 We're going to talk about public health, but instead of diving into definitions and concepts, let us start somewhere else. I want you to answer me honestly to this question. When do you think about your health? Honestly, it's usually when you're not healthy. So this scenario might look familiar to you. Sometimes you get sick. Then you go to the doctor, you get a prescription you need, and soon after you're back on your feet. And this is a very classic straightforward scenario when it comes to your individual health. But there's actually something so much more than what meets the eye here. And it goes way beyond your individual health. This is the status quo that we have. Sometimes we get sick. And sometimes we might know the immediate reason for that sickness. It could be a virus, a bacteria, unhealthy lifestyle, whatever that might be. But do we always know the reason that got us exposed to this virus, bacteria, or unhealthy lifestyle on that particular day, month, hour, year, decade? It could actually be somewhere in our gender or somewhere in our genetics. It could actually be tracked back maybe to our education or lack thereof. Maybe it has something to do with our friends, family, colleagues, neighbors, people in the supermarket that we meet every day. Maybe it has something to do with the health services around us. Are they good? Are they bad? Do we want to use those? Can we use those? Maybe it has something to do with our neighborhood, our city, our country, our continent. Or with the salary that we get at the end of the month. Do we get it? Do we don't get it? Do we have enough money? Do we have a social status within our social environment? All of these and further questions are questions that public health is concerned with. And more specifically how all of these and other determinants in combination or individually affect your health. And how we can turn this into this. So public health is the thrive to prevent diseases, prolong life, and promote health. It is the art and the science of improving the health of the public by providing everything health related for the public. Now you might ask at that point, who is actually providing this public health? And to be honest, it is a responsibility by all of society. It is a responsibility by us, by governments, by international or national organizations, by civil society, by the public and private sector as well. But the challenges in the past have been resolved or at least partially resolved mostly with legislation. And that is quite fascinating, because it means that one single law could make the difference between health and sickness. Essentially between life and death. Now we cannot mention life and death without mentioning John Snow. So let's go back to 1854 in London, the horrific cholera outbreak and talk about the superhero here, John Snow. Not the one that you were thinking of, but another one, also superhero. At a time it was commonly believed that the disease was being transmitted through the air that people were breathing. But he wasn't quite sure how correct this idea is. So he went to the neighborhood with the most fatalities he asked people around and by doing so he was able to get to the root cause of it all. It was a water pump right here in the center of it that was pumping out water contaminated with fecal bacteria. What happened after that was that the government replaced the handle of the water pump but did absolutely nothing else. Why? Well because if they had done anything else that would have been a full confession that they had allowed the water provider company to install a water pump less than one meter away from an old cesspit. That was back then but let's fast forward to today and the human right to water and sanitation is the backbone of urban development. Currently 71% of the world population has absolute access to safely managed water drinking services. And that is not all for most of those people drinking water is not only safe it is also healthy. Most of those countries 102 have adopted policies for enriching their water with fluoride. And that is actually great because it might be the reason why you don't have dental cavities or at least not as much as your parents or grandparents. Because there is sufficient evidence that fluoride in water improves your dental health. Now there is another public health measure you might be quite familiar with because we've all been there to the doctor's office. Vaccines. This is the very first public health measure ever implemented even before public health was a thing. It all started in the 18th century when Edward Jenner noticed that milkmates who had previously caught cowpox due to the nature of their work were somehow immune to smallpox. One of the deadliest diseases ever known to mankind. So he went on to create the very first vaccine and now smallpox hospitals look like this. Not because they like financing but because we just don't need those anymore. As of 1980 smallpox is the first and so far only disease we have managed to eradicate. You might be noticing the time spent right there between creating the vaccine and eradicating the disease completely that is about 200 years. And it is a very fascinating feature of public health measures. It shows that they are very sustainable, very effective, but they also require quite a lot of time and patience from all of society. That was the bad news. The good news is that it might not take us another 200 years to have the second eradicated disease. Because in the 50s, Jonas Salk created the very first effective vaccine against polio. This disease had crippled a whole generation of children and now we have a 99% decrease in polio cases compared to the 80s. That accounts for only 22 cases last year. We have never been closer to eradicating polio. But speaking of eradication there is another health problem we might soon be able to eliminate. And