The Global Population Health Summit – GPHS aims to promote population health importance by encouraging scientific and evidence-based discussions to tackle pressing challenges affecting population health. The summit took place at Jacob K. Javits Convention in New York, USA, and was accredited by the International Congress for Health Specialties – ICHS, held under the theme “Ethics and Population Health'' and provided an independent platform for renowned health specialists to share evidence-based and experiences and to discuss on how to maintain the rights, safety, dignity, continuity and well-being of the world community. Prominent Health professionals in the field of population health shared with the summit attendees their views and experiences about these important and pressing subjects to humanity and their link to population health.
By the end of the summit, the speakers and participants deliberated and agreed to issue the Global Population Health Summit New York Declaration. The following statements constitute the Declaration.
First Statement – Population Growth
• GPHS Recognizes that the current evolution of the population with a divide of nations between countries facing an aging population and countries facing important demographic growth on a worldwide growing urbanisation pattern affects global health and should be taken into consideration as a major driver for population health policies.
• Evidence suggests that countries with organised and institutionalised arrangements, higher public spending, lower income inequalities, and policy to ensure safe workplaces and access to education and housing generally have populations with better health although this situation can be weakened as witnessed with the COVID pandemic.
• Income inequality and level of education remains the strongest predictor of population health and mortality especially in Low- and Middle-Income Countries – (LMICs).
• There is a need to ensure that distribution of population and its growth is supportive to the health needs of the population and that the healthcare delivery system is more responsive to this evolution.
Second Statement - Ethics and Health Research
• The updated version of the Declaration of Helsinki (DoH), developed by the World Medical Association, is the most widely accepted code of research with its three fundamental ethical principles that are respect for persons, beneficence, and justice.
• While the Hippocratic oath originally written to guide doctors in caring for their patients, population health ethics, on the other hand, is founded on the societal responsibility to protect and promote the health of the population. From a public health perspective, research ethics must consider the risks and benefits to society in addition to the individual research participants.
• There is a moral responsibility to distribute the benefits and burdens of research fairly across society and to fully involve the people in shaping up the rules guiding health research.
Third Statement – Sexual Reproduction and Population Health
• Evidence suggests that in the past half-century, the world has witnessed a steep decline in fertility rates in almost every country but at a different pace.
• Research is demonstrating that the greater the education attainment among women and access to contraception, the more rapid the declines in fertility and deceleration in population growth.
• Studying the patterns in future population levels is integral to anticipating and planning for resources and healthcare needs allocation and will determine future environmental and economic landscapes.
• Although population evolution bears inertia, better research on the dynamic of change and shocks faced by population would allow refining consequences of population evolution on mankind's well being in the context of climate change.
Fourth Statement – Genetic Engineering
• Tools to produce genetically modified organisms mostly worked through insertion of genes into the organism’s genome at more-or-less random locations.
• The Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) technique has the advantage of extremely precise “edits” of the genome at locations of the users’ choosing.
• This advancement provided by CRISPR sparked an ethical debate whether the arguments for “therapeutic” genome editing also work to justify human enhancement.
• Human Genome Editing (HGE) is a controversial topic, but it must be grounded in the four core bioethical principles: beneficence, non-maleficence, autonomy, and justice.
• In order to arrive at decisions with far-reaching implications on HGE, relevant stakeholders, medical, and scientific communities are needed to engage in meaningful discussions on the potentials and risks of this technique.
Fifth Statement – Gender Reassignment
• GPHS adheres to the definition of the World Health Organization in its constitution of health as “a state of complete mental and social well-being and not merely the absence of disease or infirmity”.
• According to the American Psychological Association (APA), transgender persons are those who’s physical or assigned sex does not accord with their gender identity and usually suffer from gender dysphoria (GD), which is the clinical distress associated with not fitting in their physical sex.
• A holistic approach done in a timely manner should be accompanied by continuous mental and physical health care for this patient group while giving sufficient time for treatment.
Sixth Statement – Euthanasia and End-of-Life
• Euthanasia and End-of -Life are different concepts. End-of-Life care is the decision of the patient, family and/or the caregiver.
• Bioethics seeks to prioritise the concept of dignity, which must be linked to the very definition of life.
• End-of-life care will continue to be a subject of debate due to the struggle between biomedical principles, the different existing legal frameworks and the general population’s beliefs. In this debate it is important to recognize the importance of the value of the individuals. Much work to educate the general population and health professionals about End-of-Life care and dignified death is still required.
In conclusion, the scientists and speakers participating in the summit concluded, through their scientific discussions, that issuing decisions, laws or recommendations that affect communities based on the pretext of public freedoms or personal freedoms must be based purely on scientific foundations and that medical research and scientific studies are the basis of those decisions, laws or recommendations in order to safeguard the health of the population and protect communities from political, intellectual, ideological, religious, media or other influences. Healthcare needs allocation and will determine future environmental and although population evolution bears inertia, better research on climate change.