Chapter 5: The unfinished agenda beyond 2020
Health 2020, the European policy framework for health and well-being, has been a catalyst for strengthened public health action in the European Region. It has also brought the use of information and evidence to the forefront of European public health thinking and policy-making through its accountability mechanism, the Health 2020 targets and indicators. These were adopted by the 53 Member States of the European Region in 2013 and have been monitored on a regular basis ever since. Health 2020 also placed new emphasis on measuring health and well-being instead of
merely focusing on the measurement of death, disease and disability. This accords with the WHO definition of health as not merely the absence of disease and infirmity but physical, social and mental well-being. This reflected a paradigm shift in the approach to public health and was facilitated by the introduction of the cultural context of health in the Regional Office’s work, the increased use of qualitative information and reporting using new kinds of evidence from the medical humanities, including narratives, and the establishment of the unique multipartner WHO European Health Information Initiative (EHII) to coordinate and harmonize health information in the Region.
These developments are absolutely critical if the European Region is serious about reducing health inequalities and reporting on them. As Sir Michael Marmot said, “in order to reduce inequalities in health, we must first address the inequalities in health information. Where health information is poorest, health is also poorest”. The Sustainable Development Agenda 2030 has lent further support to this approach through its detailed monitoring requirement on goals and targets, using more than 300 indicators. Such reporting requirements necessitate not only strong information systems for health at the country level but an increased use of information and evidence for policy-making. For this reason, the European Member States adopted the European Action plan to strengthen the use of information, evidence and research for policy-making in 2016. This action plan is unique and Europe is the only WHO Region to have ever put such a plan forward. It is, however, crucial in order to ensure not only the generation of high quality information at the country level through routine reporting, digital health, and research, but also the translation of evidence into policy. Given these innovative and trailblazing initiatives in health information and evidence, is the European Region on course to achieve its goals and will it be able to effectively report on them under Health 2020 and Agenda 2030?