[Proposal for a Nationwide Johann-Peter Frank Cooperation Model under the National Leopoldina Initiative for Public Health and Global Health]. / Vorschlag für ein bundesweites Johann-Peter Frank Kooperationsmodell im Rahmen der nationalen Leopoldina-Initiative für Public Health und Global Health.

The discussion on the development of public health affairs was invigorated anew by the report on public health in Germany of Leopoldina/Acatech/Union of the German Academies of Sciences and Humanities of the year 2015. The report urges strengthening of public health and global health in Germany and addresses explicitly the Public Health Service (PHS). This indispensable inclusion of the PHS in further strategic planning offers for the first time an opportunity for a comprehensive and sustainable practice/policy transfer on the federal, state and community level, and also a chance for a sustainable network with modern academic public health institutions together with representation of medical specialization in public health at universities, that has been absent so far. A Johann-Peter Frank model for cooperation and stepwise modelling of this transition with the inclusion of the Academies for Public Health Service is presented.

[Medical Care for Refugees by the Public Health Services: Always Ready--But for How Much Longer?]. / Medizinische Versorgung von Flüchtlingen durch den Öffentlichen Gesundheitsdienst: Allzeit bereit--nur wie lange noch?

Refugees continue seeking sanctuary in Germany and it can reasonably be expected that their health will be affected by the conditions they lived in before and during flight. Ensuring nationwide care for refugees should be demand oriented, effective and efficient, which requires tackling mostly similar challenges a community level in a consistent manner. The aim must be providing adequate medical care based on the principle of respect for human dignity and ensuring public health standards. Within the currently situation, this basic expectations are often not sufficiently met. Generally accepted national standards, longer-term strategies and sustainable care are not yet achieved noticeably by public health services in Germany.To warrant permanent and sustainable high-quality medical care for refugees, local networks of involved institutions should be established with a longer-term perspective. Moreover, the financially eroded and personnel thinned public health service will only be able to fulfil statutory requirements and expectations of the local, state and federal policy makers for a limited amount of time only. Safeguarding that services are coping with the size of challenges over longer periods of time and anchoring the acquired expertise of medical care for refugees within the public health services, requires immediately better financial and personnel resources. Then the public health services will be a reliable partner supporting all people in Germany, particularly those that require subsidiary and socially-compensatory supply.

Ambulatory tuberculosis treatment in post-Semashko health care systems needs supportive financing mechanisms.

The tuberculosis (TB) control strategy in the Republic of Karakalpakstan, Uzbekistan, is being changed to decentralised out-patient care for most TB patients by the Government of Uzbekistan, in collaboration with the international medical humanitarian organisation Médecins Sans Frontières. Ambulatory treatment of both drug-susceptible and drug-resistant TB from the first day of treatment has been recommended since 2011. Out-patient treatment of TB from the beginning of treatment was previously prohibited. However, the current Uzbek health financing system, which evolved from the Soviet Semashko model, offers incentives that work against the adoption of ambulatory TB treatment. Based on the 'Comprehensive TB Care for All' programme implemented in Karakalpakstan, we describe how existing policies for the allocation of health funds complicate the scale-up of ambulatory-based management of TB.