Commission staff working document
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- Targets and indicators
- Actions and flagship projects Action: Contain the spread of HIV/AIDS and tuberculosis
- Action: Fight health inequalities through the improvement of primary healthcare
- Action: Prevent lifestyle-related non-communicable diseases and ensure good social and work environments
- Alcohol and drug prevention among youth
- Promotion of physical activity and healthy food among schoolchildren (ages 7-15).
- Effective and efficient implementation of national non-communicable disease prevention strategies
- Implementation and further development of a standardized, comparative methodology for population survey of drinking habits and alcohol related harm in BSR/ND countries
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http://ndphs.org/ The prosperity of the macro-region is based on its human capital; consequently a healthy population is a critical factor behind sustainable economic development of enterprises and societies. Improving people’s health and social well-being is particularly important in the context of the ageing society and the growing threat posed by non-communicable diseases, two of the greatest macro-regional challenges in the 21st century. Unless counteracted, a decline in the working-age population and a higher number of people with chronic non-communicable diseases will put immense pressure on national budgets and will lead to a loss of productivity in the decades to come. By investing in health improvement and promotion, the economic gain will be two-fold: (i) healthy people are more likely to stay in the labour market longer and remain productive, and (ii) reduced spending on treating ill health. Currently the Baltic Sea region is an area of considerable disparities in health and social conditions. It features places where social and economic problems cause high levels of mortality due to non-communicable diseases, violence, alcohol and drug abuse and the spread of infectious diseases. Social exclusion and poverty are not unheard-of problems either. Further, the growing cross-border movement of people needs to be paralleled by actions addressing inequalities in health status and in the level of health protection. Consequently, this priority area focuses on improving and promoting the health of people in the Baltic Sea region, including social aspects of health, as an important precondition for ensuring sustainable and healthy societies enjoying economic growth, and for containing future health and social care- related costs. It is also a precondition for labour market inclusion. Thus far, the EUSBSR has been instrumental in fostering macro-regional cooperation in health and making it more integrated and inclusive. In particular, by providing a common reference point, it has contributed to increased cooperation and a better division of labour among the existing networks. The Baltic Sea region countries lose human capital within the range of 9000–3000 years per 100000 inhabitants. Considering that some 80 million people live in the Baltic Sea region, it can be estimated that at least EUR 66 billion are lost every year due to premature loss of life by preventable causes. Thus, by reducing preventable mortality by 10%, the annual gain would be at least EUR 6-7 billion, excluding the expenses caused by morbidity, invalidity and human suffering. Changing the trend would give a strong boost to economic development which would in turn allow for more investments to go to other sectors, including education, culture and the environment. The main challenges are demographic changes, the lack of services in certain areas and the big regional differences in health issues (in terms of access to and quality of health services, as well as disparities in morbidity and mortality related to alcohol, drugs and tobacco, communicable diseases such as HIV/AIDS and tuberculosis). Another challenge is the impact of climate change and other environmental factors such as air pollution and hazardous substances, on health conditions, due to its impact on infrastructure and the increased risk of infectious diseases by contaminated water or infections transmitted by insects. Recent challenges – such as the increasing burden of chronic non-communicable diseases, growing costs of overall health care coupled with the rapidly growing market for new medical technologies and more informed patients – are putting heavier pressure on health care systems and leading to calls for the rationalisation of these systems. As to the individual risk factors, the harmful use of alcohol is the third leading risk factor for diseases and premature deaths globally. The WHO’s European Region has the highest per capita consumption, and the Baltic Sea region has in addition a high prevalence of excessive drinking. Further, tobacco use continues to be the leading global cause of preventable death. Drug use is relatively stable, but signs of stability with some of the more established drugs are offset by new threats, developments in the synthetic drugs market, the rapid appearance of new substances and widespread polydrug use. Finally, the continuous spread of HIV, tuberculosis and associated infections continues to pose serious challenges in the macro-region. The deteriorating infectious disease situation of risk groups, migrants and other vulnerable populations is a particular concern. At the same time, the capacity of the health care systems is insufficient to respond to the burden of HIV, tuberculosis and associated infections; the monitoring and provision of epidemiological information is unsatisfactory. Existing policies and practices do not fully support the prevention of the spread of HIV and associated infections such as resistant tuberculosis. Last but not least, the complexity of the HIV-AIDS-tuberculosis situation – including the connection to the harmful use of alcohol and drugs – needs to be properly addressed by new approaches. There is awareness that inequalities regarding access and quality of services vary a lot among – but also within – BSR/ND countries, but the extent of this needs to be assessed. Generally speaking, baseline data are hugely lacking within the health and social sector in the BSR/ND countries and there is a need to identify the inequalities among different communities by sex, ethnicity, age, social classes, level of formation, etc. Targets and