ffw 2012 summit_bertollini
TRANSCRIPT
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Health2020: a new WHO strategyto promote well-being and tackle
Chronic Diseases in Europe
Roberto Bertollini MD MPH
Chief Scientist and WHO Representative to the EU
WHO Regional Office for Europe
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Overall health improvement (5 years life expectancygained) but with an important divide
CIS: Commonwealthof Independent StatesEU12: countriesbelonging to theEuropean Union (EU)before May 2004EU15: countriesbelonging to the EUafter May 2004
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Why Health 2020?
Financial and economic crisis is threatening the gains
made across Europe in recent decades, and exacerbatingthe longer term challenges facing our health systems
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Health 2020 builds on strongvalues
Health as a fundamental human rightSolidarity, fairness and sustainability
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Health 2020 - a common purpose,a shared responsibility
Health 2020 strategic objectives: stronger equity and better governance
1. Working to improve health for all and reducing the health divide
2. Improving leadership, and participatory governance for health
Health 2020 goal
To significantly improve health and well-being of populations, to reduce health inequities and
to ensure sustainable people-centred health systems
Health 2020 visionA WHO European Region in which all people are enabled and supported in achieving their fullhealth potential and well-being and in which countries, individually and jointly, work towardsreducing inequities in health within the Region and beyond
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Health 2020: Four common policy prioritiesfor health
Investing in health through a life course approach and empowering people
Tackling Europes major health challenges of non communicable diseases and
communicable diseases
Creating supportive environments and resilient communities
Strengthening people-centred health systems and public health capacities, andemergency preparedness
The four priority areas are interlinked and are interdependent and mutuallysupportive
Addressing the four priorities will require a combination of governanceapproaches that promote health, equity and well-being
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Major burden in the Region due tononcommunicable diseases
SDR: standardizeddeath rate
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Capewell S, OFlaherty M. Rapidmortality falls after risk-factorchanges in populations. TheLancet Published Online March16, 2011 DOI:10.1016/S0140-
6736(10)62302-1.
Extensive empirical and
trial evidence shows thatsubstantial reductions inmortality can occurwithin months ofdecreases in smoking,and within 13 years ofdietary changes
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Associated with a doubling in the risk ofillness and 60% less likelihood of recoveryfrom disease*
Strong correlation with increased alcoholpoisening, liver cirrhosis, ulcer, mentaldisorders**
Increase of suicide incidence***GRE and LVA 17%, IRE 13%
Active labour market policies and well-
targeted social protection expenditure caneliminate most of these adverse effects
Unemployment
Sources: * Kaplan, G. (2012) Social Science & Medicine 74 pp.643-646.** Suhrcke M., Stuckler D. (2012) Social Science & Medicine 74 pp.
647-653.***Stuckler D. et al. (2011) The Lancet Vol378 pp124-125.**** Stuckler D. et al. (2009) The Lancet Vol374 pp 315-323
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Health impact of social welfarespending and GDP growth
Each additional 100USD percapita spending on social welfare(including health) is associatedwith 1,19% reduction in mortality
Socialwelfare
spending
Each additional 100USD percapita increase of GDP isassociated with only 0,11%reduction in mortalityGDP
Source: Stuckler D et al. BMJ 2010;340:bmj.c3311
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The economic case for health
promotion and diseaseprevention
The economic impact ofnon-communicable
diseases amount to many
hundreds of billions ofeuros every year
Many costs areavoidable throughinvesting in health
promotion anddisease prevention
Today governmentsspend an average3% of their health
budgets onprevention
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Some examples
Cardiovasculardisease
Alcohol relatedharm
Cancer
Road trafficinjuries
Obesity relatedillness (includingdiabetes and CVD)
169 billion annually in the EU; healthcareaccounting for 62% of costs
125 billion annually in the EU, equivalentto 1.3% of GDP
Over 1% GDP in the US; between 1-3% ofhealth expenditure in most countries
6.5% of all health care expenditure inEurope
Up to 2% of GDP in middle and highincome countries
Sources: Leal (2006), DG Sanco (2006), Stark (2006), Sassi (2010), WHO (2004)
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Using fiscal policy: the short term benefits ofsin taxes
TobaccoA 10% price increase intaxes could result in up to
1.8 million fewer prematuredeaths at a cost of between
$3 and $78 per DALY in
eastern European andcentral Asian countries
AlcoholIn England, benefits closeto600 million in reducedhealth and welfare costsand reduced labor and
productivity losses, at animplementation cost of less
than0.10 per capita
Source: McDaid, Sassi and Merkur, 2012 (forthcoming)
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Closer cooperation between health andfinance Ministries
OECD /WHO JointMeeting on FinancialSustainability of HealthSystems
2012, Tallinn, Estonia
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Improving governance for health andincreasing participation
Source: Kickbusch, 2011
Governing through:
collaboration
citizen engagement
a mix of regulation andpersuasion
independent agencies andexpert bodies
adaptive policies, resilient
structures and foresight
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Health 2020:Towards a healthier Europe
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