Cyprus Epidemiology and Public Health Association

14/06/2026

🏘️💚 Public Health Starts in the Community. So Why Are We Still Thinking So Small?

■ We read with interest the Cyprus Mail report on the conference on the role of municipal health services in public health.

■ The daily work of municipal health officers and inspectors is not always visible to the public — but it is substantive and it directly benefits people's quality of life.

👉 Waste management. Catering and water inspections. Swimming pool licensing. Noise pollution. Smoking in public areas. Disinfections. Stray animals.

💯 All of it matters - a lot!. All of it is Public Health. All of it is being done, by people who rarely get the credit they deserve.

🙏So — thank you. Sincerely.

🙃 BUT, NOW LET'S TALK ABOUT THE REST.

🚨The news piece is titled: "Local authorities not a replacement for 'reluctant' state services".

■ According to the report, the Union of Municipalities chairman made that point emphatically that municipalities cannot be downgraded to second-class services picking up what central government is reluctant to do.

⁉️ If the intended message was: don't make municipalities and local authorities do the state's job in Public Health, then we disagree.

■ If fact, municipalities could (and should) do much more when it comes to Public Health.

■ All the functions listed, as essential as they are, they sit almost entirely within the realm of environmental health and hygiene services.

■ Which is, in the architecture of Public Health, one room in a very very very (X three, intentionally) large house.

⁉️ Why should municipalities do more?
Because, in Public Health, going small is the only way to go big — in other words, going truly local, truly community-rooted is not the opposite of scale. It is the only way to genuinely scale up public health.

💡And Europe's most effective municipal health systems figured that out forty years ago.

🌍 A 40-YEAR-OLD IDEA WHOSE TIME, IN CYPRUS, HAS ONLY JUST COME

In 1986, WHO launched the Healthy Cities initiative with one bold insight: health is made where people live, work, age, and play — not only in hospitals and government offices.

■ Today the WHO European Healthy Cities Network encompasses thousands of cities across the region, through seven consecutive phases of expanding ambition — from environmental health to social determinants, from health promotion to Health in All Policies.

■ We believe Cyprus was among the very last EU member states to establish a national Healthy Cities Network. That tells us something about how narrowly we have historically conceived the role of local authorities in health. And how much ground there is still to cover.

■ As far as we know, two Cypriot municipalities are pursuing WHO Healthy Cities certification. We applaud that. We would love to hear about the experience — the opportunities, the barriers, the internal conversations needed to shift the frame from "hygiene services" to genuine community public health.

🔬 WHAT EUROPEAN HEALTHY CITIES ACTUALLY DO

❇️ Across Europe, municipalities in the Healthy Cities movement may run community health centres.

❇️ They may deliver vaccination programmes.

❇️ They may organise cancer screening.

❇️ They may provide mental health and social welfare services embedded in the community.

❇️ They may invest in health literacy — knowing that an informed citizen is the most cost-effective public health intervention there is.

❇️ They may build health promotion programmes tailored to their own communities and based on their neighbourhoods' needs.

❇️ They may do some of the above, or all!

🚫 Not to replace the state.
🚫 Not to pick up what central government is reluctant to do.

🟢 But for a simple reason: who knows the community better than those who serve it every day?

👉And here is another reason: Going small is not a concession. It is a strategy.

■ The most powerful public health interventions in European history have been local ones — rooted in communities, shaped by the people who live in them, delivered by the people who know the community.

■ Central coordination in Public Health remains essential — and the role of the state is (should be) clear.

○ To be the compass.
○ To strategically guide.
○ To practcally assist.
○ To devop and fund national programmes that are implemented locally.
○ To partner up with municipalities for promoting Health and preventing Disease at the local level.
○ And above all to ensure equity, so that your postcode doesn't determine your health outcomes.

👉But the energy, the proximity, the trust - that lives (should live) at local level.

💡 ARE WE READY? ARE WE EVEN THINKING ABOUT IT?

During the Public Consultation phase of the recent Local Government reform, CyEPHA had put forward the suggestion that a strategy is needed to expand the public health role of local authorities.

⁉️We were not ready then. Are we ready now?