in order to do so we don't even need to go to the doctor's office. We just need to go to the kitchen. Salt, we now know what salt actually consists of but let us ask the further question. What is iodized salt? Why is it being sold? I guess you've seen it in the supermarkets everywhere. But what is the difference between iodized and plain salt? It's the iodine that makes the difference. Iodine is a micronutrient. All of us need it in very, very minute amounts every day. But still iodine deficiency is one of the most common micronutrient deficiencies in the world. And that is a huge problem although it's a micronutrient. Because iodine deficiency is the most common preventable cause for mental retardation in children. So in the 90s the World Health Organization came up with this plan. Why not advise countries to add some iodine into the table salt? Little by little countries adopted this idea and this is what happened. In the beginning of the 90s we've had 110 countries observing iodine deficiency as a population-wide problem. Just 10 years later the number had halved. But here's the thing, even if we eliminate iodine deficiency and we eradicate polio, public health will still be there. It will still be a thing. Because we have new and equally big challenges that have come our way. You might have noticed that in the past it was infectious diseases that were posing the biggest threat for humanity. But the tables now have turned. Non-communicable, also known as non-infectious diseases, are currently posing the biggest threat to individuals and to health systems worldwide. In fact 70% of deaths worldwide are caused by non-communicable diseases and that rate goes up to 88 when we talk about industrialized countries like Germany and the US. In a case of overweight and obesity alone, which is one of the main drivers of this statistic, the numbers of people affected by excessive weight has tripled since the 70s. And here's the thing about non-communicable diseases. They are not infectious. At least not in the way we know. But a lot of them and a lot of their symptoms can be tracked back to individual behavioral patterns and that makes them infectious in another way via behavior. So what can we do about this? Well, the Work Health Organization very rightfully states that individual responsibility can only be effectful when we even have the opportunity to live a healthy lifestyle. And the organization does work very hard with countries to implement such policies, for example the introduced on Monday idea to replace trans fatty acids completely in the next five years. But while we wait for organizations and the private sector to help us achieve our healthy lifestyle, we might also try to do this ourselves. Every day we make conscious or unconscious choices that are affecting our health. How much water we drink, how much alcohol we drink, how much we smoke. If we see someone experiencing mental or physical difficulties, do we help this other person or do we stay silent? All of these and other very small changes can not only help us improve our individual health, but can also inspire our social environment. The friends, family, colleagues, people all around us lead a healthier lifestyle and eventually they might also save a life. But that is of course not all. Our social environment is not the only environment that matters. Our physical environment matters as well. In the past, in fact, the environment was observed as simply the setting in which diseases were breaking out and spreading. But it has now become one of the main health risk challenges itself. Currently 92% of the world population lives in places that are exceeding the international guidelines for clean air and that includes us. Just today, a couple of hours ago, the European Commission announced that it is suing six European countries for breaching European guidelines for clean air. And that does not only have legal consequences, it has very real consequences. Three times more premature deaths are caused by air pollution than by AIDS, tuberculosis and malaria combined. This is just one of the immediate outcomes of air pollution, environmental contamination and generally of man-made climate change. But there of course are other ramifications of this. In fact, we have been experiencing more and more extreme weather events every year. Tornadoes, hurricanes, thunderstorms, drought, floods, everything. This year was in fact the very first in recorded human history in which we have observed temperatures over 50 degrees Celsius in April. And that causes approximately 22 million people every year to flee their homes because their homes are not habitable anymore. What we can do about this is to try to live more sustainably, use only as much plastic as we actually need, unplug the electronics when we don't use those and eat less meat. Because meat production requires quite a lot of more resources than the production of any plant-based agricultural thing. We all need to do those because the world we live in is a fascinating place. In fact, you might know that there is no Plan B and there is no Planet B. Now, all of the regions in the world are experiencing some effects of climate change. But one specific region was experiencing also another trend last year. And that was the increase of rates of one specific infectious disease. There was not necessarily caused by climate change, but by another change. Four-fold increase in the rates of measles, an infectious disease that is absolutely preventable, but can have fatal consequences, especially for children under the age of one. And that region that experienced that four-fold increase was Europe. Now, the reason behind this is that more and more people are hesitant to trust vaccines and to vaccinate their children because, mostly because of the communication and media environment. There is a certain spread of false information