Complex and persistent health issues in spotlight as WHO Director-General and Georgian President address WHO governing body in Tbilisi

Copenhagen, Tbilisi, 17 September 2008

Two of the most complex and persistent issues in public health are being addressed as the meeting of the WHO European governing body – the Regional Committee for Europe – unfolds in Georgia. Over 250 representatives of the countries in the WHO European Region are seeking ways to improve the governance of health systems, which means achieving more fairness as well as greater efficiency, and to promote healthy behaviour.

Practice shows that probably no task in public health is harder than changing behaviour such as smoking, overeating, poor blood pressure control and physical inactivity. Efforts to improve the governance and performance of health systems also have a long history, and similarly patchy success. In her address to the Committee yesterday, Dr Margaret Chan, WHO Director-General, said: “We are like Sisyphus, the mythical king from ancient Greece, who is condemned to push a huge boulder up a hill, only to watch it roll back down again. … I applaud your courage in tackling these problems. Though difficult, they represent the most important barriers to health development facing every country in the world.”

Tackling HIV/AIDS, tuberculosis (TB) and the epidemic of noncommunicable diseases vividly illustrates the great difficulty of behaviour change. Prevention is by far the better option for addressing these challenges; it entails population behaviour change and coherent government policies. “It means integrating the response into health systems. As we have seen, powerful interventions and the money alone will not buy better health outcomes in the absence of efficient health systems,” stressed Dr Chan.

The burden of long-term care for people suffering from noncommunicable diseases, the huge costs of drug-resistant TB and the rise in palliative care costs not only put significant pressure on health systems but can also drive households below the poverty line. “People should not become poor because of ill health,” asserted Dr Chan.

The same calls were sent out at a special session on the final report of the Commission on Social Determinants of Health, published in August 2008. Sir Michael Marmot, the Chair of the Commission, presented the report’s finding to the representatives, who will determine how WHO will respond at the World Health Assembly in May 2009. The report notes that the most important determinants of good or ill health arise from the social conditions in which people are born, live, work and age. It challenges the assumption that economic growth alone will reduce poverty and improve health. Economic growth will improve the health of the poor only when policies and strong health systems are in place.

Addressing the Regional Committee yesterday, His Excellency Mikheil Saakashvili, President of Georgia, emphasized that fairness in access to health care and efficient services are vital. A health system should not be seen as a burden to government, but as a real producer of economic gain. He added: “The success of any country should be judged on its ability to ensure that all citizens have equal access to quality health care services. I am well aware that this can not be ensured through the private sector alone; the role and responsibility of the government in this are paramount.”

Today, the Committee is expected to adopt two important resolutions on the performance of health systems and on best practices in changing behaviour for better health.

For more information, contact:

Ms Liuba Negru
Press and Media Relations Officer
WHO Regional Office for Europe
Scherfigsvej 8
2100 Copenhagen Ø
Tel.: +45 3917 1344; mobile: +45 2045 9274