
| The Courier N° 147 - Sept-Oct 1994 - Dossier Public Health - Country report Swaziland (European Commission - The ACP Courier, 1994) |
| (introductory text...) |
| The Community approach health and development |
| Interview with Dominique David |
| An inside view of the WHO reorganisation |
| Changes and opportunities in Southern Africa's mining sector bv Philippe Queyrane |
| The SADC-EU Mining Forum |
| The CFA franc zone |
| A personal view |
| Swaziland: At the crossroads |
| Challenges ahead for the modern sector |
| Tinkhundla the Swazi democratic system |
| 'We must remain a united family' Deputy Prime Minister, Sishayi NXUMALO |
| Sugar-a booming industry |
| Swazi Nation Land: what future ? |
| The Dvokodvweni Water Supply Scheme |
| Swaziland the European Union by Robert Schroeder |
| All change at the top: New leaders chosen to head EU institutions |
| The audiovisual sector |
| Health in the developing world: Progress, despite everything |
| ACP-EU health cooperation in the 1990s |
| Reforming health systems |
| In the throes of change: Public health programmes in Africa |
| Health and nutrition of the urban poor : The worst of both worlds |
| Health research for development: A matter of equity and mutual interest |
| AIDS: towards sexual relations? |
| Gender and reproductive health |
| Managing health in developing Society as a whole, not just the professionals, should have the power to decide |
| The tragedy of extension: Missed opportunities |
| European Development the Convention at Work |
| Acknowledgments |
What does want ? by Nora Tardieu
In adopting the Green Paper: 'Strategy options to strengthen the European programme industry in the context of the Audiovisual Policy of the European Union', the European Commission was hoping to start a broad debate on the future of a sector marked by cultural specificity in the midst of the profoundly changing world of communications.
This is what it did when it organised the European Audiovisual Conference in Brussels on 30 June-2 July 1994, at the instigation of Joao de Deus Pinheiro, the member of the Commission responsible for audiovisual matters. The Conference brought together almost 600 people who were able openly to discuss ways of developing the potential of our programme industry, in the light of the size of the European and world markets, with all the operators concerned in the European Union.
The event was a great success, revealing a significant mobilisation of the audiovisual sector in Europe following the GATT negotiations. For, while it was nice to have won a battle during the negotiations, it was still important to be able to consolidate. This mobilisation is also reflected in the very high level of interest displayed by the whole of the European, and even trans-Atlantic, press and in the involvement of professionals from the sector, as remarkable in quality as quantity.
The main idea was to consult the profession on the options outlined in the Green Paper, but, since representatives of the European institutions and Member States of the European Union had also bean invited as observers, the Conference was able to give a real political boost to the Union's future audiovisual strategy.
The participants came from different sectors of the audiovisual industry, so it was difficult to reach a consensus on all the items on the agenda. However, the general opinion was that a strong European television and cinema programme industry was required to preserve and promote both the cultural identity and the specific nature of Europe. it is true that audiovisual programmes are a carriage for cultural values and that culture cannot be treated like any other product. However, Europe's identity and specificity, which are the wealth of the Union, also bring a fragmentation of the markets. Indeed, the multitude of European languages impedes the free movement of works, in addition to which there is the absence of a European distribution system, a relative shortage of European stars to counterbalance the powerful Hollywood studios, insufficient cross-border cooperation and a shortage of finance.
The conference was split into two units-a reflection and forward study group, devoted to an analysis of the major challenges of the sector, and four subject-oriented hearings, devoted to detailed examination of the subjects of the Green Paper. This latter unit was intended, above all, for professional associations and federations. The subjects of the hearings were: -support systems in the European Union;
-pan-European prospects; -the rules of the game;
-the convergence of national systems.
Main lines
Of course, the Commission has to take the time to analyse the results of this Conference in depth to draw final conclusions and make proposals for the future strategy of the Union.
However, the main lines to emerge can be summarised under six headings, as follows:
-We are seeing a general awakening to the economic, cultural and sociological importance of the programme industry and its strategic role in the convergence of the telecommunications, computer and broadcasting industries and we should take it into account in designing the link-up between the audiovisual sector and the information society.
