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

for elderly people, was established. At its outset, 17 NGOs
and 2 individuals were members, and the network connected
immediately to related EU and United Nations activities
and to the section of HelpAge International dealing with
central and eastern Europe.
Given the worsening mortality rates for CVD and cancer in
the over-65 age group, it remains to be seen whether the
integrated strategy for NCD (expected by early 2008) will
specifically address the needs of older people.
2.8. Broad intersectoral policies with a health
component
Lithuania had already developed a strategy for poverty
reduction before joining the EU. On signing the memorandum
of agreement with the European Commission in 2002,
however, Lithuania also joined the Community Process
for the Reduction of Poverty and Social Exclusion. In this
framework, the National Action Plan against Poverty and
Social Exclusion in 2004–2006 (aNAP) (26) was developed.
The Plan includes a health component, but this relates
mainly to communicable diseases and access to care. Brief
mention is made of promoting healthy lifestyles.
3. Infrastructure and resources for policies
to tackle NCD
3.1. Infrastructure
There is a Department for Public Health within the Ministry
of Health, currently composed of about 10 people and
headed by a Secretary for Health. One indication of the
increasing intersectoral interest in tackling health issues is
that the members of this group report being invited to take
part in many more intersectoral meetings than they have
the capacity to attend. Consequently, their capacity is to be
increased to about 30 staff.
As seen above, a National Health Board and Lithuanian
Health Information Centre have been established. On the
whole, they are considered to operate on a well-established
and regular basis, although there appears to be a minority
dissenting view concerning the real influence of the National
Health Board, which acts in an advisory capacity.
EU-funded projects have had an important effect on national
actors and efforts. For example, a project to develop
effective policy and practices to improve the mental health
of children and teenagers following EU enlargement is being
funded by the EU structural funds. Projects related to the
reduction of inequalities in health have been particularly
affected. A five-year project to empower communities to
cope with mental health problems is being funded by the
Open Society Fund in one of the CINDI demonstration
areas.
3.2. Human resources
Despite its small size, Lithuania plays an active role on
the international public health scene and national experts
are fully aware of policy developments in other countries.
Consequently, many Lithuanian experts have developed
strong international networks on which they can call for an
exchange of knowledge and experience. Links with countries
round the Baltic Sea are particularly important.
There appears to be a sense of national pride in the best
sense of the term, meaning that highly skilled people have
devoted their time and talents at both national and local
levels to improving the national situation. The voluntary
contribution of these experts has been crucial to the success
achieved in NCD policy development in Lithuania so
far. National policy and planning systems cannot, however,
rely endlessly on the goodwill and enthusiasm of their
national experts, and academicians must balance teaching
and research responsibilities with participation in policy
development processes. Ways will need to be found to
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Case studies: policy development in countries for tackling noncommunicable diseases