Day 2 highlights: focus continues on intersectoral action

Panel discussions on the second day of the 65th session of the Regional Committee (RC65) focused on the need to work across sectors to address the health challenges of today's interconnected world. The WHO Director-General called on Member States to pay particular attention to how corporate interests influence health policy-making, asking, "Who really governs the policies that shape our health?"

Address by Dr Margaret Chan, WHO Director-General

The Director-General began by noting the "spectacular results" of the Millennium Development Goals on reducing child mortality and improving maternal health, and explained that the Sustainable Development Goals (SDGs) would maintain the momentum for better health. She warned, however, that today's health threats are larger and more complex than those 15 years ago, and fully agreed with the statement of Dr Zsuzsanna Jakab, WHO Regional Director for Europe, on the health needs of refugees and migrants, issued on 2 September.

Reviewing examples of new health challenges, Dr Chan asked whether countries could legislate and act to promote and protect the health of their citizens: "Protecting our children from the marketing of unhealthy foods and beverages is harder than protecting our children from vaccine-preventable diseases. … All of these newer efforts face fierce opposition from powerful economic operators and their equally powerful lobbies." She asked representatives, "Who really governs the policies that shape our health?"

In response, many speakers emphasized the importance of accelerating reform to improve WHO's ability to respond to the health aspects of crises, brought into sharp focus by the Ebola outbreak in West Africa.

The Director-General concluded by cautioning that WHO has to use guidance from Member States to prioritize its actions in order to be effective, and noted that the rising number of crises need political solutions, which humanitarian responses could not replace.

Report of the Twenty-second Standing Committee of the Regional Committee (SCRC)

Ms Taru Koivisto, SCRC Chairperson and Executive President of RC65, reported that the SCRC's 5 regular sessions in 2014–2015 focused on preparing for RC65. A subgroup on the implementation of Health 2020 discussed the need to define intersectoral action, and the importance of including national examples of good practice. A subgroup on governance sought ways to improve the participation of nongovernmental organizations (NGOs) in RC sessions, and proposed four criteria for the submission of conference declarations to the RC for endorsement.

The European health report 2015

Dr Claudia Stein, Director of WHO/Europe's Division of Information, Evidence, Research and Innovation, explained the focus and key findings of the report: WHO/Europe's flagship publication, which will be launched on 23 September 2015. It shows that, although the WHO European Region has made progress towards the six targets of the European policy framework, Health 2020, much potential remains for further gains in health and reductions in inequalities. New forms of evidence are needed to report meaningfully on well-being in Europe. In addition, WHO/Europe developed an app for WHO European health statistics, to improve access to and filter data.

Member States welcomed the report, and speakers emphasized the importance of considering the cultural contexts of health and the good work of the European Health Information Initiative.

Promoting intersectoral and interagency action for health and well-being

The Regional Director introduced the issue of intersectoral action, the focus of a series of ministerial panels and discussions for the remainder of day 2. Although a complex and challenging area of policy development and practice, it is key to ensuring the achievement of the Health 2020 targets. The adoption of the SDGs would re-emphasize intersectoral action and challenge all countries to adopt new approaches to governance.

Progress in the European environment and health process

"We are increasingly aware that there is no alternative to an intersectoral approach if the ambitious goals of Health 2020 are to be realized," said the Regional Director during the session on the flagship role of the environment and health process in intersectoral action.

Representatives confirmed the need to continue working across sectors to implement Health 2020 and tackle death and disease due to environmental hazards. As health goes beyond the borders of the health sector, the whole of government needs to be committed to it, including at the local level.

Member States called for stronger action on priority topics such as air pollution, chemicals and climate change. They recommended that preparations for the Sixth Ministerial Conference on Environment and Health focus on a few, clear and measurable targets, to strengthen engagement.

Panel discussions on health in sustainable development and foreign policy, social determinants and health, and health literacy

Ministers and high-level representatives from Andorra, Belarus, France, Germany, Hungary, Portugal, San Marino, Slovakia, Sweden and Switzerland, with a wide range of experience, shared their experiences and recommendations in panel discussions.

Moderating the discussion on health in sustainable development and foreign policy, Professor Ilona Kickbusch, of the Graduate Institute of International and Development Studies in Switzerland, described the close relationship between foreign policy and health in relation to migrant and wartime crises, trade, health security and science diplomacy.

Emergent themes in the discussion included the need for a more global approach to addressing global and national health challenges, and the interrelation of health and well-being with economic prosperity. National strategies for health are critical to ensure that health remains high on the political agenda. The panel discussed the importance of interaction and the sharing of experience and best practices for developing tailored processes in countries.

In a video address, Sir Michael Marmot, of the United Kingdom, chair of the review of social determinants of health in the WHO European Region, underlined that: "health and health equity are a 'social accountant', telling us how we are doing in achieving the society we want."

The panel discussion moderated by Dr Walter Ricciardi, Catholic University of the Sacred Heart, Italy, focused on the social determinants of health and health literacy, highlighting links and policy coherence with the education and social sectors. Panellists emphasized the importance of a life-course approach to tackling social determinants, starting early and using settings such as schools to promote healthy behaviour. Good examples of intersectoral action at a local or municipal level included city planners making urban areas more inclusive, and recruiting influential people in the community to promote health.

Health 2020 implementation: Lithuanian experience and achievements

At a lunchtime ministerial briefing, Mrs Rimantė Šalaševičiūtė, Minister of Health, described the implementation of Lithuania's Health Programme 2014–2025 and gave examples of intersectoral action by the health and education ministries, and the transport, health and environment ministries. Ministers saw a video, "Acting together for health and well-being in Lithuania".

Technical briefing: sustainable health workforce

Professor James Buchan, Associate at the European Observatory on Health Systems and Policies, explained that the briefing would promote debate on how to achieve and maintain a sustainable health workforce in Member States and the Region, to support stronger, people-centred health systems. Four panellists described what health-workforce sustainability means to them, and how governments should balance the need to retain health workers educated in their countries with citizens' right to free movement.

World No Tobacco Day Award to Minister of Health of Albania

The WHO Director-General and the Regional Director for Europe presented Mr Ilir Beqaj with the Award in honour of his work on tobacco control. He received 1 of the 6 awards given in the European Region in 2015. Dr Jakab praised Mr Beqaj for "putting people's health and society's future first".

Grant agreement on tuberculosis between the Global Fund to Fight AIDS, Tuberculosis and Malaria and 11 Member States

11 eastern European and central Asian countries and the Global Fund signed a new grant agreement, worth US$ 6 million. The three-year agreement aims to promote tuberculosis (TB) control by building stronger health systems, developing up-to-date models and sustainable financing for patient-centred TB care, and advocating best practice in the Region.

Highlights of day 3

• Physical activity strategy for the WHO European Region 2016–2025
• Roadmap on tobacco control in the WHO European Region 2015–2025
• Priorities for health-systems strengthening 2015–2020
• Proposed tuberculosis action plan for the WHO European Region 2016–2020