brussels, 21 february 2013
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Brussels, 21 February 2013. Innovating Public Health Policy in times of the financial & economic crisis in the WHO European Region Hans Kluge Director, Health Systems and Public Health. WHO Health Policy Framework Health 2020. - PowerPoint PPT PresentationTRANSCRIPT
European Parliament, Brussels, 21 February 2013
Brussels, 21 February 2013
Innovating Public Health Policy in times of the financial & economic crisis in the
WHO European Region
Hans KlugeDirector, Health Systems and Public Health
European Parliament, Brussels, 21 February 2013
The WHO policy Health 2020 and instruments
Main health system policy responses
WHO work with Member States in response to the crisis
European Parliament, Brussels, 21 February 2013
WHO Health Policy Framework Health 2020
• Investing in health through a life-course approach and empowering people
• Tackling Europe´s major health challenges of NCDs and communicable diseases
• Strengthening people centered health systems
• Creating resilient communities and supportive environments
Universal health
coverage is the basis for action in these four
priority areas
European Parliament, Brussels, 21 February 2013
Tallinn Charter:Strengthening health systems “ … noone should become poor due to ill health … ”
European Parliament, Brussels, 21 February 2013
All people have access to needed health services (incl. prevention, promotion, treatment & rehabilitation) of sufficient quality
What is Universal Health Coverage?
The use of services does not expose any user (or his/her family members) to undue financial hardship
European Parliament, Brussels, 21 February 2013
The health effects of financial & economic crisis
Main health system policy responses
Messages for policy makers
European Parliament, Brussels, 21 February 2013
LOWER INPUT PRICESto cut costs, particularly in
spending on hospital services and pharmaceuticals, by negotiating
lower prices and switching to generic medicines
Health personnel SALARIES were reduced, frozen, or the rate of
increase reduced. In some cases these were across-the-board cuts, in other cases targeted
Policy responses up to end 2010
European Parliament, Brussels, 21 February 2013
Protecting public spending for health during the crisis: some options
1. Those who accumulated savings have room to maneuver
2. Those who balanced the budget and reduced government debts during the years of economic growth can opt for deficit financing
3. Those who failed to do the above are in a more vulnerable position when the crisis hits, but can still avoid adverse effects on health and equity by giving higher priority to health
It is a matter of choice in public policy and can have a direct effect on UHC
European Parliament, Brussels, 21 February 2013
Further deep cuts in health sector spending in coming years, may force staffing
levels to be further reviewed
Boosting employment is a high policy priority within EU at present
Within EU27, the health sector accounts for approx 10% GDP - more than financial services or
retail sector. Significant employment impact
Health systems are important in mitigating the effects of the crisis
European Parliament, Brussels, 21 February 2013
The health effects of financial & economic crisis
Main health system policy responses
WHO’s main work with member states in response to the crisis
European Parliament, Brussels, 21 February 2013
Analytical work to update and synthesize the evidence (for example on out-of-pocket spending)
0.00 1,000.00 2,000.00 3,000.00 4,000.00 5,000.00 6,000.000.00
10.00
20.00
30.00
40.00
50.00
60.00
70.00
Moldova
R² = 0.707004165028628
Government health spending per capita int $
Out
-of-p
ocke
t as
% to
tal h
ealth
spe
ndin
g
Source: WHO estimates for 2010, countries with population > 600,000
Influenced by a number of factors including health financing policy
19 mn people face catastrophic and 7 mn people face impoverishingexpenditures
European Parliament, Brussels, 21 February 2013
Close engagement with Member States
“Health and Social Values in times of
financial crisis” at the FT-hosted event
“Shaping the Future of Healthcare in Greece” 2012, Athens, Greece
Health System Responses to the Financial Crisis in Ireland: Options and Responses in a European Context2012, Dublin, Ireland
Continual focus on improving efficiency
Eliminate ineffective and inappropriate services
Improve rational use of medicines
Allocate more to public health, primary and outpatient specialist care at the expense of hospital care
Invest in infrastructure that is less costly to run – “invest to save”
Cut the volume of least cost-effective services
European Parliament, Brussels, 21 February 2013
People die from preventable and treatable diseases (mostly cardiovascular in productive ages)
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
European Region EU-15 EU-12 CIS
Country groups
Dea
ths
Circulatory system Malignant neoplasms External causes Infectious disease Respiratory system Other causes
European Parliament, Brussels, 21 February 2013
Policy dialogue and knowledge brokering - closer cooperation between health and finance Ministries
OECD /WHO Joint Meeting on Financial Sustainability of Health Systems 2012, Tallinn, Estonia
European Parliament, Brussels, 21 February 2013
WHO High-Level Technical Meeting
•WHO working closely with European Observatory on Health Systems & Policies generating evidence of impact on health systems, health, and policy responses•Bringing together health and fiscal policy makers from across European Region. Multilateral organisations also. •Recommendations to be tabled at Regional Committee 63 in September 2013
“Health systems in times of global economic crisis: an update of the situation in the WHO European
Region”17-18, April, 2013
Oslo, Norway
European Parliament, Brussels, 21 February 2013
Oslo Conference on health systems in times of global economic crisis April
5th Anniversary of Tallinn Charter Oct
35th Anniversary of Alma-AtaNov
Ministerial conference on NCDs Ashgabat Dec
Timeline of key WHO Europe activities for 2013