Отчет о работе Европейского регионального бюро ВОЗ (Report on the work of the WHO Regional Office for Europe)
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Д-р Zsuzsanna Jakab, Директор Европейского регионального бюро ВОЗ, Шестьдесят пятая сессия Европейского регионального комитета ВОЗ (Вильнюс, Литва, 14–17 сентября 2015 г.)/Dr Zsuzsanna Jakab, WHO Regional Director for Europe, 65th session of the WHO Regional Committee for Europe (Vilnius, Lithuania, 14–17 September 2015)
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Отчет о работе Европейского регионального бюро ВОЗ (Report on the work of the WHO Regional Office for Europe)
- 1. Отчет о работе Европейского регионального бюро ВОЗ Д-р Zsuzsanna Jakab Директор Европейского регионального бюро ВОЗ
- 2. БОЛЕЕ СПРАВЕДЛИВОЕ И УСТОЙЧИВОЕ УЛУЧШЕНИЕ ЗДОРОВЬЯ ЖИТЕЛЕЙ ЕВРОПЫ
- 3. Photo: EMLab Project Photo: European Centre for Disease Control/ Katrin Leitmeyer Photo: WHO/Sara Barragán
- 4. МЫ ДОЛЖНЫ ДЕЛАТЬ БОЛЬШЕ
- 5. Максимальное значение Региональное среднее Минимальное значение Неравенства в ожидаемой продолжительности жизни сокращаются, но разрыв остается
- 6. Maximum value Regional average Minimum value Неравенства в ожидаемой продолжительности жизни сокращаются, но разрыв остается
- 7. В Регионе планомерно сокращается преждевременная смертность Максимальное значение Региональное среднее Минимальное значение
- 8. литров чистого спирта, потребляемого на человека в год населения страдают избыточной массой тела или ожирением населения потребляют табак
- 9. Европейские страны укрепляют свои стратегии все ответы (n=31 и 36 за 2010 г. и 2013 г. соответственно) No,butplanned forthefuture Yes,anotherstrategy Yes,comprehensivehealthpolicy NationalhealthpolicyisalignedwithH2020 Allanswers(n=31and36for2010and2013,respectively) 2013 2010 2013 г. 2010 г. Да, всеобъемлющая стратегия здравоохранения Да, другая стратегия 0% 10% 20% 30% 40% 50% 60% 70% Noandnotplannedforthe future No,butplanned forthefuture Yes,anotherstrategy 2013 2010
- 10. Стратегические направления политики Здоровье-2020 остаются актуальными
- 11. Вызовы, стоящие перед нами Photo: Sharon Steele
- 12. Здоровье - это политический выбор 64-я сессия Европейского регионального комитета ВОЗ Дания
- 13. Здоровье-2020: верный политический выбор в интересах здоровья ПОВЫСИТЬ ОЖИДАЕМУЮ ПРОДОЛЖИ- ТЕЛЬНОСТЬ ЗДОРОВОЙ ЖИЗНИ УКРЕПИТЬ БЛАГОПОЛУ- ЧИЕ СОКРАТИТЬ НЕРАВЕНСТВА СКРАТИТЬ ПРЕЖДЕ- ВРЕМЕННУЮ СМЕРТНОСТЬ ПОДДЕРЖИВАТЬ ВОЗДЕЙСТВИЕ НА ПЕРВОПРИЧИНЫ ДЛЯ СТРАТЕ- ГИЧЕСКОГО РУКОВОДСТВА, ДЕТЕРМИНАНТЫ ЗДОРОВЬЯ И ВСЕОБЩИЙ ОХВАТ УСТАНОВИТЬ НАЦИОНАЛЬ- НЫЕ ЦЕЛЕВЫЕ ОРИЕНТИРЫ ДЛЯ СТРАТЕГИЙ ЗДРАВООХРА- НЕНИЯ И ПРОВОДИТЬ МОНИТОРИНГ
- 14. Вложения в здоровье окупаются Photos: Malin Bring
- 15. Photo: Malin Bring ЭФФЕКТИВНОСТЬ ИНВЕСТИЦИЙ Репродуктивное здоровье и здоровье матерей и детей 20 долларов на 1 затраченный доллар
- 16. Photo: Malin Bring ЭФФЕКТИВНОСТЬ ИНВЕСТИЦИЙ Репродуктивное здоровье и здоровье матерей и детей 20 долларов на 1 затраченный доллар
- 17. Здоровье – это инвестиции, а не расходы – необходимо инвестировать больше
- 18. Ответственные за политику в отношении здоровья Экономичес- кая и налоговая политика Образование Социальный сектор Торговля Окружиющая среда Транспорт Миграция У руководителей, ответственных за выработку политики, есть возможность выбора
- 19. Здоровье – центральный элемент развития
- 20. Изменять наш мир: повестка дня устойчивого развития до 2030 г.
- 21. Sustainable development goals Цели устойчивого развития важны для нас
- 22. Sustainable development goals Всеобщий охват услугами здравоохранения в каждой стране мира
- 23. Региональная консультация по повестке дня в области развития на период после 2015 г.
