Presentation delivered by Dr Zsuzsanna Jakab, WHO Regional Director for Europe (Positioning the Veneto Region at the core of global and European health policies, 3-4 December 2015, Scuola San Giovanni Evangelista, Venice, Italy)

1. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Health 2020 and the
post-2015
development agenda
Positioning the Veneto Region
at the core of global and European health policies
3-4 December 2015,
Scuola San Giovanni Evangelista
Venice, Italy
Dr Zsuzsanna Jakab
WHO Regional Director for Europe

2. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015

3. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Life expectancy trends
Life expectancy at birth (years), males Life expectancy at birth (years), females
70
75
80
85
1980 1990 2000 2010 1980 1990 2000 2010
European Region EU15 Italy
Source: WHO Europe: European Health for All database

4. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Proportion of the population
aged ≥ 65 and birth rate
% of population aged 65+ years Live births per 1000 population
8
12
16
20
1980 1990 2000 2010 1980 1990 2000 2010
European Region EU15 Italy
Source: WHO Europe: European Health for All database

5. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Mortality by broad cause, all
ages
SDR, Infectious and parasitic
diseases, per 100000
SDR, Neoplasms, per 100000
SDR, Diseases of the circulatory
system, per 100000
SDR, Diseases of the respiratory
system, per 100000
SDR, Diseases of the digestive
system, per 100000
SDR, External causes of injury and
poisoning, per 100000
5
10
15
20
160
200
240
100
200
300
400
500
50
100
150
20
30
40
50
60
20
40
60
80
1980 1990 2000 2010 1980 1990 2000 2010 1980 1990 2000 2010
1980 1990 2000 2010 1980 1990 2000 2010 1980 1990 2000 2010
European Region EU15 Italy
Source: WHO Europe: Mortality indicator database.

6. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Premature mortality
(0–64 years), by broad cause
SDR(0-64), Infectious and parasitic
diseases, per 100000
SDR(0-64), Neoplasms, per 100000
SDR(0-64), Diseases of the
circulatory system, per 100000
SDR(0-64), Diseases of the
respiratory system, per 100000
SDR(0-64), Diseases of the digestive
system, per 100000
SDR(0-64), External causes of injury
and poisoning, per 100000
5
10
15
60
80
100
50
100
10
20
30
10
20
30
25
50
75
1980 1990 2000 2010 1980 1990 2000 2010 1980 1990 2000 2010
1980 1990 2000 2010 1980 1990 2000 2010 1980 1990 2000 2010
European Region EU15 Italy
Source: WHO Europe: Mortality indicator database.

7. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Maximum
value
Regional
average
Minimum
value
Inequalities in life expectancy:
declining, but gaps persist

8. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Maximum
value
Regional
average
Minimum
value
Inequalities in life expectancy:
declining, but gaps persist

9. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Interactive atlases of
regional health
• The WHO Regional Office for Europe, jointly with the
European Commission, has prepared interactive atlases
of health inequalities at regional level for European
Union countries.
• The atlases facilitate exploratory analysis of health
status and inequalities at regional level.
• Freely available from http://data.euro.who.int/equity.

10. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Example: brief overview of the
health situation in the Veneto

11. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Example: disposable income and life expectancy
in the Veneto and the European Union

12. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Improve health for all and
reduce the health divide
Improve leadership and
participatory governance for
health
Invest in health
throughout the
life-course, and
empower people
Tackle Europe’s
major health
challenges:
noncommunicable
and communicable
diseases
Strengthen
people-centred
health systems,
public health
capacity and
emergency
preparedness,
surveillance and
response
Create resilient
communities and
supportive
environments
Health 2020: four common policy priorities for health
Health 2020: strategic objectives

13. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Health is central to development

14. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Transforming our world:
the 2030 agenda for sustainable
development

15. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Sustainable development goals
Sustainable Development Goals
matter to us

16. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Sustainable development goals
Universal health coverage
in every country of the world

17. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Regional consultation
On the post-2015 development agenda

18. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Health goal
Goal 3:
Ensure healthy
lives and
promote well-
being for all at
all ages
3.1
Reduce
maternal
mortality
3.2 End
preventable
diseases
3.3 End
epidemics
of AIDS,
TB, etc.
3.4
Mortality
for NCDs
3.5
Substance
abuse
3.6 Road
traffic
accidents
3.7 Access to
sexual and
reproductive
health
3.8
Universal
health
coverage
3.9
Hazardous
chemicals
& pollution
Health as a target in
other goals

19. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Health targets will be met only by joining
policy action to that for other SDGs
Example: The health target to reduce premature
mortality from NCDs will have to be implemented in
partnership with sectors and policies responsible for
education (SDG4) and economic growth and
employment (SDG8).

20. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
The health goal will contribute to
meeting other goals
Example: Health target 3.8 on achieving universal
health care will directly contribute to attaining SDGs for
poverty reduction (SDG1), reducing inequalities within
and between countries (SDG10) and ensuring inclusive,
safe, resilient cities (SDG 11).

21. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Health and well-being in
each and every goal

22. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Transforming our world:
the 2030 agenda for sustainable
development

23. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
RENEWED POLICY ENVIRONMENT
FRAMED BY
HEALTH

24. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Intersectoral action: elements for success

25. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
National and regional prevention
plans and Health 2020
• Reducing health inequities
• Intersectorality
• Improving governance
• Focus on health promotion
• Health as a tool for
development
• Strengthening coherence
• Evidence-based interventions
• Strict evaluation of all steps
• Equity lens
• Life-course approach
• Health in all policies

26. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
 Health interests all
 Hinge for social cohesion: more cohesive society = healthier
society
 Democratic tool that favours democracy
 Catalyser of involvement of civil society
 Help individuals to become better citizens
 Improve “ownership” and empowerment of people for their health
 Increase health literacy
 Positive externalization towards sectors other than health
 Favour integration and alliances for common goals
Participatory approaches in
prevention plans

27. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Viral hepatitis is inadequately
addressed throughout the
WHO European Region
• 13 million people (estimated)
live with chronic hepatitis B
• 15 million people (estimated)
live with chronic hepatitis C
• 400 deaths related to viral
hepatitis a day

28. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Viral hepatitis – a silent killer

29. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Re-emergence of polio: strong
reminder to maintain commitments
Polio: poliomyelitis

30. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Translating
commitment into action
Goal 1. Sustain polio-free status
Goal 2. Eliminate measles and
rubella
Goal 3. Control hepatitis B infection
Goal 4. Meet regional vaccination cover targets
Goal 5. Make evidence-based decisions
Goal 6. Achieve financial sustainability

31. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Measles in the WHO European Region,
1993 and 2007–2014
91687075 7892
30604 33268 26786 32174
341982
16159
98% REDUCTION

32. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015

33. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Vaccine-preventable diseases
Challenges:
• High national level coverage with vaccines masks subnational pockets
of susceptibility.
• Low commitment in some Member States to close immunity gaps
among adolescents and adults, refugees, migrants, religious groups
• Poor response to measles and rubella outbreaks
• Mass vaccination campaigns not accepted in many countries
• Suboptimal vaccine demand
• Polio outbreak in Ukraine and influx of refugees and migrants
• High diphtheria and pertussis deaths in the Region in 2015
• Italy: neither rubella nor measles has been interrupted, and vaccine
hesitancy in the general population and the health care community is
a growing concern.

34. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Vaccine-preventable diseases
Achievements:
• High coverage with routine vaccines
• Many new vaccines introduced across the Region (HPV,
rotavirus, pneumococcus).
• Polio-free status enjoyed since 2002
• Interrupted endemic transmission of measles (22
Member States) and rubella (23 Member States): fewer
cases of measles and rubella in 2015 than in the 5
preceding years

35. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Numbers of reported measles cases in
Italy, 2003–2014
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
No. reported 10998 678 215 581 410 1619 173 864 1968 605 2256 1687
0
2000
4000
6000
8000
10000
12000
No.ofreportedmeaslescases
Source: World Health Organization Regional Office for Europe. Centralized
Information System for Infectious Diseases (CISID) Copenhagen, WHO Regional
Office for Europe. Available at: data.euro.who.int/cisid/ (accessed October 18, 201

36. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
6.1
85.5
6.2
19.9
27.7
34.2
41.3
31.3 30.5
20.2
0
10
20
30
40
50
60
70
80
90
2010 2011 2012 2013 2014
Italy European Region Source: World Health Organization Regional Office for Europe. Centralized Information
System for Infectious Diseases (CISID) Copenhagen, WHO Regional Office for Europe.
Available at: data.euro.who.int/cisid/ (accessed October 18, 2015).
Measles incidence per 1 million population,
Italy and the WHO European Region,
2010–2014

37. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
A European Region free of vaccine-preventable
diseases, where all countries provide equitable
access to high-quality, safe, affordable vaccines
and immunization services throughout the life-course

38. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Prevention and control of
noncommunicable diseases (NCDs)
Photo: iStockphoto

39. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Age-standardized estimates of prevalence of
overweight and obesity, adults ≥ 18 years, 2014
Source: Global status report on noncommunicable diseases 2014

40. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
FCTC : WHO Framework
Convention on Tobacco Control

41. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Smoking prevalence
% of regular daily smokers in the population, age 15+
10
20
30
40
1980 1990 2000 2010
European Region EU15 Italy
Source: WHO Europe: European Health for All database

42. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Age-standardized estimates of prevalence of current
smoking of any tobacco product among adults, 2012
Source: Global status report on noncommunicable diseases 2014

43. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Roadmap towards
implementation of the WHO
FCTC

44. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Investing in health through a
life-course approach:
key strategic direction for Health 2020
Photo: iStock

45. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Ministerial
Conference 21–22
October 2015.
Minsk, Belarus
A life-course approach increases
the effectiveness of interventions,
promoting timely investments with
a high rate of return for public
health and the economy.

46. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
0 20 40 60
80 Health “gains” and “losses” are passed on to the next generation
Health and well-being accumulate
over a lifetime
Photo: shutterstock.com

47. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Strengthening
people-centred
health systems and
public health capacity

48. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
New vision for health systems strengthening
involves people

49. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
The way forward: coordinated, integrated health
service delivery for people-centred care
© InfoGyor

50. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Photo: Sara Barragán Montes
Migration and health: high on the agenda

51. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Public health
policies for
access of
refugees and
migrants to
health and well-
being
Photo: WHO/Santino Severoni

52. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Supporting countries on refugee and migrant
health policies

53. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
High-level meeting on refugee
and migrant health
23–24 November 2015, Rome, Italy

54. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
High-level meeting on refugee
and migrant health
23-24 November 2015, Rome, Italy Protect and promote the health and well-being of refugees and migrants
and of the host population, in accordance with the principles of
population health and human rights.
 Integrate the needs of refugees and migrants into existing health
structures, and strengthen the preparedness of health systems.
 Reinforce data collection on refugee and migrant health and make it
available to other countries as individuals move.
 Demystify the perception that refugees and migrants bring communicable
diseases; they do not pose a greater risk than other international
travellers.
 Direct efforts to the most vulnerable groups, e.g. children, women, older
people and those in need of mental health care.
 Ensure the continuity and quality of care.

55. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Photo: WHO/Sara Barragán Montes
Response to the conflict in the Syrian Arab
Republic

56. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Response to the conflict in the Syrian Arab
Republic
Photo: WHO/Nedret Emiroglu

57. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Response to the humanitarian
crisis in Ukraine
Photos WHO/Alex Glyadyelov

58. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Photos WHO/Alex Glyadyelov
Response to the humanitarian
crisis in Ukraine

59. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Health expenditure
Total health expenditure as % of GDP, WHO estimates
Public-sector expenditure on health as % of total
government expenditure, WHO estimates
5
10
15
20
1995 2000 2005 2010 1995 2000 2005 2010
European Region EU15 Italy
Source: WHO Europe: European Health for All database.

60. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Public sector and out-of-
pocket health expenditure
Public-sector health expenditure as % of total health
expenditure, WHO estimates
Private households' out-of-pocket payments on health as %
of total health expenditure
25
50
75
1995 2000 2005 2010 1995 2000 2005 2010
European Region EU15 Italy
Source: WHO Europe: European Health for All database.

61. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Public health care spending as a
percentage of total health care
spending, Italian regions, 2007
Total health care spending in the
Italian regions as a percentage of
GDP, 2007
Source: HiT Veneto Region, Italy. 2012. European Observatory on Health
Services and policies

62. Positioning the Veneto Region at the core
of Global and European health policies
Venice, Italy, 3-4 December 2015
Out-of-pocket health spending by families as a
percentage of total health spending, Italian regions,
2001 and 2007
Source: HiT Veneto Region, Italy. 2012. European Observatory on Health
Services and policies