Transcript ADG Retreat 08-10-2010 - Astana Economic Forum 2013

Health 2020: A New European Policy
Framework for Health and Well-Being
Zsuzsanna Jakab
WHO Regional Director for Europe
Presented by: Dr Melita Vujnovic, WHO
representative Kazakhstan
VI Astana Economic Forum,
Kazakhstan Astana, 24 May 2013
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Health 2020 was adopted by the WHO
Regional Committee in September 2012
53 Member States:
The European policy framework for supporting action
across government and society for health and well-being in
Life expectancy at birth, in years
<= 85
<= 81
<= 77
<= 73
Last
available
European Region
76.41
<= 69
No data
Min = 65
VI Astana Economic Forum,
Kazakhstan Astana, 24 May 2013
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Health 2020 goal
Significantly
improve health and well-being
of populations,
reduce health inequities
ensure
sustainable people-centred health systems
Why Health 2020?
Europe’s changing health landscape:
new demands, challenges and opportunities
Zsuzsanna Jakab, Regional Director for Europe
Kazakhstan country
4 visit
Astana, Kazakhstan –15 November 2012
European Region landscape
• We are dealing with complexity and uncertainty
• Health challenges are multi-faceted and require active
involvement of all levels of government (international, national,
and local)
People live longer
and have less
children.
Noncommunicable
diseases dominate
the disease burden.
People migrate
within and between
countries, cities
grow bigger.
Depression and
heart disease are
leading causes to
healthy life years
lost.
Infectious diseases,
such as HIV,
tuberculosis remain
a challenge to
control.
Antibiotic-resistant
organisms are
emerging.
Health systems
face rising costs.
Primary health care
systems are weak
and lack preventive
services.
Public health
capacities are
outdated.
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Kazakhstan Astana, 24 May 2013
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Overall health improvement (5 years life
expectancy gained) but with an important divide
Life expectancy at birth, in years
85
80
75
Kazakhstan
European Region
EU members before May 2004
EU members since 2004 or 2007
CIS
CARK
70
65
60
1970
1980
1990
2000
2010
CIS:
Commonweal
th of
Independent
States
EU12:
countries
belonging to
the European
Union (EU)
before May
2004
EU15:
countries
belonging to
the EU after
May 2004
2020
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Kazakhstan Astana, 24 May 2013
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Health 2020 strategic objectives
• Working to improve health for all and reducing
the health divide ( address all health
determinants simultaneously – mostly in other
sectors)
• Improving leadership, and participatory
governance for health
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Kazakhstan Astana, 24 May 2013
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Building on public health history
• WHO Constitution
• Alma Ata Declaration
(35th anniversary: 1978 – 2013)
• HFA
• Health 21
• Tallinn Charter
Integrated policy frameworks
can and have inspired health generating
actions on all levels.
VI Astana Economic Forum,
Kazakhstan Astana, 24 May 2013
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Health 2020: Four common policy
priorities for health
• Investing in health through a life course approach and
empowering people
• Tackling major health challenges of non communicable
diseases and communicable diseases
• Strengthening people-centred health systems and
public health capacities, and emergency
preparedness, surveillance and response
• Creating resilient communities and supportive
environments
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Kazakhstan Astana, 24 May 2013
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Why Health 2020?
Economic opportunities and threats:
the need to champion public health values and approaches
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Kazakhstan Astana, 24 May 2013
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The economic case for health promotion and
disease prevention
The economic impact of
non-communicable
diseases amount to many
hundreds of billions of
euros every year
Many costs are
avoidable through
investing in health
promotion and
disease prevention
Today governments
spend an average
3% of their health
budgets on
prevention
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Kazakhstan Astana, 24 May 2013
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Health impact of social welfare spending and
GDP growth
• Each additional dollar • Each 100 dollar per
capita increase in
per capita spending on
GDP results only in
social welfare is
associated with 1.19
0. 11 % reduction in
% reduction in
mortality;
mortality;
• There is a significantly
greater effect of social
welfare spending,
than of GDP growth on
mortality reduction.
