Health ministers and experts meeting in Oslo, Norway, today call for solutions to the economic crisis that do not threaten health objectives, despite budgetary constraints.

Consequences for health of the economic crisis
The consequences of the crisis can be felt at several levels. Evidence that tax revenues are lower than expected is common in virtually all of the 53 countries of the WHO European Region. Some countries such as Belgium, the Czech Republic, Estonia, Hungary, Latvia, Lithuania, Portugal and Slovakia have announced budget revisions. Further, the fall in value of many currencies across Europe is raising the price of health-related commodities, such as pharmaceuticals and medical devices.

Kazakhstan, the Republic of Moldova and Ukraine, for example, report pharmaceutical price increases of up to 30%. Kyrgyzstan, Tajikistan, Turkmenistan and Uzbekistan are the countries most vulnerable to rising poverty, as a result of the economic crisis, while the number of poor people in Slovenia has increased by 10% since November 2008.

Faced with rising prices, unemployment and insecurity, people may make changes to how they live that could damage their health. With less to spend, consumers may favour cheaper foods both high in fat and sugar and poor in nutrients. The food situation is particularly critical for children, young people, and pregnant and breastfeeding women. Evidence from previous crises suggests that alcohol and drug use, as well as mental illness, could increase.

“The economic crisis has broad implications for the long-term health of people in Europe. Governments have less to spend, and people could be pushed into taking less care of their health. Yet making the right decisions now – prioritizing health, sharing information, reducing the cost of medicines, expanding vulnerable groups’ access to services – will help to address health inequalities, while keeping Europe on track for lasting, sustainable health and prosperity,” says Marc Danzon, WHO Regional Director for Europe.

The economic crisis comes at a time when the world is confronting major demographic, energy and environmental challenges. “We are living through a time of change: a time when populations in Europe are ageing, and a time when the burden of disease is changing. The number of people with chronic diseases is rapidly increasing. To meet the health needs of our populations, we must adjust to these changes. We must remind ourselves of the importance of primary health care as a key to ensuring universal access to affordable health services”, says Bjarne Håkon Hanssen, Minister of Health and Care Services of Norway.

Prioritizing health on the agenda in Oslo
“Promoting health based on the values of equity, solidarity and participation remains the key priority during this economic crisis. The recommendations by the Commission on Social Determinants of Health and in the Tallinn Charter on health systems provide a clear indication that fighting the crisis offers an opportunity to address the current inequalities in health”, says Nata Menabde, Deputy Regional Director at the WHO Regional Office for Europe.

“Health has to be fully taken into account in all areas of government decision-making. Investing in health is good for social stability and for the economy. Greater focus on reducing poverty and improving access to primary health care services is needed”, she adds.

Participants at the Oslo meeting discussed how the economic crisis will affect health and social protection in their countries. They identified measures to respond to the crisis and promote health, as well as reduce poverty and inequalities.

“While addressing health inequalities in their countries, governments should protect official development assistance and support new and innovative sources of funding. As demographic changes increase the demand for those working in health, we must ensure that we invest in educating the health workforce of the future and that health worker migration is based on ethical standards”, says Bjørn-Inge Larsen, Director-General of the Norwegian Directorate of Health.

The meeting is hosted by the Norwegian Ministry of Health and Care Services and the Norwegian Directorate of Health, and organized by the WHO Regional Office for Europe.

Statements from keynote speakers

“The equation between crisis and opportunity is fast becoming the cliché of the moment. Nevertheless, I would argue that a truly global approach to economic recovery, which puts people’s lives and livelihoods at its centre, will mean that we could emerge with systems that are stronger, more efficient and more equitable than those that are currently under such serious threat.”
Margaret Chan, Director-General, World Health Organization

“As national budgets come under threat, we must recognize that spending on health is an investment not an expense. While we act in our own countries, we must also maintain our commitments in developing countries. The challenge in poor countries is the same as in Europe: to provide health care and social services to the most needy. We need more money for health and more health for our money.”
Jens Stoltenberg, Prime Minister of Norway

“Who will suffer most from the economic crisis? Who suffers the most in a war? Who will suffer most from climate change? The answer is always the same. It is the poor and disadvantaged in countries, and poor and disadvantaged countries. As the G20 meets in London, what about the G193? When will other countries be involved in the decision-making? Our focus must be on empowering individuals, societies and even countries.”
Professor Sir Michael Marmot, Director of the International Institute for Society and Health and MRC Research Professor of Epidemiology and Public Health, University College London, United Kingdom

“The crisis began as a financial crisis, which has moved to the real economy, the political world and now to real life. As the architecture of international cooperation is redefined, the links between health, poverty, development and security call for health to break out of its box. Prime ministers, foreign ministers, finance ministers – we are all in a sense health ministers.”
Jonas Gahr Støre, Minister of Foreign Affairs of Norway

“It is appropriate that this meeting on the implications of the economic crisis for health is taking place on the same day as the G20 in London. What we should look for from the G20 is long-term solutions for the people on this planet. The disaster facing rich countries is very real. But this is dwarfed by the catastrophe facing poor countries. The stimulus packages put together for the rich world must be matched by support to the developing world so that we can achieve the Millennium Development Goals.”
Mary Robinson, President, Realizing Rights: the Ethical Globalization Initiative

“We must develop different, innovative sources of funding for health and development. Without further efforts to fill the funding gap, we will not meet the Millennium Development Goals. UNITAID is launching an initiative so people can contribute one or two dollars when purchasing flights on the internet. All you have to do is click and this will contribute to a big, ambitious goal.”
Dr Philippe Douste-Blazy, Chair of the Executive Board of UNITAID

“Any spending decision has an opportunity cost. Now we need to prioritize investments to address inequalities. But does the crisis mean there will at last be a focus on patient outcomes and incentivising change?”
Alan Maynard, Professor of Health Economics, University of York, United Kingdom

“The health care system in Serbia is an integral part of the economy. It improves the health and quality of life of about 7.5 million people and provides 140 000 jobs. Faced with the economic crisis, one of our key coping strategies is to protect investment in health for the future, through the provision of a basic health package.”
Professor Tomica Milosavljević, Minister of Health of Serbia

Further information is available on the WHO Regional Office web site (http://www.euro.who.int/healthsystems/econcrisis/20090316_1).

For more information, contact:

WHO Regional Office for Europe
Faith Kilford
Conference Communications Officer
WHO Regional Office for Europe
Scherfigsvej 8, 2100 Copenhagen Ø
Denmark
Tel.: +45 39 17 12 19
Mobile: +45 21194378
E-mail: fki@euro.who.int

Liuba Negru
External Relations Officer
WHO Regional Office for Europe
Scherfigsvej 8, 2100 Copenhagen Ø
Denmark
Tel.: +45 39 17 13 44
Mobile: +45 20 45 92 74
E-mail: LNE@euro.who.int

Norwegian Directorate of Health
Jon Bakkerud
Senior advisor/communication
PO Box 7000, St. Olavs plass
0130 Oslo, Norway
Tel.: +47 99301211
E-mail: job@helsedirektoratet.no

Knut I. Tønsberg
Senior advisor/communication
PO Box 7000, St. Olavs plass
0130 Oslo, Norway
Tel.: +47 97681971
E-mail: kit@helsedirektoratet.no