But, before we can even talk about expanding the Public Health role of local authorities, we first need to start expanding our understanding to meet the definition of local Public Health.

And the big question is: is this a role that Local Authorities would welcome? If the answer is yes, then in practice, we needs:

1️⃣ A broader mandate — municipalities empowered and funded to go beyond environmental health into promotion, prevention, and community wellbeing

2️⃣ A broader workforce — health promotion specialists, community and public health nurses, health educators, social workers, and epidemiologists embedded at local level, not just health inspectors

3️⃣ Vision, and budget — that's probably the most important one!

❗️❗️❗️
□ Because vision without resources is poetry.
□ But, resources without vision are wasted.

■ The conference rightly noted the "asphyxiating cogwheels of state bureaucracy." We couldn't agree more.

■ The solution, however, is not only to remove the obstacles to doing what municipalities currently do.

🧱It is to reimagine what they could do.🧱

📰 Read the full Cyprus Mail article that prompted this post: 🔗 https://cyprus-mail.com/2026/06/12/local-authorities-not-a-replacement-for-reluctant-state-services

🔗 WHO European Healthy Cities Network: who.int/europe/groups/who-european-healthy-cities-network
🔗 WHO 20-step Healthy Cities course (2024): who.int/europe/news-room/25-04-2024-developing-healthy-cities-in-20-steps

───

Local authorities cannot be downgraded to second class services for responsibilities the central government is reluctant to take on, and this goes for the health sector as well, chairman of the Union of Municipalities Andreas Vyras said on Friday. Vyras’ address was read out at a conference in Pap...

13/06/2026

📱🧠 Social Media, Social Comparison & Mental Health: What Does the Evidence Say?

■ "Yes, but..." is the answer for anyone who has watched the new Fidias Cyprus video-interview on social media use and social comparison processes that may affect young people's mental health.

■ Yes. We scroll. We compare. We feel worse. But. Is this really new — or just a new face on a very old problem?

🔬 PART 1 — SOCIAL COMPARISON HURTS MENTAL HEALTH

Yes. A systematic review and meta-analysis (McCarthy & Morina, 2020) found that social comparison correlated with depression and anxiety. Upward social comparison triggers negative affect and reduced self-worth.

📲 PART 2 — SOCIAL MEDIA AMPLIFIES THESE PROCESSES

Yes. Social media platforms are comparison machines by design — curated feeds and highlight reels create a near-perfect upward-comparison environment, at scale, 24/7.

📊 A meta-analysis of studies in young people (Shannon et al., 2022) found correlations of social media use with depression, anxiety and stress.
📊 A broader systematic review (Ahmed O, et al, 2024) found that, problematic social media use
was positively associated with depression, anxiety, and sleep problems, and negatively associated with wellbeing.
📊 It also suggested that baseline social media use predicted later depression and anxiety— not the reverse; however, more longitudinal research is needed to confirm the directionality for these associations.

■ Loneliness paradox: the irony of our era: We have never been more "connected." But at the sane time, we have rarely felt more alone.

《And now the "BUTS"! 》

🏘️ PART 3 — BUT THE DEEPER ROOTS ARE STRUCTURAL

⚠️ The social roots of depression and anxiety long predate the smartphone and social media. Public health has documented for decades that common mental disorders cluster where:
🔸 Social disadvantage is greatest
🔸 Income inequality is highest
🔸 Social cohesion has broken down

🗺 PART 4 (and longest BUT) — THE FULL MAP: THE SOCIAL DETERMINANTS OF MENTAL HEALTH

The landmark World Psychiatry review by Kirkbride et al. (2024) — one of the most comprehensive syntheses ever produced on this topic — maps out the full landscape of social conditions that drive mental disorder across the life course.

