Seventy-first Regional Committee for Europe: virtual session, 13–15 September 2021: European Health Report 2021

WO R L D H EAL T H O RG AN I Z AT IO N R EG I ON AL O F F I C E FO R EU R O PE UN City, Marmorvej 51, DK-2100 Copenhagen Ø, Denmark Telephone: +45 45 33 70 00 Fax: +45 45 33 70 01 Email: eugovernance@who.int Web: http://www.euro.who.int/en/who-we-are/governance Regional Committee for Europe EUR/RC71/INF./3 71st session Virtual session, 13–15 September 2021 2 August 2021 210731 Provisional agenda item 2(b) ORIGINAL: ENGLISH European Health Report 2021 The publication of the European Health Report every three years gives policy-makers, politicians, public health specialists and journalists a vital snapshot of health in the WHO European Region and progress towards health and well-being for all. The report also shows trends in and progress towards the Sustainable Development Goals (SDGs) targets and indicators that are included in the global Thirteenth General Programme of Work, 2019–2023 (GPW 13) WHO Impact Framework, revealing gaps in progress, inequalities and areas of concern and uncertainty where action must be taken. “The European Health Report 2021: Taking stock of the health-related SDGs in the COVID-19 era and leaving no one behind” (EHR 2021) will address the impact of the COVID-19 pandemic on population health and how the WHO Regional Office for Europe, through implementation of the European Programme of Work, 2020–2025 (EPW), will support Member States in this transformative process. Editorial work on the EHR 2021 has begun and discussions with the Institute for Health Metrics and Evaluation (IHME) on projections for key indicators are ongoing. As IHME requires more time to produce Global Burden of Disease (GBD) estimates for 2020, some of them reflecting the impact of COVID-19, the publication of the report has been postponed from September to November 2021. This document provides an updated outline of the report and reflects the feedback received from Member States following the presentation of the proposed technical approach and outline of the report at the fourth session of the Twenty-eighth Standing Committee of the Regional Committee for Europe (SCRC) in May 2021. This document is submitted to the WHO Regional Committee for Europe for information. EUR/RC71/INF./3 page 2 Background 1. The European Health Report (EHR) is the WHO Regional Office for Europe’s (WHO/Europe’s) three-yearly flagship report. The main aims of the EHRs are to present an overview of the health status of the population of the WHO European Region, including health determinants, universal health coverage and health inequities; to take stock of the Region’s progress towards its health policy goals and targets; and to identify priority areas for further improvement and intensified action. 2. The provisional title for the EHR 2021 is “The European Health Report 2021: Taking stock of the health-related SDGs in the COVID-19 era and leaving no one behind”. The basis of the report will be the Sustainable Development Goals (SDGs) targets and indicators that are included in the global Thirteenth General Programme of Work, 2019–2023 (GPW 13) WHO Impact Framework. The COVID-19 crisis has set in motion what will be a profound transformation of health systems and social care in the European Region, with the prospect of a digital, innovative, outcomes-directed and people-centred future. The EHR 2021 will address the impact of the COVID-19 pandemic on population health and how WHO/Europe, through implementation of the European Programme of Work, 2020–2025 (EPW), will support Member States in this transformative process. Throughout the report, existing health inequalities and opportunities to address these will be highlighted. 3. For the purpose of this report, WHO/Europe is collaborating with the Institute for Health Metrics and Evaluation (IHME), an independent research centre within the University of Washington in Seattle, United States of America. IHME will produce projections for key SDG indicators for the EHR 2021. The methodology underlying the projections will be developed by IHME in close consultation with WHO/Europe. Provisional outline of the EHR 2021 4. Based on the availability of data and key projections, the proposed structure of the report has been adapted to include three chapters instead of four, and is as follows. Introduction • Rationale for and aims of the report Chapter 1. Taking stock of the health-related SDGs • The health-related SDG indicators • Health inequities • Projections for key SDG indicators Chapter 2. The impact of the COVID-19 pandemic on population health • Direct impact (death and disease caused by COVID-19) • Indirect impact, with a specific focus on mental health and universal health coverage • Impact on health inequities EUR/RC71/INF./3 page 3 Chapter 3. Moving forward: “United Action for Better Health in Europe” • Linking the findings of the report to the goals and activities of the EPW: how will we recover and get back on track? • Focus on key interventions Feedback from Member States on how WHO/Europe will support them in strengthening their health information systems for improved evidence-informed policy-making 5. The proposed technical approach and outline for the EHR 2021 were presented for feedback at the third and fourth regular sessions of the Twenty-eighth Standing Committee of the Regional Committee for Europe (SCRC). In particular, Member States were asked to consider: • the proposed technical approach to using official WHO or other United Nations databases to extract data for calculating the indicators; • the proposed structure of the report; • the proposal to report on progress towards the SDG targets at regional level (using both current indicator values and projections); and • the proposed collaboration with IHME to produce projections for key indicators. 