EuroHealthNet Statement for the 64th Session of the Regional Committee for Europe, Copenhagen, Denmark, 15-18 September 2014

Agenda Item: First report on the implementation of Health2020

EuroHealthNet, the European Partnership for improving Health, Equity and Wellbeing, congratulates WHO Europe and welcomes this first report on the implementation of Health2020. Many of our member agencies have been involved in taking forward the Health2020 vision at (sub) national level.

  1. This important policy framework for the European region has proven to be exemplary for good policy guidance and support at national and regional levels. Health2020 sets out high level ambitions and objectives and the implementation report shows clearly how awareness has been raised successfully. In particular we value the collaborative agreements and cooperation strategies with countries to increase their capacity for whole-of-government approaches. It is crucial to provide targeted support to individual countries and to clusters of countries. The resource packages, tools and structures that have been produced by WHO are extremely useful in this respect.
  2. As EuroHealthNet’s activities are mainly geared towards EU policy, advocacy and liaison with EU Institutions, we are pleased to see a strengthened cooperation between WHO and the European Union. However, we argue that more can be done, also through national cooperation, to better align strategies and activities. In this way we can increase efficiencies, such as for health monitoring systems, using the exact same indicators to measure progress in health outcomes and related data collection and analysis. Due to our relations with various DGs at the European Commission we can help advance work regarding health in other policies at EU level.
  3. Health2020 is a strong aspirational and visionary framework, but at the same time, care must be taken that this vision remains attainable. This implementation report shows how countries have successfully integrated Health2020 principles into their national health policies and strategies, but the report does not really cover what the (intermediate) outcomes are of these strategies or to what extent these policies and strategies have been backed up by financial (and human) resources. We advise to measure performance and provide learning opportunities that also inform future implementation reports. This report could have set out what the difficulties that were experienced are, define the specific challenges or discuss what further needs to be done to overcome these hurdles in the upcoming period.
  4. EuroHealthNet therefore has the following observations that could be addressed in the next phase of the implementation of the Health2020 policy framework.
  5. There are still few political leaders that consider health, social equity and wellbeing as essential for economic growth, nor invest in prevention or deal with the causes why people get sick in the first place. Bold measures are needed to structurally address a wide range of key determinants such as childhood conditions, obesogenic environments, healthy living wages, or even standing up against industry and private sector that make profits out of harmful products, to name just a few. We call on Member States to provide leadership in shifting resources and capacities from dealing with the symptoms of unsustainable societies to integrated approaches of prevention and promotion of health and wellbeing across the social gradient. This “big shift” to prioritising health in governance processes and trade-offs has, in this stage of the Health2020 implementation, not yet been made.
  6. The European level ambition, visions and approaches of Health2020 do not always correspond with the realities that many public health professionals and policy makers face “on the ground” at the national, regional or local level. The ambitions, albeit important, can be too high-level to be implementable, the reality being too complicated and resistant to change. Health authorities generally lack the capacity (time, resources, knowledge, skills) to establish the proposed alliances, undertake health (equity) impact assessments or develop joined-up work. Other sector professionals and decision makers are not easily convinced on the relevance of health to their policy goals and examples of effective inter-sectoral policies and practices for health are scarce. We recommend the WHO and Member States to recognize these realities and invest in and step up the proposed training and capacity building activities in a systematic way, using ‘train-the-trainers’ concepts and further develop practical collaborating centers of expertise.
  7. We should not underestimate the effects the austerity measures have on the social determinants of health. Not only higher unemployment rates affect health and wellbeing, but cuts in social protection measures means that many vulnerable people are left on their own. Support and services given to the poor, the long term unemployed, older people, disabled people, child care facilities etc are diminishing and we can expect a further widening of social and health inequalities in the European region. We need more emphasis on inequalities and the social gradient in all public health actions. Participative societies, social entrepreneurship, community based integrated services, new technologies, social innovation and working with businesses as well as with sustainable development actors are possible new strategic ways forward that needs further exploration and scaling up within the Health2020 context.
  8. EuroHealthNet is committed to support the implementation of Health2020 and to provide its partners with opportunities for policy innovation and advocacy for health and social equity. It raises partner profiles and visibility through the EuroHealthNet communication channels, creating an enabling environment of exchange of good practices and knowledge for capacity building and learning through, for example, publications, webinars, and study visits. It provides advice and information on funding opportunities, coordinates joint actions and projects, and generates evidence-based knowledge on social, economic, environmental and wider health determinants. EuroHealthNet is also supporting EPHOs 4 (health promotion), 7 (workforce) and 9 (advocacy) of the WHO European Action Plan on strengthening public health capacities.

About EuroHealthNet EuroHealthNet is a Partnership consisting of primarily responsible public health authorities and institutes working at regional, national and international levels across Europe. Our mission is to help improve population health and reduce health inequalities. The EuroHealthNet Office is based in the EU quarter in Brussels, Rue de la Loi 67. Please see or contact Caroline Costongs, Managing Director