Water, sanitation and health

14 people die every day in the pan-European region, due to inadequate water, sanitation and hygiene.

In response a Protocol on Water and Health has been developed which urges an holistic approach to water, sanitation and health, enabling countries to use the Protocol as a tool to implement Strategic Development Goals SDG) at national levels. Through improving their water, health and environmental situations, countries also support and reinforce the benefits to many other areas of development. This creates positive, interlinked and mutually supportive outcomes that reduce poverty, address inequality and promote sustainability – all of which are overarching themes of the SDGs.

More information about the Protocol on Water and Health on the euro.who.int website

European Knowledge Hub on Health and Migration

Although the number of refugee and migrant arrivals has seen an overall reduction in recent months, migration to Europe continues at a steady rate. In 2016 more than 330,000 refugees and migrants reached Italy and Greece with over 4,200 being found dead or reported missing at sea, compared to 3,771 in 2015.

The health systems in countries receiving refugees and migrants should be able to deal with the immediate health needs of new arrivals, as well as diagnose and treat common infectious diseases and noncommunicable illnesses. They should have effective disease surveillance and reporting systems in place to investigate and respond to outbreaks.

WHO has launched the first ever European Knowledge Hub on Health and Migration to support the work of those who deal directly with the health aspects of migration, serving as a repository for scientific evidence on the subject. It will act as a learning platform for all stakeholders working in the field of migration and health, including policy-makers, health professionals, social workers, managers of migration centres and first-line responders.

More information about Migrants and Health on the euro.who.int website

HIV & Hepatitis in Europe

There are 53 countries in the WHO European Region and within those countries there are 15 million people living with hepatitis C and 13.3 million people living with hepatitis B, the vast majority of whom are unaware of their infection and therefore at risk of developing cirrhosis or liver cancer. On average, fewer than 3% of patients with chronic hepatitis C receive treatment. In addition, there are 2.5 million people living with HIV, almost half of whom are unaware of their infection.

Safe and effective treatments exist that allow people living with HIV and/or viral hepatitis B to lead healthy and long lives. Those living with hepatitis C can be cured. Knowing your health status, however, is the prerequisite to accessing treatment and the WHO strongly supports the European HIV-Hepatitis initiative which aims to break the silence around HIV and viral hepatitis and build momentum to stop these epidemics by 2030.

Read more about HIV and Hepatitis in Europe on the euro.who.int website

How to do better health reform

Health systems are continually being reformed but why? And how?

An article in ‘Healthcare Reform, Quality and Safety: Perspectives, Participants, Partnerships and Prospects in 30 Countries’ analyses the impact that health-reform initiatives have had on the quality and safety of care in low-, middle- and high-income countries—Argentina, Australia, Brazil, Chile, China, Denmark, England, Ghana, Germany, the Gulf states, Hong Kong, India, Indonesia, Israel, Italy, Japan, Mexico, Myanmar, New Zealand, Norway, Oman, Papua New Guinea (PNG), South Africa, the USA, Scotland and Sweden. Popular reforms in less well-off countries include boosting equity, providing infrastructure, and reducing mortality and morbidity in maternal and child health. In countries with higher GDP per capita, the focus is on new IT systems or trialing innovative funding models. All countries are embracing ways to enhance quality of care and keep patients safe, via mechanisms such as accreditation, clinical guidelines and hand hygiene campaigns.

The article also highlights two important points: firstly that a population’s health is not determined solely by the acute system, but is a product of inter-sectoral effort—that is, measures to alleviate poverty and provide good housing, education, nutrition, running water and sanitation across the population. Secondly, all reformers and advocates of better-quality of care should include well-designed evaluation in their initiatives. Too often, improvement is assumed rather than measured.

Read the full abstract on Health Reform on the intqhc.oxfordjournals.org website

Environmental sustainability in health systems

Health systems have a substantial impact on the environment and are major consumers of energy and resources, according to evidence compiled in the new WHO policy paper “Towards environmentally sustainable health systems in Europe”.