Our mental health is shaped from conception to old age by the structural conditions in which we live. These social determinants operate at two levels:

■ At the individual and family level:
💰 Socioeconomic disadvantage — income, education, employment, housing and food insecurity
👶 Early life adversity & childhood trauma — abuse, neglect, and household dysfunction in childhood substantially raise the risk of mental disorder across the lifespan
😔 Isolation and loneliness — social disconnection is as damaging to mental health as many recognised clinical risk factors
⚖️ Discrimination — racism, homophobia, transphobia and gender-based discrimination are independent causes of poor mental health
🌍 Migration, displacement & refugee status — those fleeing conflict and persecution carry a compounded burden of social risk that is rarely adequately addressed

■ At the neighbourhood and wider environment level:
🏚️ Neighbourhood disadvantage — living in deprived, fragmented or high-crime communities elevates rates of depression and anxiety independently of individual-level factors
🤝 Social cohesion — communities with weak social bonds, low trust, and poor collective resources show worse mental health at the population level
🌿 Physical environment — lack of green space, poor air quality, noise, and urban design all influence mental health
🏥 Access to healthcare — inability to access affordable and acceptable mental health care deepens inequality and prolongs suffering.

■ Critically, people closer to the margins of society accumulate more of these exposures, not only increasing their personal risk, but creating intergenerational cycles of disadvantage that individual resilience can fully overcome.

💡 THE PUBLIC HEALTH MESSAGE

Digital literacy, social media and screen-time guidance matter — but they are not enough. Addressing the mental health crisis requires:

✅ Tackling inequality and social disadvantage at the structural level
✅ Investing in real community cohesion and social infrastructure
✅ Treating the loneliness epidemic as a public health priority
✅ Protecting people, and more so young people and the next generation, not just from screens, but from the social conditions that make them so costly

■ YES. The digital era gave social comparison a megaphone.
■ BUT. The underlying vulnerabilities are old — and they demand social and political solutions.



📚 Select Reference List

1. McCarthy, P.A., & Morina, N. (2020). Exploring the association of social comparison with depression and anxiety: A systematic review and meta-analysis. Clinical Psychology & Psychotherapy, 27(5), 640–671.
2. Shannon H, et al (2022). Problematic social media use in adolescents and young adults: systematic review and meta-analysis. JMIR mental health, 9(4), e33450.
3. Ahmed O, et al (2024). Social media use, mental health and sleep: A systematic review with meta-analyses. Journal of affective disorders, 367, 701-12.
5. Kirkbride, J.B., et al. (2024). The social determinants of mental health and disorder: evidence, prevention and recommendations. World Psychiatry, 23(1), 9–48.

07/06/2026

❓️Is there any country in the world that managed to reverse declining fertility rates and how⁉️

👉We asked three AIs (Gemini, ChatGPT and Claude) the above question, on a slow-n-lazy Sunday morning curiosity session.

They all provided comprehensive responses (some more detailed than others), providing specific country examples, with details of the schemes they employed and specific set of measures (the word "set" is important!), as well as the extent of success, and whether that mainly represented:
(a) a short-term spike (i.e. influencing the timing of births, rather than the total number in the long term), or
(b) a buffer from further decline and stabilisation.

👥For anyone interested, try it! It might not consist a proper and systematic exploration into the available evidence (as it deserves), but it is as start.

Certainly, a start in realising that this is not an easy-to-solve problem, no matter how much money (temporarily or consistently over long time) a country throws at it. And certainly, one-off cash hand-outs, are not the way to go, without simultaneously addressing persistent and systemic issues that make it harder for people to consider having the number of children they might otherwise choose to have.

Below, some interesting extracts from each.

■ ChatGPT: "No country has discovered a magic demographic solution. But the countries that have done best are generally those that make family life easier—not simply those that pay people to have children."

■ Claude: "What modest success looks like is France and Sweden — comprehensive, expensive, decades-long investment in work-family reconciliation, childcare, and gender equality. Not cash bonuses. And even these countries are now at 1.6 and declining."

■ Gemini: "Demographic analyses indicate that throwing money at the problem in the form of one-time birth bonuses usually yields short-lived spikes. The most successful interventions combine generous cash transfers with publicly funded IVF treatments and, crucially, accessible, high-quality childcare so mothers can balance their careers with motherhood."

06/06/2026

👶📉 Beyond Birth Rates: What Does the Evidence Tell Us About Pronatal Policies?

⚠️ Warning: Long post ahead. Then again, perhaps that is unavoidable.

This is not a topic that can (or should) be discussed in a 30-second video, a catchy slogan, or a countdown of:

💶 €5,000...
💶 €10,000...
💶 €15,000...
🎤 Going... going... gone!

