UN System, UN System, WHO andWHO and

WHO Regional WHO Regional Office Office

for Europefor Europe

UN SystemUN System established on 24 October 1945 by 51established on 24 October 1945 by 51 member states member states

General AssemblyGeneral Assembly

Secretary General and UN SecretariatSecretary General and UN Secretariat

Security CouncilSecurity Council

UN Programmes and Funds (UNDP, UNHCR, UNICEF, etc.)UN Programmes and Funds (UNDP, UNHCR, UNICEF, etc.)

Specialized agencies (WHO, FAO, ILO, etc.)Specialized agencies (WHO, FAO, ILO, etc.)

Role of the WHO in the UN Role of the WHO in the UN systemsystem

The World Health Organization is the directingand coordinating authority on international healthwithin the United Nations’ system. WHO expertsproduce health guidelines and standards, and helpcountries to address public health issues. WHO alsosupports and promotes health research. ThroughWHO, governments can jointly tackle global healthproblems and improve people’s well-being.

WHO’s missionWHO’s missionis global and permanentis global and permanent

“ “The mission of WHO is the The mission of WHO is the attainment by all peoples of the attainment by all peoples of the highest possible level of health”highest possible level of health”

Source: WHO’s Constitution

WHO’s ConstitutionWHO’s Constitution

Health is a state of complete physical, mental and Health is a state of complete physical, mental and social wellbeing and not merely the absence of social wellbeing and not merely the absence of disease or infirmity.disease or infirmity.

… … the enjoyment of the highest attainable the enjoyment of the highest attainable standard of health is one of the fundamental standard of health is one of the fundamental rights of every human being without distinction of rights of every human being without distinction of race, religion, political belief, economic or social race, religion, political belief, economic or social condition.condition.

Declaration of Human Declaration of Human RightsRights

All human beings are born equal All human beings are born equal in dignity and rights and are in dignity and rights and are entitled to all the rights and entitled to all the rights and freedoms set forth in the freedoms set forth in the Declaration.Declaration.

WHO principles and valuesWHO principles and values

•Health as a human rightHealth as a human right•Building of countries’ capacity for own Building of countries’ capacity for own

heath needsheath needs•Universal coverage according to needsUniversal coverage according to needs•Equity Equity •Society’s sense for collective Society’s sense for collective

responsibilityresponsibility•Active and direct involvement in Active and direct involvement in

shaping health agendasshaping health agendas

WHO’s four core functions WHO’s four core functions

to give worldwide guidance in the to give worldwide guidance in the field of healthfield of health

to set global standards for health to set global standards for health to cooperate with governments in to cooperate with governments in

strengthening national health strengthening national health programmesprogrammes

to develop and transfer appropriate to develop and transfer appropriate health technology, information and health technology, information and standards.standards.

Strategic directions for WHOStrategic directions for WHO Reduce mortality, morbidity and disability, Reduce mortality, morbidity and disability,

especially of poor and marginalized especially of poor and marginalized

populationspopulations

Promoting healthy lifestyles and reducing Promoting healthy lifestyles and reducing

leading risk factorsleading risk factors

Strengthen health systemsStrengthen health systems

Place health at centre of broader Place health at centre of broader

development agendadevelopment agenda

Millennium Development Millennium Development Goals (MDGs)Goals (MDGs)

Eight major goalsEight major goals::– Eradicate poverty and hungerEradicate poverty and hunger– Achieve universal primary educationAchieve universal primary education– Promote gender equality and empower Promote gender equality and empower

womenwomen– Reduce child mortalityReduce child mortality– Improve maternal healthImprove maternal health– Combat HIV/AIDS, malaria and other diseasesCombat HIV/AIDS, malaria and other diseases– Ensure environmental sustainabilityEnsure environmental sustainability– Develop a global partnership for developmentDevelop a global partnership for development

ONE WHOONE WHOthree levels of actionthree levels of action

HeadquartersHeadquarters

Six Regional OfficesSix Regional Offices

Country OfficesCountry Offices

WHO Offices

WHO in numbersWHO in numbers

WHO was established in 1948 by 61 WHO was established in 1948 by 61 governments governments

The WHO Constitution was ratified The WHO Constitution was ratified on 7 April – World Health Dayon 7 April – World Health Day

Today there are 193 Member StatesToday there are 193 Member States Employs 8000 public health experts Employs 8000 public health experts

worldwideworldwide Has 147 country offices worldwideHas 147 country offices worldwide

WHO governance in briefWHO governance in brief

Headquarters in GenevaHeadquarters in Geneva Six regional officesSix regional offices 193 Member States - 2 Associate Members193 Member States - 2 Associate Members World Health Assembly - Executive BoardWorld Health Assembly - Executive Board International working groupsInternational working groups Regional Committee - Standing committeeRegional Committee - Standing committee NGOs with formal relations with the WHONGOs with formal relations with the WHO GSMGSM

