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

Chapter 6
262
• Examining the costs. The economic argumentation for
tackling NCD has not been made sufficiently strongly.
More research is needed into the economic implications
of NCD and the cost-effectiveness of NCD interventions.
• Improving the links between policy-making and research.
Close interaction between researchers and policymakers
can be decisive in the use of scientific evidence
for NCD policy-making. Channels to enhance such
interaction could encourage the production and use of
policy-relevant research.
• Learning from peers. Peer review has proved effective in
Finland and Ireland and could be one way for countries
to assess their existing NCD policies and the potential
for improvement.
Adopting the most effective approach
The European NCD Strategy states that “It is possible for
all countries across the Region with very different incomes
and capacities to effectively combat NCD”. The most effective
approach should be adopted in a particular situation.
This may require maximization of opportunity rather than
increased resources.
• Making the best of existing assets. An assessment not
only of high-priority needs but also of available assets
could indicate where effective interventions could be
made.
• Borrowing and joining. This should include a quick review
of other ongoing policies (and not only in the health
field) on which NCD policy could “piggy-back” or into
which an NCD policy component could be added.
• Looking for quick wins. An initial focus on selected quick
wins would encourage the long-term NCD policy process.
Being aware of the wider policy environment
Increasingly, decision-making in the health sector is influenced
by decisions in the broader national policy environment
or at international level. Some of the future challenges
and opportunities were examined in the introduction to
this chapter. Unless changes in the policy environment are
adequately assessed, NCD policy could be derailed.
• Macro changes in areas such a public administration,
management, and education need to be assessed for
their possible impact on NCD policy-making.
• Working with the private sector offers considerable
potential for tackling NCD, but should be guided by a
clear code of ethical behaviour.
• In low- and medium-income countries, new forms of
partnership need to be developed between international
organizations, bilateral donors and national stakeholders
in NCD policy.
• The potential impact of globalization on NCD needs to
be more closely monitored and evaluated.
• New communication technologies offer a huge potential
for access to information, consultation and networking,
but also hold considerable threats. The opportunities
and challenges for NCD of this information explosion
need to be monitored and exploited as appropriate.
• NCD policy-makers could advocate for more openness
in the EU for linking NCD policy to developmental issues
through the structural and other funds.
It can and must be done
Most countries are facing what may appear to be overwhelming
challenges of financial stringency, looming unemployment
and the disaffection of certain social groups, and a
climate in which many of the strings appear to be not in the
hands of national authorities but in those of supranational
and international organizations and corporations. In this
difficult situation, tackling NCD could be considered not to
be a priority or to require too much effort and resources
when urgent economic issues must be dealt with.
Pointers to the future