report on the work of the who regional office for europe

Report on the work of theWHO Regional Office for Europe

Dr Zsuzsanna JakabWHO Regional Director for Europe

BETTER HEALTH FOR EUROPE:MORE EQUITABLE AND SUSTAINABLE

Photo: EMLab Project Photo: European Centre for Disease Control/ Katrin Leitmeyer Photo: WHO/Sara Barragán

WE MUST DO MORE

Maximum value

Regional average

Minimum value

Inequalities in life expectancy: declining, but gap persists

Maximum value

Regional average

Minimum value

Inequality in life expectancy are declining but gap persists

Region is on track towards reducing premature mortality

Maximum value

Regional average

Minimum value

litres of pure alcohol is drunk per person per year

of the population is overweight or obese

of the population uses tobacco

European countries are strengthening their policies

all answers (n=31 and 36 for 2010 and 2013, respectively)

0% 10% 20% 30% 40% 50% 60% 70%

No and not planned for the future

No, but planned for the future

Yes, another strategy

Yes, comprehensive health policy

National health policy is aligned with H2020All answers (n=31 and 36 for 2010 and 2013, respectively)

2013

2010



0% 10% 20% 30% 40% 50% 60% 70%

No and not planned for the future

No, but planned for the future



National health policy is aligned with H2020All answers (n=31 and 36 for 2010 and 2013, respectively)

2013

2010

2013

2010

Strategic directions of Health 2020 remain relevant

Common challenges ahead

Photo: Sharon Steele

Health is a political choice

64th session of the Regional Committee for Europe, Denmark

Health 2020:the right political choices for health

INCREASE HEALTHY LIFE EXPECTANCY

ENHANCE WELL-BEING

REDUCE INEQUITIES

REDUCE PREMATURE MORTALITY

SUPPORT UPSTREAM APPROACHES FOR GOVERNANCE AND DETERMINANTS FOR HEALTH AND UNIVERSAL HEALTH COVERAGE

ESTABLISH NATIONAL TARGETS IN HEALTH POLICIES AND MONITOR

Investing in health pays off

Photos: Malin Bring

Photo: Malin Bring

RETURN ON INVESTMENTReproductive,maternal and child healthUS$ 20

per US$ 1 spent

Health is an investment (not an expense):

we need to invest more

Health policy- makers

Economic and fiscal policies

Education

Socialsector

Trade

Environment

Transport

Migration

Policy-makers have choices

Health is central to development

Transforming our world:the 2030 Agenda

for Sustainable Development

Sustainable development goals

Sustainable Development Goals

matter to us

Sustainable development goals

Universal Health Coveragein every country of the world

Regional consultationfor the post-2015 development

agenda

Health targets – Health as a target in other goals

Health and well-being in each and every goal

Translating the 2030 Agenda into national development plans

RENEWED POLICY ENVIRONMENTFRAMED BYHEALTH 2020

Intersectoral action: elements for success• Mayors, prime ministers, celebritiesHigh-level commitment

and champions• Taxation, private sector • Coordination function needs resourcingDedicated resources

• Health promotion agencies; advisory task forces; local government• Do not discredit informal relationships and power of communityInstitutional structures

• Quality of the “planning” can be more important than the “plan”Joint planning

• Trans fats, setting up structures for health promotion Legislative tools

• Does not matter who, but needs to be clear (shared or not, health or non-health)Accountability

• Targets focus action• Results are important for advocacyMonitoring and reporting

Intersectoral action requires political commitment

European environment and health process

European environment and health process

Well constructed political process

A strong institutional legitimacy

National implementation

mechanisms

Technical excellence

WHO European Centre for Environment and Health in Bonn

Sixth Ministerial Conferenceon Environment and Health

2017

Fifth Ministerial Conferenceon Environment and Health

Italy, 2010

European Environment and Health Process – Mid-term

Review

Israel, 2015

Social determinants of health: a strategic priority

Second High-level Meeting of Small Countries,Andorra

Promoting intersectoral and interagency action for health and well-being in the WHO European Region, France

Health in foreign policy and development cooperation

International Health Forum,Turkemenistan

Intersectoral committees

Portugal

European consultative process to promote intersectoral action

© European Health Forum Gastein

National health-policy development

Photo: Teodor Pricop

Networks are effective platforms for national health policies

South-eastern Europe Health Networkleading the way

Small-countries Initiative: an efficient network

San Marino Order of St Agatha

Photo: Filippo Pruccoli

“Health 2020 has been a key reference for the health and social-health plan that is presented today, and we are sure that it will continue to be so for any future activity aimed at promoting better welfare and health of our population.”