A topic as important as demographic decline deserves something more than a bidding war of promises. In fact, one might even say it deserves a public debate.

So, at the risk of testing everyone's scrolling endurance, let's look at what the international evidence actually tells us.

🌍 Different Countries, Different Approaches

Pronatal policies come in many forms—and reflect very different philosophies.

💰 Financial incentives:
Birth grants, tax exemptions, child allowances, subsidised housing, student loan forgiveness and similar measures are among the most common approaches. Commonly, in fact, as a package. Not just one-off hand-outs!

👉 For example, countries such as Hungary, South Korea and Singapore have invested in them.

■ However, the evidence suggests that, even more generous packages than cash handouts, may shift the of births and create short-term increases ( ). Evidence that such policies reverse long-term fertility decline remains limited.

■ Hungary is often cited as a success story because fertility increased following an extensive package of family-focused measures. Yet despite substantial investment and years of intervention, fertility remains well below replacement level and recent trends have again moved downward.

■ South Korea presents an even starker example. Despite decades of investment and some of the world's most ambitious pronatal efforts, it continues to record among the lowest fertility rates globally.

👨‍👩‍👧‍👦 Family-supportive policies:
Countries such as France and the Nordic states have traditionally focused less on encouraging births directly and more on supporting families through affordable childcare, parental leave, employment protection, flexible work arrangements and broader welfare policies.

■ These countries too have experienced declining fertility, reminding us that no policy offers a simple demographic solution.

■ However, they continue to maintain some of the strongest systems of support for families, women, children and parental wellbeing.

🌍 The Arab countries paradox
An interesting contrast comes from several Arab countries, where some governments historically pursued strongly pronatalist policies while others sought to reduce fertility through family-planning programmes.

■ Surprisingly, evidence suggests that in both directions the effects of policy may have been smaller than often assumed.

■ Social, economic, educational and cultural changes frequently proved more influential than the policies themselves.

📈 More Births Today—or More Children Tomorrow?

One of the most important lessons from fertility research concerns the difference between the current-child effect and the future-child effect.

👶 Current-child effect

A policy encourages couples who were already planning to have a child to do so sooner. The result: Births increase today. Politicians celebrate!

👨‍👩‍👧‍👦 Future-child effect

A policy leads families to have an additional child that they otherwise would not have had. The result: Lifetime fertility increases. This is much harder to achieve.

👉 A temporary spike in births does not necessarily mean fertility decline has been reversed. Even if politicians celebrate!

■ A policy may successfully move births from tomorrow to today without changing the total number of children ultimately born.

■ This is why researchers increasingly focus not only on annual birth rates but also on whether policies help families achieve their longer-term reproductive intentions.

■ The strongest evidence for lasting effects tends to come from policies that reduce structural barriers to family formation and child-rearing rather than from one-off financial incentives alone.

⚠️Population policies do not operate in a vacuum.

🏠 The Structural Factors Behind Fertility Decisions

The evidence suggests that fertility decisions are shaped by much more than financial incentives.

They are influenced by:

🏠 Housing affordability
💼 Employment security
⚖️ Work-life balance
👶 Access to affordable, quality childcare
🎓 Educational and career opportunities
👩‍⚕️ Reproductive and sexual health services
🤝 Confidence in the future

🌊 The Mediterranean Trap

This is where and many other Southern European countries face a particular challenge.

Demographers have long described a "Mediterranean paradox" or "Mediterranean trap": societies that place a high cultural value on family, yet often provide relatively limited structural support for family formation.

■ In other words, the is where strong expectations around coexist with:

🏘️ Expensive housing
💶 Economic uncertainty
👵 Heavy reliance on grandparents and informal support networks
👩 Unequal caregiving responsibilities
🧒 Limited childcare availability

■ Paradoxically, societies that speak most often about the importance of family may still make family formation more difficult.

👨‍👩‍👧 Not Just a Women's Issue—And Not Just a Cash-in-Hand Issue

🔦 Fertility is often framed either as a women's issue or as a financial issue. Yet the evidence increasingly suggests it is neither.

