David's blog #50: Making Space for Magic

This year seems certain to stick in our collective memory. We are experiencing a global pandemic where many countries’ health systems have been challenged, and in some cases overwhelmed. Massive economic impacts are certain, and we will undoubtedly see significant political repercussions. Issues of inequality have been thrown into sharp relief, and there have been some searching questions asked concerning community cohesion, engagement and the trust and confidence we place in our leaders and systems. And it is only the end of the summer! Never has mutual support and collaboration been more vital.

Of course, amidst the pandemic there have been some awe-inspiring responses. Across the health sector, and within communities and NGOs, there have been institutions, groups and individuals who have exceeded what could be reasonably expected. There are examples where some countries and political leaders have demonstrated leadership and a capacity to take people with them. Others have clearly not. Looking at the positives, the crisis has provided opportunities to short circuit many of the barriers we often face in providing services. In my own niche world of alcohol and drugs, I have seen great work delivered at pace to groups who have often been overlooked or considered too complex to engage with. There have been some stunning successes.

Enforced home working has also provided time to reflect. And one of the things I keep coming back to is: what are the circumstances, the formula, that, sometimes, allows things to come together and work, which support the big improvements in terms of health and wellbeing? I have no doubt there are all sorts of theories and scientific discussions which consider the role of policy, resource, public attitudes and numerous other aspects. However, my sense and experience is that sometimes the stars align, normally after much hard work, and then there is a spark, a bit of magic, and things change. But magic requires the right kind of environment.

At the City International conference in 2015 Sir Harry Burns delivered a powerful speech which still strongly resonates with me. As well as talking about the importance of listening to individuals and communities, feelings of belonging, and societal coherence, he also mentioned the success of medicine in terms of magic bullets. Antibiotics and vaccines are good examples of medical magic bullets, and we had a recent example of that with the declaration that Africa is now free from wild polio. A great achievement. But as vital as the contribution of scientists and doctors has been, what has led to this happening in 2020, nearly seventy years after the polio vaccine was developed? Clearly it is a result of a huge amount of skill and determination but also collaboration and partnership working. It has involved the advocacy of those who have survived polio, and dozens of NGOs and volunteers; it has benefited from the support of traditional and religious leaders; and it has engaged teachers and parents. This combination of resources and skills made it possible to overcome resistance, suspicion and highly volatile environments. All concerned should be celebrated – it could not have been achieved just by one sector or profession.

Now I cannot claim to have ever been involved in such an impressive global achievement as eliminating polio, but I have seen groups of professionals, communities, advocates and others come together and improve lives at a national and local level. The ongoing efforts to eradicate Hepatitis C are a great current example of the kind of outcomes we can and should aim for. I have seen the power of partnerships and collaboration and know that success is built on a breadth of support, not just specialisms.

This is why I am so pleased to be involved with the launch of the new Global Public Health Network (GPHN). This builds on the approach of the City Health International conferences but offers exciting new opportunities. It is a work in progress, and we are dependent on you to help us shape it. Our ambition is that the GPHN will help support organisations and groups around the world, especially those operating in challenging environments.

The website will share knowledge and experience, and will also offer practical tools in terms of digital support for training and seminars. It will include a harm reduction database and provide access to a wide range of relevant materials (which we are making more accessible through translation). There is a specific section, Covidopolis, which seeks to identify and promote some of the excellent work undertaken during the pandemic (and which links to the theme for the City Health International 2021 conference). There is also a section on bright ideas to help encourage innovation and new ways of working. Further, we hope to do some “match making”, putting institutions and agencies with similar interests in touch with each other. Another objective is to help close the gap between research and practise to help deliver evidence-based initiatives. In keeping with the spirit of City Health International we are also happy to provide platforms where ideas can be discussed and challenged.

As you can see this is an ambitious, exciting, but also demanding undertaking. I am looking forward to being involved in its development, but it needs your input and support to be a success. So please, join with us in helping realise the potential of the Global Public Health Network. We cannot promise magic, but with your help the Global Public Health Network will help provide opportunities, and create a space, where magic is possible.