-There is indeed a possibility of creating a world market for the European audiovisual sector, provided conditions are right and the cultural specificity of the sector can be safeguarded.
-Europe has great creative and productive potential, but needs help fully to realise it.
-In the matter of financial investments, we must have the means of realising our ambitions, otherwise we are in danger of slipping into make-believe. The instruments which we devise for the future will have to assign considerable importance to distribution and training networks and emphasise guarantee funds and soft loans rather than grants, on which there is no retum.
-When it comes to regulations, we should make a distinction between access and content. Although access has to be liberalised in accordance with the recommendations of the report of the group chaired by EC Commissioner, Martin Bangemann, matters related to the content of programmes, whatever the method of broadcasting, need particular treatment, in particular because of their cultural specificities and their effect on society.
-A content strategy to match our ambitions can and must play a vital role in realising the potential of the information society.
The stakes are very high. It is important to act fast and to seize the opportunity of reviving the dynamics of an audiovisual industry which is on the decline, but full of potential. To begin with, this means political will. As Aurelio de Laurentis, director of Filmauro (the Italian production and distribution company), so neatly put it: 'European politicians have to shoulder their social, cultural and economic responsibilities by backing a cultural industry which creates employment.' Jack Lang, the former French Minister of Culture and chairman of the reflection and forward study group, for whom the Conference was an important moment in the affirmation of a collective awareness without which the governments would not act, went so far as to propose channelling 1% of the Community budget into a European fund.
We now have to see what the follow-up to the work of the Conference brings. The European Commission intends continuing the dialogue with all parties concerned - professionals, Community institutions (the European Parliament and the Economic and Social Committee), the Member States and the associated countries (the European Economic Area and the countries of Central and Eastern Europe) and representatives of the other third countries. The Commission will formulate its first practical proposals on the Community support machinery and a possible revision of the frontier-free television directive (defining the legal framework for broadcasting) in the light of these consultations and of reflection to be undertaken with the financial sector in September.
Green Paper: 'Strategy options to strengthen the European programme industry in the context of the Audiovisual Policy of the European Union'
The Green Paper and the debate which it launches focus on one specific aspect of the audiovisual sector, namely the development of the European film and television programme industry.
The audiovisual sector as a whole is a complex one now undergoing profound changes, in particular because of rapid technological development.
This change is determining new interactions between the various cultural, technological and industrial components of the sector.
It is also triggering the emergence of new products and new audiovisual service, in line with the multimedia and interactive approach of the information society.
These developments offer new opportunities for audiovisual operators, who are led to adapt their strategies and forge new alliances. This convergence will involve the film industry, broadcasting and the television programme industry, cable operators and telecommunications organisations, the publishing industry and the manufacturers of information and communications technology.
Sustained growth of the audiovisual sector should continue, thereby generating considerable potential in terms of the creation of jobs requiring a high level of qualification.
All these phenomena are being manifested on a world scale and it is not yet possible to assess them fully.
The Commission is aware of the difficulty of isolating this aspect from the many problems attached to the change in the audiovisual sector. But it considers that this is a necessary exercise to take account of two characteristics of the programme industry, namely that:
- films and television programmer are not like any other products. As vehicles of culture par excellence, they retain their specificity in the midst of new types of audiovisual products, of which there are an increasing number. As the living witnesses of the traditions and identity of each country, they are worthy of encouragement;
- the programme industry is and increasingly will be a strategic element in the development of the audiovisual sector. As recent developments show, the most powerful operators on the world market (cable and telecommunications operators and equipment manufacturers) are trying to control the most important programme catalogues.
The debate which this Green Paper has launched on the future of the European programme industry naturally should take account of general trends in the audiovisual sector. It will be fuelled, particularly, by reflecting on the development of the information society.
But the Commission's current analysis, taking account of the development of technology, the convergence of industries and trends in market structures, enables us already to fix on four fundamental prospects for the future of the European programme industry. The industry has to:
- be competitive in a context of openness and internationalisation of the sector;
- be focused on the future and party to the development of the information society;
- illustrate the creative genius and personality of the European peoples;
- be in a position to translate its growth into the creation of new jobs in Europe.