WHO governance WHO governance documentationdocumentation

ConstitutionConstitution Medium-term Strategic Plans 15 Medium-term Strategic Plans 15

yearsyears General Programme of Work 6 yearsGeneral Programme of Work 6 years Biennial budgetsBiennial budgets ResolutionsResolutions

Result - based managementResult - based managementStrategic approachStrategic approach

General Programme of Work:General Programme of Work: Organization-wide global priorities:Organization-wide global priorities:

3 major communicable diseases: malaria, 3 major communicable diseases: malaria, tuberculosis and HIV/AIDStuberculosis and HIV/AIDS

Cancer, cardiovascular disease and diabetesCancer, cardiovascular disease and diabetes TobaccoTobacco Making pregnancy safer and children’s healthMaking pregnancy safer and children’s health Health and environmentHealth and environment Food safetyFood safety Mental healthMental health Blood safetyBlood safety Health systemsHealth systems

Aims of the UN reformAims of the UN reform

Provide better coordination on Provide better coordination on country levelcountry level

Ensure more transparency Ensure more transparency (triggered by “Oil for food” case)(triggered by “Oil for food” case)

Ensure efficiency and savings by Ensure efficiency and savings by consolidating resourcesconsolidating resources

WHO BudgetWHO Budget

2006-2007: regular budget US$ 915 2006-2007: regular budget US$ 915

million million

20 Member States pay about 90% of the 20 Member States pay about 90% of the

budgetbudget

11 of the 20 are in the European Region11 of the 20 are in the European Region

About 3/4 of budget comes from extra About 3/4 of budget comes from extra

budgetary fundsbudgetary funds

53% - Response to concrete health 53% - Response to concrete health threats (epidemics, maternal and child threats (epidemics, maternal and child mortality etc, immunization) mortality etc, immunization)

21% - Information and knowledge for 21% - Information and knowledge for Members StatesMembers States

13% - Health care, health personnel, 13% - Health care, health personnel, quality of medicinesquality of medicines

11% - Determinants of health (nutrition, 11% - Determinants of health (nutrition, tobacco, environment etc)tobacco, environment etc)

How is the money spent?How is the money spent?

FCTCFCTC

Six meetings of the interational Six meetings of the interational negotiation body 2000-2003negotiation body 2000-2003

Convention; protocols under preparationConvention; protocols under preparation Entered into force 2005Entered into force 2005 Conference of PartiesConference of Parties Secretariat of COP housed by WHOSecretariat of COP housed by WHO 149 member states149 member states

International Health International Health RegulationRegulation

A binding international agreement on the A binding international agreement on the control of PHEICscontrol of PHEICs

4 diseases > decision algorithm > 4 diseases > decision algorithm > determination and notification of WHOdetermination and notification of WHO

rights, obligations and procedures in rights, obligations and procedures in ensuring international health security without ensuring international health security without unnecessary intereference in international unnecessary intereference in international traffic and tradetraffic and trade

in a PHEIC WHO can issue recommendationsin a PHEIC WHO can issue recommendations all Member Statesall Member States entered into force 15 June 2007entered into force 15 June 2007

Commission on SDHsCommission on SDHs

CommissionCommission Knowledge networksKnowledge networks Report in 2008Report in 2008 Implementation?Implementation? Agenda of the public health of the Agenda of the public health of the

21st century?21st century?

WHO Regional Office for WHO Regional Office for EuropeEurope

WHO/EUROWHO/EURO

WHO/EURO is the secretariat for WHO/EURO is the secretariat for

53 Member States of the European53 Member States of the European

Region - about 900 million peopleRegion - about 900 million people

WHO/EUROWHO/EURO

Office exists since 1957Office exists since 1957 About 700 staff, out of which About 700 staff, out of which

about 330 in Copenhagenabout 330 in Copenhagen More than 60 different More than 60 different

nationalitiesnationalities

EURO – Country OfficesEURO – Country Offices

Liaison officesLiaison offices

Projects and programmesProjects and programmes

Humanitarian assistanceHumanitarian assistance

PlusPlus

Centres (GDOs)Centres (GDOs)

EURO regional strategy: EURO regional strategy: Matching services to needs Matching services to needs

Support Member States in:Support Member States in: developing and sustaining their developing and sustaining their ownown

health policies, health systems and health policies, health systems and public health programmes;public health programmes;

preventing and overcoming threats to preventing and overcoming threats to health;health;

anticipating future challenges; andanticipating future challenges; and advocating public healthadvocating public health

EURO priority areasEURO priority areas

Strengthening health systemsStrengthening health systems Reduction of burden of Reduction of burden of

diseases diseases Strengthening information / Strengthening information /

intelligence functionintelligence function Partnership developmentPartnership development

WHO European Region – WHO European Region – challengeschallenges

86% of deaths account for non-communicable 86% of deaths account for non-communicable diseasesdiseases

