Health professionals have high credibility with the public and with government, and this means it is vital that they are involved with campaigns. Some health professionals are not comfortable stepping outside a rigorous scientific discipline. They fear getting tangled up in a political world where principles are few and personal ambitions are many. Even if you do not feel that way, it is likely that at least some of your colleagues will be concerned about campaigning openly.
In the UK, we have found that nongovernmental organizations (NGOs) represent one of the best ways for health professionals to make a contribution to changing policy. Such groups are sometimes staffed by nonhealth professionals who are experts in lobbying government, yet rely heavily on the credibility and guidance of health professionals. NGOs have developed, and are developing, in different ways in each country, and they offer good opportunities to make an impact on public policy.
The prize of public health is important, and your role as health professionals is crucial. Frederick Douglass ( 3), a man who fought for the abolition of slavery in the United States, nicely summarized the choices we must face: "If there is no struggle, there is no progress. Those who profess to favor freedom and yet deprecate agitation are people who want crops without ploughing up the ground. They want rain without thunder and lightening. . . . Power concedes nothing without a demand. It never did and it never will. People might not get all they work for in this world, but they must certainly work for all they get."
I thank Mike Pertschuck and the Advocacy Institute in Washington for many of the ideas in this chapter, and Jeanette Longfield for editing the speech on which the chapter is based.