PECS DECLARATION The Declaration of Pecs Co-operation and Collaboration for the Health of Rural Communities XIVth Congress of the IAAMRH, PECS, HUNGARY Facing a new century, the International Association of Agriculture Medicine and Rural Health (IAAMRH) wishes to reaffirm its commitment to the needs of all rural people and rural communities throughout the world. Rural communities at the end of the 20th Century are under increasing pressures and stresses, yet a major proportion of the World's population still live in rural areas. It is our belief that rural communities and rural life has contributed to the quality of all lives and provides the foundations for our national culture, values and customs. Rural people still have much to offer and contribute mankind at a time of great change and uncertainty. The technological and social changes of the last 50 years have accelerated the process of rural degeneration and marginalisation with an accelerating exodus of people out of the rural areas into ever growing cities. National governmental policies have tended to concentrate on urban issues developing statutes and health care policies to meet the needs of city, rather than rural dwellers. The IAAMRH is committed to improving the health of rural communities by stimulating community development, encouraging teamwork and building partnerships across the economic, health and social sectors. Health care should always be people and community focused, ensuring that limited resources are used efficiently and appropriately and that all projects and programs should be developed under the principle of long term sustainability. We need to increase the level of "health literacy" in a culture of local empowerment where rural communities can regain some control of their own destiny. It is our aim to ensure that the status of all things rural is enhanced and that rural life remains one of the cornerstones of life in the 21st Century. Whereas the challenges in the developing world tend to be those of poverty, infectious diseases, sanitation, education and limited resources, those of the developed world are chronic disease, abuse, isolation, economic inequalities and access to care due to the centralisation of expensive health services. Despite the different problems, their goals are similar and the developing and developed world have a lot to learn from each other by establishing partnerships and networks to ensure that information and experiences can be disseminated and resources can be used as efficiently and efficiently as possible. The anticipated threats to rural communities for the 21St century include: Rural poverty, malnutrition, population growth, social exclusion and health inequalities. The reversal of advances made in treating infectious diseases with increasing mortality due to infectious diseases such as tuberculosis, malaria and HIV/AIDs. The status of women in rural communities. The problems of children and the high child mortality Migration to urban areas The hazards of agriculture and the changing face of agriculture The lack of reliable data and research on rural issues An aging population The disproportionate dominant urban influence on academic health institutes and bodies The lack of sanitation and clean water The safety of the food chain and environmental pollution Global climatic change Increased local and regional conflict and tension across the world The globalisation of commerce, industry and agriculture A lack of an infrastructure in order to lead a decent and dignified human life. We have witnessed major political, social, economic and technological changes during the second part of the last century. These changes provide us with some exciting opportunities that we need to grasp. These include. The advance of Information and Communication technologies, which enables the building of invisible bridges between, isolated peoples and communities. Recent political developments allowing more and better cooperation amongst nations and societies. Scientific and technological progress, which can improve living conditions. The progress in medical and health science. An increasing public awareness concerning a stable and protected environment. We, members of IAAMRH and participants of the XIVth Congress, are determined to be faithful to our principles and continue our health policy to combine health promotion, disease prevention, effective care and rehabilitation in an interdisciplinary approach which includes political, economic, social and medical science and practice. Our association supports rural primary health care within the scope allowed by local, national and regional conditions. In order to make the best use of our resources and to reach our association's goals, we should make changes in our priorities, management and information policies in the forthcoming years. We believe that our objectives should fall into the following areas: General themes Promote the IAAMRH, its activities and increase membership Ensure that the IAAMRH is consulted about and involved in rural policy decisions and discussions. Information and data. Built and accessible information database (either on our own or in partnership with other organizations) Set up an interactive web presence on the Internet. In partnership with WONCA and similar organizations ensure that all the rural centers around the world are networked. Those at risk in our rural communities. Aim for gender equality in rural health. Promote rural as an effective form of health care Research and development. Ensure that rural health research is relevant to the needs of rural communities. Promote collaborative, participatory and action research programs. Ensure that rural research is able to inform rural policy. Ensure that rural projects can leave the projects cycle. Agriculture Health. Support the development of specialist agricultural occupational health services. Support the development of rural health insurance programs and policies. Education training and recruitment of rural health and social care workers. Ensure that all students have access and exposure to rural health and practice their training programs. Promote the development of rural based training programs. Promote the establishment of academic centers of rural health. Establish student graduate exchange programs. Networking Forms partnerships and collaborations with other organizations with a health rural focus (WHO, WONCA, ILO, etc). Run conferences and collaborate when appropriate with other organizations on a range of issues related to rural health on an integrated inter-sectoral approach. We invite everybody who is concerned about and feels responsible for the health and well being of rural people, to create better collaborations and unite our efforts and activities. We ask the international organisations to direct more attention to the health of the rural people. Participants of the XIVth Congress of IAAMRH 27th May 00 Pecs, Hungary.