In taking account of the contribution of the Treaty of Maastricht, which strengthens the instruments of European Union (in particular by enshrining provisions relating to culture), and of the achievements of the Community audiovisual policy and trends appearing in the sector, this Green Paper aims to suggested options for the future, hinged on these three fundamentals.
The Green Paper's central issue can therefore be synthesised as follows:
How can the European Union contribute to the development of a European film and television programme industry which can compete on the world market, looks to the future and is likely to ensure the spread of European cultures and create jobs in Europe 7
The approach is therefore focused on the contribution of the European Union. But, obviously, it is through the coordinated mobilisation of everyone involved at every level that these objectives will be able to be attained.
The Green Paper also fits in logically with a series of reflections and complementary debates which the Commission has launched with a view to determining the role which the European Union must play in relation to the challenge facing the audiovisual sector in Europe.
In the front line of these forward studies, the White Paper on Growth, Competitiveness and Employment, adopted by the European Council in December 1993, provides the framework for the Union's action and reflection on the development of the information society and emphasis" the growth potential of the audiovisual sector, in particular in terms of employment.
Within this medium- and long-term framework, questions relating to the European Union's aims for the development of infrastructure and applications has led to the creation of a high level think tank on the information society. The European Union indeed intends playing its full part in the control and utilisation of the new technologies.
The technological and industrial challenges inherent in the 'digital revolution' in television broadcasting are dealt with in a specific communication on digital transmission from the Commission to the European Parliament and Council. As well as monitoring the institutional progress of this document and a proposal for a directive on satellite broadcasting standards, the Commission is keenly following the work of the European Digital Video Broadcasting Group, which combines most of the European operators concerned.
Lastly, in the context of the trends in audiovisual market stnuctures and the operators' strategies, the Green Paper entitled 'Pluralism and concentration in the media in the internal market-Evaluation of the need for action', analyses the question of whether the European Union needs to intervene in the rules on media ownership.
What ultimately happens to these various undertakings will partly determine the conditions in which a new environment for the audiovisual sector and a new communication society emerges in Europe. The Commission will do its best to coordinate them closely in a global approach to these developments.
In order to take account of the analyses and suggestions of everyone involved in the Union, the Commission based the drafting of this Green Paper on a preconsultation phase in which contributions of three kinds were obtained.
First of all, the professionals presented their analyses and suggestions:
-professional organisations representing the sector at European level and the various professional structures responsible for management of the Community system of encouragement which is part of the MEDIA programme were invited to answer a questionnaire;
-all companies and organisations which expressed an interest in taking part in the operation were also invited to submit their analyses and suggestions in writing.
Then an audiovisual think tank was set up, in November, at the Commission's instigation, to present a diagnosis of the sector and make suggestions for the future. The report which was the outcome of the work of the think tank reflects the opinions of its authors and does not therefore constitute a document from or approved by the Commission.
Lastly, the competent authorities in the Member States were invited to communicate their analyses.
With the many contributions, it is possible to look beyond contrasting and even contradictory positions on the audiovisual policy instruments to be set up in the Union and highlight one or two virtually unanimous findings which confirm the need for a far-reaching debate on the future of the audiovisual sector in Europe: -the audiovisual sector is now in an excellent position among the industries with high growth potential, in particular in terms of job creation;
-the question of maintenance of the diversity of national and regional cultures, often expressed in terms of maintenance of choice for the public, is now clearly linked to the development of a programme industry which is to a large extent European and ultimately profitable;
-digital compression technology is perceived as revolutionary in that it seems destined radically to overturn the economy of the sector, by accentuating, in particular, the strategic role of the programme industry;
-if the European Union is planning to reinforce its audiovisual policy, it must do so rapidly, both to cope with the emergency inherent in the technological revolution and to take account of the ineluctable liberalisation of the sector at international level.
This Green Paper largely reflects these elements of consensus, but its principal aim is to launch a wide debate on the consequences to be drawn from them in the European Union in terms of options for the future.