- 24. Задачи в отношении здоровья… Здоровье как задача в рамках других целей
- 25. Интеграция здоровья и благополучия во все цели
- 26. Преобразование повестки дня до 2030 г. в национальные планы развития
- 27. РАЗРАБАТЫВАТЬ СТРАТЕГИИ ПО-НОВОМУ НА ОСНОВЕ ПОЛИТИКИ ЗДОРОВЬЕ- 2020
- 28. Межсекторальное взаимодействие: элементы успеха • Мэры, премьер-министры, знаменитости Приверженность и лидерство на высоком уровне • Налогообложение, частный сектор • Функция координации требует ресурсов Специально выделенные ресурсы •Агентства по укреплению здоровья; консультативные целевые группа; местные руководящие органы •Не забывать о неформальных взаимоотношениях и силе местных сообществ Институциональные ресурсы • Качество планирования может быть важнее, чем сам планСовместное планирование • Транс-жиры, учреждение структур для укрепления здоровья Законодательные инструменты • Не важно чья, но необходимо четкое определение (совместная или нет, сектор здравоохранения или иной)Подотчетность • Целевые ориентиры делают действия целенаправленными • Результаты важны для адвокацииМониторинг и отчетность
- 29. Межсекторальное взаимодействие требует политической приверженности
- 31. Европейский процесс «Окружающая среда и здоровье»
- 32. Процесс «Окружающая среда и здоровье» Хорошо организованный политический процесс Прочная институциональная легитимность Национальные механизмы реализации Техническое совершенство
- 33. Европейский центр ВОЗ по окружающей среде и охране здоровья
- 34. Шестая министерская конференция по окружающей среде и здоровью 2017 г. Пятая министерская конференция по окружающей среде и здоровью Италия, 2010 г. Совещание высокого уровня по среднесрочному обзору Европейского процесса "Окружающая среда и здоровье" Израиль, 2015 г.
- 35. Социальные детерминанты здоровья – это стратегический приоритет Второе совещание высокого уровня в рамках инициативы малых стран, Андорра Развитие межсекторального и межведомственного взаимодействия в интересах здоровья и благополучия в Европейском регионе ВОЗ, Франция
- 36. Учет интересов здоровья в международной политике и в сотрудничестве в целях развития Международный форум по здравоохранению Туркменистан
- 38. Европейский консультативный процесс в поддержку межсекторального взаимодействия © European Health Forum Gastein
- 39. Разработка стратегий здравоохранения на национальном уровне
- 40. Photo: Teodor Pricop Сети – это эффективные платформы для национальных стратегий здравоохранения
- 41. Сеть здравоохранения Юго-Восточной Европы в роли лидера
- 42. Инициатива для малых стран: эффективная сеть
- 43. Сан-Марино: Орден Св. Агаты Photo: Filippo Pruccoli “При подготовке представленного сегодня плана действий в сфере здравоохранения и социальных вопросов активно использовалась политика Здоровье-2020, и мы уверены, что она и далее будет оставаться ключевым ориентиром для будущих мер, направленных на улучшение социального обеспечения и здоровья нашего населения“. Их превосходительства Andrea Belluzzi и Roberto Venturini, капитаны-регенты Сан-Марино
- 44. Photo: WHO/David Barrett Гармонизация стратегий происходит и на субнациональном уровне Сеть «Регионы за здоровье» Сеть «Здоровые города»
- 45. Европейский офис ВОЗ по инвестициям в здоровье и развитие
- 47. Значительный прогресс в профилактике и борьбе с туберкулезом вылечен 1 миллион пациентов с ТБ предотвращены 200 000 случаев МЛУ-ТБ спасены 2,6 миллиона жизней
- 48. Самое быстрое снижение заболеваемости ТБ из всех регионов ВОЗ 313 280 31 29 122 121 50 39 198 183 96 87 20 200 2009 2010 2011 2012 2013 На100000насеоения(log) 5.9% __ 1.9% 2.4% 0.3% 2.0% 2.8% Африка Юго-восточная Азия Восточное Средиземноморье Западная часть Тихого океана Европейский регион Страны Америки
- 49. Лидерство и приверженность действиям
- 50. • 1,4 млн пациентов с ТБ вылечены • 1,7 млн новых случаев предотвращены • 3,1 млн жизней спасены • $48 млрд сэкономлено Призыв к активизации усилий по элиминации туберкулеза в течение жизни нынешнего поколения
- 52. Тревожная ситуация требует мер, подкрепленных фактическими данными Photos: WHO/James Hammond
- 53. Во всем Регионе сохраняется нерешенная проблема вирусного гепатита • 13 млн (по оценкам) людей живут с хроническим гепатитом В • 15 млн (по оценкам) людей живут с хроническим гепатитом С • 400 смертей в связи с вирусным гепатитом в день
- 54. Вирусный гепатит: незаметный убийца
- 55. Глобальные стратегии Для обсуждения в четверг
- 56. На пути к элиминации малярии Наша цель почти достигнута - ни одного случая местной передачи малярии в 2015 г.
- 57. Сохранять бдительность и не допустить возвращения малярии
- 58. В Регионе сохраняется бремя болезней, предупреждаемых с помощью вакцин
- 59. Возвращение полиомиелита: напоминание о том, как важно сохранять приверженность
- 60. Возвращение полиомиелита: напоминание о том, как важно сохранять приверженность Photo: WHO/K. Vozniuk
- 61. Возвращение полиомиелита: напоминание о том, как важно сохранять приверженность Photo: Ayberk Yurtsever Photo: WHO/B Kadirov
- 62. От приверженности – к действиям Цель 1: Поддержание статуса Региона как территории, свободной от полиомиелита Цель 2: Элиминации кори и краснухи Цель 3: Контроль инфекции гепатита В Цель 4: Достижение региональных целевых показателей охвата вакцинацией Цель 5: Принятие основанных на фактических данных решений Цель 6: Достижение финансовой стабильности
- 63. Заболеваемость корью, январь-июнь 2015 г.
- 65. Ее Королевское Высочество, Кронпринцесса Дании в Таджикистане: подчеркивая важность доступа к вакцинации для всех. Photo: WHO/Akram Isaev
- 66. ПРОФИЛАКТИКА и БОРЬБА с НЕИНФЕКЦИОННЫМИ ЗАБОЛЕВАНИЯМИ (НИЗ) Photo: iStockphoto
- 67. Сокращение предотвратимой смертности от неинфекционных заболеваний Начиная с 2000 г. почти во всех странах наблюдается снижение смертности от сердечно- сосудистых заболеваний (ССЗ) как среди женщин, так и среди мужчин в возрасте до 65 лет.