It is fundamentally a issue, a housing issue, a labour-market issue, a gender-equality issue and a public-health issue.

Many traditional pronatal approaches implicitly ask:

❓️"How can women be encouraged to have more children?"

But, increasingly, evidence points towards a different question:

❓️"How can families be better supported?"*

This is NOT the same question. And the distinction matters.

■ Children are not raised by mothers alone. They are raised by families, communities, workplaces and societies

■ Policies that support fathers' involvement in childcare, encourage shared parental responsibilities and reduce the unequal burden of unpaid care may be just as important as financial incentives.

■ Perhaps one of the most important lessons from countries with relatively stronger fertility outcomes is that successful policies place families at the centre.

❤️ More Children... or Better Futures for Future Children?

Here is an awkward but necessary—question (the uncomfortable truth!).

■ Governments often focus on the number of future children.

■ Families often focus on the future of those children.

The difference may explain why demographic policies sometimes struggle to achieve their goals.

Most people do not decide whether to have a child based solely on financial incentives.

They also think about the world that child will inherit.

🏠 Will they be able to afford a home?

🎓 Will they have opportunities to learn and thrive?

🩺 Will they enjoy good health?

🌍 What kind of environment will they grow up in?

🤝 Will they feel safe, supported and included?

🧠 Will they have the conditions to live a happy and meaningful life?

In other words, many fertility decisions are also wellbeing decisions.

■ Parents are not simply deciding whether they want children.

■ They are deciding whether they feel confident about the future of their children.

This may sound controversial, but it should not be:

❗️No parent dreams of having more unhappy children.

❗️And no society should aspire simply to produce more unhappy citizens.

🔗From a public-health perspective:

Demographic policy success cannot be measured only by the number of births.

It must also be measured by the health, wellbeing and life opportunities of the people who are born.

# # # We count births.

# # # We ask how many children a society is producing.

⁉️ We should ask what kind of childhoods, what kind of futures, and ultimately what kind of society a "demographic policy" is producing. And, what values it is based on.

🚨The real demographic challenge is not whether people want children. It is whether they believe the future is a place where their children can flourish.

🟢 Pronatal policies are not merely demographic (counting heads!) or economic policies (can we afford to pay for more births). They are (should be) also Public Health policies.

As, in fact, they raise important Public Health questions about:

🩺 Maternal and child health
🧠 Mental wellbeing
⚖️ Gender equality
🏥 Access to healthcare
👩‍⚕️ Sexual and reproductive health
🗳️ Reproductive rights
🏠 Quality and affordable Housing
👶 Affortable Childcare
👨‍👩‍👧 Family Health and Well-being
💼 Decent work
🏡 Family-friendly communities
🧱 Social Equity
💸 Economic stability
🍲 Food security ..so many more.

■ There is growing recognition that demographic goals should never be pursued independently of rights, wellbeing and public-health considerations.

🔍 So, What Can We Learn?

■ The evidence does not suggest that governments should ignore demographic decline. Nor does it suggest that pronatal policies are entirely futile.

■ Rather, it suggests that their effects depend heavily on design, context and expectations—and that the most durable results tend to come from broad investments rather than isolated financial incentives.

❓ It Is Time To Ask A Different Question

The question should not be:

"How do we persuade people to have more children?"

But rather:

"How do we create a society where people can have the children they already want, if and when they choose to do so?"

And perhaps the most important lesson from the international experience is that:

➡️ Societies rarely achieve sustainable demographic renewal by asking more from families. They come closer when they do more for families.



📚 Selected References

Thomas J, Baird S, Nandi A. (2022). *The effect of leave policies on increasing fertility: A systematic review*. Humanities and Social Sciences Communications, 9, 262.

Bergsvik J, Fauske A, Hart RK. (2020). *Effects of policy on fertility: A systematic review of (quasi-)experiments*. Statistics Norway Discussion Paper No. 902.

Gauthier AH. (2025). *Family Policies in Low Fertility Countries: Evidence and Challenges*. Population and Development Review.

McDonald P. (2000). *Gender Equity, Social Institutions and the Future of Fertility*. Journal of Population Research, 17(1), 1–16.