Public health
The choice of the title 'public health' for this Dossier rather than simply 'health' indicates only a desire to avoid becoming bogged down in esoteric debate about the nature of something which, alongside freedom, is probably man's most precious asset. Here, we offer our own small contribution to the great debate currently under way about the relevance of seeking to achieve the right of 'heath for all' -and this at a time of economic crisis which is particularly severe in the developing countries. In this context, we make a modest attempt to follow in the footsteps of the numerous international institutions who rank among the main providers of development assistance: institutions such as the World Health Organisation, the European Union and the World Bank, who have, in recent times, been considering the implications of increased 'politicisation' of hearth policies. The World Bank has just published the 1993 World Development Report on HeaIth and this has rapidly acquired the status of a standard reference work, notwithstanding the criticisms which have been leveled at the Bank about the stringent conditions of structural adjustment.
There is nothing original in the view that 'health is too important to be left to the specialists' in this field. This 'catch-phrase' has been oft repeated. But insofar as it implies that health affects all aspects of life and that one of the past mistakes was to leave it solely in the hands of technicians, it contains more than a grain of truth. At a time when hardened pessimists are talking of a health catastrophe in the developing countries, the thinking that is taking place about the failures of health programmer which have been in operation for thirty years merges with that about the wider development impasse that exists in many Third World states. It is true that, over three decades, health indicators have improved almost everywhere but the stark fact remains that developing countries, particularly in Africa, have not yet made the 'epidemiological transition' that was hoped for. In other words, in these countries, people are still dying of the same old maladies -infectious diseases- which have largely been eradicated in the developed world and which are both preventable and curable. Furthermore, one need only cite the resurgence of malaria, despite the prodigious sums expended in the battle against it, or the sharp rise in tuberculosis, as evidence that the link between health and development is not always as clear-cut as some would suggest.
The full meaning of the term 'public health' must embrace the idea of health for the people, and run by the people: in other words, where the individual plays a part in the management of his or her own health. We have sought the perspectives of authors from various backgrounds to discuss this 'public' concept of health.
As an introduction linked to the Dossier, we publish interviews with the Director-General and other officials of the World Health Organisation in our 'Meeting Point' section. The focus here is on the policies of this UN body; not just the successes but also where things have gone adrift. Officials responsible for implementing the health/development policies of the European Union describe what they see as the original aspects of the EU approach while acknowledging that 'not everything in the garden has been rosy' in the past. We also lock, of course, at actual health problems and illnesses, describing the overall health status of the developing world, with an emphasis on particular diseases such as AIDS. Occasionally, we adopt a lighter approach and we try to look at some areas that have been relatively neglected. One hears, ad nauseam, that AIDS is a disease associated largely with sexual relations, but in the preparation of this Dossier, it emerged that almost nothing had been published by health experts on the sensitive subject of relations of love (or passion) in the context of the epidemic: not even a short chapter in the bulky works put together by the most erudite specialists! Accordingly, we asked a university sociologist who has directed a study on the behaviour of young people in the face of the AIDS threat, to give us his thoughts on the theme of 'Towards new sexual relations ?' ('Vers de nouveaux rapports amoureux ?' in French). If the health situation is precarious in the poor countries, it is even more so for poorest people in them and more generally for those who are categorised as 'vulnerable'. In many countries, women are generally thought to top the 'vulnerability' league and that is why we decided to look more closely at this question. Another 'at-risk' category are the embattled urban poor whose health situation combines the disadvantages suffered by many rural people with the more specific threats of the degraded city environment.
A great many questions, and attempts to offer at least some outline answers, are to be found in the articles dealing with the particular issue of public health management. One of these seeks to examine the nature of the relationship between modern and traditional medicine in the world today. A feature of all the analyses contained in this Dossier is the desire to avoid the natural feelings of anguish and foreboding which characterise the subject. Looking anew at the role of people in the system and their reassumption of responsibility for their own health should, in itself, offer a strong reason to hope for better in the future.
For a long time, official development assistance was focused on infrastructure and, by extension, the aggrandisement of leaders who equated big buildings with development and big hospitals with health policy. Here, all of the questions posed spring from the basic tenet that the goal of development is to be found in the wellbeing of individuals. It is like a wager placed on mankind, who must be relied on to come up with the answers.
Hegei Goutier