- 68. Сокращение потребления табака и алкоголя Регионы ВОЗ Всего ПАДН* 2005 г. Всего ПАДН* 2010 г. EUR 12,2 10,9 AFR 6,2 6,0 AMR 8,7 8,4 EMR 0,7 0,7 SEAR 2,2 3,4 WPR 6,2 6,8 В мире 6,1 6,2 Источник: Глобальный доклад ВОЗ о положении дел в области алкоголя и здоровья 2014 г. Женева, Всемирная организация здравоохранения, 2014. 0% 10% 20% 30% 40% 50% 2000 2005 2010 2011 2012 2013 2014 2015 2020 2025 Male Распространенность (%) курения в настоящее время (15+) в Европе ПАДН*: потребление алкоголя на душу населения
- 70. Стороны Протокола о ликвидации незаконной торговли табачными изделиями Австрия Бельгия Бывшая югославская республика Македония Германия Греция Дания Израиль Ирландия Испания Кипр Нидерланды Норвегия Португалия Словения Соединенное Королевство Туркменистан Турция Финляндия Франция Черногория Швеция Необходимы более интенсивные действия для ликвидации незаконной торговли табачными изделиями
- 71. Дорожная карта для осуществления РКБТ ВОЗ For discussion on Wednesday
- 72. Стратегия в области физической активности дополняет План действий в области пищевых продуктов и питания
- 73. Пренебрежительное и жестокое обращение со взрослыми с нарушениями интеллекта вызывает обеспокоенность
- 74. Ведение неинфекционных заболеваний Улучшение медицинского обслуживания - важный фактор в сокращении смертности от ССЗ.
- 75. Пакет основных мероприятий в области неинфекционных заболеваний
- 76. NCD Project launch Введен в действие Географически удаленный офис (ГУО) по НИЗ в Москве
- 77. Инвестирование в здоровье с учетом ВСЕХ ЭТАПОВ ЖИЗНИ: ключевое стратегическое направление политики Здоровье-2020 Photo: iStock
- 78. Министерская конференция: 21–22 октября 2015 г. Минск, Беларусь Применение принципа охвата всех этапов жизни повышает эффективность вмешательств, стимулируя своевременные инвестиции с высоким уровнем отдачи как для здоровья населения, так и для экономики.
- 79. Достигнут прогресс в области улучшения здоровья женщин, но несправедливые различия сохраняются
- 80. Пришло время сосредоточить внимание на патологических состояниях во время беременности Photo: UNPhoto: Malin Bring
- 81. Нужно уделять больше внимания сексуальному и репродуктивному здоровью и правам Photo: Malin Bring
- 82. Укрепление СИСТЕМ ЗДРАВООХРАНЕНИЯ, ОРИЕНТИРОВАННЫХ НА НУЖДЫ ЛЮДЕЙ, и ПОТЕНЦИАЛА ОБЩЕСТВЕННОГО ЗДРАВООХРАНЕНИЯ
- 83. Таллиннская хартия предоставила направление для наших действий
- 84. Новое видение укрепления систем здравоохранения – слушать людей
- 85. Направление дальнейших действий: согласованное и комплексное оказание услуг здравоохранения с целью обеспечения помощи, ориентированной на нужды людей © InfoGyor
- 86. В центре концепции ориентированности системы на нужды людей лежит обновленное видение роли первичной медико-санитарной помощи (ПМСП)
- 87. Inauguration Photo: Serguei Gurzhin Новый ГУО по ПМСП в Алматы
- 88. Достижение всеобщего охвата услугами здравоохранения имеет важнейшее значение “Всеобщий охват услугами здравоохранения: Единственная, самая надежная концепция, которую может предложить система общественного здравоохранения“. Д-р Маргарет Чен Генеральный директор ВОЗ
- 89. Поддержка стран путем проведения учебных курсов в Барселоне 1. Барселонский курс по финансированию здравоохранения: всеобщий охват услугами здравоохранения 2. Флагманский курс по укреплению систем здравоохранения: основное внимание НИЗ
- 90. Барселонский офис ВОЗ по укреплению систем здравоохранения Photo: Fundació Privada Sant Pau/Robert Ramos
- 91. Ответные действия систем здравоохранения по борьбе с конкретными болезнями и патологическими состояниями
- 92. Health information, evidence and research ИНФОРМАЦИЯ ЗДРАВООХРАНЕНИЯ, ФАКТИЧЕСКИЕ ДАННЫЕ и НАУЧНЫЕ ИССЛЕДОВАНИЯ: основа для политики и действий Photo: iStock
- 93. Европейская инициатива в области информации здравоохранения является всеобъемлющей структурой, объединяющей все эти аспекты
- 94. Показатели здоровья и благополучия, а также культурные детерминанты играют ключевую роль в оценке результатов деятельности
- 98. Наращивание потенциала в области информации здравоохранения Польша Российская Федерация
- 99. Ключевыми элементами являются сети: CARINFONET, EVIPNet Европа
- 100. Сети фактических данных по вопросам здоровья (HEN) HEN занимается обобщением лучших из имеющихся фактических данных.
- 101. БЕЗОПАСНОСТЬ ЗДОРОВЬЯ: Усиление готовности, эпиднадзора и ответных мер при чрезвычайных ситуациях Photo: Cristiana Salvi
- 102. "Как Генеральный директор ВОЗ, я привержена формированию Организации с культурой, системами и ресурсами, позволяющими ей играть ведущую роль в области реагирования на вспышки болезни и другие чрезвычайные ситуации в области здравоохранения. Такой Организации, которую вы хотите . Такой Организации, которая необходима миру ". Д-р Маргарет Чен ВОЗ реформирует свою "деятельность при вспышках болезней и чрезвычайных ситуациях, имеющих последствия для здравоохранения и гуманитарной сферы".
