- HEALTH PROMOTING HOSPITALS Dublin 28-30 April 2005 WHO strategies on Noncommunicable diseases and...

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HEALTH PROMOTING HOSPITALS

Dublin28-30 April 2005

WHO strategies on WHO strategies on Noncommunicable diseases and Noncommunicable diseases and

Chronic careChronic care

Jill FarringtonCoordinator, Noncommunicable Diseases

Division of Technical SupportWHO Regional Office for Europe

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OverviewOverview

Themes Relevant WHO strategies /initiatives European NCD strategy

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ThemesThemes

Chronic disease (lung)

Healthy lifestyles (tobacco, physical activity)

Empowerment of patient (self-management)

Settings for care (home, community, hospital)

Evidence-based interventions (Guidance)

Cost-effectiveness Outcomes (quality of

life) Integrated care Use of technology Determinants of

health (poverty)

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Innovative Care for Chronic ConditionsInnovative Care for Chronic Conditions

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Innovative Care for Chronic ConditionsInnovative Care for Chronic Conditions

Eight essential elements for taking action

1. Support a paradigm shift2. Manage the political environment3. Build integrated health care4. Align sectoral policies for health5. Use health care personnel more

effectively6. Centre care on the patient and family7. Support patients in their

communities8. Emphasise prevention

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Preparing the 21st century global Preparing the 21st century global healthcare workforcehealthcare workforce

Five basic competencies

1. Patient centred care

2. Partnering

3. Quality improvement

4. Information and communication technology

5. Public health perspective

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Building blocksBuilding blocks

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Seven leading conditions in Europe Seven leading conditions in Europe = 4.7 million deaths and 50.8 million DALYs= 4.7 million deaths and 50.8 million DALYs

1. Ischaemic heart disease

2. Unipolar depressive disorders

3. Cerebrovascular disease

4. Alcohol use disorders

5. Chronic pulmonary disease

6. Road traffic injury

7. Lung cancer

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Noncommunicable DiseasesNoncommunicable Diseases

THE public health challenge in Europe:

77% diseases burden; 86% mortality in 2002 Widening gaps within and between Member

States Worrying trends in risk factors Increasing burden on health systems,

economy and society Significant potential for health gain

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Cardiovascular diseases cause more than half of all Cardiovascular diseases cause more than half of all deaths in Europedeaths in Europe

<= 300

<= 240

<= 180

<= 120

0 - 60

No dataSDR per 100000

CVD mortality (up to 65 years) in the WHO European Region

Last available data EUROPE

126.93

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Seven leading risk factors account for most of the Seven leading risk factors account for most of the burden of disease in Europeburden of disease in Europe

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Contribution of main risk factors to main chronic diseases

Percentage contribution of each of the seven major risk factors to the disease burden of each of the seven major chronic diseases

Conditions Contribution in percent of individual risk factors

A B C D E F G

High BP

Tobacco Alcohol High cholesterol

Over-weight

Low fruit /veg. intake

Physical inactivity

1. Ischaemic heart disease 58 22 0.2 63 33 28 22

2. Unipolar depressive disorders 3

3. Cerebrovascular disease 72 22 0 27 23 12 9

4. Alcohol use disorders 100

5. Chronic pulmonary disease 69

6. Road traffic injury 38

7. Lung cancer 85 11

Source: forthcoming European Health Report 2005, adapted from Ezzati et al.

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Global strategy for the prevention and control of noncommunicable diseases 2000

Objectives

To map emerging epidemics NCD

To reduce exposure to common risk factors for NCD (tobacco, unhealthy diet, physical inactivity)

To strengthen health care for people with NCD (CVD, cancer, diabetes, chronic respiratory disease)

Key components

Surveillance

Promotion of health and prevention of disease burden

Health care interventions to manage disease

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Diet, Physical Activity, Tobacco

Global Strategy on Diet, Physical Activity &

Health 2004

Reducing risk factors Raising awareness and

understanding of positive impact

Developing policy Monitoring, research,

support

European Food and Nutrition Action Plan

2000-2005

Growing, buying and eating the right kinds of foods can reduce the risk of disease and simultaneously promote a sustainable environment Food safety Nutrition Food security

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Diet, Physical Activity, Tobacco

Framework Convention on Tobacco Control

Entered into force on 27 February 2005

Legally binding treaty setting international standards on tobacco price and tax increases, tobacco advertising, sponsorship and labelling, illicit trade etc

17 of the 65 states ratifying the FCTC so far are European

European Strategy on Tobacco Control 2002

Strategic framework Measures to reduce

demand for tobacco products

Measures to reduce the supply of tobacco products

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Why a European NCD strategy?Why a European NCD strategy?

Regional response to global strategies Europe has diversity and specificity Opportunity to reset the focus Both horizontal and vertical approaches

needed Moving towards a common goal: reducing the

burden from NCD Greater support to countries facing particular

challenges Facilitating mobilisation of resources beyond

health sector

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10 Principles for action10 Principles for action

Political commitment

Integrated approach Active role for

health system Patient centred care Citizen involvement

Mobilisation of relevant sectors

Reduction of health inequalities

Attention to the most vulnerable

Life course approach NCD policy as part of

the broader public health effort

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RC54 ResolutionRC54 Resolution

Comprehensive action-oriented Strong focus on implementation An integral part of the updated

HEALTH21 policy framework Take account of pre-existing

commitments of Member States & relevant strategies

In collaboration with Member States, intergovernmental agencies, NGOs and other relevant partners, including industry

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TimelineTimeline

1st meeting NCD national counterparts April 05Drafting group June 2005Drafting group October 2005

2nd meeting NCD national counterparts November 2005

Country consultation March 2006Strategy finalised June 2006

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WHO strategies on WHO strategies on Noncommunicable diseases and Noncommunicable diseases and

Chronic careChronic carewww.who.int

www.euro.who.int

Jill FarringtonCoordinator, Noncommunicable Diseases

Division of Technical SupportWHO Regional Office for Europe

[email protected]

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