Day 2 highlights: Director-General outlines key health priorities

Video address by the Director-General

Prime Minister Alexis Tsipras of Greece; Dr Zsuzsanna Jakab, WHO Regional Director and Dr Tedros, WHO Director-General

Address by the Director-General

“To keep the world safe, improve health and serve the vulnerable” is WHO’s mission, as proposed by Dr Tedros Adhanom Ghebreyesus, WHO Director-General, in his plenary address. Dr Tedros laid out 5 suggested priorities for the Thirteenth General Programme of Work 2019–2023 that will help WHO achieve this mission.

Taking the Sustainable Development Goals (SDGs) as a starting point, these priorities are to:

  • prevent, detect and respond to epidemics and other health emergencies, as well as to fight antimicrobial resistance;
  • provide health services in emergencies and help rebuild health systems in fragile, conflict-affected and vulnerable states;
  • progress towards universal health coverage;
  • achieve the specific SDG health targets; and
  • provide global governance for health.

Recognizing the diversity of the WHO European Region, the Director-General praised Member States for ensuring that many millions enjoy universal health coverage and long lives. Yet he also noted that the high rates of smoking and alcohol use in the Region contribute to the heavy burden of noncommunicable diseases. Additionally, he pointed out that environmental factors that affect health require countries to work with the energy, transport and urban planning sectors.

WHO’s role in providing governance for health as well as political leadership by advocating for health was a theme of the Director-General’s address. He explained that WHO alone has the authority and credibility to convene stakeholders in global health and to build consensus. On the issue of political leadership, he concluded, “WHO should not be shy about engaging with world leaders. Our cause is too important; the stakes are too high. Meaningful change happens when political leaders are engaged. WHO must therefore not be afraid to go beyond the technical to the political in pursuit of its mission.”

Plenary discussions

A delegate of Estonia, on behalf of the European Union, thanked Dr Tedros for his address, noting that he has “hit the road running” in the 2 months since becoming WHO Director-General. The delegate emphasized the broad role of WHO not only in disease treatment and response, but also in prevention and promotion, and underlined the need to integrate cross-cutting approaches to human rights and gender.

A delegate of Kazakhstan reiterated the Director-General’s assertion that progress on health requires the highest political support, and explained that the President plans to take part in the country’s celebrations of the 40th anniversary of the Alma-Ata Declaration in October 2018.

A delegate of Israel noted the health opportunities offered by new technologies, big data and telemedicine, and called on WHO to consider innovation and technology as a strategic platform for setting new health priorities.

Address by His Excellency Alexis Tsipras, Prime Minister of Greece

In his opening address, Prime Minister Tsipras described how Greece, at the epicentre of 2 of the most significant recent crises in Europe – the economic crisis and the migrant crisis – has responded. Addressing these crises posed a fundamental dilemma, according to Mr Tsipras: “Do we confront the challenges of our time through solidarity, respect for human dignity and international law? Or do we decide that the best choice is to protect only our own nation and leave all the other choices to the markets? My country chose the first path, which is also the only path that allows Europe to have a common future.”

He added that protecting health means promoting human dignity, and explained how health reforms in Greece have sought to provide equitable access to health services despite pressure on available resources.

This extensive reform has included ensuring universal, free and equal access for uninsured citizens to the health-care system; improving transparency and public accountability and investing in human resources; confronting corruption and resource waste; providing health care to migrants, including vaccinating children; strengthening primary health care and the role of the family doctor; and facilitating patient access to innovative treatments.

“We need many more reforms … We need a global understanding that protecting human dignity and health is not a privilege or a luxury,” concluded Mr Tsipras.

Roadmap to implement the 2030 Agenda for Sustainable Development, building on Health 2020, the European policy for health and well-being

This session began with the first of 6 short films about individuals from across the European Region – the “Voices of the Region” – who have personal experiences of and insights into the topics of the 2030 Agenda. The film profiled Mr Tom Blackwell, who grew up in state care, speaking on the issue of leaving no one behind.

Dr Zsuzsanna Jakab, WHO Regional Director for Europe, introduced the Roadmap to implement the 2030 Agenda, which was developed through an extensive consultation process. Building on Health 2020, it brings the Region’s priorities forward and provides a common direction, highlighting actions that can accelerate and strengthen the capacities of Member States in implementing the SDGs.

“The African proverb ‘It takes a village to raise a child’ expresses very well the notion that it takes each and every one of us – together – to advance this agenda. Only together can we achieve better, more equitable health and well-being for all, at all ages, in Europe,” commented Dr Jakab.

The Roadmap to implement the 2030 Agenda proposes 5 strategic directions:

  • advancing governance and leadership for health and well-being;
  • leaving no one behind;
  • preventing disease and addressing health determinants by promoting multi- and intersectoral policies throughout the life-course;
  • establishing healthy places, settings and resilient communities; and
  • strengthening health systems for universal health coverage.

Implementation will be supported and accelerated by a set of enablers: investment for health; multipartner cooperation; health literacy, research and innovation; and monitoring and evaluation.

Dr Jakab concluded that the 2030 Agenda demands accountability, which can only be provided through appropriate monitoring and reporting mechanisms. She noted that these mechanisms are in place, supported by the European Health Information Initiative.

Ministerial panel

Participants in a ministerial panel shared experiences of increasing governance for health in the SDG era. The panel comprised: Mr Christopher Fearne, Deputy Prime Minister and Minister of Health, Malta; Mr Zoltán Balog, Minister of Human Capacities, Hungary; Dr David Sergeenko, Minister of Labour, Health and Social Affairs, Georgia; and Ms Olivia Wigzell, Director-General of the Swedish National Board of Health and Welfare. Dr Lucianne Licari, Executive Manager, Country Relations and Corporate Communications at WHO/Europe, moderated the session.

