"Building Public Health Dialogue and the role of Health NGOs - in the Republic of Slovenia and the EU" conference links Slovenian and EU public health NGOs

As conference co-organisers, EPHA’s role was to demonstrate how networking at EU-level can complement NGO policy work at national and regional levels, and to provide comparative insights by way of international speakers active in the SCTC’s main activity area, tobacco control. The event was spread over one and a half days, with two plenary sessions and five workshops on day one, and a roundtable discussion on day two. The plenary highlights are summarised below.

26 March 2010: Plenary Session 1

SCTC President and Chairperson of the “NGOs Protect Our Health’’ network Mihaela Lovše welcomed the audience and emphasised the role of civil society to ensure health and safety for all. The conference represented a unique opportunity to contribute to civil dialogue through the exchange of knowledge and experiences gained in Slovenia and elsewhere. Words of welcome were also expressed by conference Co-Chair and EPHA President Archie Turnbull who underlined EPHA’s role in helping NGOs to grow and develop, which was particularly important given that the public tends to receive public health messages more effectively from NGOs.

Two officials from Slovenia’s Ministry of Health, Ms. Mojca Gruntar Činč, Director of Directorate of Public Health, and Ms. Vesna Kerstin Petrič, Chairperson of the Sector for Health Promotion and Healthy Lifestyles, explained that the government-NGO partnership is already active and valued at national level, citing tobacco control as an example where NGOs exert their influence. The government provides funds for the sustainable development of NGOs and for training public servants to stimulate public participation.

Slovenian MEP Mr. Alojz Peterle (Group of the European People’s Party) also spoke in favour of NGO involvement and explained that the EP possessed formal and informal groups, including one dealing exclusively with health. While health remained a Member State competence, demand was growing for supranational action. All EU countries experienced health (system) problems and lack of funding, which called for the insertion of “health in all policies”. Citing cancer as a priority area, he stressed that stakeholders (including the EU institutions, national governments and NGOs) must mobilise common actions to promote prevention. Although overall, health remained underestimated at EU level, NGOs were allies in bringing about a paradigm shift. The economic ambition of the EU2020 strategy could not be achieved with an ill population: health must become an integral part. He said his door was open and explained how various events (e.g., briefings, working lunches, presentations, expositions, etc.) contributed to this work. Cross-border healthcare was another concern and a new health ‘’Iron Curtain” must be avoided.

Mihaela Lovše told the story of the SCTC which, since its inception in 2003, focused on health promotion, especially tobacco control, and on reducing tobacco use by way of public education, policy efforts (e.g., preparing legislative amendments), projects (e.g., smokefree workplaces) and finally, the thematic “NGOs Protect Our Health” network. Her colleagues Staša Bornar and Darija Lorbek elaborated by explaining the network’s role in contributing to knowledge transfer and providing opportunities for cooperation and activities to public health NGOs. Its organised, accessible structure included an NGO register, a dedicated website, promotional brochures and e-forms, and frequent organisation of conferences, training workshops, etc. Currently, 35 members benefited from access to partnerships at national and EU level; access to models of good practice; more coordinated and cooperated work; and obtaining up-to-date information. A multimedia website also promoted the network and disease prevention.

EPHA Policy Officer for Global Health Dorota Sienkiewicz rounded off the session by explaining how EPHA functions as an European umbrella of NGOs and other organisations. Added value was provided by being a platform and network which represents the European public health community and promotes a public health-friendly environment so that health can indeed be placed into all policies one day. Since everything we do in Europe has a worldwide impact, global health is also important to EPHA.

The remainder of the day was facilitated by EPHA’s Governance and Membership Coordinator, Sascha Marschang. Plenary session 2 focused on health inequalities and stakeholder engagement.

The first speaker, Ms. Tatjana Kranjc Nikolič from the Institute of Public Health in Murska Sobota presented a strategic action plan for health promotion which tackled health inequalities in Slovenia’s less prosperous Pomurje region. In this Ministry of Health-supported partnership, citizens play an active role and networking with NGOs, policy makers, health professionals and other stakeholders is actively encouraged. Health inequalities are confronted by promoting healthy lifestyles and enhancing social ties, by targeting non-communicable diseases and through supporting vulnerable groups such as the Roma minority.

A second presentation by Dorota Sienkiewicz focused on “Upcoming Challenges to Health”. She explained how health is a three-level concept, including interacting physical, mental, and social spheres. Challenges to health are not equally felt by people: they will affect everybody, but not everybody is equally vulnerable. Women, migrants, people living in the global south, the very young and very old are particularly vulnerable. Some of the major issues and developments that continued to impact on, and indeed threatened, human health include:
 Environment/Climate change/Global Warming
 Food and agriculture
 Trade and Open Markets
 Economic Downturn
 Rapid privatisation
 ICTs for health
 Migration
 Consumerism and multinationals.
 Non-communicable diseases

Combined these challenges called for urgent action; what was needed was solidarity that dealt with wider health determinants and repeatedly stressed the urgent need for “health in all policies’. Individuals must also be empowered to make positive lifestyle choices, and welfare policies should not just provide safety nets.