- 103. Объединенная программа ВОЗ по реагированию на вспышки и чрезвычайные ситуации Приоритетные основные возможности в соответствии с ММСП Глобальный кадровый резерв для реагирования на чрезвычайные ситуации в области здравоохранения Улучшенное функционирование, прозрачность, эффективность и действенность ММСП Активизация исследований и разработок в области эпидемий и медико- санитарных чрезвычайных ситуаций Фонд непредвиденных расходов при чрезвычайных ситуациях
- 104. Готовность и реагирование на все чрезвычайные ситуации и угрозы общественному здоровью
- 105. Предупреждение о вспышках болезней и реагирование на них Международные медико- санитарные правила Готовность стран к чрезвычайным ситуациям Действия по созданию эффективно функционирующей региональной платформы и по укреплению потенциала
- 106. Действия по созданию эффективно функционирующей региональной платформы и по укреплению потенциала Центр чрезвычайных операций ВОЗ Дания Photo: WHO/David Barrett
- 107. Мониторинг и оценка основных возможностей в соответствии с Международными медико- санитарными правилами (ММСП)
- 108. Совершенствование работы лабораторий на благо здоровья Photo: WHO/Eugene Gavrilin Photo: WHO/Eugene Gavrilin Photo: WHO/Andreas Lemke
- 109. ГУО в Стамбуле по готовности к гуманитарным и медико-санитарным чрезвычайным ситуациям
- 110. Photo: Sara Barragán Montes Миграция и здоровье: приоритетный вопрос на повестке дня
- 111. Последствия для систем общественного здравоохранения, связанные с миграцией Photo: Sandro Weltin Copyright: Council of Europe
- 112. Меры политики в области общественного здравоохранения для обеспечения здоровья и благополучия мигрантов Photo: WHO/Santino Severoni
- 113. Оказание поддержки странам по вопросам здоровья мигрантов
- 114. Миграция и здоровье Photo: WHO/Santino Severoni
- 115. Photo: WHO/Sara Barragán Montes Реализация ответных мер в связи с конфликтом в Сирийской Арабской Республике
- 116. Реализация ответных мер в связи с конфликтом в Сирийской Арабской Республике Photo: WHO/Nedret Emiroglu
- 117. Реализация ответных мер в связи с гуманитарным кризисом в Украине Photos WHO/Alex Glyadyelov
- 118. Photos WHO/Alex Glyadyelov Реализация ответных мер в связи с гуманитарным кризисом в Украине
- 119. Устойчивость к противомикробным препаратам: один из важнейших вопросов повестки дня глобальной безопасности общественного здоровья
- 120. Сеть по эпиднадзору за устойчивостью к противомикробным препаратам в Восточной Европе и Центральной Азии
- 121. Сеть по мониторингу потребления противомикробных препаратов отслеживает потребление антибиотиков
- 124. Работа со странами и для стран
- 125. Работа со странами и для стран
- 126. Работа со странами и для стран
- 127. Работа со странами и для стран
- 128. Работа со странами и для стран
- 129. Работа со странами и для стран
- 130. Укреплен технический потенциал, расширены полномочия страновых офисов
- 131. Партнерства во имя улучшения здоровья и гармонизации политики
- 132. Партнерства во имя улучшения здоровья и гармонизации политики
- 133. Партнерства во имя улучшения здоровья и гармонизации политики
- 134. Региональная тематическая группа ООН по НИЗ и социальным детерминантам здоровья
- 136. Выполнение программного бюджета на 2014–2015 гг. • Прочная финансовая база • Стратегическое распределение гибких финансовых ресурсов
- 137. Выполнение программного бюджета на 2016–2017 гг. является контрактом • Планирование "снизу-вверх" заложило прочную основу • Корректировки согласно глобальным приоритетам
Notes de l'éditeur
- Your Excellency Madam President, Your Royal Highness The Crown Princess of Denmark, His Excellency the Prime Minister, Madam Director General, the Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria; United Nations Special Envoy for HIV/AIDS in Eastern Europe and Central Asia…. Dear Ministers, colleagues, ladies and gentleman
- Better health for Europe; more equitable and sustainable, that is what we agreed to work on.
- Last year was challenging. We have been fighting against Ebola, we saw children dying from measles and diphtheria, now we face polio cases in the Region, and there is a large influx of refugees and migrants, with many people asking for help.
- We made good progress in many areas, but in some, we must do more and we must do better.
- On key Health2020 indicators, as in the example of life expectancy, Europeans are living longer and the differences in health outcomes between countries are shrinking; a clear sign that inequalities are declining and Health 2020 works.
- But the gap between countries with the highest and lowest life expectancy is still 11 years.
- The Region is on track for reducing premature mortality and Europeans are reducing their health risks.
- But people in Europe smoke and drink more than anywhere else in the world and are among the most obese.
- More decision-makers are taking coherent and inter-connected government policies, with a strong intersectoral component, using Health 2020 as the way forward. From 2010 to 2013, countries with national health policies aligned with Health 2020 almost doubled from 38% to 70%. I am proud of this.
- The progress demonstrates what we can do if we are committed and work together. It also shows that we have many challenges ahead, confirming that the key strategic directions of Health 2020 remain more relevant than ever before.
- All determinants of health; social, economic and environmental challenges and demographic changes affect both people’s health and health systems. Migration, the ageing population, and the health work force mobility; are only a few examples.
- Only those governments that put health and well-being high in their social, economic and development agenda, will be able to overcome these challenges. Health is a political choice.