The panel identified common themes for success, including strong political will; cost-effective approaches; a focus on prevention; targeted policies for people in vulnerable situations; a greater focus on primary care; and tools to monitor progress.

Plenary discussions

Member States widely supported the Roadmap to implement the 2030 Agenda. Several explained how they are facilitating interdepartmental and intersectoral cooperation to advance the SDGs. Delegates also expressed their appreciation for efforts to reduce the SDG reporting burden.

Address by Professor Recep Akdağ, Deputy Prime Minister of Turkey

Since 2002, Turkey has followed a health transformation programme focusing on accessibility and a people-centred approach to health care. In his keynote address, Professor Akdağ explained how this programme has already led to impressive results: a 5.5-year increase in life expectancy between 2002 and 2015, which surpassed WHO estimates.

Patient satisfaction also doubled over this period, according to the Deputy Prime Minister, and this was achieved with minimal increases in spending. The next stage of the health transformation process will focus on sustainability and quality of care.

Professor Akdağ also described the national platform that has gathered the contributions of over 1300 professionals to strengthen multisectoral responsibility for health. In conclusion, he called on WHO for support to empower health ministers to advocate for health at the highest levels, noting that Health 2020, the 2030 Agenda and the Roadmap to implement the 2030 Agenda “provide an opportunity to improve health and influence all the determinants of health”.

Panel of stakeholders

Dr Mihály Kökény, former Minister of Health of Hungary, moderated a panel of stakeholders who continued discussions on intersectoral collaboration and the role of different networks, civil society groups and levels of government. The panel comprised: Dr Mira Dasic, Director, South-east Europe Health Network; Mr Peter Beznec, Director, Centre for Health and Development (a member of the Regions for Health Network), Slovenia; Ms Joan Devlin, Chief Executive, Belfast Healthy Cities; and Ms Nina Renshaw, Secretary-General, European Public Health Alliance.

They noted that learning the languages of other sectors and providing them with evidence can facilitate collaboration. They also advised that it is time to move away from self-regulation initiatives for industry and instead implement proven pricing and fiscal measures. “We are not in a competitive business, but part of a movement for change,” concluded Mr Beznec.

The resolution on the Roadmap to implement the 2030 Agenda was adopted by consensus.

Outcomes of the 6th Ministerial Conference on Environment and Health

This session opened with a Voices of the Region film featuring Copenhagen resident Mr Jørgen Thomsen. He explained how we can work together to find effective and innovative solutions to prevent future flooding, establish sustainable urban green spaces and thereby strengthen community resilience.

Dr Srđan Matić, Coordinator of Environment and Health at WHO/Europe, introduced the session on the outcomes of the 6th Ministerial Conference on Environment and Health. He highlighted the Ostrava Declaration’s 7 focus areas of action and its 2 annexes.

In the panel discussion moderated by the United Nations Environment Programme, Georgia noted the need to work on strengthening and harmonizing legislation, with a particular focus on environment and health. Romania strengthened the call for greater engagement on implementing the SDGs.

Using the examples of the Protocol on Water and Health and the Convention on Long-range Transboundary Air Pollution, the United Nations Economic Commission for Europe illustrated how we can use existing instruments for environment and health to stimulate voluntary target-setting and collaboration for implementation. Dr Roberto Bertollini  emphasized how networking is and remains key to continued success.

In several subsequent interventions, Member States voiced their strong support for the Ostrava Declaration and the draft Regional Committee resolution, and echoed the need for strong collaboration and intersectoral action.

Ministerial lunch on mental health

This ministerial lunch focused on the 3 Ds of mental health: depression, disability and dementia. Individuals who have experienced depression and are living in institutional care shared personal testimonies, providing insights into how the health sector can improve support. During the lunch, participants referenced World Health Day 2017, which highlighted the issue of depression as the leading cause of nonfatal health loss in the world today.

Technical briefing on ensuring positive outcomes for health at the country level

This briefing provided an opportunity to discuss steps that can improve outcomes for health at the country level. Participants talked about the role of WHO country offices in translating WHO’s technical advice and evidence-based policies into action in countries.

Delegates of Estonia, Greece, Romania, Tajikistan and Turkey expressed appreciation for the work of WHO offices in the field, and provided examples of both country-specific work and intercountry collaboration. They discussed achievements and challenges in implementing various public health programmes, including immunization outreach, tackling health risk factors, facilitating effective responses in health emergences, and advancing national health reform.

Delegates of Germany and Switzerland noted that WHO’s operational work at the country level must be strengthened.

Breakfast briefing on strengthening community and system resilience

What makes communities and systems resilient, and how can we support intergenerational solidarity and cohesion to promote health? The development of supportive environments that contribute to building resilience and have a positive impact on population health outcomes are at the heart of WHO’s Health 2020 policy framework, and essential to achieving the SDGs.

This breakfast session began by defining what resilience is – bouncing back from adversities – and considered the concept on 3 levels: individual, community and system. Personal testimony and participant discussions touched on the challenge of promoting resilience.

Book launch: “Civil society and health: contributions and potential”

Working with civil society organizations for health and health systems can be very beneficial. It may improve policy-making, service delivery and governance. What are the opportunities and challenges governments face in working with civil society? And why are civil society organizations more effective in some countries than others?

At this book launch, the authors explained their findings, citing examples from civil society organizations engaged in anti-tobacco advocacy, food banks, refugee health, HIV/AIDS prevention and cure, and social partnership. They identified tools for engagement and contexts that can be conducive to successful collaboration, and offered participants the opportunity to share their experiences.

Highlights for Day 3

  • Towards a sustainable health workforce
  • Improving access to medicines
  • Accelerating implementation of the International Health Regulations (2005)