Interview with Dr. Hans Kluge

497B0524Brief background:

Name: Dr Hans Kluge
Birthplace: Born in Belgium, in a small city of 50.000 people, close to Oostende and in the seaside at the Flemish part of Belgium.
Education: I am a medical doctor, and I studied medicine at the Catholique University of Leuven in Belgium, then I practiced for a while as a general practitioner and went back to qualify myself as an expert in infectious diseases at the Institute of Tropical Medicine in Antwerp. After which, I worked overseas in Somalia and Liberia with Doctors Without Borders (MSF).
Profession: I am the Director of the Division of Health Systems and Public Health, and the Special Representative of the Regional Director to Prevent and Combat Multidrug Resistant Tuberculosis in the WHO European Region. As Director of the Division of Health Systems, I have basically the portfolio of six main units. First, human resources for health, second, health technology and pharmaceuticals, third, public health services, fourth, health services delivery, fifth, health financing, and last but not least governance.
Current place of employment: Copenhagen, Denmark, WHO headquarters, although I a travel a lot. I came to the WHO Regional Office from Myanmar, where I was based for 5 years, and I arrived as the coordinator for health systems in 2009, then when the new regional director came on board, I competed through the process and got the director post in August 2010.

Question: “Where were you working/studying when you were my age?”

I was working in prisons in Siberia with Doctors Without Borders (MSF), starting with my Russian colleagues the first TB control DOTS program in the TB hospital prison in Mariinsk, which is on the Transiberian Railway, for two years, in very hard circumstances, in fact introducing evidence based public health practices in the Siberian prisons, and living in the middle of Siberia for two years.

Question: “From your professional point of view, what do you feel should be the primary aim of a health oriented conference such as this one?”

From my point of view, being the Director of the Division of Health Systems and Public Health, and being responsible for 53 countries, not only the EU countries, one of the key things is exactly what we are doing this morning, bringing together the Eastern and Western part of the region. I think that’s very crucial and very significant because we observe that the western part is suffering so much from the financial crisis, while the east is in fact recovering, and is trying to teach us a lesson this morning. I mean this is really amazing and vice versa!! Of course they still have indicators which are far worse than the EU or the OECD average. If you look at 30-35 years ago though, the so called east and west were very close in terms of indicators such as life expectancy and tuberculosis control, they were quite identical, so we need to identify and exchange lessons with each other.

Question: “The theme of this year’s conference is ‘Crisis and Opportunity’. What opportunities (if any) do you see in the present financial crisis?”

Two main points here. First, if you look at the WHO 2010 World Health Report on the path to universal coverage, the main theme was that every kind of system whether it is on the west or the east, has so much room for efficiency, there is still a lot of waste, so I think here you can have the exchange of experiences of how countries coped or how some countries missed the opportunity to change, that is one key aspect. Second, and this is another key main theme that we are very concerned with at the WHO, is to really draw the attention of the international public health community to solidarity. If you look at what is happening for example in a number of countries under the austerity measures, Greece, Portugal and Ireland, it is really worrying for us that notions of solidarity, equity, participation which all comprise fundamental social values that all the member states and governments agree upon, are being undervalued. We have to put these on the agenda again, make interventions, and the regional director who is going to speak on behalf of the WHO chair will make sure that this key theme is put forward again and again.

For example the Troika, do they really look at the effects of their measures? At the vulnerable part of society and especially at the access to primary health care? Or is it only about cutting? You can see, and not only in the aforementioned countries but also in the Netherlands, that although the budget hole has been decreased, they are still being quite introverted, instead of focusing on the international notion of solidarity, as you are saying, this is the basis of our human rights. The WHO wants to have a leading and positive role, side by side with the European Observatory in this aspect, because we both have gathered great experience of how you can cut wisely. Of course we cannot ask the impossible, but we can cut wisely and protect what is working well. Fore and foremost, like a Russian colleague was telling me “first protect the human resources”, the good people, if you lose the few good people that we have now, this will be a setback for many years. I will speak at the Financial Times conference in Athens on shaping the Greek health care reform, and we are sending people there representing WHO, and probably we are going to station at least one WHO person there, working with the EU Taskforce.

Question: “Looking back on your life and career, what single lesson or message would you like to convey to Young Gasteiners and other young people attending the conference?”

Look for mentors, mentors are everywhere, the fact that we are having this discussion means that you are a mentor to me also. You should not look only upwards, you should look horizontally, left and right of you, and you will find a mentor, be modest and always try to learn, this is something that I have learned from my father who is 80 years old, and he was a chief traumatologist, and every day he would study and try to learn from whom is sitting left and right of you, and always look forward, it is a never ending process. And not only learn things in public health but learn things about everything in life. Be modest, be proud and have a mission, if the mission is noble, it will keep you on the right way.

Interview conducted by Young Gasteiner Thanassis Nikolentzos in October 2012