6. Three Member States provided written feedback on the proposed technical approach and outline for the EHR 2021 described in the working documents on this topic that were submitted at the third and the fourth regular sessions of the Twenty-eighth SCRC. The collaboration with IHME as well as the focus on SDGs and the impact of COVID-19 were endorsed. 7. The envisaged focus on health information in Chapter 3 was discussed, and there was a concern that this focus might come at the expense of other areas such as prevention. This is not planned to be the case, as Chapter 3 will address key interventions aimed at getting back on track in the Region, and prevention will be an important part of this. Furthermore, Chapter 3 will address how the necessary actions can be addressed under the EPW. Using data and indicators to measure whether the Region is on track to achieve the goals and ambitions of the EPW and the related GPW 13 and SDGs is an essential element of the work carried out under the EPW, and therefore a reflection on current data and information gaps and how to address these will also be included in Chapter 3. 8. Finally, it was suggested that the report include a thorough analysis of the performance of health systems under stress at both the national and regional levels. Chapter 2, which will detail the direct and indirect impacts of the COVID-19 pandemic on population health, will provide insight into this as well as the new Global Burden of Disease (GBD) estimates and projections that will be developed by IHME (see below for more information). Progress on the EHR 2021 to date 9. The WHO editorial team for the EHR 2021 has been set up and an overview of data availability for the health-related SDG indicators has been conducted. WHO data sources will EUR/RC71/INF./3 page 4 be used as far as possible (European Health for All database, Global Health Observatory). If data are not available in these databases, the United Nations Global SDG Indicators Database will be used. 10. Input on key interventions for getting back on track to achieve the SDGs in the Region was gathered from the technical units in WHO/Europe. Furthermore, the EHR 2021 will complement the SDG progress report that will be presented this year. 11. Several meetings with IHME have taken place to discuss the options for projections for inclusion in the report. IHME is working on updating their GBD estimates for 2020. Wherever feasible and relevant, the impact of COVID-19 will be considered, but this means that the estimates will take longer to produce than usual. However, as it is important to include projections that build on these data in EHR 2021, the publication date has been postponed to November 2021. 12. As will be detailed in Chapter 1 of the report (Taking stock of the health-related SDGs), a selection of indicators has been determined which will be structured according to the three EPW core priorities. Most of the suitable data sources and recent data have been identified, and descriptions related to the first indicators are being drafted. With regard to Chapter 2 (The impact of the COVID-19 pandemic on population health), an outline has been drafted and information sources are being collected. For Chapter 3 (Moving forward: “United Action for Better Health in Europe”), work on drafting the outline, which will highlight the main gaps and delays identified in Chapters 1 and 2, is ongoing. It will address how WHO/Europe will work with Member States under the EPW to overcome these challenges and rebuild more efficiently after the pandemic. Next steps and timeline 13. WHO/Europe will continue to discuss with IHME the key indicators to be included in the report. The WHO editorial team has started working on the draft by describing the current status of the health-related SDGs in the European Region, making use of the data sources as described above. 14. The following timeline is envisaged for the EHR 2021: • First draft of the full report ready for external review (excluding the IHME projections): end of August 2021 • External review and processing of feedback: mid-September 2021 • Final draft of the full report (including the IHME projections) and short highlights report produced: end of September 2021 • Editing and translation: October–November 2021. Note: The full report will be available in English and the highlights report in English and Russian for publication in November. As soon as is feasible after that, a Russian version of the full report will be produced as well as French and German versions of the highlights report. • Publication: end of November 2021. Originally, the publication date was set for September 2021. However, due to the great relevance of including the updated EUR/RC71/INF./3 page 5 IHME projections as described above, publication has been postponed until the end of November and the report will be presented during a special event. = = =