Day 4 highlights: RC65 adopts new tuberculosis action plan and closes

Highlights of the final day of the 65th session of the WHO Regional Committee for Europe (RC65) included adoption of the action plan, agreement on closer cooperation between WHO/Europe and the European Commission and a description of countries' experience in addressing the migration crisis in Europe.

Tuberculosis action plan for WHO European Region 2016–2020

Implementing the consolidated action plan to prevent and combat multidrug- and extensively drug-resistant tuberculosis (M/XDR TB) in the WHO European Region since 2011, Member States have made several major achievements in prevention, control and care. More than 1 million TB patients have been cured, including 53 000 with MDR-TB. Key challenges remain, especially due to ongoing primary transmission, increasing resistance of strains and deadly TB and HIV co-infections. The expected effects of the new action plan for 2016–2020 include curing 1.4 million TB patients, preventing 1.7 million new cases and saving US$ 48 billion.

Dr Masoud Dara, Programme Manager, TB and M/XDR-TB Control at WHO/Europe, underlined that there is no room for complacency in the fight against TB, and that it was important to address the disease recognizing its co-morbidities: tobacco, alcohol and HIV.

RC65 adopted the TB action plan for the WHO European Region 2016–2020. Representatives of Member States emphasized the importance of stronger collaboration, working across borders, involving all stakeholders in a common response for the Region. Several emphasized the need to focus particularly on ensuring access to prevention, treatment and care for vulnerable groups, including people with HIV.

Representatives of nongovernmental organizations (NGOs) underlined their role as the link between the medical and social responses to TB, and welcomed collaboration with governments and other partners to maximize the results achieved.

Implementing the programme budget 2016–2017

Mr Imre Hollo, Director of the Division of Administration and Finance at WHO/Europe, introduced plans for implementing WHO's programme budget for 2016–2017. These plans were realistic and based on a solid foundation of bottom-up planning, with adjustments to reflect global priorities. The budget will continue the priorities from the previous one, guided by Health 2020, in line with global priority setting and building on lessons learned, such as those from the Ebola response.

Specific technical focus areas will include scaling up work on antimicrobial resistance, hepatitis and noncommunicable diseases (NCDs); strengthening health systems; building institutional capacity in emergency risk and crisis management; and strengthening WHO's country presence.

A contract between WHO/Europe and Member States will measure the achievements made. It will set out outcomes and outcome indicators that are either the joint responsibility Member States and WHO or the managerial responsibility of WHO.

Many representatives praised the transparency and improvement of WHO/Europe's budget planning, calling the report on implementation of the 2014–2015 budget helpful and insightful.

Some speakers asked what implications the planned increase in investment in country offices will have for countries with no country presence, how the factors contributing to the implementation lag will be addressed and what impact the budget increase for 2016–2017 will have on staff planning.

Dr Zsuzsanna Jakab, WHO Regional Director for Europe, assured RC65 that WHO/Europe's business plan has not changed, and work with countries where WHO does not have an office will remain a priority. Implementation of the current budget is speeding up, but with caution, to deliver what was planned. Mr Hollo explained that WHO headquarters will distribute the first tranche of corporate funding for 2016–2017 earlier than in previous biennia, to improve implementation from the start. Staff planning will continue to focus on building capacity in technical areas, to best meet the needs of Member States.

World Health Assembly and Executive Board decisions

As the WHO Executive Board member liaising with the Standing Committee of the Regional Committee, Ms Svetlana Axelrod, of the Russian Federation, summarized a number of resolutions of the Sixty-eighth World Health Assembly that are relevant to the European Region – including those on the global strategies for the elimination of malaria and poliomyelitis and antimicrobial resistance – and appealed to WHO/Europe and European countries to ensure their implementation.

Dr Gottfried Hirnschall, Director of the Department of HIV/AIDS at WHO headquarters, discussed the development of global health-sector strategies for HIV, viral hepatitis and sexually transmitted infections (STIs) for 2016–2021, and ways to engage Members States and stakeholders. The goal is to end the AIDS epidemic by 2030 and eliminate viral hepatitis and STIs as public health threats. An NGO representative called for a European action plan on viral hepatitis.

Dr Florence Fuchs, from WHO headquarters, detailed key recommendations by the 2014 review committee for the International Health Regulations (IHR), calling on Member States to strengthen the current IHR self-assessment system, and make in-depth reviews of significant disease outbreaks. Discussing the IHR, representatives of Member States referred to the Ebola emergency and the current migration crisis. A speaker from Italy expressed the Government's willingness to host a conference on migration and health later in 2015.

Dr James Campbell, from WHO headquarters, explained how the global strategies on people-centred and integrated health services and on human resources for health were developed. He thanked European Member States for their active participation, and invited further guidance and suggestions.

Technical briefing on migration and health

Many representatives of Member States and NGOs attended the briefing, in which panellists from Albania, Germany, Hungary, Spain and Turkey described their countries' perspectives. The following key issues were raised.

• Terminology defining migrants and refugees is important in referring to the diverse group they comprise.
• As Europe is ageing, migration can be seen as an opportunity for economic growth.
• Using the example of Turkey, authorities can manage the challenges of migration if they are well prepared.
• Good, evidence-based communication with resident populations is essential.
• Small countries face special challenges in dealing with huge influxes of people and it is necessary to ensure solidarity with them.
• Where policies are aligned with Health 2020 and effectively implemented, countries are well equipped to tackle the challenges of large influxes of refugees and migrants.

Address by Dr Vytenis Andriukaitis, European Commissioner for Health and Food Safety

Welcoming the Commissioner, the Regional Director explained that they have agreed to expand and consolidate the collaboration between the European Commission and WHO/Europe launched by the 2010 joint declaration. This covers six key areas: innovation and health, health security, modernization and integration of the public health information system, health inequalities, health-system strengthening and chronic diseases.

Progress reports

Five progress reports were presented to RC65. First, the implementation of the consolidated action plan on M/XDR-TB (2011–2015) included scaling up testing, access to treatment, surveillance and meeting the needs of special populations.

The second report examined progress towards the health-related Millennium Development Goals: reducing child mortality, improving maternal health, combating infectious disease, improving access to safe drinking-water and basic sanitation, and providing access to affordable essential drugs.
Third, a report on progress on behaviour-change strategies and health covered intersectoral action, the life-course approach, mental health, nutrition, tobacco control and harmful alcohol use.

The fourth report, on the IHR, highlighted evaluating and building capacity, high-level political ownership, awareness and advocacy.
The fifth report covered stewardship and governance of health systems in the WHO European Region.

Dates and places of future RCs

• RC66 will take place in Copenhagen, Denmark on 12–15 September 2016.
• RC67 will take place in Budapest, Hungary in September 2017.

Closure of RC65

The Regional Director thanked representatives for the rich and fruitful discussions and important decisions of RC65, and looked forward to meeting them at RC66.