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Health 2020:
  the new WHO European
     policy framework

      Zsuzsanna Jakab
WHO Regional Director for Europe



                              Bolzano, Italy, 28 September 2012
WHO European Region




                  Bolzano, Italy, 28 September 2012
Outline
                           Final
                         remarks


               Content




   Rationale



                            Bolzano, Italy, 28 September 2012
Rapidly changing European context for health




                                            Bolzano, Italy, 28 September 2012

                             Photo credits: S.Turner, 2003; L. Donaldson, 2008 I. Brandemer, 2009
Changing environment for health

• Demographics (fertility, aging)

• Globalization and migration (including of health workers)

• New technologies (including medical genetics)

• More informed and demanding citizens

• Recognition of importance of health to human development

• Slower economic growth and austerity policies



                                              Bolzano, Italy, 28 September 2012
Why Health 2020 and why now?




Improvements in health and well-being: significant
but uneven and unequal


                                            Bolzano, Italy, 28 September 2012
Why Health 2020 and why now?




Europe’s changing health landscape:
new demands, challenges and opportunities


                                            Bolzano, Italy, 28 September 2012
Why Health 2020 and why now?




Economic opportunities and threats: the need to champion
public health values and approaches


                                          Bolzano, Italy, 28 September 2012
Health 2020:
a European policy framework
supporting action across government
and society for health and well-being




                               Bolzano, Italy, 28 September 2012
Final
                      remarks


            Content



Rationale




                      Bolzano, Italy, 28 September 2012
Goal of Health 2020



“To improve health and well-being of populations, to reduce
health inequities and to ensure sustainable people-centred
   health systems with further strengthened public health
                         capacities”




                                             Bolzano, Italy, 28 September 2012
Health 2020: two main strategic objectives:



1. Working to improve health for all and reducing the health
   divide


2. Improving leadership and participatory governance for health




                                               Bolzano, Italy, 28 September 2012
Rising health inequalities in Europe

                                          Life expectancy at birth, in years
                                 80




Address the social
determinants of health


                                 75
Emphasis on action across
the social gradient and on
vulnerable groups                                                                          European Region
                                                                                           EU members before May 2004
                                                                                           EU members since May 2004
                                                                                           CIS

Ensure that continuous
reduction of health inequities   70

become a criteria assessing
health systems performance                                                                 EU: European Union
                                                                                           CIS: Commonwealth
                                                                                           of Independent States




                                 65
                                   1970       1980           1990              2000




                                                                         Bolzano, Italy, 28 September 2012
Europe’s major health challenges
Implement global and regional mandates
(noncommunicable diseases, tobacco, diet and
physical activity, alcohol, HIV/AIDS, tuberculosis,                                               140



antibiotic resistance, the International Health




                                                      Standardized death rate, 0-64 per 100,000
                                                                                                  120


Regulations, etc.)                                                                                100



                                                                                                   80

Promote healthy choices                                                                                  Cause
                                                                                                   60
                                                                                                            Heart disease
                                                                                                            Cancer
                                                                                                            Injuries and violence
Strengthen health systems, including public                                                        40
                                                                                                            Infectious diseases
                                                                                                            Mental disorders

health, primary health care, health information and                                                20


surveillance                                                                                        0

                                                                                                         1980              1985             1990                 1995            2000             2005
                                                                                                                                                          Year
                                                                                                        100%

Reach and maintain recommended immunization                                                             90%


coverage                                                                                                80%

                                                                                                        70%

                                                                                                        60%




                                                                                      Deaths
                                                                                                        50%

Develop healthy settings and environments                                                               40%

                                                                                                        30%

                                                                                                        20%

                                                                                                        10%
Attention to special needs and disadvantaged                                                             0%

populations                                                                                                      European Region                  EU-15
                                                                                                                                                      Country groups
                                                                                                                                                                        EU-12                     CIS



                                                                                                                             Circulatory system       Malignant neoplasms       External causes
                                                                                                                             Infectious disease       Respiratory system        Other causes




                                                                                                                                           Bolzano, Italy, 28 September 2012
Stakeholder utility


                                    What’s in it
                                      for me?




                      Bolzano, Italy, 28 September 2012
Health ministers and key policy leaders


• Leadership
• Health-system
  management
• Influence
• Problem solving
• Engagement strategies
• Intelligence exchange


                                     Bolzano, Italy, 28 September 2012
Prime ministers and other sectoral leaders


• Economic case for
  investment in health

• Upstream interventions

• Health and well-being as
  barometers of development

• New governance models




                                     Bolzano, Italy, 28 September 2012
Public health agencies, advocates and academics

Health 2020:
• builds unity in community
• maps options and tradeoff
  for health improvement
• enhances public health
  authority
• stands up for public health
• identifies research priorities


                                   Bolzano, Italy, 28 September 2012
Health professionals
Health 2020:
• indentifies integrative
  strategies and new skills
  needed

• links clinical
  interventions to equity and
  social determinants

• advocates
  strengthening of health
  systems


                                      Bolzano, Italy, 28 September 2012
Partner agencies

Health 2020:
• sets common targets

• reduces duplication

• enhances coherence




                                      Bolzano, Italy, 28 September 2012
Society
Health 2020:

• champions engagement
  and empowerment
  approaches

• supports citizen/patient-
  centered systems

• provides a platform for
  advocacy and collaboration



                                        Bolzano, Italy, 28 September 2012
Final
                      remarks



            Content



Rationale



                        Bolzano, Italy, 28 September 2012
Governance for health requirements


1.   Whole-of-society and whole-of-government
     responsibility and mechanisms

2.   Effective health ministries

3.   Modern public health infrastructure

4.   Robust health systems

5.   New articulation and advocacy for health


                                           Bolzano, Italy, 28 September 2012
We are embarking on a new path




                                           Photos: Donaldson, 2008




                         Bolzano, Italy, 28 September 2012
Photo: L. Donaldson, 2008.