- In essence Health 2020 supports making the right political choices for health. Our key role is to protect health as a universal value and to promote it as a social and political goal for the government and the society as a whole.
- The economic case for investment in health is strong. Investing in health generates cost-effective health outcomes and economic, social and environmental benefits. The health sector’s call upon the government to invest in health will make the change. We need to give this message loudly.
- For example, current evidence suggests that investment in reproductive, maternal and child health has a potential return of more than US$ 20 for every dollar spent. For addressing NCDs, argument in investing in the “best-buy’ interventions is equally clear.
- We are proud to launch tomorrow the study of Economics of Prevention, one of the H2020 studies, prepared by the Regional Office, Observatory and OECD.
- Current investments in health and public health are not sufficient. We need to invest more. It is alarming that between 2007 and 2011 the health share of public spending fell in 24 countries in Europe. By tapping into new sources, improving efficiencies and giving high priority to health, all countries can find ways to raise sufficient funds for health.
- Policy makers have choices, even in austerity. But they cannot do this on their own and need to work in partnership, especially with those responsible for social and fiscal policies.
- Development is impossible without better health. Health is a precondition for poverty alleviation, and also an indicator and outcome of progress towards a sustainable society.
- This is an exciting year! Within 10 days, the world leaders will gather at the UN Summit to adopt the Agenda for Sustainable Development, to end poverty by 2030. The Agenda has universal goals that will apply to every nation - not just to developing countries.
- Among the 17 Sustainable Development Goals, health goal is central.
- It aims at “ensuring healthy lives and promoting wellbeing for all at all ages”. There is increasing acceptance that the goal must also aim to achieve universal health coverage in every community, in every country of the world.
- Formulation of the health goal is fully aligned with Health 2020. This was confirmed at the “Regional Consultation for the post-2015 development agenda”, where Health 2020 was defined as the Regional framework for this new vision for health.
- Focusing solely on the health goal will be a missed opportunity. All Goals will influence health, because they all address the determinants of health. The 2030 agenda will link all dimensions of development - including health - to environment, to prosperity and to all policies needed for the people.
- Now, we have a historical political responsibility to pursue the integration of health and well-being into each and every goal. We have the opportunity of putting into practice the “whole of government” and “whole of society” approaches to which we subscribed through Health 2020.
- The new development agenda will call for translating it into national development plans, with health at their heart. We are fully committed to support you in the implementation of national development plans.
- Health 2020 is key for the renewed policy environment and the expectations we had back in 2011 are becoming a reality. All Member States have shown incredible enthusiasm in embracing the principles of Health 2020.
- Real improvements in health can be achieved if we work across government. Intersectoral action is essential for policy coherence and provides the basis for accountability in health. Therefore it is the major theme of this year’s Regional Committee.
- Inter-sectoral action for health requires political commitment. It should focus on key public health priorities; upstream interventions by addressing the determinants of health and health equity; and strive for maximum impact creating “win-win” partnerships.
- Our Region has much experience in intersectoral action, for example on International Health Regulations, Antimicrobial resistance and on health system financing, working with the Ministries of Finance.
- One concrete example is the Environment and Health Process. With its 26 years of experience in intersectoral work, it has proven to be a good model.
- It brings together different sectors on equal footing and illustrates the importance of a well-constructed political process through the Environment and Health Ministerial Board. The European Environment and Health Task Force ensures accountability and establishes a strong link to national implementation.
- Generously supported by the Government of Germany, our Office in Bonn provides evidence and technical support to address environment and health challenges in the Region.
- We are grateful to Israel for hosting the High-level mid-term review in Haifa, which was a success. It provided clear directions on the way to the Sixth Environment and Health Ministerial Conference in 2017. I invite you to actively engage in the preparatory process.
- Health 2020 prioritizes social determinants of health and health literacy. Social policies - ranging from employment, education, housing must be given a strategic priority. We discussed this at the “Small Countries Initiative” in Andorra in June and the meeting in Paris in April.
- Health has great significance within foreign policy processes and development cooperation. We discussed this in Berlin in April, also at the International Health Forum in Ashgabat in July and we will continue to support Member States in the year ahead. We look forward to learning from your experiences during the Ministerial panel tomorrow.
- Taking leadership on intersectoral processes requires a new mind-set and capacities in Ministries of Health. Such a process is ongoing and is showing positive results. We are supporting the establishment of intersectoral committees in countries. We developed sectorial and thematic policy briefs to contribute to the agenda setting and successful outcome of such discussions.
- European consultative processes for engagement of interested Member States will help promote intersectoral work across the European Region in support of national implementation. These would allow dialogue, sharing of experiences, and common actions between countries, institutions and sectors. We suggest that initial focus could be on education, finance and social sectors to promote social determinants and health literacy.
- We worked intensively on the development and implementation of national health policies aligned with Health 2020, which is a success.
- Networks became a more powerful platform for sharing practical experiences of Health 2020 implementation among countries.
- For example, countries of South-eastern Europe Health Network (SEEHN) are committed for intergovernmental, intersectoral actions and agreed to further scale up implementation of Health 2020, which is in line with the SEE 2020 strategy.
- There is now another efficient network; the “Small-countries Initiative” inspired by Health 2020, committed for aligning national health policies and implementing the H2020 vision as declared in the “San Marino Manifesto” and followed up with the “Andorra Statement”.
- I am honored to be awarded with the San Marino Order of St Agatha last month for improving health in San Marino and throughout the Region. This award is a clear recognition of the value of Health2020 and the work of WHO.
- Local leadership for intersectoral action is very important and can be innovative. The “Healthy Cities” and “Regions for Health” networks are of great help in supporting Health 2020 subnational implementation and also in sharing good practices. We shall hear more about this tomorrow.
- Thanks to the Government of Italy for supporting our Office in Venice on investment in health and development, which contributes to our work in this important area.
