We are presenting the summary of Day 2 at the 68th Session of WHO Regional Committee for Europe:

1) The need for tobacco product regulation and its potential by Dr Reinskje Talhout, Senior scientific advisor involved in tobacco product regulatory science at the Netherlands National Institute for Public Health and the Environment.

In the session led by Dr Reinskje Talhout, Senior scientific advisor involved in tobacco product regulatory science at the Netherlands National Institute for Public Health and the Environment, it has been discussed that how tobacco companies are having influence on young people making their product more attractive. The current regulations have been tabled and new methods to measure the toxic content of the products have been presented. The main focus was on the use of filter ventilation in cigarettes making people think they are less harmful. It has been recommended that the new regulations should follow the WHO advices on the matter and we should be aware that whatever they do, the tobacco products are not less harmful unless you stop smoking.

 

2) Implementation of the roadmap to implement the 2030 Agenda for Sustainable Development, building on Health 2020, the European policy framework for health and well-being, and review of the joint monitoring framework

The opening of the session was done by the Albanian Prime Minister who emphasized the importance of universal health coverage, equity in access to healthcare, eHealth and digitalization and European problems like aging population. He acknowledged the efforts done regarding these topics by member states and WHO Europe, but mentioned that there is still a lot to be done. He quoted the WHO definition of health: It is not only the lack of illness, but it is a complete physical, mental and societal well-being and health promotion is a fundamental human right.

 

3) Vaccine preventable diseases and immunization – realizing the full potential of the European Vaccine Action Plan 2015-2020

This topic of the agenda started with a presentation of the achievements of 2015-2017 followed by the video “Voices of our region”, which highlighted the importance of vaccination for families and young children. After that, Dr Nedret Emiroglu from WHO Europe presented the progress of the European Vaccine Action Plan and pointed out the goals that we are on track with, which are the following:

  1. Sustain polio free status
  2. Make evidence based decisions on new vaccines
  3. Achieve financial sustainability
  4. Control Hepatitis B infection

However, we need to remember that vaccine hesitancy is increasing in the European Region and immunization is a shared responsibility for all of us.

The next speaker was Adam Finn, Head of University of Bristol giving an inspiring speech about vaccination.

“If not for vaccines, we would not be here, in this room. We would probably be dead and our parents would have more children to replace us”.

The topic concluded with statements by Member States presenting their vaccination programmes and by Non State Actors advocating for more effective vaccination in Europe.

 

4) Panel Debate on SDGs

The programme continued with the panel debate on Sustainable Development Goals. The debate was moderated by Dr Natasha Muscat (President of European Public Health). The first speaker was Chris Feame (Minister of Health, Malta), who focused on ways to connect health forces with policy makers. Sabine Weiss (Parliamentary State Secretary, Germany) emphasised that Germany fully supports WHO’s efforts on achieving SDGs, and reminded that more proactive stance from all member states are needed to achieve the goals set. Dr Arsen Torosyan (Minister of Health, Armenia) focused on the importance of preventive measures in health systems by sharing Armenia’s efforts on eliminating vaccine treatable diseases. He continued by emphasising the need for multisectoral approach to eliminate noncommunicable diseases. Dr Aniko Nagy (Minister of Health, Hungary) focused on promotion of lifestyle changes to increase the wellbeing of the population and Hungary’s efforts to provide health equity for all. Dr David Sergeenko (Minister of Health, Georgia) explained the complexity of the path to achieving SDG goals, and Georgia’s efforts to reach SDG3 through Universal Health Care. Dr. Corina Pop (Minister of Health, Romania) gave information on the High-level political meeting which took place in June on SDGs. Dr. Valery Malashko (Minister of Health, Belarus) who shared the support and measures to reach SDGs by Belarus.

 

5) Technical Briefing on healthy people through environmentally sustainable urban transport

In the technical briefing of the day, various speakers highlighted the good impacts of sustainable and healthy cities on people’s health focusing on the work done by Transport, Health and Environment Pan-European Programme.

There are big 5 health impacts of urban transport:

  1. Physical activity
  2. Injuries
  3. Air quality
  4. Noise
  5. Severance

Many of the causes of early deaths and illnesses are related to the urban transport issues.