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Improving efficiency reduces adverse effects
of the crisis: messages universal
• Eliminate ineffective and
inappropriate services
• Improve rational drug use
• Allocate more to primary and
outpatient specialist care at
the expense of hospitals
• Invest in infrastructure that is
less costly to run
• cut the volume of least costeffective services
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Kazakhstan Astana, 24 May 2013
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NCD action plan
Planning and
oversight
Health in all
policies
Healthy
settings
Secondary
prevention
Workplaces and
schools
Cardio-metabolic
risk assessment
and
management
Active mobility
(Ministry of
Sports, Ministry
of Education)
Early detection
of cancer
Kazakhstan
screening
programmes
Fiscal policies
National plan
Tobacco Control
Marketing
Health
information
system with
social
determinants
disaggregation
(Household
survey, GATS)
Salt
Trans-fat
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Kazakhstan Astana, 24 May 2013
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Support Member States to navigate the crisis
is central to our work: messages universal
• Strong economic case for health promotion
and disease prevention as economic cost of
NCD extremely high (only 3 % investment);
• Prevention one of most cost-effective
approaches to improve health outcomes;
• Fiscal policy can be used like raising taxes of
tobacco and alcohol: “Sin” taxes have
immediate benefits.
SDR, ischaemic heart disease, all ages per
100,000 population
SDR, ischaemic heart disease,
all ages per 100000
500
400
300
Kazakhstan
European Region
EU members before May 2004
EU members since 2004 or 2007
CIS
CARK
200
100
0
1970
1980
1990
2000
2010
2020
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Kazakhstan Astana, 24 May 2013
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Kazakhstan – highest political commitment
to health
“Healthy lifestyle and
the principle of shared
responsibility for health this is what should be
important both in the
policy on public health,
and in every day living”
Nursultan Nazarbayev,
President of the Republic
of Kazakhstan
Source: Address to the Nation, January
2012
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Kazakhstan Astana, 24 May 2013
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Kazakhstan:
Health as a determinant and barometer of
economic development
“In the Global Competitive Index rating
Kazakhstan holds 94 position due to its
incidence of tuberculosis (index of 2007 was
130.0) and 121th position in terms of the
influence of prevalence of tuberculosis on
business”
Source: The Global Competitiveness Report 2011–2012,
(http://www3.weforum.org/docs/WEF_GCR_Report_2011-12.pdf)
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Kazakhstan Astana, 24 May 2013
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Health 2020 documents &
Kazakhstan strategies
• Health 2020 - A European policy framework supporting
action across government and society for health and
wellbeing
• Health 2020 – European policy framework and strategy
document
&
• Kazakhstan 2030 & Health Code of Kazakhstan (2009)
• ”Salamatti Kazakhstan”: Healthy Kazakhstan 2011–2015
• 20 steps to social modernization of Kazakhstan (2012)
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Kazakhstan Astana, 24 May 2013
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Kazakhstan – Health 2020
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Kazakhstan Astana, 24 May 2013
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Kazakhstan: Health 2020 priorities
Health 2020
Salamatti Kazakhstan
•
Investing in health through a life
course approach and empowering
people
•
Tackling Europe’s major health
challenges of non communicable
diseases and communicable
diseases
• TB, HIV, especially dangerous
pathogens and smoking and
alcohol related diseases;
nutrition; CVD, cancer
•
Strengthening people-centred
health systems and public health
capacities, and emergency
preparedness, surveillance and
response
• Transport medicine and
emergency medicine; public
health surveillance
Creating resilient communities and
supportive environments
• Environment and health and
occupational health
•
• Child & adolescent health:
aging
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Kazakhstan Astana, 24 May 2013
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Health 2020 in Kazahstan
• Strengthen public health functions
• Review all determinants of health incl. social
and environmental determinants
(intersectoral mechanism in place )
• Review link between health, employment and
welfare/social policy
• Improve health literacy and empower people
through life course approach.
Health 2020 in Kazahstan
• Analyze the policy and strategy document
• Analyze the evidence-based studies
• Identify areas relevant for the Kazakhstan
context and build them into Salamatti
Kazakhstan
• “ It is the right policy that produces health”
which needs to be integrated with the
health system strengthening for best
results
Health 2020:
Towards a healthier Europe
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Kazakhstan Astana, 24 May 2013
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