The paper explains that although health systems use up natural resources, contribute to greenhouse gas emissions and produce large quantities of waste, including hazardous material, they can also have a positive impact on the environment – particularly in the areas of health promotion and environmental health protection activities.

Find out more about environmentally sustainable health systems on the euro.who.int website

Lead Poisoning in Europe

Lead poisoning is entirely preventable. Yet, the Institute for Health Metrics and Evaluation estimates that in 2013 lead exposure accounted for 853,000 deaths globally and 16.8 million disability-adjusted life years due to its long-term effects on health.

Lead poisoning can lead to developmental, behavioural and neurological disorders, anaemia, tiredness and muscle weakness, as well as kidney and liver damage. Scientific studies demonstrate that there is no safe threshold for lead in the human body; efforts should therefore focus on minimizing exposure as much as possible.

According to a WHO survey, 34 of the 53 countries in the WHO European Region report having legislation regulating lead paint in place. However, in some countries this regulation is not yet enforced. In addition to lead paint, lead is found in emissions from industrial processes and waste management, in drinking water (due to the use of lead in water pipes), in consumer products such as toys, cosmetics or jewellery, and in lead-acid batteries.

WHO/Europe encourages all European countries to join forces to advocate for reducing the risks to human health from lead through minimizing environmental and occupational exposure, particularly for children and women of childbearing age.

More information about Lead Poisoning is on the euro.who.int website.

Organising out-of-hours primary care

Out-of-hours (OOH) services provide urgent primary care when primary care physician (PCP) offices are closed, most often from 5pm on weekdays and all day on weekends and holidays. Based on a policy survey (covering 27 OECD countries) and the existing literature, this paper describes the current challenges associated with the organisation of OOH primary care and reviews the existing models of delivering OOH primary care.

Findings of the paper show that most OECD health systems report key challenges to provide OOH primary care in an accessible and safe way. These challenges relate to (i) PCPs’ reluctance to practise due to high workload and insufficient remuneration; and (ii) geographical variations in access to OOH primary care within each health system. Together these challenges are leading sources of inappropriate hospital emergency department (ED) visits. Results also indicate that several models of OOH primary care exist alongside each other in the 27 OECD countries participating in the policy survey. Hospital EDs, rota groups and practice-based services remain the most common OOH arrangements, but there is a tendency to shift OOH primary care towards primary care centres and large-scale organisations known as general practice cooperatives (GPCs). A range of solutions have been implemented to improve access and quality of OOH primary care across OECD countries. These include providing organisational and financial support to PCPs; using other health care professionals (such as nurse practitioners), making OOH care participation compulsory, setting up a telephone triage system, using new technologies, and developing rich information systems.

Download the full report on Out-of-Hours primary care from the oecd-ilibrary.org website

Global tuberculosis report 2016

WHO has published a global TB report every year since 1997. The main aim of the report is to provide a comprehensive and up-to-date assessment of the TB epidemic, and of progress in prevention, diagnosis and treatment of the disease at global, regional and country levels.

This is done in the context of recommended global TB strategies and targets endorsed by WHO’s Member States and broader development goals set by the United Nations.

Download the full report on Global Tuberculosis from the who.int website

Promoting Health and Wellbeing towards 2030

Thirty years after the Ottawa Charter for Health Promotion, EuroHealthNet has published ‘Promoting Health and Wellbeing towards 2030: taking the Ottawa Charter Forward in the context of the UN Sustainable Development Agenda 2030′.

This statement confirms the role and contribution of health promotion in achieving sustainable development and social progress and includes 10 steps to promote health in a rapidly changing world. In order to maximise the role of health promotion, EuroHealthNet believes the sector needs to be:

  • responsive
  • equitable
  • joined up
  • updated
  • value driven
  • ethical
  • new
  • active
  • technological
  • ecological

Download the full statement on Health Promotion from the eurohealthnet.eu website