That is why it is recommended to make our cities healthy cities for improving people’s health. The speakers shared the 10 indicators of a healthy city, which are:

  1. Everyone feels welcome
  2. Easy to cross
  3. Clean air
  4. Shade and shelter
  5. Places to stop and rest
  6. Not too noisy
  7. People choose to walk and cycle
  8. People feel relaxed
  9. Things to see and do
  10. People feel safe

 

6) Report of the Twenty-fifth Standing Committee of the Regional Committee for Europe

Professor Amiran Gamkrelidze: Chair, Standing Committee of the Regional Committee

They checked all technical agenda points. Multisectorial expert group from the member states. Reviewed all documents and helped to create the content of the RC. High-level taskforce on big data, ownership and governance mechanism. Development advancing PH in the region aligned with 2020, SDG and GPW13. They support men’s health and to have a broader view on gender issues. They support the european vaccine action plan – strong political commitment needed, now that antivacc movements are taking over in Europe. FENSA – reviewed the applications, they proposed 19 NSAs this year. The SCRC reviewed all the programme and event budgets. They were informed on the implementation of the programme budget 2017-2018. They are overseeing the elections and nominations happening on Day 4.

Resolution on the Report of the twenty-fifth SCRC for Europe adopted – nemo contra.

 

7) Report on the WHO high-level meeting, Health Systems Respond to NCDs: Experience in the European Region (Sitges, Spain, 16–18 April 2018)

Dr. Hans Kluge: Director, Health Systems and Public Health

The high-level meeting on health system response to NCDs in Sitges was a key step in the development of health systems.

Dr. Melitta Jakab: Senior Health Economist

Emphasized the need for multidisciplinary, contextualized, pragmatic and actionable response. 200 participants, 40 countries. Report on the meeting shall be used for the upcoming decade on health system transformation, launched on Day 3. Response from the European Region – governing for NCDs, but much needs to be done. Need for: health financing alignment, health workforce fit for purpose, multi-pronged medicines policy and information solutions. Need to transform PH education so NCDs can be addressed by the next generation of PH specialists. Early diagnosis, condition management of chronic diseases, especially CV diseases. Involving patients and their caregivers in the planning process, with this transforming primary healthcare in Europe. Transformed primary healthcare teams are the solution of managing NCDs – while specialists and hospitals are also playing a crucial role in acute care. The management of NCDs need IPC – health promoters, mental health specialists, behaviour change specialists, etc. Disease prevention, early election and good management are necessary to control NCDs. We have to transform the financing and the management of health systems in order to fight NCDs and turn the fragmented healthcare system to a united one, to leave no one behind.

Universally targetted policies can help health systems to reduce inequalities within society. European Region is a success story in reducing premature mortality due to NCds but we could do much better. Is leapfrogging (?) possible? Adapting today’s best practices and changing health systems more dramatically, in a flexible, quick response way. Conference in Sitges put much emphasis on leapfrogging.

2017-2018 was important year for transforming health systems to accommodate the fight against NCDs. The work is starting now, now comes the implementation and showing that leapfrogging is possible. List of commitments from WHO Europe is part of the report and WHO is ready to take action and provide support for Member States to act on the fights against NCDs.

 

8) Report on the WHO high-level meeting, Health Systems for Prosperity and Solidarity: Leaving No One Behind (Tallinn, Estonia, 13–14 June 2018)

Dr. Elke Jakubovski
At the WHO high-level meeting on June 13th,14th in Tallinn, Estonia 240 participants from 40 countries and many partners of WHO were present to reaffirm the commitment to the values laid out in the Tallinn Charter: Health Systems for Health and Wealth on its 10th anniversary. Within the European region life expectancy has increased by 2 years on average and greater focus has been put on primary health care and public health. Nonetheless the economic, political and social context has changed since signing the charter. In this respect, three main themes and with key messages were identified. The theme of inclusion focuses on the importance of moving towards universal health coverage and financial protection. The theme of investing resituates the charters call for “health systems for health and wealth” in the current context making the case for investing in health systems. The theme of innovation focuses on harnessing health innovation and scaling up solution to meet people’s needs.

 

9) CAN PEOPLE AFFORD TO PAY FOR HEALTH CARE? NEW EVIDENCE ON FINANCIAL PROTECTION IN EUROPE

Financial protection is the degree to which people are protected from out-of-pocket payments when using health care. WHO Europe states ‘No one should experience financial hardship or unmet need. No one should have to choose between healthcare and other basic needs.’ In order to achieve universal health coverage, financial protection is vital. More public spending on health means lower burden on patients. Improving financial protection requires many interventions but most importantly putting people first.