Addressing the economic crisis in the context of Health 2020

Zsuzsanna JakabWHO Regional Director for Europe

Addressing the economic crisis in the context of Health 2020

17–18 April 2013, Oslo, NorwayHealth Systems in Times of Global Economic Crisis

Addressing the economic crisis in the

context of Health 2020

Wednesday, 17 April 2013

Rationale and background

Generating evidence

Challenges and questions for debate

Next steps




Why is WHO so concerned?

Financial and economic crisis is threatening the health gains made across Europe in recent decades, and exacerbating the longer-term challenges facing our health systems.




Growing health divide

The crisis exacerbates the health divide within and across countries by:

• multiplying exclusionary factors• increasing vulnerability• depleting the coping capabilities

of individuals and communities




Health 2020 adopted by 2012 Regional Committee for EuropeAim: to significantly improve health and well-being of populations, to reduce inequalities in health and to ensure sustainable people-centred health systems




Solidarity at a time of uncertainty for many

Prolonged economic crisis in affected

countries is in its fifth year

Policy response, based on our strong values as

solidarity, critical to ensure our citizens’ health is protected

This meeting takes stock of the evidence and identifies some emerging messages




WHO’s engagement with Member States

Oslo 1Andorra ForumRC60

2009–2011

Survey of 53

countriesIreland report

2011–2012

Joint OECD–WHO

meetingTallinn

2012

Barcelona course on

health financing

2012–2013

Updated evidence

synthesized2012–2013

EU health ministers, Ireland

Mission to Greece

2013

HEALTH 2020

RC: Regional CommitteeOECD: Organisation for Economic Co-operation and Development EU: European Union




Our involvement since the onset of the crisis





Generating evidence


Next steps




Health 2020 – a two-year process of generating evidence

• With Member States and partners

• Unprecedented evidence review • Gathering of new evidence• Solutions that work• Integrating and connecting• Stakeholder (Peer) reviewed




Impact of crisis on health and health systems: the most up-to-date evidence (1)

Two surveys of policy responses in all 53

Member States

Review of published literature and official

databases(fiscal and health)

In-depth studies of selected countries

underway




Impact of crisis on health and health systems: the most up-to-date evidence (2)

ECONOMIC SHOCK:GDP declines across the

Region in 2009

NOT ALL COUNTRIES EQUALLY AFFECTED

PROLONGED CRISIS,particularly in

the EUUNEMPLOYMENT:fiscal shock turns into

rapid increase in unemployment,

especially in the EU

GDP: gross domestic product




Economic impact of health systems

In the EU, the health sector accounts for about 10% of GDP: more than financial services or retail sector

Health sector is a major employer – an important

political priorityFurther, unemployment is the single largest way in

which financial crises directly increase the risk of

ill health




UNEMPLOYMENT

Increased risk of alcohol

poisoning, liver cirrhosis

Increased risk of mental

health problems and

suicides

Recovery from illness

60% less likely

Active labour and social policy can mitigate effects

Ensure safety nets in place.

Broader social

spending also matters





Generating the evidence


Next steps




How can we spend more efficiently?Cardiovascular diseases (CVD)

Alcohol-related harm

Cancer

Road-traffic injuries

Obesity-related illness (including

diabetes and CVD)

€169 billion annually in the EU, health care accounting for 62% of costs

€125 billion annually in the EU: equivalent to 1.3% of GDP

Over 1% of GDP in the United States, 1–3% of health expenditure in most countries

6.5% of all health care expenditure in Europe

Up to 2% of GDP in middle- and high- income countries

Sources: data from Leal et al. (Eur Heart J, 2006, 27(13):1610–1619 (http://www.herc.ox.ac.uk/pubs/bibliography/Leal2006)), Alcohol-related harm in Europe – Key data (Brussels, European Commission Directorate-General for Health and Consumer Protection, 2006 (http://ec.europa.eu/health/archive/ph_determinants/life_style/alcohol/documents/alcohol_factsheet_en.pdf)), Sassi (Obesity and the economics of prevention – Fit not fat. Paris, Organisation for Economic Co-operation and Development, 2010) and Stark (EJHP Practice, 2006, 12(2):53–56 (http://www.google.co.uk/url?q=http://www.eahp.eu/content/download/25013/162991/file/SpecialReport53-56.pdfandsa=Uandei=BNI4T-K7JoKL0QGXs6HFAgandved=0CBwQFjAFandusg=AFQjCNHS922oF8d0RLN5C14ddpMVeRn8BA).

http://www.herc.ox.ac.uk/pubs/bibliography/Leal2006)

http://ec.europa.eu/health/archive/ph_determinants/life_style/alcohol/documents/alcohol_factsheet_en.pdf)

http://www.google.co.uk/url?q=http://www.eahp.eu/content/download/25013/162991/file/SpecialReport53-56.pdfandsa=Uandei=BNI4T-K7JoKL0QGXs6HFAgandved=0CBwQFjAFandusg=AFQjCNHS922oF8d0RLN5C14ddpMVeRn8BA

http://www.google.co.uk/url?q=http://www.eahp.eu/content/download/25013/162991/file/SpecialReport53-56.pdfandsa=Uandei=BNI4T-K7JoKL0QGXs6HFAgandved=0CBwQFjAFandusg=AFQjCNHS922oF8d0RLN5C14ddpMVeRn8BA




How can we better monitor the health effects of economic downturns?

Monitoring the health impact of the crisis during the crisis

Priority area for joint work in the future




How can we protect funding for public health?

How can we safeguard access to services?

How can we better protect poor and vulnerable people?

How can we make our health systems more resilient in the future?





Generating the evidence


Next steps




From here to Regional Committee 2013

Discussion draft Oslo meeting

outcome document

Open SCRC

May 2013

Web-based consultation with Member States

Summer 2013

Finalization of evidence

generationSummer 2013

Submission of Oslo meeting outcome

document to Regional Committee

Sept 2013

SCRC: Standing Committee of the Regional Committee

Addressing the economic crisis in the context of Health 2020

Health & Medicine

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