Evaluation of the Estonian Green Paper on Alcohol Policy

The Green Paper on Alcohol Policy has been Estonia’s strategy document for addressing alcohol-related harms since 2013. Its objectives include: reducing alcohol consumption and curbing harmful drinking patterns; preventing underage drinking; minimizing alcohol-related crime, social problems and health damage; and developing treatment and rehabilitation services for alcohol dependence.This technical report evaluates the public health impact of the Green Paper and associated policies, providing evidence-based insights for future alcohol control efforts in Estonia. The evaluation analyses alcohol consumption and related harms in Estonia from 2000 to 2023, focusing on periods before and after the implementation ofthe Green Paper’s recommendations.Following the Green Paper’s adoption (2013–2019), adult per capita alcohol consumption in Estonia decreased notably. Key indicators, such as age-standardized all-cause mortality and life expectancy at birth, demonstrated positive trends until the onset of the coronavirus disease pandemic. Evaluation of specific indicators revealedmixed outcomes: while there was a notable reduction in alcohol consumption and intoxication among minors, the target of reducing the annual population alcohol consumption to under 8 L per capita was not achieved. Although policy implementation coincided with decreases in alcohol-attributable injuries and mortality rates,it is challenging to attribute these improvements solely to the Green Paper.

Monitoring children’s development in Europe and central Asia with a focus on primary health care: directions for policy and practice

This publication was developed by the United Nations Children’s Fund (UNICEF) Regional Officefor Europe and Central Asia and the World Health Organization (WHO) Regional Office for Europe. It aims to support policy makers, professionals, advocates and academics in introducing developmental monitoring as a part of routine child health services at the primary health care level. The publication provides guidance for professionals on the essentials of developmental monitoring, based on the available literature and findings regarding the currentstatus of developmental monitoring in the region.

Support tool to strengthen health information systems: guidance for health information system assessment and strategy development

It is essential for policy-makers to have a reliable and clear picture of how health is distributed in a given population, and what indicators contribute to or reduce opportunities to be healthy. Therefore, the surveillance of population health and well-being is the first of ten essential public health operations defined by WHO. WHO has a long tradition of providing support to Member States to strengthen their health information systems (HISs). Support tool to strengthen health information systems, is only one of WHO tools which provides guidance for HIS assessment and strategy development.The tool was first published in 2015, and an updated version was published in 2021. Current edition contains refined assessment methodology for the core module and four new add-on modules – Emergency response information management system, Geographic information system, Long-term care, and Migration health data - complementing the add-on modules included in the 2021 update (Health data governance, Health information for the Thirteenth General Programme of Work and the European Programme of Work 2020–2025, Human resources for health, Infectious disease surveillance, and Noncommunicable diseases monitoring).The tool has two main parts: guidance for performing an assessment of a full HIS and guidance for the subsequent development of an HIS strategy. The assessment methodology aims to achieve a good balance between data collection and actual data use and reflects the growing importance of electronic health records and other digital solutions. Add-on modules provide support for a more in-depth assessment of specific functions of HISs. Based on the outcomes of the assessment, the tool describes a stepwise and practical approach for HIS strategy development. The HIS assessment item sheets that are part of the assessment methodology are also available in the form of an excel sheet and published as a separate Web Annex.

Service delivery models for people with post COVID-19 conditions in selected European countries: summary report

Coronavirus disease (COVID-19) has affected millions of people across the WHO European Region. While the acute phase of the pandemic has passed, it is estimated that 10–20% of those infected with SARS-CoV-2 continue to have symptoms long after their initial illness. Using a tool devised by WHO for collecting data on the management of the post COVID-19 condition (PCC), also known as long COVID, three countries – Israel, Italy and the United Kingdom – and two autonomous regions of Spain – Aragon and Catalonia – collated detailed descriptions of service delivery models that support patients with PCC. This report synthesizes findings from those countries and regions, showing differences and similarities, and concludes with suggestions as to how other health systems can adjust their services to better meet the needs of patients with this debilitating condition.