Next up was Florence Berteletti Kemp, President of the Smoke Free Partnership (SFP) who presented her organisation and explained how she works together with various partners to fight the tobacco industry. She challenged the audience to think about the meaning of the term “stakeholder”, in particular whether the word exists in other languages and what differences there are between stakeholder engagement at national and European levels.

She emphasised it is crucial for NGOs to carefully choose their area(s) of engagement and define messages with others. The identification of relevant targets (who has power? what is important?) in addition to the “right” communication channel and time frame were equally important. Stakeholder engagement entailed various activities such as consulting multiple opinions, empowerment, representation and follow-up. (Pro)active planning, monitoring and reporting were also essential. Unfortunately, due to limited resources, NGO voices were often feeble and unlike in Slovenia, in many EU countries this translated into restricted access to senior policy makers.

That said, in tobacco control the EU can impose legislation on Member States as directives are binding. NGOs contribute to this process by lobbying for instruments that contribute to tobacco control, e.g. smokefree environments, labelling, taxation, generic packaging, etc. Taking European legislation on tobacco products as an example, she highlighted the long-term planning, revision, and impact assessment process involved in bringing about change.

This plenary was rounded off by Mojca Vivod Zor of the Cancer Patients’ Assocation of Slovenia, who shared her personal experiences as a cancer patient that encouraged her to become involved in the association. She stressed that patients must be active if they wish to improve healthcare, and to this end her organisation promoted volunteer work and healthy lifestyles, and it provided information on patients’ rights so that cancer would become a disease everybody could comfortably talk about. By tapping into new energy sources patients could express solidarity and share their experiences for the benefit of others.

The Saturday roundtable was facilitated by Mr. Goran Forbici of the Centre for Information Service, Co-operation and Development of NGOs (CNVOS) who welcomed participants and explained that he is working on a framework for civic participation in Slovenia. There is also an NGO memorandum, created by a broad coalition of Slovenian NGOs and done at the request of the Slovenian Prime Minister.

He reminded the audience of the purpose of the roundtable - to discuss the “Role of NGOs in shaping health policy”. Present were representatives from the SCTC and its network partners, EPHA, the Smoke Free Partnership, ASH Ireland and the Slovenian government.

The EPHA team briefly reminded participants why public health matters by way of a video and an abridged presentation that summarised EPHA’s work and took up the main issues already discussed on the previous day.

Mr. Forbici explained that NGOs all over Europe were both taking part in formulating agendas (lobbying) and in providing services. In order to do this, two prerequisites were needed:
 Open public institutions: willing to cooperate and staffed by decision makers/implementers, and
 Proper enabling environment: a policy framework and the ability for NGOs to function, e.g. through financial subsidies or core grants.

The question was whether something was missing; can anything be done to improve the situation for NGOs? Luke Clancy of ASH Ireland said that NGOs can effectively reconcile national and EU aims if they try to work with governments; unfortunately, NGOs’ impact can also be resented. Legitimacy was extremely important and could be achieved by staying tangible (supporting relationships, shared knowledge, etc.) and by displaying integrity, but also through public health and media advocacy to shift public opinion.

Florence Berteletti-Kemp said there are different NGOs with very different objectives – their role cannot be defined without reference to their specific purpose. Some NGOs do not need to relate to the EU as it is not relevant to their mission. However, the Slovenian participants felt that NGO worlds are more flexible than those of other sectors. NGOs can adapt and work on many different levels (local, national, European) simultaneously. It was important that strategies are combined and priorities shared.

Archie Turnbull also stressed that NGOs need to change and be flexible. Euro NGOs cannot have any legitimacy if they do not represent national NGOs.

SCTC legal officer Marko Pisnik then introduced the proposed amendments to the existing Slovenian tobacco control legislation the SCTC had worked on (including a proposed “Tobacco Euro” tax, specialised stores selling tobacco, and the “NGOs Protect Our Health” foundation) that were presented in the February newsletter. The aims of these amendments are:
 improved public health;
 funding of health NGOs; and
 better implementation of health programmes

Conference Chair Mihaela Lovše explained the SCTC had already contributed to a Ministry of Health Tobacco Control Action Plan. There was lack of private funding in Slovenia and the “NGOs Protect Our Health” network went beyond tobacco control as there was a need for a broader public health coalition to move things ahead. She asked participants to consider signing an anti-tobacco decree that would be e-mailed to all roundtable participants. This resulted in a discussion about the need for clarity and more specific information about timelines, content, and motives for this petition. The conversation will certainly continue long after the end of the conference.

For More Information

 SCTC/"NGOs Protect Our Health" website
 Smoke Free Partnership
 ENSP
 ASPHER
 CNVOS
 ASH Ireland
 Government of the Republic of Slovenia - Ministry of Health

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