Regional Committee Day 1

Tofik Babayev

Highlights of 12 September 2011

A packed first day at the sixty-first session of the WHO Regional Committee for Europe began with an address by Ilham Aliyev, President of Azerbaijan, and concluded with a plenary discussion on how to develop the new European health policy, Health 2020.

Address by President of Azerbaijan

After a warm welcome to all delegates, Ilham Aliyev, President of Azerbaijan, expressed his appreciation for the “precious” work of WHO, and explained how Azerbaijan is reforming its health system. “My Government attaches great significance to health care and social sector issues,” he stated. “Over the past five years we have greatly increased our health budget and the technical foundations for health have been strengthened.” The President underlined that reforms are taking place in all regions of the country, and emphasized efforts to educate doctors and improve their international experience, reduce mother and child mortality, develop a healthy environment for citizens, ensure all have access to scarce water resources, encourage young people to adopt healthy lifestyles, and address poverty. He concluded that health and economic reform go hand in hand.

The work of WHO/Europe

The past year has been one of achievements and challenges, commented Zsuzsanna Jakab, WHO Regional Director for Europe, in her opening address to delegates today. Citing the polio outbreak in the European Region last year, as well as ongoing outbreaks of measles and rubella, and the alarming problem of multidrug-resistant tuberculosis, Ms Jakab acknowledged the great work and 45 million doses of oral polio vaccine that were administered to stop the spread of polio, but that more needed to be done to tackle other communicable diseases.

Although we are now on track to eliminate measles from the Region by 2015, for example, the number of people living with HIV has tripled in eastern Europe and central Asian countries since 2000.

It is not only in communicable diseases that the Region needs to take action, however, as “Europe and the Americas share the dubious honour of having the highest proportion of deaths from noncommunicable diseases and injuries,” said Zsuzsanna Jakab. Action plans on noncommunicable diseases, alcohol, HIV/AIDS, drug-resistant tuberculosis and antibiotic resistance will be discussed during the week. Those plans were developed using a new “health systems approach” to ensure that when taken up, the systems have the ability to deliver.

In conclusion, the Regional Director raised the issue of WHO reform, and assured delegates that the analyses of the core functions of the Regional Office, as well as the capacity to develop and implement action plans, take account of and will adjust to the continuing developments in the reform process.

Setting targets for Health 2020

During a lunchtime briefing, countries discussed the process and challenges of setting targets to complement the European health policy, Health 2020, currently under development. The European Region has a long history of setting health targets linked to policies, with Health for All and HEALTH21 policies notable examples. Work has already been undertaken in mapping past policies and linking these to the six key areas of Health 2020: governance, health inequalities, investing for healthy people, the burden of disease, creating healthy environments and strengthening health systems.  This mapping has revealed a plethora of targets to build on, but also notable gaps in the areas of governance and well-being. It was noted that in its 60-year history, WHO had measured how much death, disease and ill health existed, but had never set a target for well-being.

Countries expressed their support for setting targets, but also acknowledged significant challenges, related to the diversity in the Region, the contradiction between short-term political mandates and the long time often needed to achieve health targets, and the intersectoral commitment needed to achieve them. 

Joint operational plan between WHO/Europe and Global Fund

During a short ceremony in plenary, Zsuzsanna Jakab, WHO Regional Director for Europe, and Michel D. Kazatchkine, Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria exchanged letters and initiated a joint operational plan for 2011/2012.

Speaking of this closer cooperation between the two organizations, Michel Kazatchkine stated: “Although the WHO European Region is facing tremendous health challenges, I also see great opportunities, such as the strong partnerships emerging between civil society and governments in some countries, better coordination between multilateral organizations (exemplified by the signing today), the commitment of many dedicated professionals to address health issues, and the increase in governments’ political and financial commitment to health. All these give me hope that we will meet these challenges by working together.” 

Address by WHO Goodwill Ambassador for health-related Millennium Development Goals (MDGs)

Mrs Sandra Roelofs made a short address to delegates, in her capacity as WHO Goodwill Ambassador in the European Region for the health-related MDGs, calling for sustained political support and financial resources to achieve these goals by 2015.

Social inequities in health and governance for health in the 21st century

A series of studies are being undertaken to guide the development of Health 2020. During lunch, ministers were presented with the updates so far. Professor Sir Michael Marmot, University College London, United Kingdom, introduced a study on social inequities in health, citing examples of the health divide within cities. In Oslo and London for example, there are 17- and 10-year differences in life expectancy respectively, between high- and low-income populations. Ministers discussed the need to engage different sectors to address health inequities.

Professor Ilona Kickbusch, Director of the Global Health Programme at the Graduate Institute of International and Development Studies in Geneva, Switzerland, detailed the main findings of the study she chaired on governance for health. She informed ministers that while environmental issues were generating a “whole-of-government” approach by policy-makers, health issues were lagging behind, despite health being key to economic development.

Closer cooperation among governing bodies

In the last year, the Eighteenth Standing Committee of the Regional Committee (SCRC) for the first time held a meeting open to all Member States as observers and a joint meeting with European members of the Executive Board. Josep Casals, Chairperson of the SCRC, described how this increased transparency and its expanded membership of 12 had strengthened the SCRC, and further changes to its rules of procedure were proposed. Having reviewed and discussed most of the key items on the Regional Committee’s agenda, the SCRC was confident that progress made by the Regional Committee would set the direction for the European Region for the next 10 years.
Maris Jesse, Estonian observer to the SCRC and a European member of the Executive Board, indicated that adoption of the World Health Assembly resolution on WHO reform, including its future financing, was “an opportunity for us to voice our expectations in the 21st century.” She highlighted other matters arising out of resolutions and decisions of the World Health Assembly and the Executive Board of particular interest to the European Region: International Health Regulations, pandemic influenza preparedness, strengthening health workforces, sustainable health financing structures, and drinking-water and sanitation. Explaining that the European Region had been particularly active in supporting global initiatives in these areas, the last three initiated by European members of the Executive Board, she added: “Good governance does make a difference in making this a better world.”

Developing the new European health policy, Health 2020

Discussions on the development of Health 2020, its visions, values, main directions and approaches began today with a ministerial panel discussion and plenary debate. The discussions will conclude tomorrow, and the outcomes will be included in the next update.

Highlights for Tuesday include:

  • conclusions to the debate on developing a European health policy, Health 2020;
  • an address by Margaret Chan, WHO Director-General;
  • ministerial panel discussions on addressing the social determinants of health and critical health system challenges; and
  • a discussion on the role of the WHO Regional Office for Europe.