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

Chapter 6
Pointers to the future
Péter Makara & Anna Ritsatakis
Introduction
In the coming years, the substantial reduction of NCD and
their related health inequalities constitute one of the major
public health challenges facing Europe. Gaining health (1),
WHO’s European NCD Strategy, outlines a comprehensive,
action-oriented approach to the prevention and control of
NCD.
Those who plan and deliver policies and services to tackle
NCD face increasing pressure to demonstrate that their
actions are worthwhile, effective and efficient. They are
faced with questions on: whether an NCD policy is a good
investment; how the short- and long-term aims of such a
policy can be harmonized; whether there are general rules
of planning, coordinating, implementing and monitoring policies
to tackle NCD; to what degree social and economic
factors related to policies tackling NCD can be influenced;
and how the resulting mutual gains can be measured. Policies
and programmes to tackle NCD, if properly planned
and implemented, involve complex and sophisticated activities.
NCD policy action requires multiple approaches, relies
on interdisciplinary inputs and operates at several levels
over long periods of time. Despite this complexity, policy
development must be monitored, assessed and revised.
Fortunately, over the last 2–3 decades, knowledge and
understanding about how best to develop policies to tackle
NCD have significantly improved. Decision-makers and
practitioners, however, are not always fully aware of these
developments or their implications. This study was not intended
to provide a “cookery book” for NCD policy-making.
Nevertheless, some of the lessons learnt may offer a
source of inspiration and pointers for future policy-making.
The extreme complexity of the task requires originality and
creativity, to build on existing experience while exploring
new ways and solutions. In looking forward, policy-makers
are faced with a wide range of issues, both long-standing
such as the ageing population and newly emerging such as
technological changes in health care and the communications
field, globalization and an expanding EU. In this final
chapter, therefore, some of the challenges and opportunities
in the policy environment are briefly touched on to
give an idea of the comprehensiveness and complexity of
the task ahead. Some pointers for the future are then suggested.
Challenges and opportunities
Demographic and health issues
By 2050, on average in OECD countries, a quarter of the
population will be aged 65 years and older (2). A new, older
society is emerging, with implications for families, health
care, and social and economic development. In the WHO
European Region, people aged 65 years can expect to live a
further 17 years and, if present trends continue, those aged
65–79 years will be more active and in better health than
in previous generations. They represent a valuable resource
for society, so it is more important than ever that people
remain healthy and independent.
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Pointers to the future