A record number of ministers, nongovernmental organization representatives, youth delegates and international partners ended 3 days of discussions and deliberations today at the 72nd session of the Regional Committee for Europe (RC72), further shaping
WHO/Europe’s work for the coming years.
Healthy ageing for all in Europe
The parallel session on healthy ageing for all highlighted the fact that the WHO European Region has the highest median age globally, with elderly people bearing the brunt of the COVID-19 epidemic, and at risk of loneliness and social isolation with severe
consequences for their mental and physical health. In the coming months, a framework for action will be outlined focusing on healthy ageing throughout the life course, health-friendly environments, integrated and long-term care, combating ageing,
and monitoring research and innovation.
Delegates raised the need to meet the challenges of the demographic transition that many countries currently face, such as the need to strengthen data-driven solutions and new technologies within primary health care settings; focus on predictive, proactive
and preventive care; and maintain the individual in the middle of all actions, strengthening people-centred health-care settings. Simultaneously, focus is needed on improved salaries, working conditions and the health of the Region’s health
and care workers, improving their work–life balance.
Tackling childhood overweight and obesity in the European Region
At the session on tackling childhood overweight and obesity, co-chair Maria João Gregório of the Portuguese Directorate-General of Health, highlighted how regulating marketing to children is one of the most effective policies, with a 6-fold
return on investment, but is challenged by the complexity and power of digital marketing. WHO/Europe’s Dr Kremlin Wickramasinghe, presented the key messages of the WHO European Regional Obesity Report 2022, which provides valuable insights on
the most effective policies for countries to implement.
Dr Nino Berdzuli, Director of the Division of Country Health Programmes at WHO/Europe, stressed the importance of the Childhood Obesity Surveillance Initiative of the Regional Director’s Advisory Council on Innovation for Noncommunicable Diseases.
According to the latest WHO data, almost two thirds of adults and 1 in 3 children in the European Region are living with overweight or obesity, and these rates are still increasing.
Dr Sanja Musić Milanović, the First Lady of Croatia, stressed that no single intervention can halt the obesity epidemic on its own. Rising to this challenge, she announced the launch of a new Network of First Ladies and First Gentlemen of the WHO European
Region to take the lead on advocating a multi-level approach and high-level political action to counter this threat. A summit on this topic will be held in Croatia in 2023.
Implementation of Resolution EUR/RCSS/R1 (WHO European Office for Prevention and Control of Noncommunicable Diseases)
Member States had requested the WHO Regional Director for Europe, Dr Hans Henri P Kluge, to provide an update on the implementation of Resolution EUR/RCSS/R1, which had been passed by a majority of Member States at a special session of the Regional Committee
on 10 May 2022, concerning the WHO European Office for Prevention and Control of Noncommunicable Diseases (the NCD Office) based in Moscow and funded by the Russian Federation (US$ 26 million over 5 years). The Resolution was adopted following the
Russian Federation’s invasion of Ukraine.
Noncommunicable diseases (NCDs) account for nearly 90% of deaths in the Region and it is crucial to protect the technical work in this area.
Summarizing the situation so far, Dr Kluge made the following points:
- WHO/Europe has taken several initiatives to safeguard the technical work of the NCD Office. As of 27 August 2022, the NCD Office had reached 70% of its annual financial implementation for activities, which is an indication of the continued technical work of the Office.
- The current remote modality of work for the NCD Office, with international staff working from their home locations, has proven successful in safeguarding delivery over the past months.
- Regarding meetings in the Russian Federation, as defined under Paragraph 5 of the Resolution, no such meetings have been held there since 10 May 2022.
- Nine out of 11 international staff, all the administrative staff and the running costs of the NCD Office are fully funded by the Russian Federation grant of US$ 26 million over 5 years.
- The NCD Office has continued its technical work with Member States through subregional approaches and bilateral or direct country support. It has also organized online events to launch regional products and when regional level engagement was required.
- There have been several WHO technical publications and country reports during this period, which further shows that the measures WHO/Europe has taken have been adequate to safeguard the technical work of the Office.
- Member States requested the Secretariat to consider all options, analyse the impact on financial and human resources for each of the operational models for the Office and report to the next meeting of the Special Committee of the Regional Committee (SCRC) with a clear timeline. Member States highlighted the need for diversification of funding for WHO/Europe’s work on NCDs.
RC72 adopts regional action plans for ending HIV and the epidemics of viral hepatitis and sexually transmitted infections 2022–2030; and tuberculosis 2023–2030
Delegates voted in favour of 2 long-awaited action plans: one aimed at ending HIV and epidemics of viral hepatitis and sexually transmitted infections (STIs) and another on tuberculosis (TB) – on the final day of RC72.
During this session, Dr Berdzuli outlined that the action plans to tackle HIV, hepatitis, STIs and TB had 3 key components: 1) placing people at the centre of the response, with local services made available; 2) improving access for the most vulnerable
and at-risk communities, including rapid uptake of new technologies and testing strategies; and 3) accelerating the current pace for early diagnosis with decentralized and integrated service models.
Joining the session, 2 community representatives – one living with HIV and another who had survived multidrug-resistant TB – spoke in plenary and called on decision-makers to support the action plans.
Civil society organizations (CSOs) also called on Member States to include TB in primary health care reforms, prioritize user-driven care and recognize gaps between countries in the Region. Dr Berdzuli advocated that countries should invest smartly in
shared approaches across conditions where it makes sense, while keeping focus on core disease functions – moving away from the dichotomy of vertical and horizontal approaches, with solutions that work locally.
