Drawing light from the pandemic: Rethinking strategies for health policy and beyond.

The COVID-19 pandemic is a catastrophe. It was also preventable. The potential impacts of a novel pathogen were foreseen and for decades scientists and commentators around the world warned of the threat. Most governments and global institutions failed to heed the warnings or to pay enough attention to risks emerging at the interface of human, animal, and environmental health. We were not ready for COVID-19, and people, economies, and governments around the world have suffered as a result. We must learn from these experiences now and implement transformational changes so that we can prevent future crises, and if and when emergencies do emerge, we can respond in more timely, robust and equitable ways, and minimize immediate and longer-term impacts. In 2020-21 the Pan-European Commission on Health and Sustainable Development assessed the challenges posed by COVID-19 in the WHO European region and the lessons from the response. The Commissioners have addressed health in its entirety, analyzing the interactions between health and sustainable development and considering how other policy priorities can contribute to achieving both. The Commission's final report makes a series of policy recommendations that are evidence-informed and above all actionable. Adopting them would achieve seven key objectives and help build truly sustainable health systems and fairer societies.

Gaps in coverage and access in the European Union.

This study identifies gaps in universal health coverage in the European Union, using a questionnaire sent to the Health Systems and Policy Monitor network of the European Observatory on Health Systems and Policies. The questionnaire was based on a conceptual framework with four access dimensions: population coverage, service coverage, cost coverage, and service access. With respect to population coverage, groups often excluded from statutory coverage include asylum seekers and irregular residents. Some countries exclude certain social-professional groups (e.g. civil servants) from statutory coverage but cover these groups under alternative schemes. In terms of service coverage, excluded or restricted services include optical treatments, dental care, physiotherapy, reproductive health services, and psychotherapy. Early access to new and expensive pharmaceuticals is a concern, especially for rare diseases and cancers. As to cost coverage, some countries introduced protective measures for vulnerable patients in the form of exemptions or ceilings from user chargers, especially for deprived groups or patients with accumulation of out-of-pocket spending. For service access, common issues are low perceived quality and long waiting times, which are exacerbated for rural residents who also face barriers from physical distance. Some groups may lack physical or mental ability to properly formulate their request for care. Currently, available indicators fail to capture the underlying causes of gaps in coverage and access.

Системы здравоохранения, здоровье и благосостояние: оценка аргументов в пользу инвестирования в системы здравоохранения: справочный документ 3

В последние годы организаторы здравоохранения находились под огромным давлением проблем относительно финансовой устойчивости и сдерживания стоимости. В любом обществе доступные ресурсы ограничены, однако новые данные свидетельствуют о том, что системы здравоохранения являются не «дырой в бюджете», а выгодной областью вложения средств в здоровье населения и экономический рост. Системы здравоохранения, здоровье и благосостояние неразрывно связаны посредством ряда взаимно усиливающих динамических отношений. Эта новая парадигма предлагает возможность для фундаментальной переоценки роли систем здравоохранения в обществе. При этом возникают три основных вопроса: Как мы можем улучшить здоровье, благосостояние и социальное благополучие посредством инвестирования в системы здравоохранения? Как мы можем гарантировать эффективность деятельности систем здравоохранения в будущем? Как мы можем контролировать, управлять и улучшать деятельность систем здравоохранения, чтобы добиться от них максимальной эффективности? В данном справочном документе для Министерской конференции ВОЗ по системам здравоохранения (Таллинн, Эстония, 25–27 июня 2008 года) изучаются ответы на эти вопросы. Здесь представляются аргументы в пользу соответствующих инвестиций в системы здравоохранения. Целесообразность данного обхода обусловлена способностью систем здравоохранения улучшать здоровье и положительно воздействовать на экономические системы, а также отражением в ней основных ценностей, укрепляющих европейские общества.

Health systems, health and wealth: assessing the case for investing in health systems: background document 3

Health policy-makers have been under enormous pressure in recent years over concerns about financial sustainability and cost-containment. The resources available to any society are finite, but emerging evidence is recasting health systems not as a drain on those resources but as an opportunity to invest in the health of the population and in economic growth. Health systems,health and wealth are inextricably linked in a set of mutually reinforcing and dynamic relationships. This new paradigm offers an opportunity for a fundamental reassessment of the role of health systems in society. Itposes three key questions.• How can we improve health, wealth and societal well-being by investing in health systems?• How can we ensure that health systems are sustained in the future?• How can we monitor, manage and improve performance so that health systems are as effective and efficient as possible?This background document to the WHO Ministerial Conference on Health Systems (Tallinn, Estonia, 25–27 June 2008) explores this evidence. It makes the case for appropriate investment in health systems because they can improve health and impact positively on economies and because they reflect core values that underpin European societies.

Health systems in transition: learning from experience

The period following the break-up of the Soviet Union has brought enormous political and socioeconomic change to the WHO European Region. The health sector has not been spared the effects of transition, and the countries emerging from the process have each engaged to varying degrees in health system reform. It is at last possible to reach some judgement about how this process has unfolded, to identify successes and failures, and to understand better the scale and nature of the remaining challenges. This book draws on the experience and lessons learned in the Region over the past 10 years of transition in key health systems areas, such as health care financing, the restructuring of hospitals, public health and gains in health system quality.

Health care systems in transition: Russian Federation

The Health Systems in Transition (HiT) series provide detailed descriptions of health systems in the countries of the WHO European Region as well as some additional OECD countries. An individual health system review (HiT) examines the specific approach to the organization, financing and delivery of health services in a particular country and the role of the main actors in the health system. It describes the institutional framework, process, content, and implementation of health and health care policies. HiTs also look at reforms in progress or under development and make an assessment of the health system based on stated objectives and outcomes with respect to various dimensions (health status, equity, quality, efficiency, accountability).

Health care systems in transition: Armenia

The Health Systems in Transition (HiT) series provide detailed descriptions of health systems in the countries of the WHO European Region as well as some additional OECD countries. An individual health system review (HiT) examines the specific approach to the organization, financing and delivery of health services in a particular country and the role of the main actors in the health system. It describes the institutional framework, process, content, and implementation of health and health care policies. HiTs also look at reforms in progress or under development and make an assessment of the health system based on stated objectives and outcomes with respect to various dimensions (health status, equity, quality, efficiency, accountability).