‘Public Health Is Gaining Prominence and Respectability’ .
For 27 years, Agis Tsouros was responsible for carrying out strategic and operational development for the World Health Organization’s Healthy Cities project, with the ultimate goal of meeting one of their main priorities of “health for all.” He nurtured the project from its initial launch at WHO EURO to its international expansion, which, he says, “reached every corner of the planet.”
Tsouros’s focus on the health of cities came from his “deep interest in the social and political dimensions of health and health care” while he was in medical school in Greece. This interest lead to a master’s in community medicine and a PhD on the evaluation and impact of medical technology. His specialization in public health gave him the opportunity to work in “a fascinating multicultural district” in the center of London, in which he initiated the WHO framework for their “health for all” strategy at the local level. It was this project that attracted the attention of WHO EURO headquarters, where he was asked to start up the Healthy Cities project.
Throughout his career, Tsouros continued to push the importance of local action, the urban context, and the key role local governments play in the development of sustainable health systems. After watching the Healthy Cities project expand across the globe, Tsouros retired from the WHO in TK and is currently advising individual countries and cities worldwide on health policy and governance. He continues to work to strengthen Healthy Cities through the establishment of Global Healthy Cities and the implementation of the new sustainable development goals agenda at the local level.
On September 25 as part of the Dean’s Seminar series, Tsouros will deliver a talk titled “Lessons Learned from a Life in WHO: Governance and How We Generate Global Health.” Ahead of his talk, the Career and Practicum Office spoke with Tsouros about public health’s need to reach out across sectors, how the field is evolving, and what the biggest threats to human health will be in the future.
What was the best piece of advice you gained during your career that you think would be helpful for public health students and graduates motivated to positively impact world health?
To understand the politics of health; to always uphold the values of, and fight for, the right to health and equity; to develop leadership and strategic skills; to always have the big picture and anticipate change; and last but not least, to be proud they chose public health and believe they can make a difference.
What do you know now that you wish you knew at the start of your career?
During the last 30 years, there has been a major accumulation of scientific evidence in many fields of public health, which has significantly strengthened our ability to make the case that health goes hand in hand with social, economic, and sustainable development. Certainly, I would have invested more time and effort reaching out to decision-makers across sectors. I feel public health practitioners keep talking to and applauding each other while the big challenge is to convince stakeholders from key sectors such as economy, education, social services, environments, trade, housing, and urban planning. A turning point in my work was in 1997 when I approached Michael Marmot [chair of the Commission on Social Determinants of Health] and proposed to publish the Solid Facts- The Social Determinants of Health (SDH), a concise publication for decision makers. It was a WHO bestseller for 15 years.
What helps keep you motivated and inspired today?
Health is increasingly recognized as a key issue for development by world leaders. The UN sustainable development goals have created political legitimacy and a momentum for change. Public health in the 21st century can be an effective and smart player at global, international, national, and local levels. We have the knowledge, the evidence, and the tools. There is a lot to do in all countries. The social landscape is changing fast, with major implications for the health of the population, and climate change is knocking on our door every day. Science, including genetics, could also radically change the way we understand prevention and health promotion. I think this is a great time work in public health.
What has been the hardest moment of your career thus far?
Retiring from WHO and still feeling young, inspired, and full of energy to continue my international work. The day I retired I said I could start my career at WHO all over again.
Employers tell us that writing skills and data skills are so important in an MPH hire and that the ability to tell the story is pertinent within global health. Are there other skills or attributes that you feel are significant for someone getting into the field or interested in a job at WHO?
Listening and communication skills, thinking strategically, negotiation and diplomacy skills, and, as I said before, a good understanding of the political and social context within which public health is practiced.
What do you see as the changes happening in your field that new public health grads should be aware of?
A better understanding of the social, commercial, environmental and political determinants of health. The appreciation of what it takes to address health inequalities, to protect our communities from the consequences of climate change and to become effective advocates of human rights in the face of migration, globalization, and the aging of the population. And lastly, to take advantage of the huge political leverage of the SDG agenda.
What do you think will be the biggest issues facing public health in the coming years?
Health inequalities, the communicable disease epidemics, antimicrobial resistance, and public health emergencies constitute major threats for human health in richer and poorer countries. The biggest issues facing public health today are: its weak place on the political agenda; the outdated public health systems; the challenge of ensuring universal coverage; and the lack of capacity to implement health goals that require the contribution of many sectors. The good news is that public health is gaining prominence and respectability.
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