– Their Excellencies Andrea Belluzzi and Roberto Venturini, Captains Regent of San Marino'

Photo: WHO/David Barrett

Alignment of policies mirrored at the subnational level

Regions for Health network Healthy Cities network

WHO European Office for Investment for Health and Development, Venice

COMBATINGCOMMUNICABLEDISEASES

Photo: Cristiana Salvi

Major progress in prevention and control of tuberculosis (TB)

• 1 million TB patients cured• 200 000 multidrug-resistant TB (MDR-TB)

cases averted• 2.6 million lives saved

Fastest TB decline of all WHO regions

2009 2010 2011 2012 201320

200

313280

31 29

122 121

50

39

198 183

9687

per 1

00 0

00 p

opul

ation

(log

)

5.9%

____

1.9%

2.4%

0.3%

2.0%

2.8% Africa

South-east AsiaEastern MediterraneanWestern Pacific

EuropeanAmericas

Leadership and commitment for action

• 1.4 million TB patients cured• 1.7 million new cases prevented• 3.1 million lives saved• US$ 48 billion saved

Call for scaled-up efforts to eliminate TBin our lifetime

Alarming situation calling for evidence-based actions

Photos: WHO/James Hammond

Viral hepatitis remains unaddressed throughout the Region• 13 million people (estimated) live

with chronic hepatitis B• 15 million people (estimated) live

with chronic hepatitis C• 400 deaths related to viral hepatitis

a day

Viral hepatitis – a silent killer

Global strategiesfor discussion on Thursday

Very close to eliminating malaria

Very close to achieving our goal –no locally acquired malaria cases in the WHO European Region in 2015

Remaining vigilant to prevent malaria reintroduction

Vaccine-preventable diseases continue to burden the Region

Re-emergence of polio: strong reminder of the need to maintain commitments

Polio: poliomyelitis


Photos: WHO/K. Vozniuk


Photo: Ayberk Yurtsever Photo: WHO/B Kadirov

Translating commitment into actionGoal 1. Sustain polio-free status

Goal 2. Eliminate measles and rubellaGoal 3. Control hepatitis B infectionGoal 4. Meet regional vaccination cover targetsGoal 5. Make evidence-based decisionsGoal 6. Achieve financial sustainability

Measles in the WHO European Region, 1993, and 2007-2014*

20092010

20112012

20132008

2007

1993

9168

7075 78923060

43326

82678

63217

4

341982

16159

2014*

98% REDUCTION

Her Royal HighnessThe Crown Princess of Denmark in Tajikistan: focusing on the importance of access to immunization for all

Photo: WHO/Akram Isaev

PREVENTION and CONTROL ofNONCOMMUNICABLE DISEASES (NCDs) Photo: iStockphoto

Decline in avoidable NCD deaths

Since 2000, almost all countries show a decline in deaths from cardiovascular diseases (CVD) in both women and men aged under 65.

SDR: standardized death rate

Alcohol and tobacco use declinesWHO regions Total APC*

2005Total APC

2010Europe 12.2 10.9Africa 6.2 6.0Americas 8.7 8.4Eastern Mediterranean 0.7 0.7South East Asia 2.2 3.4Western Pacific 6.2 6.8All 6.1 6.2

Source: Global status report on alcohol and health 2014. Geneva: World Health Organization; 2014.

2000 2005 2010 2011 2012 2013 2014 2015 2020 20250%

10%

20%

30%

40%

50% Male Female Both sexesPrevalence of current tobacco smoking (15+) in Europe

APC: alcohol per capita consumption

FCTC : Framework Convention on Tobacco Control

Parties to the Protocol to Eliminate Illicit Trade in Tobacco ProductsAustria

Belgium

Cyprus

Denmark

Finland

France

Germany

Greece

Ireland

Israel

Montenegro

Netherlands

Norway

Portugal

Slovenia

Spain

Sweden

The former Yugoslav

Republic of Macedonia

Turkey

Turkmenistan

United Kingdom of Great Britain and Northern Ireland

More action needed to eliminate illicit trade in tobacco products

Roadmap towards implementation of WHO

FCTCFor discussion on Wednesday

Physical activity strategy: complementing food and nutrition action plan

Neglect and abuse of adults with intellectual disabilities

Management of NCDSImproved medical care is a strong contributor to declining illness and mortality from CVD.

Essential interventions package for NCDs

NCD Project launchGeographically dispersed office (GDO) in Moscow

for NCDs

Investing in health through a LIFE-COURSE approach: key strategic direction for Health 2020 Photo: iStock

Ministerial Conference 21–22 October 2015

Minsk, Belarus

A life-course approach increases the effectiveness of interventions, promoting timely investments with a high rate of return for public health and the economy.

