The year opened with a meeting of technical experts from a variety of sectors, including national and subnational governments, public health institutions, academia and civil society. They successfully advanced the development of a toolkit for Member States that will guide activities towards achieving health, equity and well-being for all at all ages in the WHO European Region, within the framework of the SDGs.
A gathering of 43 mayors and 85 high-level political representatives took place in Copenhagen, Denmark, for a historic Summit of Mayors. They shared experiences and ideas of how to place health and well-being at the heart of urban development. The group – collectively representing nearly 125 million people living in urban centres in the Region and beyond – adopted a visionary document, the Copenhagen Consensus, which presents a transformative approach to creating happier and healthier cities for all. The Summit of Mayors was a forerunner to the International Healthy Cities Conference in October in Belfast, United Kingdom, which celebrated 30 years of the WHO European Healthy Cities Network.
In the face of rising numbers of cases of vaccine-preventable diseases in the Region, the health ministries of 12 countries in south-eastern Europe and beyond endorsed a statement of intent to speed up progress towards the goals and strategic objectives of the European Vaccine Action Plan 2015–2020. Ministers of health and other country representatives embarked on a joint effort in Podgorica, Montenegro, to create a tailored roadmap focused on common challenges and opportunities to increase individual and community protection against diseases such as measles, rubella, diphtheria and others. News – 12 European countries commit to greater efforts to protect people from vaccine-preventable diseases
The 2 most pressing emergencies in the Region were in particular focus in March. A stark picture was painted of the health situation and humanitarian crisis in eastern Ukraine at a high-level conference in Brussels, Belgium. WHO joined with other United Nations agencies in calling on partners to respond to the health and humanitarian needs of Ukrainians with increased investment. As the Syrian Arab Republic reached the grim 7-year mark of a conflict that has led to severe health consequences – including alarming levels of mental health problems – Syrian social workers, psychologists and physicians gathered in Gaziantep, Turkey, near the Syrian border, for a training organized by the WHO field office there. They came together to learn skills and standardized approaches for helping people suffering from mental health conditions, with the aim of taking these skills to a new cadre of psychosocial workers across northern Syria.
Since achieving measles elimination in 2015, Albania has reported sporadic imported cases of measles, including cases in the second half of 2017 that were followed by a few separate outbreaks with a small number of cases and limited period of transmission. A much larger outbreak in 2018 was a greater test of the Albanian health system. However, due to sustained high immunization coverage through the country’s well performing national immunization programme, along with a prompt and comprehensive outbreak response, the country managed to control the outbreak.
On World Health Day, WHO Regional Director for Europe Dr Zsuzsanna Jakab stated, “Health is our most precious asset. It must not be a luxury enjoyed by the privileged. We all benefit socially, economically and environmentally from a world that seeks health for all. It is time that we come together and make this a common goal.” Her remarks came as WHO launched a global campaign to recommit all countries of the world to achieving universal health coverage. The overarching themes of World Health Day were echoed in the high-level meeting in Sitges, Spain, which focused on ways that health systems can coordinate their response to the epidemic of noncommunicable diseases (NCDs) facing Europe. Universal health coverage was also underscored during a high-level event in Tallinn, Estonia, which recognized the 10th anniversary of the Tallinn Charter and affirmed that European health systems should be built upon the key principles of solidarity and equity.
A new financial protection review for Lithuania was presented at the international conference Effectiveness and Sustainability of the Lithuanian Health System in May. The report was also discussed at the Tallinn Conference in June and the 68th session of the WHO Regional Committee for Europe (RC68) in September. The Minister of Health asked for further WHO support in reducing out-of-pocket payments in the country.
On 1 May 2018, new tobacco control legislation came into effect in Georgia. In response to a high prevalence of tobacco use and the related burden of disease, the Georgian Parliament significantly amended tobacco control regulations and passed new legislation in May 2017, with strong support from the WHO Country Office. The new legislation is considered one of the strongest tobacco control laws in the Region.