- Now let me move to communicable diseases. While much progress has been made to date, they still challenge Europe´s public health.
- Major progress has been made in the fight against tuberculosis over the past five years in the Region. Over a million TB patients were cured; about 200 000 MDR-TB cases were averted; and more than 2.6 million lives were saved.
- The incidence of tuberculosis dropped by 6 % annually during the past five years, which is the fastest decline of all Regions in the world. All patients detected with MDR-TB are put on treatment, compared to only 63% back in 2011.
- This was possible through extensive actions and initiatives taken in partnership, with your leadership and commitment. You reiterated this commitment through the Riga Declaration at the first Eastern Partnership Ministerial Conference in March once more. Thanks to Latvian Presidency for their leadership.
- Yet, this is not enough to end the Tuberculosis epidemic by 2035 and eliminate by 2050. Through the new European Tuberculosis Action Plan, we estimate that more than 1.4 million TB patients will be cured; 1.7 million new cases will be prevented; and over 3 million lives and 48 billion US$ will be saved. It will be presented on Wednesday and I call for your continued commitment, so that our dream to eliminate tuberculosis in our lifetime comes true.
- Unfortunately progress towards HIV control is not as good. With 136 000 new infections, 2014 was the year with the highest number of new HIV cases, a staggering 80% increase since 2004.
- Since 2010, I have repeatedly raised your attention to this alarming situation, calling for concerted actions. Evidence is available; we know what works. Only bold actions in implementing evidence based policies will get us on track to end the epidemic by 2030.
- Viral hepatitis remains unaddressed throughout the Region, with 13 million people estimated to live with chronic hepatitis B and 15 million with chronic hepatitis C, leading to 400 viral hepatitis-related deaths a day.
- Even though treatments are now available for hepatitis B and C, access and affordability remains a challenge for most countries We have to implement a comprehensive approach to fight this “silent killer”, using available tools and focusing on prevention.
- I look forward to your input to define how the Regional Office can support you to get these public health threats under control, when we discuss the Global Strategy on Thursday.
- We are very close to achieving a historical moment; malaria elimination by the end of 2015. As of today, there are no locally acquired malaria cases in the whole Region. Let me congratulate you all for your commitment and dedication, in partnership with all stakeholders.
- Achievements are huge, still the situation is fragile, and we have to remain vigilant. I request that all of you maintain the highest political commitment. This is the focus of the High-level consultation in Turkmenistan in February next year.
- Vaccine-preventable diseases continue to burden our Region. The loss of a child from diphtheria, the death of infants from measles complications, alongside thousands cases of measles, represent solemn reminders of an unfinished business. Accepting the status quo is not an option.
- There is no stronger reminder of the need for vigilance than the return of polio. Two polio cases in Ukraine, reported on August 28, is alarming, particularly given the large pockets of susceptible populations who could be exposed to this crippling, deadly disease.
- We immediately deployed a rapid response team to initiate the case investigation and risk assessment. We are supporting the Ministry of Health to be well prepared for three rounds of national supplementary immunization campaigns. The first round will start on….
- I commend the Ukrainian authorities for their commitment to take all necessary action for a rapid response. I also thank the Global Polio Eradication Partners for their support. It is imperative that Ukraine and all European countries continue to mitigate the risks posed by polio by maintaining high immunization coverage and surveillance.
- In adopting the European Vaccine Action Plan, you committed to eliminate measles and rubella by 2015.
- Progress will be evident as many countries are on track to eliminate measles and rubella by the end of this year. However, the regional goal continues to elude us due to the lack of a steadfast political commitment in some countries.
- The tenth anniversary of European Immunization Week (EIW), celebrated throughout the Region in April included some of the most interactive and high-profile efforts to promote immunization we have seen to date.
- I was personally honoured to visit Tajikistan with HRH The Crown Princess of Denmark in October. This was the occasion to advocate for stronger immunization delivery and to increase investments in maternal and child health services.
- Ladies and gentleman, in the area of noncommunicable conditions we continue to see significant advances in implementation of the European action plan.
- In almost all countries, we continue to see a decline in cardiovascular mortality. Declines in behavioural risk factors including smoking and biological risk factors such as blood pressure and serum cholesterol contribute to these reductions.
- There is an annual reduction of around two percent in the overall consumption of alcohol. And we see a continuing decline in tobacco smoking among adults. However, we remain the Region with the highest overall rate of adult smoking,
- I am proud that our countries are taking the global leadership in plain packaging. Ireland, the United Kingdom and France became pioneers and several other countries announced their intent to follow. Congratulations to WHO FCTC for celebrating a decade of actions.
- Since my last report, four additional countries from our Region have become party to the Protocol to Eliminate Illicit Trade in Tobacco Products. I congratulate them and call others to join.
- On Wednesday, we will discuss the proposed Roadmap for tobacco control, setting an ambitious goal of full implementation of FCTC. We are grateful to Turkmenistan for their support in implementation of the Roadmap in the coming years.
- We will also discuss the Physical Activity Strategy, which complements the Food and Nutrition Action Plan adopted last year. Since then, among other things, we attained a membership of 30 countries participating in the Childhood Obesity Surveillance Initiative.
- I have been approached by Member States expressing concerns about the neglect and abuse towards adults with intellectual disabilities living in institutions. It is a challenge which requires intersectoral action and we cannot ignore this as a Region. I have initiated a review and will report back, presenting the way forward.
- There is strong evidence that improved medical care is a strong contributor to declining CVD and mortality. We will review new evidence on this at an international conference in St Petersburg in November.
- It is my special plea that we increase our attention to the management of NCDs, and at the same time re-examine our programmes for early detection and screening. We developed a “package of fifteen essential interventions” to tackle NCDs which is being implemented in 23 countries. All these are core components of the essential package.
