What will European health services look like in 2020?
by Viv Taylor Gee
19 September 2011
The growing burden of cancer, heart disease, diabetes and strokes is linked to the unhealthy lifestyles that most of us lead
Ministers and high level policymakers gathered in Baku, Azerbaijan, last week at the annual meeting of World Health Organisation regional office for Europe. They had a raft of action plans to discuss and a new vision of public health: health 2020. Beyond the pristine facades and dramatic new buildings of downtown Baku, the seaside boulevard, the ceaseless traffic and the glinting windows of Versace and Christian Dior - a host of issues preoccupied health ministers from all across the European Region. In times of economic constraint, how do we protect health?
There are immense challenges. We need to provide adequate services and support to the ageing population. There is a growing burden of non-communicable diseases such as cancer, heart disease, diabetes and strokes - and it is linked to the unhealthy lifestyles that most of us lead. And there is an ever expanding array of technology we can buy for diagnosis and treatment - health systems are expensive, and will become more so. Also, there are expectations among the public for high-quality care, which treats its patients as partners. We need to be prepared for emergencies and shifts in populations and, most of all, resources are coming under enormous pressure and budgets are under threat.
This may be the moment when public health steps forward. It is at last being widely understood that health contributes to wealth and enables people to be productive and independent, and that investing in promoting and protecting health is a sure means to invest in the future. It certainly makes more sense to focus on trying to keep a population fit and well than pouring scarce resources into treating them when they become ill. It is not shiny new clinics which keep us healthy; their expertise simply picks up the pieces. Health is generated by employment, opportunity, housing, clean air and water, green spaces and the many other socio-economic determinants. Public health, for so long the poor relation of medicine, is coming into its own.
The 53 member states in Baku were being consulted on our new policy, health 2020. It went back to first principles: equity, ethics, and the right to health. It argued for the recognition that the whole of government should be involved with health and for resources to be put into promotion of prevention of disease - and ensuring that everyone has access to care. It is based on sound evidence on what has been shown to work best. The country delegates in Baku welcomed this as "a breath of fresh air", but discussions continue.
This does not mean that technical issues have been sidelined, on the contrary. Every one of the five action plans on the agenda in Baku emphasized prevention: preventing the transmission of HIV/AIDS, which looks increasingly possible; preventing the growth of antibiotic resistance; preventing the spread of drug resistant tuberculosis; preventing the devastation caused by the harmful use of alcohol; and preventing the main killer diseases in the European Region - cancer, heart disease, diabetes and strokes. Addressing all of these involve improving primary health care services, which in some countries still have some way to go.
Over the last few years, the emphasis has been on making health systems stronger. And this emphasis on public health and primary care is, in fact, building on the achievements that ministries have made - and continue to make - with strengthening their health systems. In most countries, they are already working across sectors and trying to hold on to their public health services, so the backing this approach received in Baku will hopefully give them support during these straitened times.
Now, WHO Europe will have to deliver on the decisions made by its governing body, but with the commitment that countries demonstrate in Baku, it may be that - as the WHO Regional Director for Europe, Zsuzsanna Jakab says, there is a new momentum. WHO Director General Dr Margaret Chan, agrees. "You are aiming at nothing less than a rejuvenation of the public health agenda," she says.
Viv Taylor Gee is communications adviser at WHO Europe
Ministers and high level policymakers gathered in Baku, Azerbaijan, last week at the annual meeting of World Health Organisation regional office for Europe. They had a raft of action plans to discuss and a new vision of public health: health 2020. Beyond the pristine facades and dramatic new buildings of downtown Baku, the seaside boulevard, the ceaseless traffic and the glinting windows of Versace and Christian Dior - a host of issues preoccupied health ministers from all across the European Region. In times of economic constraint, how do we protect health?
There are immense challenges. We need to provide adequate services and support to the ageing population. There is a growing burden of non-communicable diseases such as cancer, heart disease, diabetes and strokes - and it is linked to the unhealthy lifestyles that most of us lead. And there is an ever expanding array of technology we can buy for diagnosis and treatment - health systems are expensive, and will become more so. Also, there are expectations among the public for high-quality care, which treats its patients as partners. We need to be prepared for emergencies and shifts in populations and, most of all, resources are coming under enormous pressure and budgets are under threat.
This may be the moment when public health steps forward. It is at last being widely understood that health contributes to wealth and enables people to be productive and independent, and that investing in promoting and protecting health is a sure means to invest in the future. It certainly makes more sense to focus on trying to keep a population fit and well than pouring scarce resources into treating them when they become ill. It is not shiny new clinics which keep us healthy; their expertise simply picks up the pieces. Health is generated by employment, opportunity, housing, clean air and water, green spaces and the many other socio-economic determinants. Public health, for so long the poor relation of medicine, is coming into its own.
The 53 member states in Baku were being consulted on our new policy, health 2020. It went back to first principles: equity, ethics, and the right to health. It argued for the recognition that the whole of government should be involved with health and for resources to be put into promotion of prevention of disease - and ensuring that everyone has access to care. It is based on sound evidence on what has been shown to work best. The country delegates in Baku welcomed this as "a breath of fresh air", but discussions continue.
This does not mean that technical issues have been sidelined, on the contrary. Every one of the five action plans on the agenda in Baku emphasized prevention: preventing the transmission of HIV/AIDS, which looks increasingly possible; preventing the growth of antibiotic resistance; preventing the spread of drug resistant tuberculosis; preventing the devastation caused by the harmful use of alcohol; and preventing the main killer diseases in the European Region - cancer, heart disease, diabetes and strokes. Addressing all of these involve improving primary health care services, which in some countries still have some way to go.
Over the last few years, the emphasis has been on making health systems stronger. And this emphasis on public health and primary care is, in fact, building on the achievements that ministries have made - and continue to make - with strengthening their health systems. In most countries, they are already working across sectors and trying to hold on to their public health services, so the backing this approach received in Baku will hopefully give them support during these straitened times.
Now, WHO Europe will have to deliver on the decisions made by its governing body, but with the commitment that countries demonstrate in Baku, it may be that - as the WHO Regional Director for Europe, Zsuzsanna Jakab says, there is a new momentum. WHO Director General Dr Margaret Chan, agrees. "You are aiming at nothing less than a rejuvenation of the public health agenda," she says.
Viv Taylor Gee is communications adviser at WHO Europe
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