1. European Strategy for the Prevention and Control of Noncommunicable Diseases & Strategies for Promotion of Healthy Lifestyles
St Petersburg. Russian Federation
11 December 2007
Dr Jill Farrington, Coordinator, Noncommunicable Diseases
WHO Regional Office for Europe

2. CVD causes more >50% of all deaths in Europe
Cardiovascular mortality (up to 65 years) in the WHO European Region
<= 300
<= 240
<= 180
<= 120
Last available
data
0 - 60
No data
SDR per
….and is a main contributor to the almost 20 year difference in life expectancy across Europe

3. The main causes are known

4. Determinants of health
Health inequalities cannot be reduced by the health service alone.
Determinants of health cannot be tackled by the health service alone
Source: Dahlgren G, Whitehead M. 1991

5. Strategic direction Tobacco Control Alcohol Control
European Strategy for Tobacco Control 2002
Framework Convention on Tobacco Control
Alcohol Control
Framework for Alcohol Policy in the WHO European Region 2005
Diet, Physical Activity, Obesity
Global strategy for diet, physical activity and health 2004
2nd European action plan for food and nutrition policy 2007
Ministerial Conference on Counteracting Obesity 2006
Steps to health: a European framework to promote physical activity for health

6. Strategic direction Mental health Children and adolescents
Mental Health Action Plan for Europe 2005
Children and adolescents
Children’s Environment & Health Action Plan for Europe (CEHAPE) 2004
European strategy on child and adolescent health and development 2005
Violence and injuries
Resolution on preventing injuries in the European Region (RC55/R9)

7. Outline of European NCD Strategy
Introduction
Challenges
Potential for health gain
Guiding principles
Strategic approach
Framework for action
Taking action
The way forward

8. Comprehensive and balanced
Upstream approach
Disease prevention
Health-oriented health services
Health promotion
Spanning the continuum
Determinants
Risk factors
Diseases
Comprehensive approach:
Population-level prevention programmes
Targeting high risk individuals
Improved quality and coverage of care
Systematic reduction of inequalities

9. Objectives and Framework for Action
To take integrated action on risk factors and their underlying determinants across sectors
To strengthen health systems for improved prevention and control of noncommunicable diseases
Framework for Action
ADVOCACY
KNOWLEDGE
REGULATION AND FINANCING
CAPACITIES
COMMUNITY SUPPORT
HEALTH SERVICE DELIVERY

10. Building on existing commitments
A coherent and mutually reinforcing framework
NCD
WHA53.17
Diet & Physical activity
WHA57.17
Infant & Child Feeding
WHA55.25
Food & Nutrition
EUR/RC50/R8
Tobacco
EUR/RC52/R12
Alcohol
EUR/RC55/R1
Children & Environment
EUR/RC55/R6
Children & Adolescents
EUR/RC55/R4
Mental Health
EUR/RC55/R2
Commitments

11. Building on existing commitments
A coherent and mutually reinforcing framework
NCD
WHA53.17
Diet & Physical activity
WHA57.17
Infant & Child Feeding
WHA55.25
Advocacy
Food & Nutrition
EUR/RC50/R8
Knowledge
Regulation and financing
Tobacco
EUR/RC52/R12
Capacities
Alcohol
EUR/RC55/R1
Community support
Children & Environment
EUR/RC55/R6
Health service delivery
Children & Adolescents
EUR/RC55/R4
Mental Health
EUR/RC55/R2
Framework
Commitments

12. Building on existing commitments
A coherent and mutually reinforcing framework
NCD
WHA53.17
Diet & Physical activity
WHA57.17
Infant & Child Feeding
WHA55.25
Advocacy
Knowledge
Food & Nutrition
EUR/RC50/R8
Regulation and financing
Tobacco
EUR/RC52/R12
ACTIONS
Capacities
Alcohol
EUR/RC55/R1
Community support
Children & Environment
EUR/RC55/R6
Health service delivery
Children & Adolescents
EUR/RC55/R4
Mental Health
EUR/RC55/R2
Framework
Commitments

13. Regulation and financing
Develop and enforce regulatory frameworks e.g.
Restrict advertising, sponsorship and promotion of tobacco, alcohol and certain foods
Protect people against environmental smoke
Use licensing and sales laws to control tobacco and alcohol supply
Control quality of consumer information about tobacco, alcohol, food products
Develop clear and understandable nutritional labelling
Agreements with industry on levels of added salt, fat and sugars to manufactured food
Regulate the built environment to promote walking and cycling
Use fiscal measures to promote healthier choices e.g.
Use subsidies to influence food-related behaviour within schools /workplaces
Use health financing mechanisms to effect change e.g.
Use financial incentives for enhanced disease prevention services and to improve quality of care

14. Key messages
Prevention throughout life is effective and must be regarded as an investment
All settings should be health-supporting environments to make healthy choices easy choices
People should be empowered to promote their own health, actively manage disease and interact with health services effectively
Health and medical services should be fit for purpose, responding to present disease burden and increasing opportunities for health promotion
Universal access to health promotion, disease prevention and health services is central to achieve equity in health
Governments at all levels have the responsibility to build healthy public policies and ensure action across all sectors concerned

15. An integrated approach
CANCER
Prevention
Early detection
Diagnosis & treatment
Palliative care
HEART DISEASE & STROKE
Population-level public health & prevention programmes
Risk factor detection & control
Emergency care /acute case management
Rehabilitation /long-term case management
End-of-life care
Population-level health promotion & disease prevention
Targeting high risk groups & individuals
Improved quality & coverage of effective care
Systematic reduction of inequalities in health

16. Summary Tackling NCD = Significant potential for health gain
Main causes are known
Effective interventions are known
Prevention is a vital investment
Comprehensive and integrated approach is needed
European NCD strategy provides an opportunity to:
Establish a unifying framework for NCD action
Build on what is already in place
Assess & refine current approaches
Develop or further strengthen public policies for tackling NCD in a comprehensive and integrated way

17. Thank you!