- Our capacity to respond to NCDs this year increased with the launch of the new Geographically Dispersed Office for noncommunicable diseases in Moscow. We are grateful to the Russian Federation for the support.
- Ladies and gentlemen, many countries are applying the life-course approach in developing their national policies or improving collaboration between different sectors, which is a key strategic direction of Health2020.
- European Ministerial Conference on Life-course approach in Minsk in a month time will be the first event linking Sustainable Development Goals with Health 2020 and focusing on maternal and child health, as well as reproductive health and rights. I would like to thank Belarus for hosting this important Conference.
- We are making progress in improving health of women. However, wide inequities in women’s health among and within countries still remain. Use of modern, effective methods of contraception is alarmingly low in many countries. Some countries have the highest abortion rates in the world.
- Implementation of effective perinatal care resulted in decrease of the major killer of mothers – severe obstetrical bleeding. Now it is time to focus on pre-existing medical conditions such as diabetes, obesity, cardiovascular and mental diseases that are exacerbated by pregnancy.
- More needs to be done on sexual and reproductive health and rights, an area we plan to bring to your attention in the future. We will outline the European Women’s Health Report to be published in 2016 at the technical briefing today.
- Ladies and gentlemen, our work for strengthening health systems and public health capacity aims for improving health outcomes in an equitable manner, ensuring financial protection, responsiveness and efficiency.
- Tallinn Charter has been guiding this work and we will present the final report on its implementation on Wednesday. This report directly fed into the new Health Systems Strengthening vision for the next five years.
- Transforming health services to match the needs of the 21st century is the strategic priority in our new vision. This new vision reaches out to the “Voice of the People. It will provide health leaders an inclusive approach that harnesses feedback from citizens in designing health systems that are more responsive to people’s needs
- Coordinated, integrated health-service delivery towards people-centred care is the way forward. We scaled up our efforts and preparing an action-oriented framework that will be presented next year at the Regional Committee.
- Taking forward the renewed vision of Alma-Ata Declaration, and integration of the Essential Public Health Functions, focus is now on supporting countries in revising their primary health care delivery models, with a focus on quality.
- Inauguration of the Geographically Dispersed Office on Primary Health Care in Almaty in February expanded our capacity, thanks to the Government of Kazakhstan for the support.
- We estimate that 19 million people face catastrophic payments in the Region, with 7 million people facing impoverishing expenditures. Universal Health Coverage is central to address this challenge, therefore an essential part of our work and we accelerated our support to countries.
- Annual training courses delivered by the Barcelona Office were again a success. In 2015, many senior officials from 33 Member States benefitted from one of the two courses.
- Let me thank the government of Spain for their continued support to our Office in Barcelona, on health financing.
- We are addressing health systems barriers for specific diseases and conditions, including communicable and noncommunicable diseases, which are then translated into policy decisions and actions. We are now broadening to include “environmentally sustainable health systems”.
- Ladies and gentlemen, Our collective investments are paying off in health information, evidence and research, as the basis for policy -making.
- Since its launch in 2012, the European Health Information Initiative has been the umbrella for all health information activities and I encourage you to join. Let me now highlight some major achievements of this initiative.
- We continued to work on the development of information on health and well-being, with a focus on indicators. This year, we examined new evidence for the cultural determinants, which will help us consider the impact of culture on health and well-being across the culturally diverse European Region.
- We supplied a wide range of information and analytical resources; the new health information web portal is one of them. It is widely used by policy makers and it soon will allow simultaneous analysis of indicators in all databases.
- In addition to tools for health information strategies and national e-health strategies, we actively supported the Pan-European conference during “eHealth Week” in May.
- We launched a new a bilingual journal “Public Health Panorama”, to highlight successful public health examples in countries. At this Regional Committee we are launching the second issue with a special theme on intersectoral policies.
- The annual Autumn School on Health Information and Evidence for Policy, hosted by Poland in October was a success. As you requested, we organized the advanced workshop on health information and data assessment in Moscow in July for more in-depth training.
- The Central Asian Republics Health Information Network (CARINFONET) serves as the platform to improve health information systems. The Evidence-informed Policy Network (EVIPNet) Europe aims to build the country capacity. We will discuss this on Wednesday at the technical briefing when we present an accelerated roadmap for evidence informed policies.
- The Health Evidence Network (HEN) provides a synthesis of best available evidence. We launched two reports last year; three more on migration and health will be presented at the Ministerial lunch later today.
- Ladies and gentlemen, the recent Ebola outbreak in West Africa demonstrated that the international community is not sufficiently prepared to manage major health hazards. We contributed to the response by deploying. 25 staff for 36 missions. We are grateful to all partners and Member States for the support they provided to the outbreak response.
- This is a defining moment for change. We have to ensure that the world is adequately prepared to effectively detect and respond, whenever and wherever an emergency with health consequences strikes.
- We are fully committed to take all necessary actions. This is clear in the statement issued in March by the Director General and all six Regional Directors. We are moving ahead with the six areas of work as outlined by the Director-General and we will discuss the progress and next steps later today.
- In the Regional Office, we take an integrated, generic, all-hazards and multi-sectorial approach for preparedness both for humanitarian crisis and outbreaks. Risk communications is an integral element of this approach.
- Already back in 2010, I have merged three areas of work; Outbreak alert and response; IHR and country emergency preparedness under a clear command control system. We continuously screen signals of potential health threats. We revised the emergency procedures, and the emergency operations centre in the Regional Office is functioning as the regional hub.
- We continuously screen signals of potential health threats. We revised the emergency procedures, and the emergency operations centre in the Regional Office is functioning as the regional hub. David, to consider a new slide, with EOC in EURO photo here, and if so, we need a new photo for the next slide where it shows EOC
- Compliance with IHR obligations is crucial for national and global health security. As raised by many Member States, there is a need to supplement self-assessment of core capacities, with an independent evaluation. Your input to the proposed global IHR monitoring and evaluation approach is critical and I look forward to the discussion on Thursday.