indicators A comprehensive system for the design, the monitoring and the follow-up of indicators and targets will be set up in 2013, under the responsibility of the priority area coordinator. A limited number of indicators that translate what the main objectives of the priorityare about will be defined. They will be accompanied with relevant targets and deadlines, baseline and statistics/information sources. Actions and flagship projects Action: Contain the spread of HIV/AIDS and tuberculosis Through partnerships and international collaboration in prompt and quality care for all, focusing on tuberculosis/HIV co-infection and ensuring early diagnosis of HIV infections, providing access to treatment and strengthening interventions to reduce vulnerability, especially for Injecting Drug Users (IDU), prisoners, etc. Flagship projects The NDPHS Expert Group on HIV/AIDS and Associated Infections will plan a comprehensive flagship project on Strengthened prevention and reduction of impacts of HIV, AIDS & AI (TB, hepatitis B & C, syphilis, gonorrhea) among key populations at risk in the Baltic Sea region. Action: Fight health inequalities through the improvement of primary healthcare By assessing differences in the accessibility and quality of primary health care in the macro-region, by reviewing the situation of patients and health professionals, including their deployment, mobility and training and by promoting e-health technology as a means of closing gaps in healthcare access and quality. Action also needs to be taken to enhance border health management by developing effective and efficient primary health care, with particular attention to cross-border disease prevention, health promotion and control of communicable diseases. Flagship projects PrimCareIT. Counteracting brain drain and professional isolation of health professionals in remote primary health care through tele-consultation and tele-mentoring to strengthen social conditions in remote parts of the Baltic Sea region. The Interreg IV B project ‘PrimCareIT’ aims at raising the attractiveness of remote primary health care for medical professionals by using tele-consultation and tele-mentoring, including social media. Information and communication technologies have a strong potential for reducing professional isolation and providing opportunities for professional networking, continuing medical education and career development for younger and experienced doctors and health workers in remote areas. ‘PrimCareIT’ has been developed under the umbrella of ‘eHealth for Regions’ network and it complements and reuses outputs from the flagship projects ‘ImPrim’ and ‘ICT for Health’. Lead: South Ostrobothnia Health Care District (SOHCD), Seinäjoki Finland. Deadline for finalisation: March 2014. Action: Prevent lifestyle-related non-communicable diseases and ensure good social and work environments By developing comprehensive policies and activities throughout the entire macro-region aimed at preventing and reducing the negative consequences of alcohol and drug use to the society, and particularly among children, youth, women of child-bearing age and pregnant women. Actions will contribute to the implementation of the Global Strategy to reduce the harmful use of alcohol, Framework Convention on Tobacco Control, the UN 2011 Declaration on Prevention and Control of Non-communicable Diseases, the regional strategy and action plan for the prevention and control of NCDs and Health 2020, and the ‘Northern Dimension Partnership in Public Health and Social Well-being (NDPHS) Strategy on Health at Work’.34 Flagship projects Alcohol and drug prevention among youth. Project aims to reduce hazardous and harmful alcohol use and alcohol and substance use in general among young people. Lead: Northern Dimension Partnership in Public Health and Social Well-being (NDPHS) and its Partner Countries. Deadline: October 2013. Potential flagship projects Promotion of physical activity and healthy food among schoolchildren (ages 7-15). Project aimed at improved long-term health among school-age children by reducing selected essential non-communicable disease risk factors (overweight, obesity and sedentary lifestyle). Lead: Northern Dimension Partnership in Public Health and Social Well-being (NDPHS) and its Partner Countries. Deadline for progress review: to be determined. Effective and efficient implementation of national non-communicable disease prevention strategies. Project aimed at tackling the non-communicable disease epidemic and to support BSR/ND countries to efficiently implement non-communicable disease prevention strategies. Lead: Northern Dimension Partnership in Public Health and Social Well-being (NDPHS) and its Partner Countries. Deadline for progress review: to be determined. Implementation and further development of a standardized, comparative methodology for population survey of drinking habits and alcohol related harm in BSR/ND countries. Project aiming at implementation and further development of the Standardized Measurement of Alcohol Related Troubles (SMART) methodology in the BSR/ND countries for a more informed and evidence based policy making in the field of reduction of the harmful use of alcohol. Project will also assist the BSR/ND countries to develop common approaches to alcohol data gathering in order to enable EU-wide monitoring and cross-country comparison. Lead: Northern Dimension Partnership in Public Health and Social Well-being (NDPHS) and its Partner Countries. Deadline for progress review: to be determined. Note: The practice of teaching health education in formal and non-formal education should be examined, in cooperation with priority area coordinator(s) of ‘Education’. Cooperation with other priority areas will also be reinforced. For example, the existing flagship project ‘ScanBalt Health Region’ will be developed as a pilot cross-PA flagship project between priority areas ‘Innovation’, ‘Health’, ‘SME’, ‘Tourism’ (health tourism) and ‘Agri’ (healthy food) with the purpose of connecting innovation with health and the bio economy aiming to maintain and improve overall BSR competitiveness. Cooperation platforms and/or dialogues will be promoted, in order to facilitate exchanges of ideas and practices with other partners involved in health issues (e.g. Nordic Council of Ministers, Baltic Region healthy cities association, city of Umea, etc.).
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