Day 4 highlights: Regional Director thanks “the strongest minds and warmest hearts in public health”

On the fourth and final day of the 69th session of the WHO Regional Committee for Europe (RC69), Member States adopted a resolution on promoting health literacy that seeks to help people make informed health decisions. Dr Zsuzsanna Jakab also expressed her deep thanks to delegates and staff for their commitment to public health during her 10-year mandate as WHO Regional Director for Europe.

Matters arising from resolutions and decisions of the World Health Assembly and the Executive Board

Ms Outi Kuivasniemi, Deputy Director for International Affairs at the Ministry of Social Affairs and Health of Finland, in her function as liaison with the Standing Committee of the Regional Committee, briefed the Committee on technical resolutions adopted by the World Health Assembly.

Many delegates commented on the issue of transparency in medicine markets, and the importance of ensuring that products meet the needs of the population. High – sometimes inaccessibly high – medicine prices threaten our health systems and universal health coverage, said the delegate of Norway. He noted that this represents a democratic problem, and stated: “The resolution could therefore prove to be a game changer.”

Delegates expressed their support for the draft global strategy to accelerate cervical cancer elimination. They agreed on the vital importance of the human papillomavirus vaccine and the need to start vaccinating girls at an early age.

Regarding tuberculosis (TB), delegates stressed the need for effective preventive strategies, and the importance of targeting vulnerable groups and adopting innovative approaches with digital health technologies. Dr Masoud Dara, Acting Director of Communicable Diseases at WHO/Europe, underlined the linkage to social determinants and highlighted the threat of latent TB.

Delegates noted that the document on digital health does not mention health-care providers and the means of implementation, and that it should focus on interoperability and health data governance. They requested that the Secretariat revisit the document. Other comments emphasized the need to safeguard personal data, improve policy insight and better address the needs of health providers.

Regarding healthy ageing, delegates suggested that WHO should:

  • focus on ageing in the health sector itself;
  • involve other key players;
  • take social determinants and gender-specific aspects of healthy ageing into account;
  • seek to keep older people in the labour market for longer; and
  • place more emphasis on lifelong learning.

Promoting health literacy in the WHO European Region

Member States adopted a resolution on the implementation of health literacy initiatives throughout the life course. Civil society bodies and professional and international organizations also welcomed this initiative. By providing guidance on the practical means of promoting health literacy, it aims to strengthen Member States’ and WHO/Europe’s work to promote healthy behaviours and ensure health equity.

Health literacy deeply affects people’s abilities to make informed health decisions, develop health-related digital competencies, and access and navigate health systems. It is important that services, organizations and systems develop health literacy responsiveness to make health information and resources available and accessible according to the needs of the population.

Several Member States spoke about national efforts to implement health literacy initiatives. They stressed that the resolution will be a key driver for reducing social inequality in health, ensuring that no one is left behind, and providing everyone with access to high-quality health information from reliable sources.

To provide an example of health literacy in action, the session opened with a short film featuring Ms Noorihe Halimi, who works for the Swedish Association for Sexual Education (RFSU). She teaches migrants about their bodies, their rights and the state health-care system, ultimately empowering some of the most vulnerable people to make positive choices about their health.

Accreditation of regional non-State actors

Seven additional regional non-State actors were accredited to the Regional Committee, bringing the total number to 26. These organizations are: AFEW International, AGE Platform Europe, AIDS Healthcare Foundation Europe, the European Federation of Nurses Associations, the European Patients’ Forum, the European Respiratory Society, and the Norwegian Cancer Society.

This accreditation allows representatives of these organizations to attend Regional Committee sessions and submit written and/or oral statements. Applications are open for accreditation in 2020.

Progress reports on action plans and the roadmap to implement the 2030 Agenda

This agenda item measured progress on the implementation of action plans for HIV, hepatitis, and sexual and reproductive health. While countries across the Region report progress, WHO and Member States assessed that it remains insufficient to reach the targets.

A reduction in mother-to-child transmission of HIV and improvements in country validation are among the main successes in this area. However, the number of new HIV cases has grown in the last decade. Only a few countries are on track to achieving the 90–90–90 targets, while most are stalling and many record a growing epidemic. A focus on prevention, early detection, integrated treatment and stigma reduction were identified as effective ways to improve the situation.

For hepatitis, the number of countries with action plans has almost tripled since 2013. A growing number are implementing universal newborn and childhood hepatitis B vaccination programmes, and access to treatment for hepatitis C has increased overall in the Region. Nevertheless, more attention should be devoted to the most vulnerable populations.

