WORLD HEALTH OR GANIZAT ION • R EGIONAL OFF ICE FOR EUROPE Scherfigsvej 8, DK-2100 Copenhagen Ø, Denmark Telephone: +45 39 17 17 17 Fax: +45 39 17 18 18 Electronic mail: postmaster@euro.who.int World Wide Web address: http://www.euro.who.int Regional Committee for Europe Sixtieth session Moscow, 13–16 September 2010 Provisional agenda item 6(g) EUR/RC60/12 Add.1 (+EUR/RC60/Conf.Doc./6) 9 September 2010 102442 ORIGINAL: ENGLISH Partnerships for health in the WHO European Region Annex 2 to document EUR/RC60/12, entitled “European Commission and WHO Regional Office for Europe: A shared vision for joint action” was developed jointly by the WHO Secretariat and the European Commission. Both organizations consulted internally, according to their individual procedures and requirements, and the final stages of these consultations have now concluded. The attached document, “European Commission and WHO Regional Office for Europe: Joint Declaration”, is the final version of Annex 2. Copies of the Declaration will be exchanged between the European Commissioner for Health and Consumer Policy and the WHO Regional Director for Europe at the sixtieth session of the WHO Regional Committee for Europe.
EUR/RC60/12 Add.1 page 1 Annex 2. European Commission and WHO Regional Office for Europe Joint Declaration Introduction Developments in recent years have underlined the importance of international cooperation in the area of public health. Globalization, with increases in the movement of people, goods, services and information, and the attendant increases in health risks and unhealthy lifestyles, not to mention the impacts of economic recession, have demonstrated that international action is needed. The European Commission and the regional body of the World Health Organization (WHO) are strong actors in the area of global health and cooperation between these two bodies can greatly contribute to a better and more efficient delivery of good health and of health services to millions of people. The purpose of this declaration is to outline the framework for the future cooperation between the European Commission and the WHO Regional Office for Europe (WHO/Europe) with a view to more efficient and effective collaboration in the area of public health. Relations between the European Commission and WHO are governed by an exchange of letters of 14 December 2001. This exchange strengthened the existing framework and arrangements for cooperation between WHO and the European Commission, and also outlined the objectives, priorities, areas of cooperation, as well as the procedures, activities and practical arrangements for its implementation. Since then the WHO and the European Commission have established, with varying degrees of success, operational working arrangements between their offices at global, regional and country levels. At the European level, WHO/Europe and the European Commission have also had long- standing and strong cooperation; there are no formal arrangements between the two entities, but operational working arrangements are formulated in regular Senior Officials Meetings. The moment is right, at the beginning of the terms of office of the new Commission and the new WHO Regional Director for Europe, for the relations between the two organizations to enter a new phase for giving a new impetus to our existing cooperation The timing is right also in view of the recent entry into force of the Lisbon Treaty. We are confident that a reinforced European Union, to which legal personality has now explicitly been attributed, and strengthened external relations representation will contribute to further intensifying cooperation between our organizations. We have worked well together across a wide range of policy areas on various topics in many countries. However, in view of the challenges Europe is facing, there is an obvious need to scale up our activities and further develop complementarities and synergies, and to spread the benefits of our interventions to all people in the European Region. More specifically we need to work together to help provide and ensure the fastest possible dissemination of scientific evidence, data and information, thereby facilitating assessments and comparisons that can guide policy- making. We also need to work to provide counsel and technical assistance and build up capacity, wherever and whenever needed, as well as to support, complement and coordinate the actions of WHO’s Member States in the European Region, and to help bridge local and national with European and global levels. EUR/RC60/12 Add.1 page 2 To do so, and within the limits of our respective competences, we shall maintain and further foster our policy dialogue, technical cooperation on health-related matters and our joint work at country level. Recognizing that health needs to be addressed in all policies, we shall endeavour to work together across traditional sector boundaries, engaging in partnerships with all sectors and stakeholders. Key challenges and issues Health is a core asset, central for the overall well-being of Europeans. Health is also a key sector for the European economy, representing about 10% of gross domestic product and employing about 10% of the European workforce. Health is a driving force for innovation. However, countries across the European Region are facing major challenges that have impact on health, such as the implications of globalization, the threat of the economic crisis to the sustainability of our health systems, demographic and sociological changes, the impact of climate change on health and rapid technological development. Although knowledge, evidence and experience with regard to health, public health and health systems are vast, their translation into practice remains slow and uneven. Challenges also exist in the way we work together. The overview of our existing cooperation reveals significant and positive interactions, for instance with the European Strategy for Tobacco Control, the European Charter on Counteracting Obesity or the work done on environment and health and on joint data collection. However, there is a manifest need to do it better, especially with regard to our cooperation at the country level. At the same time, there are numerous overlaps and duplication of efforts, for example in data- and information-sharing and in developing guidance for Member States on health issues. There is a need to increase complementarities and to develop new synergies through our strategic partnership, and we have identified a number of key areas where enhanced cooperation can bring particular benefits to citizens and countries in the Region. Innovation and health Health is a sector open to innovation. It harbours the potential to constantly translate scientific advances into concrete benefits for citizens and into productivity of health systems in general. European-level cooperation in this area of health could provide added value for innovation, enabling us to learn from concrete examples elsewhere in Europe. It should be noted that innovations in one part of Europe are not taken up elsewhere in the Region as quickly and widely as they could or should be. In this context, countries need more practical support for knowledge-sharing on health at European level. The European Commission and WHO/Europe will work together to improve support to and bring countries together for identification, evaluation and application of good practices and innovations. There will a particular focus on areas of key added value such as e-health, pandemic preparedness and research cooperation. We