DSP participates in panel of experts to discuss the evidence behind Health 2020 at the 62nd session of the WHO Regional Committee for Europe
On day 2 of the 62nd session of the WHO Regional Committee for Europe, a panel discussion was held to discuss the evidence underpinning Health 2020. The Division of Health Systems and Public Health (DSP) participated in the panel, reflecting on how countries are coping with the crisis and the implication for the Health 2020 agenda. In summary, 5 points were made:
- Member States have been affected to varying degrees by the crisis in terms of impact on public finances, with countries to the west of the Region hardest hit. Elsewhere, economic growth has dampened and unemployment had grown.
- For those countries facing significant downward pressure on budgets, initially at least, the challenge has been to protect levels of government spending on health - at a minimum in terms of relative allocations to the sector. However, many Member States have had to cope with significant budget reductions, and the challenge has been to put into practice the clear commitments and values enshrined in the Tallinn Charter, Health 2020 and other political commitments, most importantly to protect access to essential services for the population.
- The way in which cuts to health spending are made is central to maintaining access to services. Fortunately, Member States have generally managed to navigate the crisis while maintaining universal coverage, largely by seeking greater efficiencies within their health systems rather than pushing the costs onto patients. Many countries have achieved savings in pharmaceutical spending, either through the renegotiation of prices with industry or the greater use of generic medicines. There has also been a focus on reducing spending on the hospital sector, where in many countries there is scope for substantial savings.
- In addition, many countries have looked to raise additional revenue through payroll contributions, or other taxes, so-called sin-taxes, which in their own right also constitute a direct public health intervention. The pressure to move quickly, however, has meant that patient charges have increased in a number of countries, raising concerns around the rolling back of universal coverage. Some countries have positively used the crisis to strengthen universal coverage by extending benefits to vulnerable groups.
- Finally, it is critical that the bigger picture is not forgotten, particularly with respect to the longer term challenges facing the health sector. It is clear that across the Region, much spending on hospitals represents a significant misallocation of resources given the urgent need to strengthen efforts to tackle risk factors and other preventive measures related to noncommunicable diseases. Short term measures, while clearly necessary in the hardest hit countries, lay new foundations for the future development of the health system, and as far as possible need to be consistent with the broader challenges facing all health systems in the Region.