Day 1 of high-level meeting Health Systems Respond to NCDs: focus on equity and people centredness

WHO

With its clear ambition to articulate the key elements of an aligned and comprehensive health systems response to noncommunicable diseases (NCDs), the WHO high-level meeting Health Systems Respond to NCDs in Sitges, Spain, is paving the way to the United Nations High-level Meeting on NCDs in New York, United States of America, in September 2018.

More than 200 delegates from 39 Member States, nonstate actors and other United Nations agencies assembled for the first day of the regional meeting to share country experiences of strengthening health systems for better NCD outcomes, to celebrate successes and to inspire action.

In her opening speech, WHO Regional Director for Europe Dr Zsuzsanna Jakab stated that Europe presents a major success story in the reduction of premature mortality from NCDs. The decline is so fast, in fact, that the WHO European Region will likely achieve Sustainable Development Goal target 3.4 earlier than 2030.

However, this advance is not evenly distributed across the Region. This inequity prompts countries to learn from one another and adopt the most effective shortcuts to better population health. “This is why we are here,” Dr Jakab noted. “We are doing well but we could be doing much better.”

WHO Assistant Director-General for NCDs and Mental Health Dr Svetlana Akselrod outlined the global perspective on NCDs and the aim for universal health coverage. She explained that to achieve WHO’s goal of ensuring better health and well-being for 1 billion more people, the most effective and affordable NCD interventions – known as the best buys – must be implemented.

Dr Melitta Jakab, Senior Health Economist at WHO/Europe, stressed that targeted, equity-enhancing policies are crucial if we are to leave no one behind. As an underpinning value, equity should be central to all efforts to transform health systems.

In the opening plenary session, delegates unpacked the 9 cornerstones of a comprehensive health systems response. “Everything starts with people, and people should be able to co-create their health and health system,” said Dr Hans Kluge, Director of the Division of Health Systems and Public Health at WHO/Europe.

Shared experiences for inspiration

On this first day of the 3-day meeting, presentations highlighted achievements and challenges in countries and illustrated progress towards population health. Examples included implementing intersectoral coordination mechanisms at the ministry level with involvement of other sectors, introducing tobacco control legislation, enforcing drink–driving regulation and strengthening the workforce to ensure people-centred primary health-care services.

Several presentations highlighted the fact that countries can do much more with much less by moving from reactive to proactive care and by using analytics to transform health services. For example, countries can use data to address conditions and diseases before they appear, study morbidity trends and tackle multimorbidity.

Presenters also reiterated the need for information on how to transform health systems to better respond to NCDs. Referring to the economic challenge of NCDs, they made the key point that although investing in health contributes to growth, 20% of spending is wasted. Tackling NCDs requires spending on prevention, high-performing primary and people-centred care, and sustainable financing. This in turn requires effective dialogue with finance ministries and broader intersectoral collaboration for sustainable partnerships.

The first day of the high-level meeting closed with a poll of which actions participants would prioritize to implement people-centred strategies. The top 3 interventions were to integrate policies, to listen to patients at all levels and to expand community-based primary health care.