Gaining health : analysis of policy development in European ...

Chapter 1
Introduction
Péter Makara
The greatest disease burden in Europe comes from noncommunicable
diseases (NCD). In 2005 (1), an estimated
86% of deaths and 77% of the disease burden 1 were caused
by NCD, a broad group of conditions linked by common
risk factors, underlying determinants and opportunities for
intervention.
At its fifty-forth session in 2004, the WHO Regional
Committee for Europe acknowledged the importance of
the problem (2). It charged the WHO Regional Office for
Europe with developing a comprehensive, action-oriented
strategy for the prevention and control of NCD in the
WHO European Region, to be presented at its fifty-sixth
session in 2006.
The resulting document, entitled Gaining health: the European
Strategy for the Prevention and Control of Noncommunicable
Diseases (3) 2 was endorsed by the Member States in
2006 (4). It is integral to the updated Health for All framework
(5) and takes account of existing Member States’ commitments
through WHO ministerial conferences, relevant
strategies and resolutions, 3 as well as the experience gained
through the countrywide integrated noncommunicable
diseases intervention (CINDI) programme.
The European NCD Strategy promotes a comprehensive
and integrated approach to tackling NCD. Its objectives
1
As measured by disability-adjusted life-years (DALYs).
2
Hereinafter referred to in short as the European NCD Strategy.
3
For a list of the relevant WHO strategies, action plans and ministerial
conference declarations, see Annex 2 of the European NCD Strategy (3).
are to combine integrated action on risk factors and their
underlying determinants across sectors with efforts to
strengthen health systems with a view to improving prevention
and control. The Strategy puts forward a framework
for action to assist countries in formulating their response
to NCD, building on strategies and actions already in place
and encouraging them to assess and refine existing approaches.
It is guided by six key messages: the importance
of prevention throughout life, the value of health-supporting
environments, the need for health services to be fit for their
purpose, the empowerment of people as active partners in
promoting health and managing disease, and the crucial role
of government in building intersectoral policy and facilitating
access. While recognizing the diversity of European
countries and the variety of resource/capacity levels and
challenges faced, it nevertheless sees an effective response
to be within the reach of all.
To support Member States in implementing the Strategy,
the Regional Office was requested, through the accompanying
resolution, to facilitate an exchange of information on
evidence and best practice, and to establish a monitoring
mechanism to measure progress in policy development
and implementation and their related impact on health
development (4). A network of national counterparts was
to be established as an international resource and advisory
mechanism to support this work.
Within this framework, the then Coordinator, Noncommunicable
Diseases at the Regional Office, Jill Farrington,
initiated a qualitative review of NCD policies in selected
European countries. The aim was to broaden understanding
on NCD policy development and implementation within
Introduction
Chapter 1
1