Internetconsultation Global Health Strategy

Reactie

Naam	de Nederlandse ggz (coördinator Waardenetwerk Internationaal Verbinden VH Hemmelder)
Plaats	Amersfoort
Datum	21 augustus 2022

Vraag1

Session 1: Diplomacy and human rights-based

Question 1: How could we best include the input of marginalized groups in our diplomacy efforts?

Question 2: The Netherlands is often referred to as a donor with courage. If the Netherlands wants to continue being such a donor, which are the (health-related) themes we should focus on?

Question 3: How can the Netherlands best align the national and international efforts regarding Global Health?

Question 4: How can the Netherlands make more effective use of its diplomatic network abroad, including embassies, permanent representations and thematic experts (such as health attachés)?

Question 5: How can the Netherlands' position within the UN (and its reputation in the field of international (human) rights) be used to advance global health objectives?

Question 6: How can we systematically link diplomatic efforts in Brussels, Geneva and New York to the benefit of coherence and greater effectiveness?

Question 2: Mental Health is an important theme to focus on. Mental health is crucial for wellbeing and mental ill-health represents the leading cause of disability around the world, especially in young people and adults. Early investment in mental health skills and early detection of mental health problems brings lifelong returns on health and participation outcomes. The Netherlands is rich in good practices, for example for the implementation of assertive community treatment (FACT), peer led recovery services, effective acute mental health including IHT, collaboration between the health and social domain, destigmatisation, positive health, effective prevention strategies, and forensic mental health care. Many of these good practices themselves have once been adapted by the Netherlands from other countries. Sharing our knowledge, lessons and practices about population mental health can have a positive impact on countries where mental health is still a taboo subject or on countries that still have a dominantly clinical approach to mental health. Meanwhile, we can also learn from other countries, for example from creative low-cost approaches of countries that have significantly smaller budgets allocated to improve mental health.

Question 5: Mental Health and Human Rights are very closely intertwined – for example around subjects such as restraint and seclusion, and discrimination and stigma of people with mental health problems. See recent guidance and trainings by the WHO on this subject: https://www.who.int/publications/i/item/9789240025707 and https://www.who.int/teams/mental-health-and-substance-use/policy-law-rights/qr-e-training. There are inspiring examples in other countries, such as Italy, Ireland and the UK, where human rights form a strong foundation for national mental health strategies, leading to more inclusive and healthier communities and societies.

In addition, (mental) health is unfortunately not divided equally. Low economic status groups are prone to have underdeveloped health skills, have less access to (and knowledge of) prevention, lifestyle-care or healthcare options. This division between the ‘haves’ and ‘haves not’ is not a phenomenon exclusive to the Netherlands. International cooperation could decrease the gap between economic status groups.

Vraag2

Session 2: Health systems strengthening

Question 7: How can we reach everyone, especially the most marginalized people, to ensure their access to information and medical service?

Question 8: How can we make use of the specific knowledge and experience of all different sectors involved in global health? How can we also involve the private sector in meeting the people in greatest need?

Question 9: How can we promote green and sustainable health systems strengthening?

Question 10: How can we gear health systems strengthening most effectively towards better preparedness?

We believe that for a (mentally) healthy society, we need a mental health system that:

- Focuses on health instead of disease and therefore on value-based positive health care
- Realizes that mental health is health, and that mental and physical health are strongly interdependently connected
- Addresses the socio-economic determinants of health and aims to reduce socio-economical health differences by choosing an interdepartmental and intersectional approach
- Detects and intervenes early and effectively, in a way that is accessible for everyone
- Connects to all necessary domains of someone’s life, such as school, work, housing, neighborhood, family, physical health etc. and reduces mental health stigma.
- Empowers people to be in charge of their own health, by providing them with all necessary tools and promoting co-creation with citizens, patients, experts by experience, family members, supporters, schools, communities etc.
- Creates a satisfactory, supportive work climate for health care professionals that stimulates development of expertise and innovation
- Realizes that our mental health, and especially the mental health of young people, is increasingly influenced by global developments, such as pandemics, war and the growing climate crisis

Exchanging knowledge, strategies and best practices globally can be helpful for policy makers all over the world in supporting citizens in becoming mentally healthy and mentally skilled, so that they can face the (global) challenges that come their way.

Vraag3

Session 3: Pandemic prevention, preparedness and response

Question 11: Which lessons should we learn from our approach in earlier pandemics, and more specifically, what could we do better?

Question 12: What are the most pressing gaps in the current global health architecture regarding PPR, and how should/can they be addressed?

Question 13: How can we best ensure sustainable financing for PPR?

Question 14: To what extent should new international agreements be legally binding?

Question 15: To what extent should the Netherlands promote the sharing of IP, knowledge and data in the context of PPR?

Question 16: How could we best communicate to a global public audience in order to not only prevent but also respond better to a pandemic?

Question 11. One of the most important conclusions of the pandemic is the increased awareness of the importance of mental health. A recent inquiry by the World Economic Forum (Mental health, inequality and trust: What we learned from the COVID-19 pandemic. April 2022) shows that mental health is perceived equally or more important than physical health by 91% of respondents, but almost half of the respondents still perceive their health system to prioritize physical health. Another important conclusion is that existing inequalities and disparities across age, gender, ethnicity and geography have been exacerbated during the pandemic.

An important lesson going forward for pandemic preparedness is to take mental health and socio-economic differences into account more strongly in decision-making processes, and to invest early into community building and mental skill training interventions, to reduce the mental health effects and health disparities of the pandemic and the pandemic response.

Vraag5

Session 5: One health multisectoral approach

Question 20: There are noticeable links between global public health and other themes, including climate, food security and nutrition, clean leaving environment (e.g. WASH/clean water and air), animal health, economy, school health (e.g. CSE, ASRHR) and sustainability (social, economic and environment). Which should be the priorities that are also practically feasible for the Netherlands in this regard?

Question 21: How do we best engage in this intersectional approach of global health?

Question 20. Given the high global prevalence of mental ill-health and the strong interdependency between physical and mental health and between mental health and socio-economical factors, mental health cannot be missed in the One Health Multisectorial Approach.

Question 21. There are many international structures that the the Dutch government could engage in to make the One Health approach - including Mental Health- reality. For example, the WHO and UNICEF are very active on the subject (https://www.who.int/teams/mental-health-and-substance-use/world-mental-health-report), (https://www.unicef.org/on-my-mind), including a WHO worldwide Special Initiative (https://apps.who.int/iris/handle/10665/310981) and WHO Europe framework for action (https://www.who.int/europe/publications/i/item/9789289057813). Other relevant international networks are for example IIMHL & IIDL, EuroHealthNet, United for Global Mental Health and many more. All these initiatives take an intersectional and integral approach. As het Waardenetwerk Internationaal Verbinden (in English: the Dutch International Mental Health Hub) of the Nederlandse ggz we would gladly take a role in connecting the Dutch government to the right people/partners.