A 2018 survey confirmed that reproductive health and maternal and newborn health are priority areas addressed in national strategic documents in 94% of reporting countries. Despite improvements in sexual and reproductive health across the Region, however, great inequalities persist between and within Member States. The evidence to date suggests that universal access to sexual and reproductive health is an unfinished agenda for the Region and challenges the attainment of several Sustainable Development Goals (SDGs).

The session also looked at progress on the roadmap to implement the 2030 Agenda for Sustainable Development. Good progress has been made in some areas, including increasing life expectancy, decreasing maternal and child mortality, improving emergency preparedness capacity, and eliminating poliomyelitis and malaria.

Yet interventions must be significantly scaled up if the Region is to reach a number of the health-related SDG targets by 2030. In particular, Member States and partners pointed to closing gaps on TB and HIV, addressing the threat of antimicrobial resistance, protecting people from mental disorders, supporting healthy ageing, and ensuring equity in access to health services.

To date, 43 countries have developed national reviews of SDGs and all are progressing on different priorities. Many have appointed SDG focal points, but reporting on health needs to be more integrated with interlinked areas. The roadmap to implement the 2030 Agenda is a critical tool for implementing WHO’s 13th General Programme of Work and accelerating the implementation of the SDGs.

Dates and places of future Regional Committee sessions

  • RC70 will take place in Tel Aviv, Israel, on 14–17 September 2020.
  • RC71 will take place in Copenhagen, Denmark, on 13–16 September 2021.
  • RC72 will be held on 12–15 September 2022.

Closure of RC69

Speaking on behalf of all Member States, the delegate of Austria thanked all those present for a successful Regional Committee session, which “showcased how important multilateral work is for us”. He added his thanks to the Regional Director “for what you have achieved for us, for your leadership and unmatched charm”.

In her concluding remarks at her last Regional Committee session as WHO Regional Director for Europe, Dr Jakab thanked delegates and staff alike: “I have been privileged to work alongside you – the strongest minds and warmest hearts in public health. I am grateful for the opportunity afforded me to serve the people of this Region and steer the direction of this remarkable Regional Office and its staff.”

Side event: Online data platform to tackle health workforce challenges

At a morning side event, WHO experts introduced the online data platform National Health Workforce Accounts, which enables countries to record, analyse and visualize health workforce information for their use.

The tool helps in planning and shaping health workforce policy, assessing implemented policies and reorienting existing policies. It supports health workforce policy-makers to find solutions to issues they often face, such as providing education to equip health workers to deliver effective care, attracting and retaining health-care professionals, and enabling multidisciplinary teams for primary care.

A WHO resource pack to assist policy-makers in navigating and using the National Health Workforce Accounts platform, available online, was launched at the side event.

Technical briefing: Children’s and adolescents’ health in the WHO European Region

The message of this technical briefing was clear: although great progress has been made, severe inequities persist and children suffer from preventable health issues on a large scale. Policy-makers must abandon the misconception that the health and well-being of children and adolescents need no longer be a priority in Europe.

The session illustrated the need for action by policy-makers with examples of areas where children’s health is impacted severely, from oral health and road safety to consumption of alcohol during pregnancy and lack of access to health services.

The briefing included the launch of a new initiative for children’s and adolescents’ health, which will invite all relevant sectors to contribute to making the Region the best place for children to grow up.

Country collaboration strategy signed between WHO and Israel

On Monday, Deputy Minister of Health of Israel M.K. Yakov Litzman, Regional Director Dr Zsuzsanna Jakab and WHO Director-General Dr Tedros Adhanom Ghebreyesus signed a country collaboration strategy. It outlines collaboration between WHO and Israel for 2019–2025 in the following areas:

  • using digital health innovation as a tool for increasing the accessibility and quality of medical services;
  • improving quality of life throughout the life course with a focus on noncommunicable and communicable diseases, personalized medicine, and genomics;
  • advancing emergency preparedness and response; and
  • strengthening the role of Israel in global health.

Meeting of national counterparts

National Counterparts gathered for their regular meeting at the Regional Committee session to discuss with WHO Representatives and Heads of WHO country offices WHO’s work at country level. Key points raised included the capacities available and needed in WHO offices to implement GPW13; and how interactions and collaboration with Member States would change, including with countries without a WHO presence.