Progress in improving women’s health, but with persistent inequities

MKD: the former Yugoslav republic of Macedonia

Time to focus on medical conditions during pregnancy

Photo: UNPhoto: Malin Bring

Sexual and reproductive health and rights need more attention

Photo: Malin Bring

Strengthening PEOPLE-CENTREDHEALTH SYSTEMS and PUBLIC HEALTH CAPACITY

The Tallinn Charter has led the way

New vision for health-systems strengthening reaches out to people

The way forward: coordinated, integrated health-service delivery towards people-

centred care

© InfoGyor

Renewed vision of primary health care (PHC)

at the centre of people-centred care

Inauguration

Photo: Serguei Gurzhin

New GDO in Almaty for PHC

Moving towards universal health coverage is vital

“Universal health coverage: The single most powerful concept public health has to offer.”

– Dr Margaret ChanWHO Director-General

Supporting countries through the Barcelona-based training courses

1. Barcelona Course on Health Financing (focus on universal health coverage)

2. Flagship Course on Health Systems Strengthening (focus on NCDs)

WHO Barcelona Office for Health Systems Strengthening

Photo: Fundació Privada Sant Pau/Robert Ramos

Health-systems response to tackle specific diseases and conditions

Health information, evidence and research

HEALTHINFORMATION,EVIDENCE andRESEARCH:basis for policy and action

Photo: iStock

European Health Information

Initiative is the umbrella: adding

it all up

Indicators for health and well-being, cultural determinants are key to measuring performance

Enhanced dissemination of health information

Public Health Panorama

Building capacity on health information

Poland Russian Federation

Health information networks are key elements: CARINFONET, EVIPNet

Europe

CARINFONET: Central Asian Republics Health Information Network EVIPNet: Evidence-informed Policy Network

Health Evidence Network (HEN)

HEN provides syntheses of the best available evidence.

HEALTH SECURITY:strengthening emergency preparedness, surveillance and response

Photo: Cristiana Salvi

“As Director-General of WHO, I am committed to building an Organization with the culture, systems, and resources to lead the response to outbreaks and other health emergencies. The Organization you want.

The Organization the world needs.”

– Dr Margaret Chan

WHO reforming its work in outbreaks and emergencies with health and humanitarian

consequences

A unified WHO programme for outbreaks and emergencies

Priority to core capacities of the International Health Regulations

A global health

emergency workforce

Improved

functioning, transparency, effectiveness and efficiency of International Health Regulations

Accelerated

research and development in epidemics or health emergencies

WHO

Contingency Fund for Emergencies

Preparedness for and response to all emergencies and public health threats

Outbreak alert and response

International Health

Regulations

Country emergency

preparedness

Action for well functioning regional platform and capacities

Action for well functioning regional platform and capacities

WHO Emergency Operations Centre, Denmark Photo: WHO/David Barrett

Monitoring and evaluation of International Health Regulations (IHR) core capacities

Better Labs for Better Health

Photo: WHO/Eugene Gavrilin Photo: WHO/Eugene Gavrilin Photo: WHO/Andreas Lemke

GDO in Istanbul for preparedness for humanitarian and health emergencies

Photo: Sara Barragán Montes

Migration and health: high on the agenda

Public health implications of migration

Photo: Sandro Weltin Copyright: Council of Europe

Public health policies for

migrants’ access

to health and well-being

Photo: WHO/Santino Severoni

Supporting countries on migrant-health policies

Migration and health

Photo: WHO/Santino Severoni

Photo: WHO/Sara Barragán Montes

Response to the conflict in the Syrian Arab Republic

Response to the conflict in the Syrian Arab Republic

Photo: WHO/Nedret Emiroglu

Response to the humanitarian crisis in Ukraine

Photos WHO/Alex Glyadyelov

Photos WHO/Alex Glyadyelov

Response to the humanitarian crisis in Ukraine

Antimicrobial resistance: high on the global health security

agenda

Central Asian and Eastern European Surveillance of Antimicrobial Resistance (CAESAR) network

Antimicrobial Medicines Consumption network monitors antibiotic use

DDD: daily defined dosesKosovo: Kosovo (according to United Nations Security Council resolution 1244 (1999))

WORKING WITHCOUNTRIES andPARTNERS

Working with and for countries

Greater technical capacity, empowered country offices

Partnerships to improve health and policy coherence

Regional United Nations thematic group on NCDs and social

determinants of health

WHO REFORMremains a priority

Implementation of the programme budget for 2014–2015

• Solid financial foundation

• Flexible funds distributed strategically

Regional implementation plan for programme budget 2016–2017 is the contract• Bottom-up planning laid solid

foundation• Adjustments made to reflect global

priorities

report on the work of the who regional office for europe

Health & Medicine