The World Health Assembly in Geneva, Switzerland, marked a turning point in the year as delegates agreed on a new 5-year strategic plan that sets 3 ambitious targets: to ensure that by 2023, 1 billion more people benefit from universal health coverage, 1 billion more people are better protected from health emergencies, and 1 billion more people enjoy better health and well-being. The 13th General Programme of Work (GPW13) will guide WHO’s activities for the coming years. Countries across the Region expressed robust support for this strategic plan, highlighting that its vision aligns closely with and will support the achievement of the SDGs. The Region continued to emphasize the importance of fighting the rising tide of NCDs. New data from the Childhood Obesity Surveillance Initiative (COSI) showed that southern European countries have the highest rates of childhood obesity. At the same time, a report revealed that too few European countries have incorporated healthy traditional diets, such as the Mediterranean diet, into their food policies.
In June, WHO/Europe opened its 30th country office in the Region at a ceremony in Greece attended by the WHO Director-General, the WHO Regional Director for Europe and the Greek Minister of Health. The new office will help to further strengthen collaboration with Greece, a country that has done a great deal of work to reform and transform its health system with a particular focus on revamping primary health care and ensuring health for all. WHO/Europe continued to focus on strengthening country-level work across the Region in 2018. This approach was further validated by the adoption of the GPW13, which prioritizes working within countries. Country-level work was also highlighted during RC68, where Member States discussed the strategic role of country offices in the Region.
The WHO Country Office in Turkmenistan and the WHO European Office for the Prevention and Control of NCDs launched the preliminary results of 3 surveys in the areas of street food, NCD risk factors and childhood obesity in Turkmenistan during a high-level meeting on 18–22 July. The findings reveal some great successes, and also highlight some areas of concern.
Ahead of the International AIDS Conference in Amsterdam, the Netherlands, WHO/Europe convened ministers of health and senior policy-makers from 10 countries in eastern Europe and central Asia for a ministerial policy dialogue on HIV and related comorbidities, calling for urgent action to accelerate the HIV response. While many regions of the world have seen falling numbers of new HIV cases, the European Region has experienced a persisting trend of rising numbers of new infections. The urgency was further underscored by new HIV data released jointly with the European Centre for Disease Prevention and Control later in the year, which showed that nearly 160 000 new HIV cases were diagnosed in the Region in 2017 – with the highest number ever diagnosed in the eastern part of the Region.
Measles cases hit a record high in the Region, with data showing that more than 41 000 children and adults had been infected with measles in the first 6 months of 2018. In response to this sobering news, WHO/Europe continued its efforts to work closely with the countries facing measles outbreaks, including through enhanced routine and supplemental immunization as well as heightened surveillance to quickly detect cases. WHO/Europe also focused on communicating the safety and effectiveness of immunization: 2 doses of measles-containing vaccine provide nearly complete immunity. At least 95% immunization coverage with 2 doses of measles-containing vaccine is needed every year in every community to provide herd immunity and protect people from becoming ill with this serious and highly contagious disease.
To help dispel some of the new and old misconceptions surrounding healthy nutrition, WHO and the Russian Ministry of Health hosted an unconventional event in one of Moscow’s parks – a culinary master class on healthy nutrition for representatives of the media. Led by famous Russian television personality and celebrity chef John Warren, a team of WHO and Ministry of Health experts prepared a 3-course meal during the open-air event on 22 August. The objective of the event was to demonstrate to the media that healthy nutrition can be easy and affordable, and created by following a few simple and straightforward rules.