Billari FC, Kohler HP. (2004). *Patterns of Low and Lowest-Low Fertility in Europe*. Population Studies, 58(2), 161–176.

Nadan A. (2024). *Are population policies in Arab countries largely ineffective? Past and present perspectives*. Digest of Middle East Studies.

Bharadwaj P, Gaitonde R, et al. (2025). *Effects of pronatalist policies on sexual and reproductive health: a scoping review protocol*. BMJ Open, 15:e115081.

UNFPA. (2020). *Policy Responses to Low Fertility: How Effective Are They?* United Nations Population Fund Working Paper.

05/06/2026

🍬 Η σύντομη «καριέρα» της ζάχαρης ως προϊόν μηδενικού ΦΠΑ στην Κύπρο

❓Γνωρίζατε ότι η ζάχαρη βρέθηκε για σχεδόν έναν χρόνο στον κατάλογο προϊόντων με μηδενικό ΦΠΑ στην Κύπρο;

Μια σύντομη ιστορική αναδρομή:

📅 Τον Μάιο 2023, όταν εφαρμόστηκε το μέτρο μηδενικού #ΦΠΑ για προϊόντα πρώτης ανάγκης, η ζάχαρη δεν περιλαμβανόταν στον κατάλογο.

📅 Τον Νοέμβριο 2023 προστέθηκε η #ζάχαρη, μαζί με τον καφέ, στον μηδενικό συντελεστή ΦΠΑ (0%).

📅 Τον Οκτώβριο 2024 αφαιρέθηκε από τον κατάλογο και επέστρεψε στον μειωμένο συντελεστή 5%, όπου παραμένει μέχρι σήμερα.

👉Συνολικά, η ζάχαρη παρέμεινε στο καθεστώς μηδενικού ΦΠΑ για 11 μήνες, και τώρα παραμένει στο συντελεστη 5%.

🔍 Η τότε απόφαση για προσθήκη της ζάχαρης στο κατάλογο προϊόντων πρώτης ανάγκης με μηδενικό συντελεστή ΦΠΑ, προκάλεσε προβληματισμό σε αρκετούς φορείς , και φυσικά και στην Cyprus Epidemiology and Public Health Association.

◾ Τον Σεπτέμβριο του 2023, η Κυπριακή Εταιρεία Επιδημιολογίας και Δημόσιας Υγείας (ΚΕΕΔΥ/CyEPHA) απέστειλε επιστολή προς τους Υπουργούς Οικονομικών και Υγείας, εκφράζοντας την ανησυχία ότι η ένταξη της ζάχαρης στον κατάλογο «βασικών προϊόντων» στέλνει αντιφατικά μηνύματα προς το κοινό σχετικά με τη διατροφική της αξία και τους τεκμηριωμένους κινδύνους από την υπερκατανάλωσή της.

◾ Ειδικότερα όταν, την ίδια περίοδο, πολλές χώρες διεθνώς ακολουθούσαν ακριβώς την αντίθετη κατεύθυνση. Για παράδειγμα, πέραν των 45 χωρών είχαν υιοθετήσει ειδικές φορολογικές πολιτικές για προϊόντα και ιδιαίτερα ροφήματα με υψηλή περιεκτικότητα σε ζάχαρη, με στόχο:
✔️ τη μείωση της κατανάλωσης,
✔️ την ενθάρρυνση αναδιαμόρφωσης προϊόντων από τη βιομηχανία τροφίμων,
✔️ τη βελτίωση της υγείας του πληθυσμού,
✔️ και την εξοικονόμηση μελλοντικών δαπανών υγείας.

🏥 Χαιρετίζουμε το γεγονός ότι οι επόμενες αναθεωρήσεις των καταλόγων μηδενικού ΦΠΑ έχουν στραφεί περισσότερο προς τρόφιμα που συνάδουν με τις σύγχρονες συστάσεις δημόσιας υγείας, με την προσθήκη νωπών φρούτων, λαχανικών και άλλων επιλογών που διευκολύνουν την υιοθέτηση υγιεινότερων διατροφικών προτύπων.

