For more than 50 years, The Salzburg Seminar has provided a forum for distinguished leaders from around the world to engage in dialogue on social and cultural issues, including education, law, medicine, journalism, and world trade. In a special session of The Salzburg Seminar, leaders in medicine, public health and health services from every corner of the globe gathered to discuss Critical Issues in Global Health: Leadership Challenges in the 21st Century. The seminar was sponsored by the C. Everett Koop Institute at Dartmouth and National Center for Health Education, and was convened with the assistance of TC faculty and students and the Academy for Educational Development. The W.K. Kellogg Foundation and the Rockefeller Brothers Fund provided grant support for the seminar.

	Professor John Allegrante with TC Student Fellows Joanna Andusei, Diane Dobry, Danna Crawford Ethan and Ray Marks
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The approximately 60 participants and observers gathered for the seminar at Schloss Leopoldskron, a 17th century palace, in Salzburg, Austria. The Schloss, the lake on which it is situated just west of the old city and its surrounding gardens, were the site of filming for the popular 1960 movie, The Sound of Music, in which Julie Andrews starred. Many of the seminar participants, including John Allegrante, Professor of Health Education and Director of the Center for Health Promotion, are contributing authors to Critical Issues in Global Health (Jossey-Bass, 2000), as well as leaders from a wide range of backgrounds with extensive experience in public health, health services, and health policy.

Allegrante served on the Faculty Secretariat that developed, planned and convened the seminar, and was instrumental in garnering additional funds that supported the participation of four TC graduate students as Student Fellows.

The students were Joanna Andusei, a master's graduate of TC's Health Education program and a summer intern with the World Health Organization in Geneva, Switzerland; Diane Dobry, Director of Communications at TC and a master's student in International Education Development; Danna Crawford Ethan, a master's student in Health Education and Elihu Rose Fellow; and Ray Marks, a doctoral student and in Health Education and Dewey Scholar.

	C. Everett Koop and Allegrante.
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Under the direction of former U.S. Surgeon General C. Everett Koop, the seminar's objectives were to examine the challenges in the new century for leaders in global health and to identify what competencies future leaders will need to carry out the necessary steps to meet these challenges. As a result of the deliberations that took place, the faculty secretariat is compiling a report that will make recommendations for future international seminars on this issue.

The seminar keynote speaker was President Emeritus of the World Academy of Art and Science, Harlan Cleveland. Cleveland, who has had a distinguished career in public service and academe, served as Assistant Secretary of State for International Organization Affairs under President Kennedy and as US Ambassador to NATO under President Johnson, spoke about collaborative leadership in global health.

"Our biggest problem," he said, "is not so much the management of world health-important and difficult as that already is. The transcendent problem is managing ourselves-analyzing and guiding the human actions and inactions that are by far the largest component of human health."

In light of the economic shift to the age of information, Cleveland also suggested that access to information, the world's dominant resource, will change the measurement of a society's potential. "The complexities of modern life, and the interconnectedness of everything to everything else, now means that in our communities, our nations and our world, nobody can possibly know enough to be in general charge of anything important or interesting," Cleveland noted. "If nobody can be effectively in charge, that means everyone associated with a collective activity is partly in charge of it-and should be acting accordingly. Every participant is, to some self-selected degree, a leader."

Allegrante, who chaired the second day of the conference, organized seminar participants into six groups, and charged them with the task of responding to four questions reflecting the objectives of the seminar. Facilitators from each group later reported on their discussions in an effort to determine what future leaders in health would need to understand to meet the challenges in public health in the 21st century, and what barriers they would face along the way.
Dr. Derek Yach, Executive Director of the World Health Organization in Geneva, Switzerland, addressed participants on the third day, saying, "Health is one of the true universal values. Amidst all priorities, we have to fight for health to be regarded for its intrinsic value. It hasn't been the major way decisions have occurred in national and international organizations."

Decisions are instead often made on the basis of economics, which have an enormous impact on health. For example, rapid changes that have affected dietary patterns are causing increasing obesity, diabetes and cancer rates in countries around the world.

Yach outlined the World Health Organization's goals to make global health a priority. They include placing health at the center of the broader development agenda, strengthening sustainable health systems, and managing the information going out to be sure the facts are accurate.

On the final day of the seminar, the Student Fellows were asked to present their impressions of what they would bring away from the conference as future leaders in public health. Addressing the seminar, Ray Marks observed that she found the seminar to be " . . . an excellent prototype for deriving some preliminary guidelines that might foster the development of transformational leadership."

In his closing keynote address, Koop discussed the changes that access to information through technology will mean to world health. "Nothing known in Philadelphia will remain unknown in Delhi or Botswana," he explained. "I am convinced that the Internet will change the way medicine is practiced in those countries because knowledge empowers people to make decisions with their doctors. I believe the Internet will be able to have public health be better understood by the masses and the practice."

"Our greatest need for a foreign or international health policy," he added, "is illustrated by the history of AIDS and polio. Discoveries in the west eliminated those problems domestically but not abroad where the need was greatest."
He added that those who are charged with bringing health information to the public should be credentialed to report on medical matters. In that way, the public can be better able to distinguish correct information from incorrect information.

"Let each one, teach one," was the motto Koop hoped would dominate world health policy. "There is no prescription I can give you better than knowledge," he said, envisioning industrialized nations teaching health care to developing nations.

Published Tuesday, Sep. 18, 2001