Professor Kickbusch is a leading global health expert. She has contributed to many innovations, policies and educational initiatives during her distinguished career. She has received many prizes, honorary degrees and recognitions. She was awarded the Cross of the Order of Merit of the Federal Republic of Germany (Bundesverdienstkreuz) and the WHO Medal for contributions to global health. She is honorary professor at the Charité, Berlin.

She continues to advise the WHO and is a member of the Global Preparedness Monitoring Board. She served as a member of the path-breaking WHO Council on the Economic of Health for All. She was key instigator of the Ottawa Charter for Health Promotion, WHOs Healthy Cities Network, WHO’s Health Behavior and School Children Survey, health literacy and Health in All Policies. She has always been committed to women’s health and rights and initiated the @wgh300 list of women leaders in global health.

She is the founder and Chair of the Global Health Centre at the Graduate Institute of International and Development Studies in Geneva and was the director of the Global Health Division at Yale University School of Public Health. She has pioneered new approaches to leadership training in global health: she initiated the first executive training in Global Health Diplomacy and is program chair of the leaders in health network SCIANA at Salzburg Global. She publishes widely in distinguished journals.  

She was co-chair of the Lancet FT Commission on “Governing health futures 2030: growing up in a digital world” and is now working on following through on its recommendations, especially addressing the digital determinants of health.

She chaired the international advisory board for the development of the German global health strategy, advised on the establishment of the WHO Hub on Pandemic and Epidemic Intelligence in Berlin and has been involved in German G7 and G20 activities relating to global health as well as the global health initiatives of the German EU presidency in 2020. She works on a continuous basis with EU presidencies on global health and was advisor to the development of a revised EU Global Health Strategy. She is vice-president of the European Health Forum Gastein.

She is a political scientist with a PhD degree from the University of Konstanz.

*VIDEO PRESENTATION*

The Ottawa Charter was meant to be a provocation. It told health systems they were doing the wrong thing, in the wrong place, for the wrong reasons. Forty years on, that provocation is still unresolved. Why has the most politically ambitious health framework of the 20th century has in many areas remained aspirational rather than operational. Health promotion lives in intersectoral space, no single ministry owns it, no single budget funds it. That ambiguity has been its political weakness as well as the restrictions of being placed within health systems, run by medical logic. One of the five key action areas of the Ottawa Charter was to “reorient health services”. Systems have not. Why? There are clear structural arguments: incentive architecture, professional power, fiscal logic and governance gaps as well as hierarchies of knowledge, race, gender, and class. To move forward structural conditions will need to be addressed such as binding accountability mechanisms and participation decision-making authority with resources. Most critical will be to reframe the economy of health including fiscal health policies, wellbeing economics, the care economy, taxation as health intervention. A key challenge in the digital and AI transformation is the governance for health promotion as public interest framework that protects health and empowers  communities as collective actors. The Ottawa Charter challenged the biomedical model at a moment when biomedicine was becoming globally dominant, commercially profitable, and politically powerful and is now fully reinforced by technological, digital and AI developments. At this point of time, we need to approach the Charter is not as a historical monument but as an unfinished agenda. The question for this generation is if and how they will take it forward.

John Holmberg is a Professor of Physical Resource Theory at Chalmers University of Technology and holds Sweden's first UNESCO chair in sustainable development. He leads a research group at Chalmers "Navigating Sustainability Transitions", which currently has a main focus on systemic transformations in healthcare. He was the Vice President of Chalmers 2007-2016 and is currently the vice chairperson at University of Borås.
 
He has been/is advisor to the United Nations Headquarters in New York in the preparation of Agenda 2030; to UNESCO in Paris in the expert group for the UN-Decade on Education for Sustainable Development; to UN-Environment in Nairobi; to EU on Eco-efficiency; to the Swedish Environmental Technology Council (Swentec); Sahlgrenska University hospital in Gothenburg and to Carl-Zeiss-Stiftung, Stuttgart.

In many countries healthcare systems are undergoing a transition, where prevention and proactive health promotion as well as specialised health care at home are becoming increasingly important alternatives to traditional healthcare. This development is partly driven by an aging population, a rising prevalence of chronic diseases, and the need for more cost-effective care models.

Specialised health care at home is a clear example of a systemic transformation, where organizational, cultural, and structural aspects must be addressed to achieve long-term and sustainable effects. It challenges established structures and requires extensive changes in areas such as ways of working, technology, regulations, and financing models. The process of change is particularly complex, as it demands integration and collaboration across different levels of care, professions, and solutions.

Many organizations within the healthcare system are experiencing a growing tension between the need for change and the difficulty of truly addressing their challenges. Breaking old patterns is seen as both risky and difficult, and measures taken are often experienced as too marginal in relation to the challenges. The lecture will show some ways of how to get out of this dilemma.

The lecture builds on knowledge on and experience from systems innovation and transformation of large societal systems. It departs from the keywords of UN's Agenda 2030 and points out the importance of understanding the difference between complicated and complex systems and the different logics behind improving and transforming. It also positions levels of learning that are necessary to transform complex systems, and the kinds of processes that can help navigating such transformations in practice. It ends with some observations regarding leadership for sustainability transformation.

Georg F. Bauer, MD, DrPH, is Professor and head of the Division Public and Organizational Health and of the Center of Salutogenesis at the EBPI, University of Zurich, Switzerland. His research focuses on the concept of Salutogenesis and on positive, salutogenic health development at work and in organizations, new work and corresponding interventions.

He chairs the Global Working Group on Salutogenesis, aiming to advance and disseminate theory and research on salutogensis (www.stars-society.org). He co-edited the Handbook of Salutogenesis. He regularly advises companies and hospitals on the topics of work, health and occupational health management (OHM).

Currently, he coordinates a large-scale, transdisciplinary research project on human centered health care, focusing on a mutual beneficial co-creation of care by nurses and patients.

Considering mission statements of hospitals and healthcare staff associations, the importance of healthcare workers’ wellbeing is widely acknowledged. However, it has been mainly viewed as a pre-condition for achieving patient outcomes, aggravating a tendency of healthcare staff to sacrifice their own health for their clients.

To promote healthcare workers’ wellbeing as a value in its own right, we can build on the salutogenic model of health and on its core, the sense of coherence (SoC). SoC constitutes a global orientation towards life as being comprehensible, manageable and meaningful and has been linked to various positive health outcomes at work and beyond. Interventions to promote staff wellbeing can foster comprehensibility by building on a consistent, easily comprehensible model showing that balanced job demands and job resources prevent negative and promotes positive health outcomes. Manageability can be improved through regular employee surveys and participatory workshops aiming to improve the balance between job demands and resources.

Experiencing meaningfulness requires that employees can continuously shape their working life and can live their work-related purpose. In case of healthcare workers, caring for patients can be considered the essence of their job and professional identity. Beyond the operational, physical caring processes, psycho-social relationships with patients constitute the core of caring. At the same time, social relationships are a key health resource for both staff and patients.

Thus, the ongoing, everyday co-creation of care by healthcare workers and patients should be focused upon, understood as a reciprocal, mutually beneficial relationship. Emerging models emphasize high quality working and caring relationships as well as task-related and relational communication as the core components of successful co-creation in care.

Building on these developments, I will present our own model for studying and promoting everyday co-creation of care. It suggests considering staff and patients as equally valued humans contributing to and co-benefitting from the co-creation of care. This model completes the shift from patient-centered to person-centered to fully human-centered healthcare. Patients move from a passive role of recipient of healthcare services to an active role of co-creators of their healing process, while staff wellbeing is valued in its own right, eye-to-eye with and strengthened by patient wellbeing.