will also bring the European research community together in order to help jointly identify, advocate and resource key research priorities, with a view to maintaining Europe's cutting edge in research at the forefront of health development. Health security The European Commission and WHO/Europe will join forces in order to gradually develop a uniform and efficient surveillance and alert system, using the same case definitions and methods EUR/RC60/12 Add.1 page 3 for data collection and analysis as well as quality assurance. To allow for quick and efficient response across the Region, we will jointly encourage and support countries to join the information platforms on epidemic intelligence and response. We will support all European countries in strengthening their overall preparedness, response and response capacity, including those measures that address climate change. The European Commission and the European Centre for Disease Prevention and Control (ECDC) will work together with WHO/Europe to help European countries assess and improve their response systems, as well as their communication on major public health events. The threats of antimicrobial resistance and especially multidrug resistance call for a greater and better coordinated effort throughout the entire European Region and beyond. Modernizing and integrating the public health information system Information and evidence for health policy- and decision-making in Europe is vital. Intercountry comparisons add a unique dimension to a country's own efforts and have proven to be very effective in pinpointing areas for public health action, at both European and country levels. This requires joint work to provide a common basis of information and evidence to ensure both the efficiency of our work and also its effectiveness. Users of health information expect answers to questions about health at European level to be consistent, regardless of the source. Different answers to the same question undermine the credibility of both the Commission and the WHO. Working in partnership on the common collection and provision of information also reduces the burden on countries and makes best use of limited resources. We will therefore strengthen our cooperation in order to work towards a single integrated information system for health in Europe. This can build on existing cooperation, including expanding the use of shared data collection, collaborative analysis of health issues and generation and dissemination of knowledge in support of health policy. Investing in health All European countries are facing major challenges, including growing health care expenditures due to ageing and the need for more care, unhealthy behaviours and an increase in chronic diseases, and increasing costs of innovations in medical technology. Furthermore, European countries will continue to be affected by the ongoing economic crisis, which has and will have major and long-lasting implications on public finances and consequently on countries’ capacity to finance health. Therefore, more than ever, it will be necessary to facilitate the efforts of Member States to get more value and health for money. In the present perspective, where no real increase in health funding can be expected, it will be crucial to assess, identify and disseminate information on the most cost-efficient practices and technologies, as well as obsolete practices, in order to inform decision-making on health budgets with the aim of protecting the values of solidarity, universality and equity of access to health care. We shall therefore work to assist interested countries to make the most efficient use of available resources, disseminating evidence and best practices on how to protect health budgets, maximize health returns on health and non-health investments and help orient public spending towards the most effective and efficient interventions. In this way, we hope not only to contribute now to the protection of health but also to help communities and economies to be ready and able to take advantage of the economic upturn when it arrives. EUR/RC60/12 Add.1 page 4 Health inequalities Health inequalities among and within countries across Europe and concerns about their negative consequences for social cohesion and economic development are real and serious. We shall work together to better monitor inequalities in health (including by producing more disaggregated data), raising awareness, promoting and assisting the exchange of information and knowledge between European countries, identifying and spreading good practices and facilitating design of tailor-made policies for the specific issues prevailing in European countries. We shall also, at the request of Member States, monitor and evaluate the progress in the application of such policies. Strengthening in-country cooperation in non-EU countries We see strong potential and synergies to be gained by reinforcing cooperation between EU delegations in third countries and the WHO country offices. Particular opportunities exist where health is a focal issue under the EU’s external policies; these policies and the related policy instruments will be implemented in close cooperation between the European External Action Service and the European Commission's services in charge, with the participation of the EU Member States under the established mechanisms. Such cooperation can concern many areas, including but not limited to information exchange, health sector assessment, policy dialogue with the host country, facilitation of donor coordination and identification of capacities and support needs. Experience has shown that a “one size fits all” approach will not work and that we need to adapt to the varying needs, capacities and strategic goals among countries and regions. The way forward We will work together to agree on specific objectives and priorities for our cooperation in the European Region and to define clear road maps for joint and complementary actions based on the annual work programmes of each organization, while respecting the principles of subsidiarity and proportionality. These road maps will be discussed and monitored in an improved format of our regular Senior Officials Meetings, which will be made more action- and results-oriented. We will develop a programme of information and exchange, in order to increase our respective staff’s knowledge and understanding of the other organization’s mandates, roles, responsibilities, policies, constraints and ways of working. A particular and coordinated effort will be made to work together more effectively in order to develop, support and complement the European Health Policy, which will be developed in full collaboration with Member States. We will work together across other sectors with a “health in all policies” approach. Efforts will be made to improve our cooperation at the country level. We will work towards building stronger relations between our representations in countries, through sharing of information and working together towards improving the relevance and quality of health sector assessments, as well as advocacy and recommendation to countries. As part of our shared commitment to full transparency and accountability, we plan to monitor the cooperation operationally, as well as strategically. We will analyse what works and what does not, and we will agree on common key indicators for the proven added value of our shared work, together rather than individually and in parallel to one another. The results of our joint health action will be evaluated in 2013 and again in 2015.