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

• Of the countries responding in 2005/2006, 71% reported
that they had national targets for chronic disease
prevention and control.
• There is an increasing tendency for having a national
action plan for tobacco control, diabetes, heart disease
and cancer. The proportion of countries responding to
both surveys that had such an action plan increased by
40%, 14%, 13% and 17%, respectively, over the five-year
period.
• Almost two thirds of the countries had become contracting
parties to the WHO FCTC and 24% were
already under way with plans for implementation.
• Of the countries responding in 2005/2006, 92%
reported that they included chronic diseases in their annual
health reports.
• Of the 30 countries responding to both surveys, the
proportion having a routine surveillance system for
chronic diseases increased 10% between 2000/2001
and 2005/2006 to 84%.
• Most countries responding in 2005/2006 reported
having national or provincial studies or surveys of the
risk factors tobacco use, unhealthy diet, physical activity
and alcohol consumption (87%, 84%, 82% and 84%,
respectively).
• Nearly two thirds of the countries responding in
2005/2006 had established a national demonstration
programme for integrated chronic disease prevention
and control.
• A large proportion of responding countries in
2005/2006 reported having national protocols, guidelines
or standards for hypertension, diabetes, heart
disease and cancer (79%, 82%, 74% and 82%, respectively).
• The proportion of countries responding to both
surveys that had a specific budget for implementing a
national policy or strategy for chronic disease prevention
and control rose from 50% in 2000/2001 to 73% in
2005/2006.
The main characteristics of NCD policies, programmes and
legislation in place in European countries, based on the replies
submitted by 38 countries, are summarized in Table 1.
Thus, at the time of the development and launch of the
European NCD Strategy, the NCD policy field in European
countries already appears to have been rich in “vertical”
issue-specific national policies and programmes as well as
more “horizontal” or “umbrella” policies and programmes
relevant to chronic disease prevention and control as a
whole.
The results of the survey indicate clearly the opportu nities
but also the limits of such a quantitative approach.
While the survey had measured the quantity of policies and
programmes present in a country, it could not indicate their
quality or their success in implementation, or explain how
or why they had evolved in such a way over time and their
interrelationships. The case studies presented in Chapter
IV aim to provide deeper, more refined qualitative data and
information on the assessment of Member States’ policies
and capacities to respond to NCD.
Gaining health
The WHO Regional Committee for Europe, at its fiftyfourth
session in 2004, while acknowledging the extensive
work and experience already existing in the European
Region, pointed out the lack of and need for a strategy for
NCD prevention and control in Europe. Such a strategy
needed to take an integrated approach across the continuum
of health promotion, disease prevention, rehabilitation
and health care, and should draw on Member States’ existing
relevant commitments, such as the various resolutions
alluded to above on risk factors and determinants. For such
an ambitious strategy and complex task, there then began
an extensive consultation process with countries, experts,
nongovernmental organizations (NGOs) and other stakeholders
for its development.
Chapter 2
9
History and context of policies to tackle NCD