Track apps

The new normal is ‘dual-track health’

Wednesday, September 14, 2022, Tel Aviv, Israel

Shalom, hello. Thank you all for being here today.

A heartfelt thank you to Israel and its Ministry of Health, Minister Nitzan Horowitz and his team, and everyone who helped make our session of the WHO Regional Committee for Europe, RC72, a reality. . Your support and hospitality helped make our first in-person Regional Committee in 3 years a real success.

My thanks also to Israel for its continued commitment to public health – including its strong handling of the pandemic as set out by the Minister – as well as innovations in digital health. Digital health is one of the flagships of our WHO European work programme, whose action plan was formally adopted yesterday by Member States. The Regional Office looks forward to working closely with you.

Dear media colleagues, before I answer your questions, I have 2 main messages today, both related.

First, the overarching take-home message that I conveyed to all delegates when RC72 began – a message that I really want to convey far and wide – is this: in a world of ever-escalating health crises, at a time of economic turbulence, we must accept and work within the reality of a new normal requiring a dual approach to health.

This means, on the one hand, that we must invest considerably in preparing for growing and often overlapping emergencies. On the other hand, we must ensure that we maintain and further strengthen essential health services on a daily basis.

We need to emphasize both and give them equal priority – a two-track approach to the new normal. And that’s really a lesson learned from COVID-19.

Now let’s move on to current emergencies.

The pandemic itself is far from over. Too many people are still dying unnecessarily – more than 3000 last week in our Region. And we expect an upsurge in fall and winter, with many people still unvaccinated. Additionally, at least 17 million people in the WHO European Region may have experienced long COVID in the first 2 years of the pandemic. This week’s meeting discussed how we can better deal with this long-term crisis.

The number of monkeypox cases is falling in some countries, but we cannot be complacent. We have many tools to control the epidemic, but we need greater political will. And, not least, we need to target the stigmatization of affected populations – in this case, primarily men who have sex with men. I sincerely commend Israel for placing the rights and dignity of LGBTQI+ people at the heart of its health policy.

Poliomyelitis has resurfaced unexpectedly in our Region and elsewhere. There are genetic links between the virus recently discovered in the United States of America and the virus found in parts of our Region, including Israel, which in turn is linked to poliovirus in South Asia.

Basically, a threat anywhere can be a threat everywhere. Failure to act now to prepare could prove disastrous in the future. We had in-depth discussions with countries and health partners this week, including how regional and global responses can be better aligned.

Let us now turn to maintaining and strengthening health systems and essential services.

The pandemic, as we know, has overwhelmed health systems. Many essential programs and services have been abandoned. As we recover, we need increased investment on multiple fronts using the best science, tools and technology available.

This week’s Regional Committee has clearly shown the way.

We have introduced ambitious yet practical roadmaps and frameworks to eliminate cervical cancer and end tuberculosis, HIV, sexually transmitted infections and viral hepatitis.

We also have action plans to reduce alcohol consumption and target a range of non-communicable diseases that kill millions.

In addition, countries adopted a WHO European framework for action to achieve the highest attainable standard of health for people with disabilities – another landmark achievement.

The Oslo Medicines Initiative has led to growing partnerships between governments, civil society and the pharmaceutical industry to increase affordable access to high-cost, innovative medicines – a process that will be led by WHO /Europe as a neutral broker.

I am particularly pleased to see that Member States have adopted 2 of the 4 WHO/Europe Flagship Initiatives: the Behavioral and Cultural Insights (BCI) Framework for Action and the Digital Health Framework for Action.

BCI helps us better understand how individual behavior and social circumstances can impact people’s health, helping us to design and implement more impactful and responsive health programs and initiatives.

An example of BCI in action comes from the UK, where BCI has been used to combat antimicrobial resistance (AMR), one of the world’s leading public health threats. If antibiotics are misused, pathogens can develop resistance to them, leading to the creation of superbugs that do not respond to treatment. Globally, antibiotics are often over-prescribed by doctors, which contributes to AMR.

In the UK, health authorities have used a BCI pilot project to address this issue. The chief medical officer sent a letter to primary care doctors, or general practitioners (GPs), who were prescribing more antibiotics than would normally be expected. The letter was developed using BCI, with a social norms approach. The aim was to raise awareness of these particular general practitioners about their behavior compared to their peers and to reduce these over-prescriptions by 4%.

The result: over 73,000 fewer antibiotic prescriptions over 6 months – a 3.3% reduction in antibiotic prescribing, saving taxpayers almost £100,000 in prescription costs. The successful pilot has been extended to the UK, with some other countries also adopting the same BCI approach.

Digital health gives us advanced tools to better deliver health on various platforms in various settings, which truly allows us to transform the healthcare landscape in so many ways. As indicated, Israel will be a key partner in this area, working with us, sharing its expertise with the Region and the world.

Allow me, Minister Nitzan, to give an Israeli example of digital health in action: the work done at Sheba Medical Center’s Digital Innovation Center, where new tools are being developed – for example, an app which allows pregnant women to see their doctor at home and midwives to check the vital signs of the fetus remotely, so that women in rural areas do not have to travel long distances. And we know that this specific tool is deployed for the benefit of Israeli and Palestinian women.

We are truly excited about the potential that the digital health collaboration and our other achievements at this week’s Regional Committee have to benefit millions of people.

Now on to my second main message today. It is a warning: there is a ticking time bomb threatening all these aspirations.

Our health and care workforce was already challenged before COVID-19 by staff shortages, insufficient recruitment and retention, migration of skilled workers, unattractive working conditions and a lack of opportunities of professional development. The pandemic has only made things worse. If not treated urgently, it could be catastrophic. We absolutely need an optimal health and care workforce in place on all fronts.

That is why I am taking this opportunity to publish a new report urgently calling on governments and health authorities to act now.

Consider the current reality. In a third of the 53 countries in our Region, 40% of doctors are close to retirement age. Their adequate replacement, as well as that of other health and care workers, will be a significant challenge for governments and health authorities in the near future. Countries must act quickly and strategically to train, recruit and retain the next generation of health professionals.

This means innovative and flexible approaches, such as welcoming professionals trained in other countries without unnecessarily cumbersome protocols even as we provide quality assurance.

Another key finding of the report is the worryingly poor mental health of so many of our health workers. Long working hours, inadequate professional support and severe staffing shortages, as well as high COVID-19 infection and death rates among frontline workers – especially during the early stages of the pandemic – have all left traces to this day.

Absences of health workers in our Region increased by 62% during the first wave, and mental health problems were reported in almost all countries.

Our report presents a practical 10-point action plan to close these gaps. These include making jobs in the health sector more attractive by increasing salaries, developing future health leaders, supporting professional development and mental health, improving data collection and better use digital tools.

Tackling the health and care workforce crisis is absolutely essential to successfully navigating the dual track of our new normal. I urge all countries to take this seriously. WHO/Europe is your partner in all respects.

Despite these challenges, I would like to end on an optimistic note, because optimism is also a form of medicine.

Look at what we can accomplish if we put our hearts into it. This week’s Regional Committee proved that beyond doubt. It might not always be smooth, but it’s not impossible.

Let me conclude with a quote in the beautiful Hebrew language from a famous singer in Israel, Arik Einstein, loved by both Jewish and Arab communities. Ani ve’ata neshaneh and ha’olam. Together, you and me, we will change the world. Thanks. Toda reduced.