1. - HEALTH PROMOTING HOSPITALS Dublin 28-30 April 2005 WHO strategies on Noncommunicable diseases and Chronic care Jill Farrington Coordinator, Noncommunicable Diseases Division of Technical Support WHO Regional Office for Europe

2. - HEALTH PROMOTING HOSPITALS Dublin 28-30 April 2005Overview Themes Relevant WHO strategies /initiatives European NCD strategy

3. - HEALTH PROMOTING HOSPITALS Dublin 28-30 April 2005 Themes 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)

4. - HEALTH PROMOTING HOSPITALS Dublin 28-30 April 2005 Innovative Care for Chronic Conditions

5. - HEALTH PROMOTING HOSPITALS Dublin 28-30 April 2005 Innovative Care for Chronic Conditions Eight essential elements for taking action 1.Support a paradigm shift 2.Manage the political environment 3.Build integrated health care 4.Align sectoral policies for health 5.Use health care personnel more effectively 6.Centre care on the patient and family 7.Support patients in their communities 8.Emphasise prevention

6. - HEALTH PROMOTING HOSPITALS Dublin 28-30 April 2005 Preparing the 21st century global healthcare workforce Five basic competencies 1.Patient centred care 2.Partnering 3.Quality improvement 4.Information and communication technology 5.Public health perspective

7. - HEALTH PROMOTING HOSPITALS Dublin 28-30 April 2005 Building blocks

8. - HEALTH PROMOTING HOSPITALS Dublin 28-30 April 2005 Seven leading conditions in Europe = 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

9. - HEALTH PROMOTING HOSPITALS Dublin 28-30 April 2005 Noncommunicable 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

10. - HEALTH PROMOTING HOSPITALS Dublin 28-30 April 2005 Cardiovascular diseases cause more than half of all deaths in Europe

11. - HEALTH PROMOTING HOSPITALS Dublin 28-30 April 2005 Seven leading risk factors account for most of the burden of disease in Europe

12. - HEALTH PROMOTING HOSPITALS Dublin 28-30 April 2005 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 ConditionsContribution in percent of individual risk factors ABCDEFG High BP TobaccoAlcoholHigh cholesterol Over- weight Low fruit /veg. intake Physical inactivity 1. Ischaemic heart disease58220.263332822 2. Unipolar depressive disorders 3 3. Cerebrovascular disease722202723129 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.

13. - HEALTH PROMOTING HOSPITALS Dublin 28-30 April 2005 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

14. - HEALTH PROMOTING HOSPITALS Dublin 28-30 April 2005 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

15. - HEALTH PROMOTING HOSPITALS Dublin 28-30 April 2005 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

16. - HEALTH PROMOTING HOSPITALS Dublin 28-30 April 2005 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

17. - HEALTH PROMOTING HOSPITALS Dublin 28-30 April 2005 10 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

18. - HEALTH PROMOTING HOSPITALS Dublin 28-30 April 2005 RC54 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

19. - HEALTH PROMOTING HOSPITALS Dublin 28-30 April 2005 Timeline 1 st meeting NCD national counterparts April 05 Drafting group June 2005 Drafting group October 2005 2 nd meeting NCD national counterparts November 2005 Country consultation March 2006 Strategy finalised June 2006

20. - HEALTH PROMOTING HOSPITALS Dublin 28-30 April 2005 WHO strategies on Noncommunicable diseases and Chronic care www.who.int www.euro.who.int www.who.int www.euro.who.int www.who.int www.euro.who.int Jill Farrington Coordinator, Noncommunicable Diseases Division of Technical Support WHO Regional Office for Europe jfa@euro.who.int

21. - HEALTH PROMOTING HOSPITALS Dublin 28-30 April 2005