Health 2020 midterm progress report 2012-2016
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Presented by Piroska Östlin, Director and Åsa Nihlén, Technical Officer, Division of Policy and Governance for Health and Well-being, WHO/Europe, at the 66th session of the WHO Regional Committee for Europe.
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Health 2020 midterm progress report 2012-2016
- 1. Piroska Östlin, Director Åsa Nihlén, Technical Officer Policy and Governance for Health and Well-being Health 2020 midterm progress report 2012-2016
- 2. Regional Office support for health policies 2
- 4. Coherence in our work through Health 2020 4
- 5. National health policies Start 5 Situation analysis 4 Process 8 Planning 8 22 Implementation Monitoring and evaluation 6 Member State progress on Health 2020 (and 2030 Agenda for Sustainable Development) Number of Member States in each phase Regional Office support for national health plan development 5
- 6. Updated evidence base, raising awareness and partnerships 6 Photo: IISD/ENB
- 7. Division of Policy and Governance for Health and Well-being 7
- 8. Working towards 2020 and beyond 8
- 9. Advancing the public health agenda 9
Editor's Notes
- Ladies and gentlemen I am delighted to be able to offer you a mid-term report on progress towards the implementation of Health 2020, during the period 2012 until 2016. We launched both H2020 and the Public Health Action Plan together in 2012. This was intentional as the two are very closely related. Health 2020 is our overarching policy framework to bring coherence into the work of the Regional Office, aiming to promote health, equity, human rights, gender, and to address the “upstream” determinants of health through intersectoral action at Regional and national levels. It is a public health policy. Our aim with the European Public Health Action Plan was to support Health 2020 as a “main implementing pillar” by building public health operations into the health system and by extending public health capacities and services.
- Since 2012, The Regional Office has supported the implementation of Health 2020 both conceptually and through collaborative work with Member States. The slide shows the “package” of Health 2020 related products and services which we introduced onto our website and which we have worked with Member States to achieve. Our aim has been to promote regional, national and subnational health policy development, and good governance for health, and helping Member States to develop and implement Health 2020 inspired national health policies, strategies and plans. Mechanisms of our assistance have included analyzing public health situations and policy gaps; identifying assets; encouraging political commitment from Heads of State; organizing policy dialogues and making policy recommendations and monitoring progress; and encouraging leadership and good governance for health. We have also helped countries to identify common interests and pursue joint goals with other sectors; develop frameworks that address upstream determinants of health and health equity; strengthen health and health information systems; and foster implementation of whole-of-society and whole-of-government approaches. The report on Health 2020 implementation for 2012-2016 submitted to this Regional Committee includes a detailed summary description of the last 4 years work, highlighting the progress made, as well as some future developments. This presentation will provide some highlights from this report.
- Promoting health and reducing health inequities is at the heart of Health 2020 implementation. The Health 2020 progress report considers the general uptake of the Health 2020 policy framework in the European Region. The monitoring of the Health 2020 targets and indicators shows that, since 2012, Member States are on track to increase life expectancy and reduce health inequities and premature mortality, but that still, despite these favorable trends, absolute differences between countries remain substantial. Some progress in inequities: gaps between the highest and lowest reported values for the Health 2020 indicators linked to the social determinants of health – such as primary school enrolment and unemployment – have shrunk, although absolute differences between countries remain large. Reducing health inequities remain the greatest challenge of Health 2020 but overall the progress indicates that the adopted strategies work.
- Since the adoption of Health 2020, all WHO European strategies, action plans, ministerial conferences and other high-level meetings have been aligned with the policy framework and have served as important vehicles for moving the Health 2020 agenda forward in the European Region. Some examples are included on this slide.
- Overarching national health policies are in different stages of development and implementation in over 70 % of the Member States of the Region. Since 2012, the Regional Office has supported 25 Member States in developing their national health policies, with support ranging from expert advice and advocacy to policy cycle facilitation. This support is ongoing and continuing. At the subnational level, the Regional Office has supported the development and implementation of subnational policies aligned with Health 2020 through the Regions for Health Network and the WHO Healthy Cities Network. In addition Health 2020 has served as a vehicle for broad social movements inspiring National Health Policies and mobilizing many sectors and organizations to work together. It has strengthened partnerships of regions, cities, schools, worksites, institutions and professionals, NGOs and other organizations for health and wellbeing. We will continue to work on developing tools and instruments in supporting national health policies and national policies for health in development, implementation and review responding to Member States’ needs and requests. Recently published guidance in this area include the task group reports of the European Review of social determinants and the health divide, on economics and health inequalities, social protection and income, and measurements and targets. We have also published a HEN report on “Evidence on financing and budgeting mechanisms to support intersectoral actions between health, education, social welfare sectors”, and two editions of the Public Health Panorama focusing on promoting intersectoral action. The WHO/OECD/OBS study on economics of prevention was also launched last year. Upcoming guidance will include an assessment package for national health policies, including a multi-country study on developing national health policies in Europe; a national health policy assessment tool (check list); a tool to support policy makers to increase cross sectoral investments for health equity within the context of implementing national SDGs plans; and a forthcoming book together with the European Observatory on “Working with Society: functions, action and tools for implementing the whole-of-society approach.” Extra info MS supported for NHP development: Albania, Andorra, Armenia, Azerbaijan, Bulgaria, Croatia, Czech Republic, Hungary, Iceland, Italy, Kazakhstan, Kyrgyzstan, Latvia, Lithuania, Malta, Poland, Portugal, Romania, San Marino, Slovakia, Slovenia, Spain, the former Yugoslav Republic of Macedonia, Ukraine and Uzbekistan Regarding the Health 2020 targets and indicators related to policies, the proportion of countries with national health policies aligned with Health 2020 increased from 58% in 2010 to 75% in 2013. Countries with implementation plans and accountability mechanisms rose from 40% in 2010 to 56% in 2013. The proportion of countries adopting focused, stand-alone policies to address health inequities rose from 58% in 2010 to 67% in 2013. Most Member States have explicitly included equity and social determinants, gender and human rights values and approaches in the design of national and local health policies. In some countries, specialized agencies or committees have been established on these issues with authority to ensure implementation. Problem: lack of health disaggregated data which is an important tool for identifying within country inequalities and monitoring the pathways from social and economic factors to un/equal health risks and outcomes.