RC68 took place in Rome, Italy, bringing together health ministers from across the Region to discuss and take decisions on several high-priority health issues. In plenary debates, delegates focused on topics ranging from the SDGs and the GPW13 to public health preparedness and the EVAP. RC68 was also the platform for the launch of 2 important reports. The European health report 2018, WHO/Europe’s flagship publication, reveals that life expectancy in the Region continues to rise. However, significant inequalities exist between countries, and the negative effects of tobacco smoking, alcohol consumption, overweight and obesity, and under-vaccination remain causes for real concern. The first-of-its-kind report on men’s health and well-being in the Region aims to uncover what lies behind patterns of health behaviour among men. The Strategy on the health and well-being of men in the WHO European Region, adopted by delegates at RC68, complements the report. It proposes measures that governments can take to make health systems gender responsive and ensure a model of care that makes health services more accessible for boys and men.
The 3rd World Nomad Games took place in Cholpon-Ata, Kyrgyzstan, on 2¬–8 September. For the first time in the history of the Games, the event was declared smoke-free. This initiative highlighted the incompatibility of sports games with tobacco consumption. It was the result of close collaboration between the Kyrgyz Government, the Secretariat of the World Nomad Games, the Ministry of Health and the WHO Country Office in Kyrgyzstan. Nearly half of the male population in the country smokes, and smoking is one of the leading causes of heart disease and stroke.
In an effort to speed up progress towards universal health coverage, the Ministry of Health of Romania is prioritizing primary health care. Establishing a network of community health centres and strengthening the role of community nurses within the health system are 2 vital steps the Ministry has taken to ensure health for all.
The world came together in Astana, Kazakhstan, to mark the 40th anniversary of the adoption of the Declaration of Alma-Ata, which identified primary health care as the key to health for all. Leaders reflected on the progress made since 1978 and endorsed a new declaration to revitalize primary health care for the 21st century. Many countries of the Region have already implemented innovations that help strengthen primary health care. These were detailed in a report released ahead of the Global Conference on Primary Health Care in Astana.
Following the publication earlier this year of a report from the Organization for Economic Co-operation and Development on Czechia, the Ministry of Health announced that the findings of the report confirm that the country’s health reforms are on course. The Minister welcomed the publication as a source of useful recommendations. He noted that it serves as a basis for further professional and political debate to ensure the long-term sustainability of the health-care system, and to address the country’s main public health challenges. WHO supports and closely collaborates with the Ministry of Health on the country’s reform agenda in the health sector, focusing on integrating health services, digitalizing the health system, strengthening primary health care, reforming public health services and addressing the main determinants of health in the country, including tobacco use, alcohol consumption, obesity and exposure to environmental threats.
On World Day of Remembrance for Road Traffic Victims on 18 November, WHO country offices in the Region actively engaged with high-level policy-makers, nongovernmental organizations, police forces, churches, emergency services and civil society to commemorate the lives lost or irreversibly impacted by road trauma. Across the Region, they organized activities and events to raise awareness about the preventable deaths of 83 000 people killed each year on the Region’s roads and to push for action to make roads safer. Additionally, WHO/Europe shared the personal stories of people affected by road traffic injuries and deaths, detailing the trauma and pain of loss – but also recovery and hopes for the future.
On 10 December – Human Rights Day – the global community recognized the 70th anniversary of the Universal Declaration of Human Rights, which underpins WHO’s work in many significant ways. The Declaration was adopted in the same year as WHO’s founding, and the language of the WHO Constitution served as inspiration for the articulation of the human right to health included in the Declaration. The concept of “health for all” has guided WHO’s work for the past 70 years. The Organization works across many sectors and from local to global levels to promote everyone’s right to health.
To mobilize all schools and communities to undertake concrete actions that support the adoption of a healthy diet and active lifestyle, this December WHO in collaboration with local health specialists introduced school lessons in Transnistria to educate young people in these areas. “I’m happy to learn more about nutrition and healthy eating,” 15-year-old Maria Grebinnaia said enthusiastically. “Also, I like to dance and I have classes 2 times per week. I will share my new cooking experience with my parents. I didn’t know that a salad can be prepared from affordable ingredients and be so tasty!”
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