Delegates were largely supportive of the need to strengthen action in these areas; however, some Member States opposed certain sections of the plans. The action plan on TB was adopted with 40 delegations present, with 38 voting in favour to 2 against,
with no abstentions. The action plan on HIV, hepatitis and STIs was adopted with 40 delegations present: 37 voted in favour, 3 voted against, with no abstentions.
Genomic medicine approach for improving health
Genomic medicine has the potential to tailor health interventions. It also offers the chance to strengthen preventive medicine – to identify people at risk of certain diseases and reduce costs for health systems. Yet challenges exist to making the
most of this field, from the trust required from citizens to engage with centralized health information systems, to cooperating with partners across society – including both public and private entities. At this parallel session, attendees highlighted
the important role of WHO to act as a facilitator for this area of work – and to reflect the varying cultural contexts of different countries, making this vision a reality for countries of all income levels.
Launching the regional report “Health and care workforce in Europe: time to act”
The parallel session dedicated to the new WHO report on the health and care workforce in the European Region highlighted the severe challenges faced; issues include an ageing workforce, poor mental health among the workforce, long working hours, inadequate
professional support and serious staff shortages. Strategic planning and smart investment are crucial next steps to ensure that health workers in the Region have the tools and support they need to care for themselves and their patients. The report
provides key data for each Member State and outlines dire consequences if we fail to deliver. However, it also sets out a 10-step action plan, along with tools, solutions and opportunities to address the challenges ahead.
A European framework to reduce alcohol consumption and harm
Opening this agenda item, Dr Berdzuli explained that the European Region has the highest level of alcohol consumption of any WHO region and reiterated that there really is no “safe” level of consumption. Indeed, 1 in 10 deaths in the Region
is caused by alcohol, many of them among young people.
The new European Framework for Action on Alcohol, 2022–2025, developed through an extensive consultation process with Member States and CSOs, and through a public consultation, provides evidence-based policy guidance to reduce harms due to alcohol
consumption.
Adja Stepisnik, a youth representative, made a powerful plea for Member States to work with young people to take action and protect them from the harms of alcohol.
“Think of the legacy you want to leave – implementing this framework and establishing a responsible attitude to alcohol is the best legacy you can provide,” she said. Following interventions endorsing the Framework from several Member
States, it was adopted by consensus.
Strong support for roadmap to accelerate the elimination of cervical cancer
Pledging their commitment to action, Regional Committee delegates endorsed a roadmap to combat cervical cancer and accelerate the elimination of this preventable disease. Dr Berdzuli stressed that we have the opportunity to make the Region cervical cancer
free.
Knowledge and tools including the human papillomavirus (HPV) vaccine exist; however, stronger and more consistent commitments are needed to end the inequalities between and within countries in mortality, vaccination and screening. Dr Dilyara Kaidarova,
Director General of the Kazakh Institute of Oncology and Radiology, spoke about strengthening cervical cancer screening in her country to ensure no one is left behind, specifically noting Kazakhstan’s efforts to increase participation among
hard-to-reach populations – using behavioural and cultural insights to tailor services and bring them closer to the people.
Delegates were touched by the video testimony by the parents of deceased HPV advocate Laura Brennan, who would have turned 30 this year, had the family been aware of the HPV vaccine. Delegates encouraged alignment with the European Union’s Beating
Cancer Plan and adoption of a whole-of-society approach, and stressed the need for strengthened awareness-raising for HPV vaccination and national screening programmes, combined with community engagement campaigns, proper health workforce capacity
training, and innovative, local solutions adapted to local challenges.
Following interventions endorsing the roadmap, the Framework was adopted by consensus.
Strengthened strategy for collaboration between WHO/Europe and Member States
The Regional Committee adopted by consensus WHO/Europe’s first strategy for collaboration with countries: an important step towards meeting their expectations about WHO’s role in supporting Member States and ministries of health in their tasks,
and leadership in health.
Increasing WHO/Europe’s relevance for Member States lies at the core of the European Programme of Work, 2020–2025 (EPW), highlighted Dr Gundo Weiler, Director of the Division of Country Support and Emergencies.
Drawing on 1.5 years of extensive consultations with countries, partners and staff, the strategy will, among other activities, bring technical expertise closer to the field, tailoring collaboration and leveraging partnerships, and intensifying direct
support through WHO’s 30 country offices and many presences in the European Region.
During the discussion, delegates stressed the importance of open communication channels and a tailored approach with strengthened country offices, and welcomed new, diverse cooperation opportunities and models, and the progress made with the network of
national coordinators at country level.
Closure of RC72
Closing the Regional Committee session, Dr Kluge thanked support staff and interpreters, delegates, members of the 29th Standing Committee, and the Regional Committee host country, Israel, for excellent cooperation, preparations and active participation
in the discussions.
Reiterating the historic importance of the action plans, frameworks and roadmaps adopted – not least on 2 EPW flagships, behavioural and cultural insights and digital health (the other 2, mental health and immunization had been adopted last year
at RC71) – Dr Kluge highlighted the need to meet the expectations of the citizens of the Region, leaving no one behind. In practice, this means preparing and responding to emergencies better, while maintaining and strengthening essential health
systems and services. He called this the “new normal/dual track" approach, stressing the crucial role of multilateralism in responding to all challenges and opportunities that lie ahead.
Wishing all delegates safe travels back home, Dr Kluge called on all to set to work on the initiatives and action plans agreed, until the next Regional Committee session in 2023.