presentation – health status of the europeans – challenges and main tasks
TRANSCRIPT
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Dr Zsuzsanna Jakab
WHO Regional Director for Europe
6 October 2017, Debrecen, Hungary
Presentation –
Health status of the Europeans
– challenges and main tasks
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(2)Photo: Malin Bring
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Health at the centre of development
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Health at the centre of development
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Health is a political choice
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Moving towards joint commitments
1. Focus on inequities
2. Achieve universal health coverage
3. Strengthen health systems
4. Work upstream: health promotion and disease prevention
5. Address all the determinants of health
6. Strengthen emergency preparedness and response
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Health 2020
Priorities
Health systems
Burden of disease
Life-course
approach
Resilient commun-
itiesSDG3
Universal health
coverage
Emergency management
(IHR)
Halve deaths and injuries from road
traffic accidents
Reduce deaths and illness
from environmental
pollution
Reduce maternal mortality
End preventable
deaths of children under
5
Strengthen prevention and
treatment of substance
abuse
Universal access to
sexual and reproductive
health services
End AIDS, TB, malaria and
other communicable
diseases
Reduce premature
mortality from NCDs and promote
mental health
Research for vaccines and
medicines
Strengthen FCTC
Health financing and
health workforce
Health 2020 is fully aligned with the SDGs
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70
72
74
76
78
80
82
Overall Men Women
Life expectancy is increasing in the WHO European RegionYe
ars
77.7
74.4
81.0
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63
64
65
66
67
68
69
70
71
Overall Men Women
Healthy years at birth has reached 68 years across the RegionYe
ars 68.3
65.6
70.5
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The NCD mortality trend for those aged 30–69 is declining.
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2–3% annual average decline in premature mortality in most countries
Aim is a decline of 40% by 2025
Decline in premature mortality
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Progress so far in the Region
• Infant mortality: 6.7 per thousand live births
• Children vaccinated against measles and rubella: 94%
• Proportion of children not enrolled in school: boys 2.5%, girls 8.3%
• Populations with improved sanitation facilities: 92.9%
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Discrepancies remain
Life expectancy at birth ranges from
71.2 to 83.4 years
Healthy years of life ranges from
59.8 to 73.1 years
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Infant mortality ranges from1.9 to 22.1
Rubella vaccination ranges from 42% to 99%
Discrepancies remain
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National and local networks –catalysing action towards common goals
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*Rep
Defined Health 2020 targets
Health 2020 alignment
0 20 40 60 80 100
2010
2017
Health 2020 increasingly incorporated into
national health policies
73%
88%
58%
93%
*Reported countries
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0 20 40 60 80 100
Implementation plans
Accountability mechanisms
Reducing health inequities
2010
2016
Most countries have policies addressing health inequalities
*Reported countries
46%
86%
45%
89%
88%
98%
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Investing in public healthpays back.
We need a new, invigorated public health movement, since public health is a driver of equitable health improvement.
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High returns for public health investments
• For every £1 invested in public health, £14 is returned to the wider health and economy.
• Reducing health inequality by 1% a year increases the annual rate of GDP growth by 0.15%.
Health promotion and preventions works
• A 10% reduction in heart disease saves €20 billion annually in lower- and middle-income countries.
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Investing in the positive effects of universal social protection pays back.
• Early years development investment is estimated to produce a 17-fold return.
The cost of non-action is significant.
• The direct and indirect costs of high disease burden in countries can consume 15–20% of GDP.
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There is scope for increased investments in public health.
• An average of only 3% of national health budgets is spent on public health in the Region.
Moving the public health agenda forward
• Review commissioned to look at the future of public health to contribute strongly to achieving the SDGs and Health 2020
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Health systems
Health 2020
Priorities
Health systems
Burden of diseaseResilient
communities
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Universal health coverage
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Sales
1st Qtr 2nd Qtr 3rd Qtr 4th Qtr
“…all people and communities receive the quality services
they need, including health promotion, disease prevention,
treatment and rehabilitiation, without financial hardship.”
