Con the SARS COV-2 pandemic, all political agents have put on paper that one of their highest priorities was to strengthen public health. Now what the great covid emergency seems to be subsidingit is time to act so that our public health can really be capable of responding to the challenges we face.
1.- Firstly, two big problems: infectious diseases, especially epidemics and pandemics, and chronic non-communicable diseases. We need to detect them as soon as possible, know their characteristics and trends. We need to improve surveillance and epidemiological intelligence, and this means providing public health with well-trained human resources, computer resources and technologically well-equipped laboratories and adaptable to the needs that may arise.
2.- The climate crisis is one of the most important priorities in public health and we are already late. We must establish strategies to minimize the negative effects of climate change on the health of the population. In January 2020, the Government of the Generalitat approved promoting the Public Health Response Program to the Climate Emergency. The pandemic stopped him. The climate crisis has not stopped.
3.- To achieve these objectives we need policies that, necessarily, They must be transversal and multidisciplinary. Only by guaranteeing a healthy environment and animal world can we guarantee good human health. It is the philosophy of the One Health strategy (one health), absolutely essential, together with the proposals for Health in all policies: any policy proposed by any Administration has an impact on people’s health, and therefore, it is necessary to take into account and assess that this impact is positive and not negative. It is therefore necessary to support these two policies if we want to achieve good results.
4.- To make it come true we need powerful structures able to get ahead, and in Catalonia we have a lot of ground to run.
Our public health services are quite fragmented. The municipalities are responsible for part of the protection health, such as control of food retailers and participation in health promotion tasks; to the Public Health Agency of Catalonia (ASPCat) the rest of the protection corresponds to him and health promotion, disease prevention and epidemiological surveillance, among other functions such as those related to occupational health or addictions. On the other hand, the ASPCat has a territorialized organization that allows you to act locally, generating a series of spaces in which effective competition remains unclear. Both the local authorities and the agency have health authority functions. let’s add preventive medicine services of hospitals, primary care, universities and research centers and county councils. Great acting potential, and yet Lack of a clear structure. It is necessary to create a public health network for Catalonia with all these elements, well structured and, if necessary, hierarchical.
From very close collaboration Between public health services, primary care and municipalities, policies oriented towards action on the social determinants of health must emerge. This is a must-have community orientation to develop policies such as those mentioned above.
Related news
Finally, we have a Public Health Agency created in 2009, dissolved by the cuts of the year 2013 and recovered in 2019. The text of the Law of the Public Health Agency of Catalonia, unanimously approved by Parliament, It gave six months for the elaboration of its statutes. The pandemic came. The agency, more than three years later, still does not fully exist legally.
In Catalonia, public health It represents around 2% of the health budget. In 2019, the last one before the covid, the ASPCat budget was 21 euros per person per year. Totally insufficient. Obviously, the pandemic has led to a notable increase in spending, but the question is: when we return to “normality”, Will the necessary resources be available to do so?