🤝 Χαιρετίζουμε, επίσης, την υιοθέτηση της νέας Εθνικής Στρατηγικής (και Σχεδίου Δράσης) για τη Βελτίωση της Ποιότητας Ζωής μέσω της Υγιεινής Διατροφής και της Φυσικής Δραστηριότητας και προσβλέπουμε στη συμβολή μας στην υλοποίηση, παρακολούθηση και αξιολόγησή τους. Υπουργείο Υγείας Κυπριακή Δημοκρατία

🍎🥦 Η πρόσβαση σε υγιεινά τρόφιμα αποτελεί σημαντικό κοινωνικό και δημόσιο αγαθό. Οι πολιτικές που επηρεάζουν το κόστος και τη διαθεσιμότητά τους μπορούν να αποτελέσουν ισχυρό εργαλείο βελτίωσης της ποιότητας ζωής του πληθυσμού.

📈 Όταν τα νοικοκυριά δυσκολεύονται να καλύψουν βασικές ανάγκες, οι κοινωνικές και οικονομικές ανισότητες διευρύνονται και, αναπόφευκτα, διευρύνονται μαζί τους και οι ανισότητες στην υγεία. Η πρόσβαση σε επαρκή και υγιεινή διατροφή αποτελεί θεμελιώδη κοινωνικό προσδιοριστή της υγείας.

Η ιστορία της ζάχαρης στον ΦΠΑ (όσο σύντομο και να ήταν το πέρασμα της από τον κατάλογο) πρέπει πάντα να μας υπενθυμίζει ότι
◾ η φορολογική πολιτική δεν είναι απλώς οικονομική πολιτική. Είναι και πολιτική Δημόσιας Υγείας.
◾ η αντιμετώπιση της ακρίβειας, και η μείωση των ανισοτήτων, δεν αποτελεί μόνο οικονομικη πολιτική. Αλλά και πολιτική Δημόσιας Υγείας.
◾ Και πάνω από όλα, ότι οι αποφάσεις πολιτικής στέλνουν μηνύματα. Και τα μηνύματα έχουν σημασία.

#ΔημόσιαΥγεία

04/06/2026

🇨🇾✈️🇰🇿 Ο Πρόεδρος της Κυπριακής Δημοκρατίας βρίσκεται αυτές τις μέρες σε επίσημη επίσκεψη στο Καζακστάν.

❓Στη Δημόσια Υγεία, όλοι γνωρίζουμε για τη Διακήρυξη της Alma-Ata (Άλμα-Άτα) του 1978. Γνωρίζατε όμως ότι η Alma-Ata (σημερινή Almaty) βρίσκεται στο Καζακστάν; 🇰🇿

📜 Η Διακήρυξη της Alma-Ata (1978) θεωρείται ένα από τα σημαντικότερα κείμενα στην ιστορία της Δημόσιας Υγείας. Υιοθετήθηκε από τον Παγκόσμιο Οργανισμό Υγείας και τη UNICEF και έθεσε τα θεμέλια για την Πρωτοβάθμια Φροντίδα Υγείας ως το κλειδί για την επίτευξη του οράματος:

🎯 «Υγεία για Όλους μέχρι το έτος 2000» (Health for All by the Year 2000).

Η Διακήρυξη βασίστηκε σε ορισμένες θεμελιώδεις αρχές:

✅ Η υγεία αποτελεί θεμελιώδες ανθρώπινο δικαίωμα.
✅ Οι ανισότητες στην υγεία μεταξύ χωρών και πληθυσμών είναι κοινωνικά και πολιτικά απαράδεκτες.
✅ Η Πρωτοβάθμια Φροντίδα Υγείας αποτελεί τον πυρήνα ενός αποτελεσματικού συστήματος υγείας.
✅ Η συμμετοχή των πολιτών και των κοινοτήτων είναι απαραίτητη.
✅ Η υγεία δεν είναι αποκλειστική ευθύνη του τομέα υγείας αλλά απαιτεί διατομεακή συνεργασία.
✅ Η πρόληψη και η προαγωγή της υγείας είναι εξίσου σημαντικές με τη θεραπεία.

🌍 Το φιλόδοξο όραμα του «Υγεία για Όλους μέχρι το 2000» δεν υλοποιήθηκε πλήρως. Ωστόσο, οι αρχές της Alma-Ata συνεχίζουν να καθοδηγούν τη δημόσια υγεία μέχρι σήμερα.

