Day 1 of Life-course Conference: synergies between Health 2020 and sustainable development goals
On the first day of the Conference, delegates from across the WHO European Region recognized that the importance of giving children the best start to life is scientifically based and should be reflected in policies. They also discussed the unique opportunity provided by the recently agreed sustainable development goals (SDGs) and by the Health 2020 policy framework for pursuing a life-course approach to health.
Opening statement by Alexander Lukashenko, President of Belarus
President Lukashenko welcomed delegates to Belarus and called for open, transparent sharing of experiences during the Conference to promote the health of future generations. The President described the many developments in health care provision in Belarus in recent years, from health workforce training, tobacco and alcohol policies, the promotion of physical activity, stronger health care infrastructure and equipment and provision of medicines, to strengthening medical research centres and scientific and educational exchange.
President Lukashenko described the Minsk Declaration, the Conference's outcome document, as "a very important instrument in health policy".
Opening statement by Zsuzsanna Jakab, WHO Regional Director for Europe
Dr Jakab welcomed over 160 delegates, including ministers and high-level representatives of countries and partners, gathered in Minsk, Belarus, for the WHO European Ministerial Conference on the Life-course Approach in the Context of Health 2020.
Dr Jakab described the links between the life-course approach – focusing on the developmental origins of health and disease and policies to address health at the transitions in life, across ages and generations; Health 2020's strategic directions of improving health outcomes and reducing health inequalities; and the newly adopted SDGs.
"Achieving the sustainable development goals by 2030 is critical to health and health equity, taking into account that most of the 17 goals are in fact social, economic and environmental determinants of health…. We cannot succeed in these ambitions unless we take a truly lifelong perspective on their solutions, the very theme of this Conference."
Interventions that support the "accumulation" of health and reduce inequalities during the life-course include promoting exclusive breastfeeding for the first 6 months of life, health literacy and parenting programmes, safe school programmes, tobacco and alcohol control measures and active labour market policies.
Dr Jakab called for redoubled collaboration among sectors and with the whole of society and strengthened health systems in which people are empowered to make decisions about their own health and well-being to ensure health throughout the life-course and for generations to come.
Andorra Statement: Health promotion and disease prevention throughout the life-course
Rosa Ferrer, Minister of Health, Social Affairs and Employment of Andorra, presented a statement on behalf of the Member States of the WHO Small Countries Initiative. The statement notes that investing in health promotion and disease prevention programmes in the early stages of life have high returns in terms of economic, social, development and equity and underlines the commitment of small countries in the WHO European Region to foster best practices for the life-course approach.
Joint statement by the South-eastern Europe Health Network
A statement on behalf of the nine Member States of the South-eastern Europe Health Network described some of the ways in which the Network improves access to public health and health-care services for people throughout their lives. These include its regional health development centres for the prevention and control of noncommunicable diseases (NCDs), communicable diseases surveillance, mental health and human resources for health, and the Network's lead in the health dimension of the South-east Europe 2020 growth strategy, actively promoting collaboration with other sectors, such as agriculture and the environment.
Life-course approach to health promotion
Cyrus Cooper, Professor of Rheumatology and Director, MRC Lifecourse Epidemiology Unit, University of Southampton, and Professor of Epidemiology at the University of Oxford, gave two examples of the life-course approach in practice: the factors that affect musculoskeletal ageing and childhood obesity.
Professor Cooper outlined several studies of the factors that influence the risk for osteoporotic fractures later in life, explaining that low weight at birth and in infancy predicts the childhood growth trajectory and later risk for hip fractures; maternal nutrition (vitamin D insufficiency) is associated with reduced intrauterine and bone mineral growth in children.
With regard to the dramatic increases in childhood obesity, Professor Cooper outlined certain maternal factors during the child's first month of life that are strongly related to the risk that they will be overweight or obese as older children. The factors include the mother's body mass index (above 25 kg/m2), excessive weight gain during pregnancy, vitamin D insufficiency, smoking in late pregnancy and breastfeeding the infant for less than 1 month.
Belarus country case study
Vasily Zharko, Minister of Health of Belarus, described the country's health system and said that the Government gave priority to protecting and promoting health. He reported that 5.7% of GDP is spent on health care. Describing the focus on reducing maternal and child mortality as "one of Belarus' brightest social achievements", the Minister continued by explaining how the health needs and concerns of children and adolescents are served at 47 centres. He also outlined the work of 17 scientific centres in gathering health evidence and sharing good practices. The country is working to reduce the risk factors for NCDs, notably physical inactivity, smoking and alcohol consumption.
United Nations 2030 sustainable development agenda and life-course
The adoption of the SDGs is a timely opportunity for mobilizing global efforts to address health determinants across sectors, according to Bosse Pettersson, Senior Public Health Advisor, National Board of Health, Sweden. As many other sectors have responsibilities for achieving the SDGs, they will represent a new entry point for promoting health in all policies and a life-course approach, but this will also require political commitment and action. "We seek a life like a candle flame – it should burn at full strength almost to the end," he said.
A good beginning lasts a lifetime
Philippe Grandjean Professor at the University of Southern Denmark and Harvard University, spoke of the impact of exposure to chemicals early in life on brain development and diseases later in life. He explained that exposure of fetuses and children to risks such as alcohol, chemicals, lead and mercury causes much more damage than on adults, and the damage is often irreversible. Professor Grandjean emphasized that interventions should be targeted to where they have the greatest effect, such as advising pregnant women to avoid foods with high levels of heavy metals.
"We think that if we put money into education, we'll have smart people, but brains have to be ready – we need to stop the 'brain drain' early, and give optimal conditions for brains to develop." He appealed for early action to give children the best start, and not to wait until symptoms develop later in life.
Ministerial panel: Long-term investment in the health of women and the next generation
Ministers from Hungary, Kazakhstan, Lithuania, the Russian Federation, San Marino and Slovenia described the interventions and actions being taken in their countries to invest in the health of women and infants and the life-course approach.
Dmitry Pinevich, Deputy Minister of Health, Belarus, explained that development of the Minsk Declaration had been guided by a scientific advisory committee, contributions from partner organizations and input from Member States via an open consultation. Member States took the floor to discuss both the process and the content of the Declaration.
Biennial collaborative agreements (BCAs) signed
In separate bilateral meetings on 21 October 2015, the ministers of health of Armenia and Belarus signed BCAs with WHO/Europe, setting priorities for joint work in 2016–2017.
Press conference in Minsk
On 20 October 2015, Zsuzsanna Jakab, WHO Regional Director for Europe, Vasily Zharko, Minister of Health of Belarus, and Gauden Galea, Director of the Division of Noncommunicable Diseases and Promoting Health throughout the Life-course, briefed national media representatives on the meaning of a life-course approach to health. Dr Jakab noted successful ways in which Belarus is implementing policies to address health at the transition stages of life and across ages and generations, such as the significant reduction in maternal mortality and high immunization rates among children.
On the agenda for day 2
- Childhood and adolescent years – optimizing growth and development
- Middle years 40–60 – sustaining the peak of health and well-being
- Economy and health across the life-course