SESPAS Declaration of the XIII Congress held in Seville.

The XIII Congress of the Society Espaola administracinė of public health and Health (SESPAS), which under the banner of Times for PUBLIC HEALTH was held in Seville from 3 to 6 March 2009 and the we have assisted some 1,300 experts and professionals in different fields of health openly about all Espaa, remember the following statement:

In the world we live in, where the determinants of health are increasingly global ms, we lack sufficient effective mechanisms of protection in the field worldwide. Urge for establishing, as such have the appropriate international regulatory procedures. We ask that the World Bank, International Monetary Fund, the International Labor organization and the World Trade organization, taking into account the health of poblacina when making their decisions. Arrangements should reform and strengthen multilateral agencies responsible for health-Specific, as the World Health organization.

Limited health inequalities and social development of public health measures can reduce them. Investing in Health, educaciny development of women, for example, one way to improve the health of all people, since they are mainly affected by the majority of social determinants such as poverty, precarious discriminacin employment and the sharing of power.


Climtico change is a real threat to the health of humanity, especially for people and vulnerable ms passes, so it requires an immediate response. We demand the Government of Spain, European governments and Autonmicos Local Authorities effective actions to reduce emissions of greenhouse gases in compliance with the Kyoto Protocol and adopting new international agreements in the same direction. These actions must be aimed at changing the system energtico and transport, or development of renewable energies and sustainable mobility, and no slo permitirn reduce CO2 emissions level but also No atmosfricos many other pollutants that now have significant impacts on our cities. We demand of enterprises and held in public and private entities responsible action to reduce their own emissions, and call the ciudadanaa participate responsibly in this collective effort. En la medida en que, adem s, son necesarias medidas de adaptaci n al cambio clim tico que ya se est produciendo, la salud deber a estar en el centro de las pol ticas nacionales de adaptaci n as in programs of cooperation with the countries vulnerable ms.


In the recent years has developed a process uncontrolled urbaniza without an adequate territorial ordenacin present and future needs of people. As the healthy city let alone anyone else has been completely absent from the process developed in the ltimos urbansticos years. We demand much of those responsible for the incorporacin PUBLIC health value in planificacin estratgica future urban cities and towns.


Sistmica The Economic and global crisis we suffer is a significant impact on poblacin, ms brutal in the excluded and with fewer resources. We require the strengthening of social policies that reduce the negative impact on the affected poblacinms. The current crisis has its causes and responsible so you should not persist in growth patterns and predators and unsustainable development. The crisis can be an opportunity if we learn the lecciny act accordingly, changing things. Not that there is another world possible, is that right now is imperative.


We call the attention on the growing medicalizacin of daily life due to the role the pharmaceutical industry and medical technologists, but Also health administrations, professional and health services. The growth of health costs, partly due to demand, medicalizaciny Also depends on the exponential growth of sophisticated technological and drugs of last generation that, in most cases, provide low added value. Preocupacin particular raises the magnitude reached by the adverse effects of medical attention, which have become a real problem of public health.

It is necessary therefore to undertake major changes. First, change the rules in relations between the administracinė Sanitary and health professionals (and their institutions and associations) on one side and industry on the other.
Second, redefine the relationships between all these actors and the society itself, especially in the necessary participation in making decisions about new services and incorporacin health technologists to avoid populist decisions on the enlargements No portfolio of preventive services (without an independent process of evaluation will deliberate upon their impact and opportunity costs), and prevent or at least hinder the Propagation of wrongdoing beliefs and false expectations about the power of health services to prevent any risk or to treat any life event.

We must refocus our health system towards health or development and community participation, strengthening public health. In that sense, must rethink the coordi relaciny between different levels of care and public health, especially those of primary attention, as to improve the coordination between the National Health System and the Social Security. Assuming responsibility for our part, we propose an alliance between estratgica citizens' associations, professional and Scientific and health systems that could exploit the crisis to effectively reorient health policies to the needs of poblacin, reducing this medicalizaciny thus iatrogenic.


In our European natural Pblico Health occupies a marginal place in the agendas POLICIES-institutional and intersectoral approach to health determinants personal portfolio has a strong presence. We therefore need to strengthen our relationship with the European Public Health Association (EUPHA) and, together, claim the European institutions and governments with greater commitment and strategy PUBLIC HEALTH Health in All POLICIES .



For last of them, and on the basis of experience gained in the years ltimos where errors estn Also, we strongly support reform movements and of public health Actualizacin initiated in several communities Autnomas, as the commitment of the Ministry of Health of a new law promoting public health. Actualizacin reform initiatives and to be carried out in a transparent and participatory, with the professionals, but ciudadanay Also with other sectors and social actors. The participation of society, with an articulacin difficulties involved, remains an unresolved between us, but we can no longer for people but with them, recognizing the right of cities legtimo aa participate in making decisions affecting their health.

We live in times of crisis and uncertainty, but the crisis is threatening ms of not wanting to fight to overcome it. We put our knowledge and our abilities to service changes and changes needed to make all people equal opportunity, can lead a healthy ms.

These are times for PUBLIC HEALTH!