📍 Σαράντα χρόνια αργότερα, το 2018, οι χώρες του κόσμου επέστρεψαν και πάλι στο Καζακστάν και υπέγραψαν τη Διακήρυξη της Astana (σημερινή πρωτεύουσα.

Η Διακήρυξη της Astana δεν αντικατέστησε την Alma-Ata· την ανανέωσε για τον 21ο αιώνα.

🔄 Τι παρέμεινε το ίδιο;

✅ Η Πρωτοβάθμια Φροντίδα Υγείας ως θεμέλιο των συστημάτων υγείας.
✅ Η καθολική πρόσβαση σε υπηρεσίες υγείας.
✅ Η ισότητα και η κοινωνική δικαιοσύνη.
✅ Η σημασία της ενεργού συμμετοχής των κοινοτήτων.
✅ Η ανάγκη για διατομεακή δράση για την υγεία.

🆕 Τι προστέθηκε;

📱 Ο ψηφιακός μετασχηματισμός και οι νέες τεχνολογίες
👥 Η ενδυνάμωση του ανθρώπινου δυναμικού υγείας.
🛡️ Η ανθεκτικότητα των συστημάτων υγείας απέναντι σε κρίσεις.
💰 Η βιώσιμη χρηματοδότηση της υγείας.
🎯 Η σύνδεση με την Ατζέντα 2030 και τους Στόχους Βιώσιμης Ανάπτυξης (SDGs).
🏥 Η καθολική κάλυψη υγείας (Universal Health Coverage) ως κεντρικός στόχος.

🇨🇾 Στη Κύπρο;

✅ Οι αρχές της Alma-Ata και της Astana βρίσκονται στον πυρήνα σημαντικών μεταρρυθμίσεων που υλοποιήθηκαν και στη χώρα μας τα τελευταία χρόνια.
✅ Η εισαγωγή του Γενικού Συστήματος Υγείας (ΓεΣΥ) το 2019 αποτέλεσε ένα σημαντικό βήμα προς την καθολική κάλυψη υγείας (Universal Health Coverage), έναν από τους κεντρικούς στόχους τόσο της Alma-Ata όσο και της Astana.
✅ Παράλληλα, η θεσμοθέτηση του Προσωπικού Ιατρού και της Πρωτοβάθμιας Φροντίδας Υγείας επανέφεραν στο προσκήνιο μια βασική αρχή που διατυπώθηκε ήδη από το 1978: ότι τα περισσότερα προβλήματα υγείας πρέπει να αντιμετωπίζονται όσο το δυνατόν πιο κοντά στον πολίτη, μέσα στην κοινότητα, με έμφαση στην πρόληψη, τη συνέχεια της φροντίδας και τον συντονισμό των υπηρεσιών.

💡 Ίσως η μεγαλύτερη κληρονομιά της Alma-Ata και της Astana είναι ότι μας υπενθυμίζουν πως η Υγεία δεν είναι μόνο αποτέλεσμα πολιτικών, αλλά και προϋπόθεση για την επιτυχία όλων των πολιτικών — Υγεία ΣΕ και Υγεία ΓΙΑ όλες τις Πολιτικές (Health in All Policies & Health for All Policies).

🤔 Ίσως τελικά το πιο ενδιαφέρον στοιχείο της σύμπτωσης αυτής δεν είναι ότι η Alma-Ata και η Astana βρίσκονται στο ίδιο κράτος.

◾ Είναι ότι, σχεδόν μισό αιώνα μετά, εξακολουθούμε να συζητούμε τις ίδιες θεμελιώδεις αρχές:

◾ Από την Alma-Ata του 1978 μέχρι την Astana του 2018 και τους Στόχους Βιώσιμης Ανάπτυξης του 2030, το όραμα παραμένει το ίδιο.

❓Το ερώτημα είναι πόσο κοντά βρισκόμαστε σήμερα στην υλοποίησή του: και αν το 2000 αποδείχθηκε υπερβολικά αισιόδοξο, μήπως το 2030 είναι η επόμενη μεγάλη δοκιμασία;