Reducing the disease burden from noncommunicable diseases in Europe

274 VOLUME 4 | ISSUE 3 | SEPTEMBER 2018 | 271–490PUBLIC HEALTH PANORAMA EDITORIAL The health of the population in the WHO European Region is improving rapidly, but there has been unequal progress both between and within countries and across broad disease groups. Noncommunicable diseases (NCDs) are the main cause of ill health and are currently responsible for 89% of deaths and 85% of disability in the European Region. The rate at which progress in reducing the disease burden from NCDs is being achieved is slower than that in other areas such as communicable diseases and injuries, so the relative share of the disease burden caused by NCDs is increasing. For this reason, reducing the burden of NCDs is one of the main priorities of Health  2020 and the health-related Sustainable Development Goals (SDGs). Achievement of WHO’s Thirteenth General Programme of Work 2019–2023 with its ambitious “triple billion” goal, namely one billion more people benefiting from universal health coverage, one billion more people better protected from health emergencies and one billion more people enjoying better health and well- being, will be possible only if we comprehensively tackle prevention and control of NCDs across all settings, including in emergency settings, and strengthen health systems so that they can respond effectively to NCDs. In achieving this goal, both a whole-of-society approach and multisectoral action for health, as outlined in Health 2020, are indispensable. The European Region has long been at the forefront of the fight against NCDs. The fact that it is the only WHO region that is on track to achieve SDG target 3.4 (“By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being”) confirms the leadership role that Member States in the European Region have taken in the global fight against NCDs. One major development in this regard was the founding in 2015, through a generous voluntary contribution from the Russian Federation, of the WHO European Office for the Prevention and Control of NCDs. Located in Moscow, the Office is an integral part of the Division of Noncommunicable Diseases and Promoting Health through the Life-course, and is both a powerhouse of innovation in the fight against NCDs in the European Region and an invaluable resource for high- quality technical assistance that is used to enable Member States in the Region to accelerate progress towards the achievement of national, regional and global NCD commitments. As this issue of Public Health Panorama goes to press, two key governance meetings addressing the NCD burden are about to be held. The first is the 68th session of the WHO Regional Committee for Europe, which will be held in Rome, Italy, on 17–20 September 2018. Topics to be discussed at that meeting include implementation of the roadmap to implement the 2030 Agenda for Sustainable Development in Europe and the strategy on the health and well-being of men in the WHO European Region. In addition, progress reports will be considered on implementation of the Action Plan for the Prevention and Control of NCDs in the WHO European Region 2016– 2025, the Physical Activity Strategy for the WHO European Region 2016–2025 and the Roadmap of actions to strengthen implementation of the WHO Framework Convention on Tobacco Control (WHO FCTC) in the European Region Reducing the disease burden from noncommunicable diseases in Europe Zsuzsanna Jakab WHO Regional Director for Europe 275 ТОМ 4 | ВЫПУСК 3 | СЕНТЯБРЬ 2018 Г. | 271–490ПАНОРАМА ОБЩЕСТВЕННОГО ЗДРАВООХРАНЕНИЯ 2015–2025. A week later, the third United Nations High-level Meeting on Noncommunicable Diseases will take place in New York, United States of America. In that meeting, heads of State and other government officials will come together to undertake a comprehensive review of the global and national progress made in putting measures in place to prevent people from dying prematurely from NCDs. In doing so, they will reaffirm their leadership and commitment in the fight against NCDs, which is imperative given the enormous burden of NCDs on our societies and the importance of the whole-of- government approach, as outlined in Health 2020. Although the European Region is on track to achieve the SDG target on premature NCD mortality, progress in the rest of the world is well off track. In addition, even the European Region is off track with respect to achieving several SDG and other NCD-related targets. For example, it is not on track to meet SDG target 3.a on implementation of the WHO FCTC, and none of the Member States in the Region will be able to halt the rise of overweight, obesity and diabetes if current trends continue. Moreover, progress regarding the implementation of WHO “best buys” for the prevention and treatment of NCDs has been limited in recent years, so we need to intensify our commitment and step up our actions in this regard if we want to reverse the situation by 2030 and achieve the agreed goals. In response, Member States in the European Region have proposed a tailored and contextualized plan for “leapfrogging” over progress in the fight against NCDs, with a focus on fully exploiting the WHO “best buys” for the prevention and control of NCDs and with a special emphasis on reducing excess male and cardiovascular mortality. The ongoing work on investment cases for NCDs in Member States in the European Region, combined with the discussion on financial protection, will also help countries to scale up interventions and reduce inequity. Several of the topics and reports that will be discussed at the 68th session of the Regional Committee, such as the strategy on the health and well-being of men in the European Region, and the outcome statements of two major high-level meetings on health systems strengthening  – Health Systems Respond to NCDs: Experience in the European Region (Sitges, Spain, 16–18 April 2018) and Health Systems for Prosperity and Solidarity: Leaving No One Behind (Tallinn, Estonia, on 13– 14 June 2018)  – highlight important follow-up actions taken by the Secretariat of the Regional Office in response to this proposal by Member States. As part of its ongoing support for Member States, the Regional Office will continue to report on achievements made in reducing the NCD burden, through its annual Monitoring NCD commitments in Europe publication, as well as by facilitating high-level regional dialogues. To this end, the next high-level regional meeting will be held in early 2019 to discuss progress in the implementation of the Ashgabat Declaration on the Prevention and Control of Noncommunicable Diseases in the Context of Health 2020. This special issue of Public Health Panorama is, therefore, very timely. It showcases the impressive work ongoing in European Region in all four priority action areas of the Action Plan for the Prevention and Control of NCDs in the WHO European Region 2016–2025. I wish you pleasant reading and hope that the articles will provide both inspiration and a useful tool for stepping up the fight against NCDs in your own country. EDITORIAL