Book Review‘Politics and health updated’ by Marc Danzon and Yves Charpak Marc Danzon is an innovative and well-rounded health policy analyst, a former colleague at WHO, where he was the Regional Director of the European Office in Copenhagen during the first decade of the 21st century. With his one-time scientific adviser Yves Charpak, Dr. Danzon has now published a remarkably frank commentary on the interface between the health sciences and politics – Notre Santé dans l’arène politique mondiale, Belin (www.editions-belin.com ISBN 978- 2 70111-9599-5). This 253 page book is presented as a dialogue between the two seasoned participants on the development of health services and their comparative performance. The key concept that the joint authors explore is ‘the context’ of health policy delivery. Their candid conversations on policy and programme development are set within that extraordinary era in Europe after the implosion of the Soviet Union, the challenges of the evangelical proponents of the ill-fated global policy of Health for All by the year 2000, contrasted with Danzon’s own 2008 Tallinn charter. In their joint commentary, presented in the form of a recent exchange of amiable but incisive letters, they ponder again on the big questions of their days, re-examining some of the fundamental issues of the organisation, financing, management and evaluation of health services, and more pertinently services for health. By training, a psychiatrist, Marc Danzon won his spurs in France by heading up the Comité français d’éducation pour la santé (CFES), where he took on fearlessly Big tobacco and Big alcohol, achieving international acclaim. For Danzon and Charpak the important question is not why there is such a variation between countries in the number of hospital beds per thousand population, or the expenditure on health service per capita, but why such a big divide in expectation of life, and deaths from preventable illness and accidents. The chapters in this fascinating dialogue span the obstacles to vaccination, health risks, the food industry, Ebola, depression and suicide, public and private sector financing for health, and finally the strategies for the reorientation of health service towards health. The book underlines the reactionary bias of many health professionals and policy makers in their visions of health services, plus the sheer political and commercial threats of industries that kill people. This stimulating book just lacks an English edition and an index. Their review, through the engaging process of dialogue, offers to the reader fresh access into the corridors of power at ministerial and international levels. In an encounter with Dr. Danzon in Paris, on my recent travels, I was further astonished at the Snowdon type revelations he cited on the clandestine snooping, with high-tech gadgets, uncovered in international health offices, that presents a sinister challenge to collegial confidence and collaboration. Danzon and his colleague, after two terms at the top in the WHO in Europe, draw back the veil on deliberations on the changing face of the health sector in the rapid period of transformation after the Gorbachev years, which saw half of Europe re-emerging from its http://www.editions-belin.com/ servile status under the heavy imprint of the Soviet era. Yet the authors see the liberation of Europe as a capricious process in which the fundamentals of the welfare state, the opportunities and flaws of the free market model, the democratic process of greater freedom of speech and the re-action by ordinary people, all come into sharp confrontation with both professional authority and commercial clout. This confrontation tested the metal of those at the top. The dialogue throws new light on the way Danzon and his colleagues kept the show on the road, whilst challenging the traditional inertia of health systems, by offering a fresh agenda of innovative action especially against commercial interests that were undermining health. At the same time the health press awakened by the voice of the people, vigorously questioned the role of the WHO and the rigid authority of health professionals. The notion of context is a leitmotif that pervades this fascinating book, for whilst international comparative analysis is deeply penetrating, the pursuit of health has to be conducted in each place in a way relevant to local capacities and priorities. For some the focus is safe water, for others mental health and wellbeing. The mission of the authors is to reveal insider dealing in the quest for improving world health. But, whilst truth is neither simple nor absolute, this important book offers a fresh motivation to analysis which should stimulate public and private reflections on health outcomes, at home and abroad. Dr. John L. Roberts Email: john.laing@hotmail.com @ 2016 Mauritian current affairs magazine Weekly mailto:john.laing@hotmail.com