Work in progress, developing of guidelines - How could EPMA contribute to better health care in developing countries

Predictive preventive and personalized medicine is certainly far from optimal also in industrialized countries, in particular as far as the predictive aspects, but also the preventive ones. In fact the predictive aspects are still a sort of goal and final scope also in countries with the “best” medical care! The level of development of medical care in industrialized countries is various and depends to a certain level on each country, but it might be generally considered to be at “reasonable good” level, although certainly not optimal, taking into account present economical constrains. Therefore it is sometimes a short of a shock to work on projects in developing countries. In my case, as I have been experiencing a lot of changes in direction in medical health care. It comes natural to look back at try to analyze different tendencies, also related to economical situations. From the period of building big hospitals and medical structures to the nowadays tendency to reduce the stay of patients to absolute minimum and other examples. Difficult to say what is the best approach as diagnostic and therapeutically means have changed so much due to fast technical as well as clinical developments. Now comes a big question: is there a short cut for developing countries? In case it might be possible to go back 30-40 years ago, what could be done to reach a good level of health care, better than present, with more prevention, avoiding the mistakes and focusing on the right objectives. The role of errors and trials is certainly important but that has already been experienced and therefore it should be a must to take advantage of other experiences to evaluate pros and cons and better understand priorities and objectives. The possibility “to go back in time” is everybody’s dream, and, it is what (to a certain extent) could happen in developing countries. In fact, in many countries the level of health care is more or less comparable to our realities 30- 50 years ago (clearly depending on the country). This is a challenging opportunity indeed! It is a big responsibility to let it go in vane! But, unfortunately, from my experience, this is what is happening in many developing countries, starting a fast as well as useless “competition” with industrialized countries. It might look more important to buy some top “high tec” equipment than invest on basic medical structures, education and prevention.