Universal health coverage
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“It is unacceptable that
people become poor as a
result of ill-health”
The Tallinn Charter
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Out-of-pocket payment share of total health spending
high in many countries
0
5
10
15
20
25
30
35
40
45
50
55
60
65
70
75
Out-
of-
pocket paym
ent
as %
of
tota
l health s
pendin
g
DANGER ZONE: > 30%
WARNING
SAFE: < 15% with pro-poor policies
Source: WHO data for 2014
High and middle-income countries in the WHO European Region
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Health systems respond to NCDs
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INCLUDE INVEST INNOVATE
A vision for health systems in Europe: the future of the Tallinn Charter
Celebrating the 10th anniversary of the Tallinn Charter
Tallinn, Estonia13–14 June 2018
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40th anniversary
Alma Ata Declaration
2018
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Tackling the main disease burdens
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SDG3
End AIDS, TB, malaria and
other communicable
Reduce premature
mortality from NCDs and
promote mental health
Vaccines and medicines
Reduce premature
mortality from NCDs and
promote mental health
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We can do better
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We can do better
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We could achieve further reductions in disease burden by fully implementing the available evidence on cost-effective actions.
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Accelerating progress towards disease prevention and
elimination
Photo: Malin Bring
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Major gains in measles and rubella elimination
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Measles cases,WHO European Region, 2016
Progress hampered by setbacks
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Immunization: Leaving no one behind
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From malaria elimination to
maintaining malaria-free status
THE ASHGABAT STATEMENT
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3.6
0
1
2
3
4
5
6
7
8
9
10
2000 2005 2010 2015
Rat
e p
er 1
00
00
0 p
op
ula
tio
n
– 8.5% yearly
between 2011 and 2015
36
0
10
20
30
40
50
60
70
80
2000 2005 2010 2015
Rat
e p
er 1
00
00
0 p
op
ula
tio
n
– 4.3% yearly
between 2011 and 2015
The Region has the fastest decline in
TB incidence and mortality
Estimated TB incidence rate Estimated TB mortality rate
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0
0.5
1
1.5
2
2.5
3
3.5
4
2000 2005 2010 2015
Rat
e p
er 1
00
00
0 p
op
ula
tio
n
Estimated TB/HIV rate
6.2% annual increase
between 2011 and 2015
TB/HIV coinfection on the rise
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0
20000
40000
60000
80000
100000
120000
140000
160000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Nu
mb
er
of
ne
w H
IV d
iag
no
se
s
East
Centre
West
Increase
2006–2015
Region: 75%
East: 109%
HIV epidemic moving at an alarming rate
New HIV diagnoses in the WHO European Region 2006–2015
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Building on the momentum to eliminate viral hepatitis
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Comprehensive response guided by national strategies
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(45)Photo: United Nations
Stronger partnerships across sectors and institutions to combat AMR
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Health emergencies, preparedness,surveillance and response
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Roles
Responsibilities
Accountabilities
Timelines
Partnerships
WHO Emergency Programme is fully functional
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NUCLEAR DISASTER(SPECIALIZED MECHANISMS)
CHEMICAL(SPECIALIZED MECHANISMS)
INFECTIOUS OUTBREAKS(WHO LEAD ROLE)
NATURAL DISASTER(IASC/OCHA LEAD)
CONFLICT(IASC/OCHA LEAD)
IMS
and
RES
PO
NSE
EVEN
T G
RA
DIN
G
Rapid and efficient response
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(49)Essential public health operations
10th anniversary of IHR
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The determinants of health
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Determinants of health
Behavioral
Environmental
Social
PoliticalEconomic
Cultural
Commercial
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Focusing on behavioral determinants
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Making good progress
on tobacco control
Tobacco plain packaging legislation now in:
• France• Georgia• Hungary• Ireland• Norway• Slovenia• United Kingdom
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Tobacco taxation works
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Alcohol consumption declining too slowly
Per capita alcohol consumption among people over 15 yearswithin a calendar year
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Alcohol consumption declining too slowly
We are aiming for a 10% decline until 2025 to achieve the 2030 global target
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Obesity prevalence for over 18s: men – 21.0%, women – 23.9%
Photo: Malin Bring
Overweight and obesity alarmingly on the rise
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Social determinants
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Social determinants
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Environmental determinants
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Ostrava Declaration: European countries
committed to national implementation by
2018
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(70)www.euro.who.int
WHO Regional Office for Europe
UN City
Marmorvej 51
DK-2100 Copenhagen Ø
Denmark
Thank you