination and stigmatisation of people living with HIV/AIDS. You will see Red Cross Red Crescent volunteers working alongside others, reaching out to asylum seekers, refugees, homeless people, helping them decrease their vulnerability and improve health. But we can only do this together.

The work of the volunteers must be supported with resources and appropriate policy environments. We urgently need to work at eliminating the stigma and discrimination that continues to fuel the epidemic of HIV and AIDS. Similarly, other vulnerable groups, like prisoners, detainees, migrants and displaced populations, face discrimination when they are denied access to care and treatment, simply because of their status or situation. There is a humanitarian and public health imperative to provide basic health care to all populations without discrimination and based on vulnerability and principles of social inclusion, not exclusion.

As I have mentioned, our efforts need to be supported by ministries of health through resources, through supportive legislation and policy environments, through clearly defined roles and responsibilities for National Societies, and other measures that can facilitate Red Cross Red Crescent volunteer action.

Mr. Chair,

The International Conference of the Red Cross and Red Crescent Movement will bring together all the world’s National Societies and Governments in December to discuss an agenda for humanitarian action framed around the theme of protecting human dignity. Partnerships to reduce the vulnerability to disease caused by discriminatory policy environments will be a major component in this agenda at the conference. It is our hope that new links and partnerships will be forged at and from the Conference, allowing us to respond much more effectively to the challenge of protecting human dignity. Many governments will include Ministers or Senior Officials with responsibility for health and community care in their delegations to our International Conference in December, and I look forward to building further this dialogue with you, or your representatives, at that time and at other occasions which will bring us together.

Thank you.