In brief: the 70th session of the WHO Regional Committee for Europe (RC70)

For the first time, the WHO Regional Committee for Europe took place virtually due to the ongoing COVID-19 pandemic. Among the highlights of this year’s session was the endorsement by Member States of the European Programme of Work (EPW). The EPW sets down a 5-year vision of how WHO/Europe and Member States will work together to meet citizens’ expectations for health.

Opening of the session

At the opening of the virtual session, outgoing President of RC69 Mr Magnus Heunicke, Minister of Health and Senior Citizens of Denmark, handed the position over to Dr Alexey Tsoy, Minister of Health of Kazakhstan, the elected President of RC70.

Other officers elected were:

• Dr Søren Brostrøm of Denmark as Executive President
• Dr Iva Pejnović Franelić of Croatia as Deputy Executive President
• Ms Nora Kronig Romero of Switzerland as Rapporteur.

Address by Her Royal Highness Crown Princess Mary of Denmark

Crown Princess Mary of Denmark, Patron of WHO/Europe, addressed delegates, describing the pandemic as a “tough teacher” and underlining that there can be no health care without the health workforce. “To all the nurses, midwives, health and care workers across the European Region, you have my deepest respect and admiration, and I thank you,” she said.

Re-emphasizing her commitment to advocating for maternal and child health, immunization, and addressing antibiotic resistance, Her Royal Highness concluded, “Working together to make the world a safer and healthier place for everyone is the most fitting of legacies to honour those we have lost as a result of this virus, and an invaluable gift to the children of the future.”

Address by Dr Tedros Adhanom Ghebreyesus, WHO Director-General

Speaking remotely to RC70, Dr Tedros expressed his support for the EPW on this year’s agenda, and its close alignment with WHO’s 13th General Programme of Work (GPW 13). “Health and well-being, universal health coverage and health security are the legs of a 3-legged stool that provide social, economic and political stability,” he said.

Considering lessons from the COVID-19 pandemic, Dr Tedros warned that WHO and Member States must follow through on these reviews and recommendations. “Working together in humility and solidarity, we can ensure that a pandemic of this magnitude and severity never happens again,” he concluded.

Address by Dr Hans Henri P. Kluge, WHO Regional Director for Europe

The address by Dr Kluge – his first as WHO Regional Director for Europe – had 2 parts: the first focused on laying the foundations for the future beyond COVID-19, and the second on the COVID-19 response. On the first point, Dr Kluge explained that the work is based on 3 axes:

• maintaining direct contact with each country for a more targeted response
• strengthening partnerships with other organizations working in the WHO European Region
• restructuring WHO/Europe to be fit for purpose.

Speaking of the COVID-19 response, Dr Kluge sent his condolences to the victims, families and communities that have been hit hard by the pandemic. He paid tribute to the health and social workers and other front-line workers, such as teachers, who have kept society running.

“The whole world has recognized their merit and bravery,” he said. Dr Kluge also announced that he will extend the Year of the Nurse and the Midwife through 2021.

In addition to his emphasis on providing specific support to Member States and working across WHO and with the international community and civil society to tackle the virus, the Regional Director outlined some key lessons learned from COVID-19 that must be applied now.

He underlined that there is no health without the health workforce. He drew attention to the need to maintain immunization services and health services for people with chronic conditions, including cancer. Further, he called on countries to continue to cooperate in the spirit of solidarity and to review the International Health Regulations (2005) in the light of this pandemic.

Regarding lessons learned from the pandemic, Dr Kluge emphasized the reciprocal relationship between health and the economy, the recognition of which is essential to moving towards an economy of well-being. The recently formed Pan-European Commission on Health and Sustainable Development will rethink policy priorities in this context.

In his final comments, the Regional Director spoke of historical precedents for transforming European society in the face of challenges and building back better as examples to the world. “Those successful transformations were based on 4 ingredients. Two we have already: necessity and innovation. What we need to gather now is courage and collaboration.”

Statement by Professor Mario Monti, Chair of the Pan-European Commission on Health and Sustainable Development

Professor Monti, President of Bocconi University in Milan, Italy, former Prime Minister of Italy and former European Commissioner, spoke to delegates in his capacity as Chair of the recently formed Pan-European Commission on Health and Sustainable Development.

Referring to the Commission’s mandate to make forward-looking recommendations on health and social policy, Professor Monti made an appeal to Member States. “The Commission will seek to establish partnerships with countries, and I trust I can count on your valuable engagement and expertise as we are about to sail these uncharted waters.”

Reflections by Member States

Many representatives of Member States and international partners took the floor, offering insights and experiences of the COVID-19 response. Common themes emerged, with many recognizing the value of WHO and its crucial role in global health. Countries thanked Dr Kluge for his transparency in leading WHO/Europe’s response and the constant communication he has maintained.

