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“Ethics is important. Trade is more important”, said a MoH during a European Union meeting on tobacco advertisement. One could not find a better example of the completely opposite of the ideal MoH. Why do we permit people that think as if they were trade ministers to become MoH? What is the safety valve that keeps such a (trade) Trojan horse outside the health sector?
I propose that a master of public health (MPH) should be the minimum qualification for anybody to be considered for this post. Otherwise s/he will: misinterpret health as being determined by health services (which represent only a very limited determinant11); not give battles for health in the Council of Ministers (cabinet); not create multisectoral strategies and partnerships for sustainable health.11,12 If an essential prerequisite for the ideal MoH is to be a reader of this journal,8 the essential prerequisite for being a reader is an MPH. Ministers are supported by technical staff, but all MoH need a minimum training—that is, an MPH—to understand staff without being governed by them (or by “conflict of interest”), and to inspire staff and society.
It is inconceivable for somebody without advanced studies in economics to become finance minister. Why do we accept this for the MoH? Do health professionals also rank health at the bottom of the cabinet’s agenda? Economically naive finance ministers would not last, while health naive MoH tend to flourish. Do health professionals recognise, accept, and expect a genuine lack of health sophistication among MoHs? The science of health differs from the politics of health, as the science of economics differs from the politics of economics, however nobody accepts a finance minister without studies in the science of economics.
Will the proposed safety valve work every time? Perhaps not, but someone can expect it to work most times. An MPH is just the minimum guarantee. Moreover, MPH holders could help a colleague to live up to the occasion; but first of all they should demand that nobody without an MPH could become a MoH. Public health managers “must be trained in public health to postgraduate level”11; it is ironic that the same is not a prerequisite for the manager of managers, the MoH. Do we believe in born MoHs?
I am thankful to Dimitrios Dimoliatis, Efrosini Pappa, Thomas Trikalinos, and my reviewers for their constructive comments.
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