Banja Luka Pledge signed

Predrag Milašinović

The Banja Luka Pledge was signed on 14 October 2011

The Third Health Ministers’ Forum, held in Banja Luka, Bosnia and Herzegovina on 13–14 October 2011, ended in the signing of the Banja Luka Pledge. Unique in the WHO European Region, the Pledge sets a five-year course towards including health in all policies and working across sectors to address the social and economic determinants of health and reduce noncommuniable diseases. 

As countries’ representatives signed, they emphasized their commitment. One called the Pledge a “historic step forward in the recognition of continuous and concerted effort to enhance regional cooperation in public health. It reaffirms the important achievements of the South-eastern Europe Health Network and sends a clear message that the countries in the region will strengthen links between health and other policies.”

Another said that, “Health is more and more seen as an indicator of well-being and sustained economic development, and this is another strong reason to support the Pledge. The establishment of the regional health development centres is a good result and must be sustained.”
Representing the Presidency of the South-eastern European Health Network, Ranko Skrbic, Minister of Health and Social Welfare of Republika Srpska, concluded, “Equity and health in all policies are our ultimate objectives.”

The 10 countries in the Network – Albania, Bosnia and Herzegovina, Bulgaria, Croatia, Israel, Montenegro, the Republic of Moldova, Romania, Serbia and the former Yugoslav Republic of Macedonia – agreed

  • to sustain and strengthen regional cooperation in public health in south-eastern Europe;
  • to work towards equity and accountability in health; and
  • to strengthen public health capacities and services for control and prevention of noncommunicable diseases.

In particular, they pledged to work towards the goal of including health in all policies: for health and health equity to be considered in all policy and investment decisions at the local and national levels.

The Forum celebrated a decade of remarkable regional cooperation in public health in south-eastern Europe, which has resulted not only in productive and shared expertise but also 9 centres for regional health development, 10 pilot community mental health centres and a region-wide network of 60 institutions working on public health issues.

The Banja Luka Pledge calls on national governments in the WHO European Region and partner organizations to support the Network in achieving its extended goals. It concludes: “We are convinced that our combined efforts at national, regional (south-eastern European) and European levels will bring about changes that will substantially improve the health and well-being of all our citizens.”

The first and second health ministers’ forums, in 2001 and 2005, resulted in the Dubrovnik and Skopje pledges.

Intersectoral collaboration needed on noncommunicable diseases

The Forum participants discussed the burden of noncommunicable diseases (NCDs) on south-eastern Europe and considered the implications of 2011developments in this area, including the adoption of the Moscow Declaration, the Action Plan for the Implementation of the European Strategy for the Prevention and Control of Noncommunicable Diseases and the political declaration of the United Nations high-level meeting.

NCDs – such as heart disease, stroke, cancer, diabetes and chronic lung diseases – are the leading causes of sickness and death in south-eastern Europe. Experience in the region varies; some countries have an excellent record in the control of cardiovascular diseases and cervical cancer, for example, while others are still developing an organized response. The Forum reviewed evidence that public health responses can have a rapid impact; for example, certain tobacco-related diseases can be reduced within 1–2 years after measures are taken that increase the prices of tobacco products and ban smoking from public places. There is much scope for regional cooperation in these fields and a new regional development centre is being set up in Montenegro to facilitate it.

The Forum also recognized that effective cooperation between the health and other sectors is crucial to reducing the NCD burden. Presenting a study of the Network’s experience in this field, Andrei Usatii, Minister of Health of the Republic of Moldova, said: “Public health must intervene in all social, environmental and other activities of populations. It cannot be limited only to the actions of health practitioners. Therefore societal and environmental, as well as medical, solutions should be employed to reduce public health problems. Intersectoral collaboration and action for health are crucial in the effective prevention and control of NCDs.”

About the Forum

The Forum is a unique entity that was set up in the context of the Stability Pact for South East Europe, following economic collapse and conflict in region in the 1990s. In the last decade, the health ministries in its member countries have worked closely together and with WHO/Europe through a regional cooperation on public health, now supported by the Regional Cooperation Council (RCC).