- Since it adoption in 2012, the Regional Office has constantly promoted the Health 2020 policy framework in all relevant settings, including high-profile international health policy events. The Regional Office has also been active in disseminating and raising awareness on Health 2020 with key sectors addressing the determinants of health – recent examples include a high-level side-event to the Conference of the Parties (COP) of the UN Framework Convention on Climate Change, in Paris, December 2015. The Regional Office has worked to establish and maintain effective collaboration with many partners in order to strengthen regional work and in the provision of technical assistance to countries. The Regional Office has also worked to strengthen the evidence-base for Health 2020 uptake on topics such as health inequities, the life course approach, financing and investment for public health, environmental health determinants, whole-of-society approaches, well-being and resilience, and the cultural determinants of health. Extra info: In 2014-15, 15 new publications documenting best practices from countries in addressing health inequities have been published, translated and widely disseminated. Work has begun on a volume to support Member States in taking forward whole-of-society approaches jointly between the WHO European Office and the European Observatory on Health and Health Systems (late 2016). In October 2015, the WHO European Ministerial Conference on the Life-course Approach in the Context of Health 2020 discussed the evidence and policy implications of evidence on the social, genetic, and behavioral determinants of health across the life-course. WHO/Europe is currently reviewing case studies of these approaches in practice and designing and commissioning an authoritative evidence review distilling the policy implications of this approach (end of 2017). During 2016, the Regional Office is launching a European report on women’s health looking at gender and other determinants of women’s health from a life-course perspective. Strengthening the evidence-base related to important Health 2020 concepts, such as well-being and resilience, is ongoing and specific publications forthcoming (2017).
- As a result of the Health 2020 mid-term review and as part of our ambition to strengthen coherent approaches in our support to countries, at both national and sub-national level, we have made some organizational changes within the Regional Office. The coordination of Health 2020 policy implementation and the Agenda 2030 has been brought to a single Division , which also responsible for governance and equity focusing on gender, human rights, social and environmental determinants of health, and vulnerabilities. This Division is also coordinating networks, such as the Small Countries Initiative, the Regions for Health Network, Healthy Cities network as well as the WHO CCs. These are all important vehicles for Health 2020 and SDG implementation. On all these fronts there is extensive on-going work in close collaboration with other Divisions to ensure coherence across the Regional Office.
- We are now at the mid-term of Health 2020 implementation and we will continue to intensify our efforts in the years to come. As our Regional Director just presented, this will involve developing a roadmap for implementing the SDGs building on the progress that Health 2020 has achieved. Moving towards the Health 2020 targets will involve scaling up our efforts on reducing health inequalities and a continued strong focus on intersectoral interagency and multistakeholder action for health and well-being aligned with SDGs. From this perspective, preparations are ongoing for a high-level conference focusing on identifying common policy objectives for the health, education and social sectors, which will take place in Paris in December this year. In 2017, the 6th Ministerial Conference on Environment and Health will also be a crucial stepping stone on our path towards 2020 and beyond.
- As I mentioned we launched both the Health 2020 and the European Action Plan for Strengthening Public Health capacities and Services together in 2012 and the two are very closely related. Health 2020 provides the overarching policy framework bringing coherence into the work of the Regional Office with Health 2020 promoting the equitable improvement of health and well-being through addressing all health determinants, and the European Public Health Action Plan with its 10 Essential Public health Operations (EPHOs) looking to strengthen public health capacities and services in a comprehensive way. Health 2020 and the European Action Plan are closely linked and work together. We are now in the process to further conceptualize this connection and looking towards the future, given even more impetus as well as more opportunities by 2030 Agenda and the SDGs. Internally we have a task force to operationalize this link and we intend present the results of this work in the next Regional Committee. I will now conclude and pass the word to Dr Hans Kluge, Director, Division of Health Systems and Public Health, to give an overview of progress achieved under the European Public Health Action Plan and the issues we expect will be in focus going forth.