Many also acknowledged the essential role of health workers, the need to strengthen health systems, the importance of solidarity in vaccine and treatment development, and that health and the economy go hand in hand.

Introduction to the EPW

The Regional Director explained that the proposed EPW for 2020–2025 was developed from the starting point of what people across the Region hold their health authorities accountable for. Under the EPW, European Member States will implement 3 core priorities:

• guaranteeing the right to universal access to quality care without fear of financial hardship;
• protecting against health emergencies; and
• building healthy communities, where public health actions and appropriate public policies secure a better life in an economy of well-being.

The EPW was informed by an extensive consultative process with Member States, non-State actors and other international partners.

Video statement by Her Majesty Queen Mathilde of the Belgians

Her Majesty Queen Mathilde of the Belgians addressed delegates on the subject of mental health, a topic that is the focus of her work as an advocate for the Sustainable Development Goals.

“Good mental health helps us all to achieve our full potential. It boosts our resilience and ability to manage change and uncertainty. Investing in mental health is essential for societies to prosper,” she said. She described the inclusion of mental health in the EPW as “encouraging”.

Video statement by European Commissioner for Health and Food Safety Dr Stella Kyriakides

Dr Kyriakides spoke of the renewed collaboration between WHO/Europe and the European Union, particularly in the context of the pandemic. She expressed her support for the EPW, commenting that it provides an excellent framework for improving health in the Region and offers opportunities for synergies in common priority areas, such as immunization.

WHO/Europe and the European Commission released a joint statement outlining closer partnership in 5 areas of shared interest.

Interventions by Member States on the EPW

Countries expressed their support for the EPW, and commended WHO/Europe for the accelerated and inclusive process to develop it. Common themes in interventions included appreciation for integrating COVID-19 and emergency preparedness and response, as well as access to affordable medicines; the importance of emphasizing primary health care; the need to address the epidemic of noncommunicable diseases in the Region; and the need to prioritize health systems strengthening.

Many speakers underlined their support for the 4 flagship initiatives covering mental health, immunization, behavioural and cultural insights, and digital health. Overall, they expressed that the EPW will make WHO/Europe more proactive and that it fully aligns with the GPW 13.

On 14 September 2020, Member States adopted the EPW 2020–2025, “United Action for Better Health in Europe”, by consensus.

Election to the Standing Committee of the Regional Committee (SCRC)

In a private session, Czechia, Kazakhstan, Norway and the United Kingdom were elected as new members of the SCRC for a 3-year term until 2023.

Transformation in the WHO European Region

Dr Kluge explained that for WHO/Europe, the WHO transformation is about enhancing country impact in all 53 Member States while building a safe, respectful and optimal working environment grounded in WHO values.

He explained that the restructuring of WHO/Europe will largely be complete by the end of October 2020. One specific initiative to be piloted by 5 countries is the Pan-European Transformational Leadership Academy, which will offer public health experts opportunities to gain experience at WHO/Europe and exchange knowledge.

Proposed high-level programme budget for 2022–2023

Mr Imre Hollo, Director of Planning, Resource Coordination and Performance Monitoring, explained that the process for developing WHO’s global programme budget for 2022–2023 will be presented for consideration to the Executive Board in January 2021 and for approval at the World Health Assembly in May 2021.

The financial estimates for the GPW 13 anticipated a base budget of US$ 4.254 billion, a 7.8% increase compared to 2020–2021. This increase will need to be reviewed in the light of COVID-19 response activities, WHO transformation initiatives and country-level poliomyelitis-related activities. Mr Hollo therefore asked the Regional Committee to expect that a revised budget will be submitted to the World Health Assembly in May 2022. There will be a proposal to extend the GPW 13 to 2025 in recognition of the impact of COVID-19 on the achievement of the triple-billion targets.

Accreditation of non-State actors

EUROCAM, the European Hospital and Healthcare Federation, the European Stroke Organisation and the Finnish Association for Substance Abuse Prevention were accredited by the Regional Committee.

Future Regional Committee sessions

• The 71st session will take place on 13–15 September 2021 in Copenhagen, Denmark.
• The 72nd session will take place on 12–14 September 2022 in Tel Aviv, Israel.
• The 73rd session will take place on 11–13 September 2023.

In the future, Regional Committee sessions will be held over 3 days rather than 4.

Closure of the session

In his closing remarks, Dr Kluge thanked all participants for the “free, frank and friendly debates” that prevailed at this virtual Regional Committee session.

“Your adoption by consensus of the EPW is a strong act, and promising for the future. I consider this a contract of trust between you and us – a sign of the solidarity we so frequently refer to these days. Your feedback over these 2 days has provided powerful insight into the future implementation of our vision,” he said.