In an attention-grabbing presentation, Paul Walker, of the US affiliate Green Cross International, engrossed delegates at the World Congress of Public Health in Addis Ababa with his skillful exposition of the burden on humanity represented by warfare and the preparations for it. Tying the issues neatly into the concerns of Africa, he noted that the global annual expenditure on military activities of all sorts was in the order of $1.5 trillion and that was twice the GDP of the entire continent. The annual expenditure in relation to nuclear war preparation is, by itself, $100bn. He named the guilty parties; those countries that were not yet signed up to the Test Ban Treaty, the Non Proliferation Treaty, the Chemical Weapons Convention, and the Biological Weapons Convention.
Paul finished with one of the most powerful quotes I have ever heard. It is from a 1953 speech by Dwight Eisenhower: “Every gun that is made, every warship launched, every rocket fired signifies, in the final sense, a theft from those who hunger and are not fed, those who are cold and are not clothed.”
The problems of both sexually transmitted diseases and of sexual exploitation were themes of the congress. There was a wonderfully enthusiastic presence of those trying to address these problems in Ethiopia. I admire their determination and commitment. The absence of sex education in Ethiopian schools, beyond the biological facts, combined with an unwillingness to discuss sex publicly and the criminalisation of homosexuality all combine to make it tough for young people and young women in particular. The very many massage parlours, some of them offering much more than massage, and, when darkness falls, the innumerable sex workers lining the streets make it clear that big issues of gender, sexuality, and the exploitation of women need to be addressed.
One of the practical problems affecting those attending this most efficiently run congress has been the horrendous traffic congestion that afflicts Addis Ababa. Morning and night the streets grind to a halt and the pall of air pollution hanging over the city thickens. A sustainable transport is as needed here, as it is anywhere. After a week without cycling I miss my bike, but the only bicycle to be seen in Addis Ababa is the one parked neatly in the lobby of one of the posh hotels where its basket serves as a newspaper rack.
It was great to see Liverpool University with a stand at the congress, the only other UK exhibitor being GeoWise, the mapping company. What a pity there weren’t more UK institutions and companies at this global showcase for public health education and enterprise. Perhaps there will be a greater involvement in the 14th World Congress, which will be held in February 2015 in Kolkata (Calcutta).
Finally, the mention in my previous blog that AMREF won the World Federation of Public Health Associations’ top award prompted a loud hurrah, via Twitter, from former president of the UK’s Association of Directors of Public Health. Frank Atherton owes his life to them for a skillful medevac in Kenya following a burst appendix. All of us in UK public health will join in that hurrah.
Gabriel Scally is a public health physician and holds visiting chairs at the University of the West of England and the University of Bristol.