- Better Labs for Better Health is a new initiative we launched for improving laboratory capacity to detect and respond to diseases and outbreaks. It is an important component of IHR core capacity and I ask Member States and all stakeholders to join the initiative to make it a success.
- We signed the host agreement with the Government of Turkey to establish the Geographically Dispersed Office in Istanbul for preparedness for humanitarian and health emergencies, which will contribute to the regional and global capacity.
- Let me now move to migration and health which is high on the agenda across the Region. The situation is becoming more challenging with the increasing influx of refugees and migrants to many European countries, calling for an urgent response to their health needs.
- I issued a statement on our website highlighting public health implications, which is a challenge both for the refugees and the receiving countries. The common systematic association between migration and importation of infectious diseases is not true.
- Countries should implement policies that allow migrants to have access to a broad range of health services, including prevention and care. This will also be beneficial for the receiving populations.
- We continued to respond to this increasing demand and provided support to affected countries, delivered emergency kits to address the health needs of refugees and migrants. We developed new research and evidence to support decision makers in migrant health policies.
- I want to thank Italy for the support during in this area. The Ministerial Lunch today is dedicated to migration and we are looking forward to your guidance on how to take this important topic forward.
- The conflict in the Syrian Arab Republic sent 2 million refugees into Turkey. We are working with the Government of Turkey who is demonstrating an outstanding performance in managing the response to the refugee influx.
- We are leading the health cluster to assist Syrian refugees in Turkey and we are contributing to “whole of Syria approach” following the UN Security Council Resolution in collaboration with the Eastern Mediterranean Regional Office.
- In response to the humanitarian crisis in Ukraine which affects more than 5 million people, we are leading the Health and Nutrition Cluster to coordinate response to internally displaced persons and affected communities. The WHO teams in the UN Field Offices are facilitating the delivery of medical kits, supplies and medicines to treat hundreds of thousands of people.
- The network of Mobile Emergency Primary Health Care units and Health Impact Specialists play a crucial role in assessing health threats and delivering health services in difficult-to-reach areas.
- Ladies and gentleman, it has been an exciting year for the work on antimicrobial resistance, with adoption of the global action plan. Europe is leading the way. Almost half of our Member States have an intersectoral coordination mechanism and national action plans.
- The Central Asian and Eastern European Surveillance on Antimicrobial Surveillance network (CAESAR) which now includes around 250 laboratories is supplementing the EU surveillance data. I am happy to inform that the network published its first report last month.
- Antimicrobial Medicines Consumption network (AMC) allows us to monitor the use of antimicrobials in 17 countries outside the EU, providing evidence from 45 Member States.
- Building on the success of European Antibiotic Awareness Day, we are shaping a global campaign to launch the World Antibiotic Awareness Week in November. This year, we hope that all 53 Member States will mark the week!
- All this work is done together with you, Member States and with partners in order to achieve our goal: better health for all; equitable and sustainable.
- We worked with all Member States tailoring the support to their priorities, needs and circumstances. We now have a fully functional National Counterparts network which streamlines all correspondence and improves the knowledge and information flow.
- We worked with all Member States tailoring the support to their priorities, needs and circumstances. We now have a fully functional National Counterparts network which streamlines all correspondence and improves the knowledge and information flow.
- I had the privilege of visiting many countries, meeting with Heads of State, Prime Ministers and Ministers, advocating for health and promoting intersectoral work.
- I was honored together with the Director General to receive the "Turkmenistan State Award” from His Excellency the President of Turkmenistan on behalf of WHO, in recognition of our collaboration over the past two decades.
- I was also honoured to receive on behalf of the Organization, the Gold Medal of the Portuguese Ministry of Health.
- We welcomed Ministers and senior delegations at the Regional Office. We have also given Member States a stronger voice by a new initiative: the Country Days. They are proven to be valuable platforms for identifying priorities for our joint work.
- To ensure that the Regional Office is a strong, evidence-based organization, relevant to the whole Region, we continued to increase our technical capacity. We empowered Country Offices by delegating more authority and responsibility in planning, implementing and monitoring country programs. I would like to thank all my staff for their dedication and hard work and.
- We invest in partnerships to increase policy coherence, improve health in our region and serve Member States more efficiently. I am pleased that many of our partners including civil society organisations are here with us.
- This year the partnership session, together with the Global Fund and GAVI Alliance, will focus on opportunities and challenges for a successful transition from international to domestic funding.
- On our work as “One UN”, let me highlight one important element. We coordinate a regional UN thematic group on NCDs and social determinants of health to support implementation of the UN Political Declaration on NCDs and Health 2020. We are pleased that in recently developed UNDAFs, health and NCDs are prominently present, and we look forward to implementing these jointly.
- WHO reform remains a priority. Later today, we will discuss on-going reform initiatives on governance and we will present our work on strengthening accountability and enhancing transparency in the Regional Office. Let me emphasize two points here.
- We continue the biennium on a solid financial foundation, with more fully flexible funds which are now distributed strategically, thanks to you Member States and also to the Director General for making this happen.
- Adoption of Programme Budget 2016-2017 at the World Health Assembly with a 8% budget increase was a historic moment, demonstrating the trust of Member States. The regional implementation plan for Programme Budget 2016–17 which will be presented on Thursday will be the main instrument of corporate accountability in the Region and the contract between you and me.
- Your Excellencies, ladies and gentleman, We have a big responsibility for health and wellbeing of our populations Next week we will approve the 2030 agenda on sustainable development. Let’s make sure that we are ready, and leave no one behind! ..... Nedret to rework…