9% - for communicable diseases9% - for communicable diseases ObesityObesity Children and adolescent healthChildren and adolescent health High tobacco and High tobacco and alcohol consumptionalcohol consumption Mental healthMental health Injuries and accidentsInjuries and accidents HIV/AIDSHIV/AIDS TBTB Measles and rubellaMeasles and rubella

Healthy life expectancy Healthy life expectancy (latest available )(latest available )

HighestHighestSan Marino: 73.4 yearsSan Marino: 73.4 yearsSweden: 73.3 yearsSweden: 73.3 yearsSwitzerland: 73.2 yearsSwitzerland: 73.2 years

LowestLowestTurkmenistanTurkmenistan: 54.4 years: 54.4 yearsTajikistan: 54.7 yearsTajikistan: 54.7 yearsKazakhstan: 55.9 yearsKazakhstan: 55.9 years

Leading NCD conditions in Leading NCD conditions in EuropeEurope

DiseaseDisease Disease Disease burden burden

(DALYs) %(DALYs) %

Deaths Deaths %%

Cardiovascular diseasesCardiovascular diseases 2323 5252

Neuropsychiatric disordersNeuropsychiatric disorders 2020 33

CancerCancer 1111 1919

Digestive diseasesDigestive diseases 55 44

Respiratory diseasesRespiratory diseases 44 44

Diabetes mellitusDiabetes mellitus 11 11

Musculoskeletal diseasesMusculoskeletal diseases 44 00

Sense organ disordersSense organ disorders 44 00

Other NCDsOther NCDs 55 22

TotalTotal 7777 8686

The main causes are knownThe main causes are known

Prevalence of overweight among Prevalence of overweight among school children in Europeschool children in Europe

IOTF 2004

Prevalence of overweight among school children in Europe

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30

1970 1980 1990 2000 2010

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IOTF estimates. IOTF-Cole et al definition of overweightIOTF 2004

Prevalence of overweight among school children in Europe

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1970 1980 1990 2000 2010

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IOTF estimates. IOTF-Cole et al definition of overweightIOTF estimates IOTF-Cole et al definition of overweight

What does the future hold?What does the future hold?

By 2050, more than one-quarter of By 2050, more than one-quarter of Europe’s population is expected to be Europe’s population is expected to be over 65 yearsover 65 years

More than one-third of men over 60 More than one-third of men over 60 years of age have 2 or more chronic years of age have 2 or more chronic conditions conditions - - with the number increasing with the number increasing with age and among womenwith age and among women

Actions: Actions: health systemshealth systems

Policy support: Stewardship, Policy support: Stewardship, Financing, Service delivery, Financing, Service delivery, Resource GenerationResource Generation

Health intelligence serviceHealth intelligence service Ministerial conference on Ministerial conference on

Health Systems 2008Health Systems 2008

Actions: Actions: communicable diseasescommunicable diseases

Influenza Preparedness PlansInfluenza Preparedness Plans Revised International Health Revised International Health

Regulations Regulations HIV/AIDS - The 3 x 5HIV/AIDS - The 3 x 5

100,000 more patients on ART100,000 more patients on ART Measles and congenital rubellaMeasles and congenital rubella

European immunization week 2005European immunization week 2005

Actions: Actions: non-communicable non-communicable

diseasesdiseases

Ministerial Conference on Mental Ministerial Conference on Mental Health, January 2005Health, January 2005

European Strategy on NCDEuropean Strategy on NCD Ministerial Conference on Ministerial Conference on

counteracting obesity, November counteracting obesity, November 20062006

Alcohol Action Plan – RC55Alcohol Action Plan – RC55 Framework Convention on Tobacco Framework Convention on Tobacco

Control – European Action PlanControl – European Action Plan

Actions:Actions:Environment and health Environment and health

Ministerial conferences 2004 (2009)Ministerial conferences 2004 (2009) Mid term review 2007Mid term review 2007 Ministerial declarationMinisterial declaration Children’s environmental health action Children’s environmental health action

planplan EEHCEEHC Direct support to member statesDirect support to member states

Financial resourcesFinancial resources

Programme Budget for 2006-07: USD Programme Budget for 2006-07: USD 212 m212 m

Regular budget USD 58 m (Regular budget USD 58 m (~~ 27%) 27%) Other sources USD 154 m (Other sources USD 154 m (~~ 73%). 73%).

ResourcesResources

Partnerships: UN organizations, EU, Partnerships: UN organizations, EU, NGOs, WHO Collaborating CentresNGOs, WHO Collaborating Centres

Vast network of specialists in Vast network of specialists in public health, universities and public health, universities and research institutes across the research institutes across the RegionRegion

More information is More information is availableavailable

Internet WHO/HQ Internet WHO/HQ www.who.www.who.intint Internet WHO/EURO Internet WHO/EURO

www.euro.who.intwww.euro.who.int