Harnessing disruption to improve health
Disruption was the theme of this year’s European Health Forum Gastein (EHFG). Leaders in health from across Europe met to discuss how to embrace disruption in a responsible way to achieve better health for all.
WHO/Europe was well represented, taking part in discussions on various themes including managing the growth of digitalization in health, addressing inequity in health and facing up to the challenges posed by climate change.
Digitalization and the future of care
WHO Regional Director for Europe nominee Dr Hans Kluge delivered keynote remarks on ensuring “the human touch in a digital world”. He focused on the potentially disruptive nature of digitalization and artificial intelligence on patients and those providing health care.
Digital health, which is anchored within the Sustainable Development Goals, targets the development of safe and inclusive digital services.
Dr Kluge explained that while digital innovations in health are exciting and warrant optimism, they also “raise questions and concerns, and even challenge what we feel comfortable with in terms of our health-care delivery and the use of our personal health data”.
Dr Kluge added that we need to act now to avoid sleepwalking into a worsening digital divide, and to ensure that digital health services are safe, accessible and affordable for all. New models of governance and action will play a crucial role in leveraging the digital technologies of the future.
Closing gaps in health equity
Disrupting the status quo also involves challenging policy-makers to invest more in addressing health inequities.
Ms Christine Brown, Head of the WHO European Office for Investment for Health and Development, took part in a session on changing the game on health inequalities, highlighting the work of the Health Equity Status Report (HESR). She identified the main trends in health inequity and presented concrete measures that policy-makers can take to reduce inequalities.
The session underlined the fact that a relatively small increase in investment could yield results in a short period of time. For example, if a country of 60 million invested 0.1% of its gross domestic product into social protection, housing and community facilities, and labour market policies, the lives of 250 000 people would improve.
Climate change challenges
Closing this year’s EHFG, Dr Piroska Östlin, WHO Regional Director for Europe ad interim, spoke about the global climate crisis alongside Dr Vytenis Andriukaitis, Commissioner for Health and Food Safety of the European Commission.
When asked about climate change as a public health emergency and WHO/Europe’s work in this area, Dr Östlin said, “WHO is getting more and more passionate about this as well. I think it’s quite clear when we look at our 13th General Programme of Work for 2019 to 2023 – we see that climate change as well as universal health coverage are top priorities and these are interlinked.”
Dr Östlin also pointed to the publication of a WHO report on climate change last year, which summarized current knowledge on climate change and highlighted the health benefits of climate action.
In the session on alcohol, a youth panel was asked: if you were 10 times bolder, how would you tackle the challenges? The young people proposed a total ban on alcohol marketing that normalizes behaviour, investments in healthy drinks and the creation of healthy settings for socializing where alcohol is completely out of the scenario.
They also stressed the need for a clear message that alcohol is not an ordinary commodity – that all consumption of alcohol is harmful.
These suggestions were aimed at shaking policy-makers into taking bold action, thinking creatively and implementing the WHO best buys: reducing availability, increasing taxation, enforcing bans on marketing and sponsorship, and regulating labelling. The youth panel emphasized the importance of shifting social norms around alcohol to create transformative change for health and well-being.
Making health care affordable
Financial protection is achieved when out-of-pocket payments for health services no longer expose people to financial hardship, and is at the core of universal health coverage. Data on unmet need and out-of-pocket payments, however useful, are not enough – policy-makers need context-specific stories.
This session included a summary of select results from WHO’s new analysis of financial protection, entitled “Can people afford to pay for health care?” Digging into the data tells us about who is most affected by out-of-pocket payments and for which health services.
Policies on copayments play a large role in affordability: evidence from WHO shows that these expenses often lead to financial hardship for households, but some aspects of copayment policy design are more harmful than others.
The session explored how European countries can transform complex, unfair, ineffective and bureaucratic copayments to reduce financial hardship. It pointed to reforms which have transformed copayment policy to protect people from financial hardship, including progressive steps in Austria and Estonia. Participants also explored methods that overcome obstacles to fair copayment policy and financial protection.
Health workforce disruption
Conference attendees identified strengthening the health workforce with an improved skill mix as another way to improve health system performance.
Commenting during the session on wellbeing, Dr Jon Cylus, Research Fellow of the WHO European Centre for Health Policy, spoke on the theme of ageing. He noted that informal caregiving contributes a great deal, and doubles employment rates.
Dr Sarah Thomson, Senior Health Financing Specialist at the WHO Barcelona Office for Health Systems Strengthening, added that there is no economic justification for making vulnerable people pay for health care.
With health care high on the agenda, this year’s EHFG made it clear that harnessing disruption in a responsible way can play an important role in ensuring health for all.
The content on this article was amended on 25 October 2019 because an earlier version incorrectly referred to Dr Jon Cylus commenting during the 'skill mix' session, when the 'wellbeing' session was meant.