     Bolzano, Italy, 28 September 2012
South Tyrol:
sustainable and healthy community




                            Bolzano, Italy, 28 September 2012

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Health 2020: the new WHO European policy framework

  • 1. Health 2020: the new WHO European policy framework Zsuzsanna Jakab WHO Regional Director for Europe Bolzano, Italy, 28 September 2012
  • 2. WHO European Region Bolzano, Italy, 28 September 2012
  • 3. Outline Final remarks Content Rationale Bolzano, Italy, 28 September 2012
  • 4. Rapidly changing European context for health Bolzano, Italy, 28 September 2012 Photo credits: S.Turner, 2003; L. Donaldson, 2008 I. Brandemer, 2009
  • 5. Changing environment for health • Demographics (fertility, aging) • Globalization and migration (including of health workers) • New technologies (including medical genetics) • More informed and demanding citizens • Recognition of importance of health to human development • Slower economic growth and austerity policies Bolzano, Italy, 28 September 2012
  • 6. Why Health 2020 and why now? Improvements in health and well-being: significant but uneven and unequal Bolzano, Italy, 28 September 2012
  • 7. Why Health 2020 and why now? Europe’s changing health landscape: new demands, challenges and opportunities Bolzano, Italy, 28 September 2012
  • 8. Why Health 2020 and why now? Economic opportunities and threats: the need to champion public health values and approaches Bolzano, Italy, 28 September 2012
  • 9. Health 2020: a European policy framework supporting action across government and society for health and well-being Bolzano, Italy, 28 September 2012
  • 10. Final remarks Content Rationale Bolzano, Italy, 28 September 2012
  • 11. Goal of Health 2020 “To improve health and well-being of populations, to reduce health inequities and to ensure sustainable people-centred health systems with further strengthened public health capacities” Bolzano, Italy, 28 September 2012
  • 12. Health 2020: two main strategic objectives: 1. Working to improve health for all and reducing the health divide 2. Improving leadership and participatory governance for health Bolzano, Italy, 28 September 2012
  • 13. Rising health inequalities in Europe Life expectancy at birth, in years 80 Address the social determinants of health 75 Emphasis on action across the social gradient and on vulnerable groups European Region EU members before May 2004 EU members since May 2004 CIS Ensure that continuous reduction of health inequities 70 become a criteria assessing health systems performance EU: European Union CIS: Commonwealth of Independent States 65 1970 1980 1990 2000 Bolzano, Italy, 28 September 2012
  • 14. Europe’s major health challenges Implement global and regional mandates (noncommunicable diseases, tobacco, diet and physical activity, alcohol, HIV/AIDS, tuberculosis, 140 antibiotic resistance, the International Health Standardized death rate, 0-64 per 100,000 120 Regulations, etc.) 100 80 Promote healthy choices Cause 60 Heart disease Cancer Injuries and violence Strengthen health systems, including public 40 Infectious diseases Mental disorders health, primary health care, health information and 20 surveillance 0 1980 1985 1990 1995 2000 2005 Year 100% Reach and maintain recommended immunization 90% coverage 80% 70% 60% Deaths 50% Develop healthy settings and environments 40% 30% 20% 10% Attention to special needs and disadvantaged 0% populations European Region EU-15 Country groups EU-12 CIS Circulatory system Malignant neoplasms External causes Infectious disease Respiratory system Other causes Bolzano, Italy, 28 September 2012
  • 15. Stakeholder utility What’s in it for me? Bolzano, Italy, 28 September 2012
  • 16. Health ministers and key policy leaders • Leadership • Health-system management • Influence • Problem solving • Engagement strategies • Intelligence exchange Bolzano, Italy, 28 September 2012
  • 17. Prime ministers and other sectoral leaders • Economic case for investment in health • Upstream interventions • Health and well-being as barometers of development • New governance models Bolzano, Italy, 28 September 2012
  • 18. Public health agencies, advocates and academics Health 2020: • builds unity in community • maps options and tradeoff for health improvement • enhances public health authority • stands up for public health • identifies research priorities Bolzano, Italy, 28 September 2012
  • 19. Health professionals Health 2020: • indentifies integrative strategies and new skills needed • links clinical interventions to equity and social determinants • advocates strengthening of health systems Bolzano, Italy, 28 September 2012
  • 20. Partner agencies Health 2020: • sets common targets • reduces duplication • enhances coherence Bolzano, Italy, 28 September 2012
  • 21. Society Health 2020: • champions engagement and empowerment approaches • supports citizen/patient- centered systems • provides a platform for advocacy and collaboration Bolzano, Italy, 28 September 2012
  • 22. Final remarks Content Rationale Bolzano, Italy, 28 September 2012
  • 23. Governance for health requirements 1. Whole-of-society and whole-of-government responsibility and mechanisms 2. Effective health ministries 3. Modern public health infrastructure 4. Robust health systems 5. New articulation and advocacy for health Bolzano, Italy, 28 September 2012
  • 24. We are embarking on a new path Photos: Donaldson, 2008 Bolzano, Italy, 28 September 2012
  • 25. Photo: L. Donaldson, 2008. Bolzano, Italy, 28 September 2012
  • 26. South Tyrol: sustainable and healthy community Bolzano, Italy, 28 September 2012