regarding the risks and benefits of vaccines that can be observed in all media types. But it is particularly visible in social media. This is one of the biggest challenges for health in the digital era and actually not only for health only. This is why I would like to challenge you to live more cautiously online and offline. Gather your information only from validated sources like the website of the World Health Organization if you have specific questions about a disease or a vaccine. And when you scroll through your feeds, your social media feeds and see a false news story, like, for example, that vaccines cause autism, report it. Generally, please question what you read and what you hear not only on April 1st because measles is not a joke. I challenge you to do all of these things because public health is of the public, for the public, but also by the public. And with that said, I would like to leave you with this message. Ask not what a public can do for your health. Ask what you can do for the health of the public. Thank you. Thank you, Anna. So we have some time for questions, please. Eugenics have been justified by public health concerns. Indeed, if you sterilize or physically eliminate all the chronically ill or the mentally deficient, the disease may be exterminated, or at least hampered. My question for you is, where is the borderline between public health concern and the individual right of a free individual? That's a very good question. So the question is, there is a borderline for intervention in the private life and happiness of the individual in the benefit of public health. Okay, I see where your concern is. And I, as an individual, also as a public health person, always have the right to be concerned of something. Public health as a discipline, public health officials can always be concerned of something when that poses a real threat of a population being diseased, of some disease, or dying of prematurely due to air pollution or excessive consumption of meat, for example. Now, public health can always intervene in the matter of promoting healthy lifestyle. There, of course, is, this is my very personal opinion, but there is a huge difference between positive reinforcement and negative reinforcement also in public health. Now, one thing is promoting healthier lifestyle. And just a couple of days ago, the World Health Organization released a new report stating that just $1 invested in health-promoting campaigns results in over $12 of return on investment and actually improved healthier lifestyle. Now, no one can take your meat away or your cigarettes away, but public health officials will always try to make you do the healthier, the better choice. There are actually laws limiting it. It's not left for my own choice. Limiting what? For instance, taxes on sugar drinks. Not many countries have taxes on sugary drinks right now. A lot of people... I think we're going into discussion here. Ilya is actually one of our speakers and he's a professional historian, so... I can go on and on about this also. Yeah, so you can take it offline, I'm probably... Some more questions? Please. As we know, being sick or being healthy is also part of the economical system of the country. When you're sick, you go to doctors and you buy some medicines. So what happens if we all, in this society, become absolutely healthy? What happens with doctors? So the question is, is it going to be bad, actually, if all their diseases will be eradicated, for example, for the pharma business? Otto, I think that your question could be a little bit utopian and I don't know how related to the reality it is, but I don't think it will be necessarily that bad if all diseases are eradicated, if no one ever has the risk of dying of cancer or anything else, or influenza, as for example. I don't think this will necessarily be bad, but we still need doctors, until we get to this point, we still need doctors, we still need the pharmaceutical industry to work with public health officials and with individuals as well to promote healthier lifestyle and to make us healthier. Of course, we also have the individual responsibility to do it, because if you have the choice between smoking or not smoking, you have the choice. Okay. We have time for the last question. Please. Yeah, my question is a bit specific and it's about eye or dying. So my family moved to Germany some years ago, and my daughter immediately began to gain weight. And then we were told that this is because there is very little amount of iodine in German products, and so we began buying this iodine salt and then everything went back to normal. But we didn't have such a problem in Russia. So is there any special in the German products that will make this problem prominent? Because so where is the diet so different between Germany and all other countries? So the question is about iodine dying. Is it influence weight gain? And maybe it's related somehow to a diet in different countries. Yes, iodine deficiency is related to the diet in different countries. For example, the Scandinavian countries do not have as often observable iodine deficiency on a population level as other countries do. Now, I am sure that there are dietary differences between your life back in Russia and your life here in Germany, but it could also be not the German products if necessarily caused or locked out this order in the daughter, her need to weight gain, but it could just be due to her, due to the natural aging process of her growing up and the disorder becoming visible. Now, iodine, iodized table salt is sold everywhere in Germany, but the next challenge is to make the food industry implemented, not to use plain regular salt, but to use iodized salt. It would of course cause a little bit more money for the food industry, but it would generally be so much better for the whole population. Thank you very much, Anna.