FfW 2012 Summit_Bertollini

7/30/2019 FfW 2012 Summit_Bertollini

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Health2020: a new WHO strategyto promote well-being and tackle

Chronic Diseases in Europe

Roberto Bertollini MD MPH

Chief Scientist and WHO Representative to the EU

WHO Regional Office for Europe

Join in the conversation #FfWSummit


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Overall health improvement (5 years life expectancygained) but with an important divide

CIS: Commonwealthof Independent StatesEU12: countriesbelonging to theEuropean Union (EU)before May 2004EU15: countriesbelonging to the EUafter May 2004



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Why Health 2020?

Financial and economic crisis is threatening the gains

made across Europe in recent decades, and exacerbatingthe longer term challenges facing our health systems



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Health 2020 builds on strongvalues

Health as a fundamental human rightSolidarity, fairness and sustainability

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Health 2020 - a common purpose,a shared responsibility

Health 2020 strategic objectives: stronger equity and better governance

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

2. Improving leadership, and participatory governance for health

Health 2020 goal

To significantly improve health and well-being of populations, to reduce health inequities and

to ensure sustainable people-centred health systems

Health 2020 visionA WHO European Region in which all people are enabled and supported in achieving their fullhealth potential and well-being and in which countries, individually and jointly, work towardsreducing inequities in health within the Region and beyond



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Health 2020: Four common policy prioritiesfor health

Investing in health through a life course approach and empowering people

Tackling Europes major health challenges of non communicable diseases and

communicable diseases

Creating supportive environments and resilient communities

Strengthening people-centred health systems and public health capacities, andemergency preparedness

The four priority areas are interlinked and are interdependent and mutuallysupportive

Addressing the four priorities will require a combination of governanceapproaches that promote health, equity and well-being



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Major burden in the Region due tononcommunicable diseases

SDR: standardizeddeath rate



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Capewell S, OFlaherty M. Rapidmortality falls after risk-factorchanges in populations. TheLancet Published Online March16, 2011 DOI:10.1016/S0140-

6736(10)62302-1.

Extensive empirical and

trial evidence shows thatsubstantial reductions inmortality can occurwithin months ofdecreases in smoking,and within 13 years ofdietary changes



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Associated with a doubling in the risk ofillness and 60% less likelihood of recoveryfrom disease*

Strong correlation with increased alcoholpoisening, liver cirrhosis, ulcer, mentaldisorders**

Increase of suicide incidence***GRE and LVA 17%, IRE 13%

Active labour market policies and well-

targeted social protection expenditure caneliminate most of these adverse effects

Unemployment

Sources: * Kaplan, G. (2012) Social Science & Medicine 74 pp.643-646.** Suhrcke M., Stuckler D. (2012) Social Science & Medicine 74 pp.

647-653.***Stuckler D. et al. (2011) The Lancet Vol378 pp124-125.**** Stuckler D. et al. (2009) The Lancet Vol374 pp 315-323



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Health impact of social welfarespending and GDP growth

Each additional 100USD percapita spending on social welfare(including health) is associatedwith 1,19% reduction in mortality

Socialwelfare

spending

Each additional 100USD percapita increase of GDP isassociated with only 0,11%reduction in mortalityGDP

Source: Stuckler D et al. BMJ 2010;340:bmj.c3311



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The economic case for health

promotion and diseaseprevention

The economic impact ofnon-communicable

diseases amount to many

hundreds of billions ofeuros every year

Many costs areavoidable throughinvesting in health

promotion anddisease prevention

Today governmentsspend an average3% of their health

budgets onprevention



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Some examples

Cardiovasculardisease

Alcohol relatedharm

Cancer

Road trafficinjuries

Obesity relatedillness (includingdiabetes and CVD)

169 billion annually in the EU; healthcareaccounting for 62% of costs

125 billion annually in the EU, equivalentto 1.3% of GDP

Over 1% GDP in the US; between 1-3% ofhealth expenditure in most countries

6.5% of all health care expenditure inEurope

Up to 2% of GDP in middle and highincome countries

Sources: Leal (2006), DG Sanco (2006), Stark (2006), Sassi (2010), WHO (2004)



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Using fiscal policy: the short term benefits ofsin taxes

TobaccoA 10% price increase intaxes could result in up to

1.8 million fewer prematuredeaths at a cost of between

$3 and $78 per DALY in

eastern European andcentral Asian countries

AlcoholIn England, benefits closeto600 million in reducedhealth and welfare costsand reduced labor and

productivity losses, at animplementation cost of less

than0.10 per capita

Source: McDaid, Sassi and Merkur, 2012 (forthcoming)

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Closer cooperation between health andfinance Ministries

OECD /WHO JointMeeting on FinancialSustainability of HealthSystems

2012, Tallinn, Estonia



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Improving governance for health andincreasing participation

Source: Kickbusch, 2011

Governing through:

collaboration

citizen engagement

a mix of regulation andpersuasion

independent agencies andexpert bodies

adaptive policies, resilient

structures and foresight



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Health 2020:Towards a healthier Europe


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FfW 2012 Summit_Bertollini

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