Tuberculosis surveillance and monitoring in Europe 2024 – 2022 data

This report provides an overview of the latest tuberculosis (TB) epidemiological situation and is published jointly by the WHO Regional Office for Europe and the European Centre for Disease Prevention and Control. In 2022, a little over 170 000 incident TB cases were notified in countries of the WHO European Region, a slight increase from 2021. The increase in 2022 is likely due to a good recovery after the COVID-19 pandemic in access to and provision of TB services in many countries and the introduction of active TB case-finding activities. Despite the notable progress achieved in the fight against TB, countries still face various challenges in reaching the goal of ending the TB epidemic in the WHO European Region. Monitoring progress towards the targets of the new Tuberculosis action plan for the WHO European Region 2023–2030 is difficult due to limited or no reporting on some indicators. Further improvement of data completeness and representativeness should be the focus for all countries.

Alcohol taxation and pricing policies and their impact on alcohol consumption in Ukraine from 2011– 2021: country report

This report provides an overview of Ukraine's taxation and pricing policies for alcoholic beverages between 2011 and 2021. The report also provides insights into the health consequences of alcohol consumption and endeavours to establish links and correlations between alcohol taxation, pricing, affordability and decreased consumption. The report aggregates the available data from various sources over the decade and provides commentary on the quality of this evidence. This work was intended to serve as grounding evidence to perform different scenario-building analyses and to further inform decisions for other alcohol taxation policies in Ukraine. Due to the invasion of the Russian Federation of Ukraine, which started on 24 February 2022, these plans were postponed, but it is hoped that they will be resumed as part of country's recovery strategy. The report also provides essential evidence to support the WHO SAFER initiative and promote action plans to reduce the harm done by alcohol.

Prevention and control of antimicrobial resistance in the food chain: guidance for food safety authorities in Europe

In 2011, the WHO Regional Office for Europe launched the publication Tackling antibiotic resistance from a food safety perspective in Europe. The publication explored the options for prevention and containment of antibiotic resistance in the food chain through national coordination and international cooperation. Over the past decade, significant progress has been made and good achievements have been reached. However, foodborne antimicrobial resistance remains an issue in the WHO European Region. Every year, 23 million people fall ill, nearly 5000 people die from unsafe food, and several foodborne disease hazards are showing increasing levels of resistance to commonly used antimicrobials. This publication gives an overview of the current context and recent developments regarding foodborne antimicrobial resistance in the Region. It also explores the role of food safety authorities in reducing antimicrobial resistance and provides updated and practical advice on the prevention and control of antimicrobial resistance at the animal–human–environment interface using the One Health approach, including examples of successful interventions and programmes undertaken by Member States in the Region to prevent and contain antimicrobial resistance in foodborne pathogens. The publication is aimed at policy-makers and food safety authorities working in the public health, agriculture, food production and veterinary sectors in Member States in the Region.

City leadership for age-friendly communities in the post-pandemic era: five lessons for building health emergency resilience from 16 European cities

The COVID-19 pandemic hit older people hardest. This policy brief, intended for planners, policy-makers and politicians, was produced by the 16 cities of a Healthy Ageing Task Force and the WHO Regional Office for Europe. During the pandemic, cities provided leadership and innovative programmes to meet the four key challenges of survival, equity, creating conditions for people to adapt and thrive, and ensuring older people have a voice which is listened to and acted upon. Drawn from the experience of the cities, five lessons should inform age-friendly, resilient and adaptive cities for all types of health emergency: building resilience together; using a cycle of preparedness, response and recovery; adopting an all-hazards approach; investing in community infrastructure; and creating systems for feedback from older citizens. Older people should not be left behind when cities prepare for, respond and recover from future crises.

Prevention and control of iodine deficiency in the WHO European Region: adapting to changes in diet and lifestyle: web annex D: iodine supplementation in pregnant women in the WHO European Region

Iodine deficiency, especially mild deficiency, is still a widespread problem in the WHO European Region. Since the last WHO report on iodine deficiency in the Region was published 15 years ago, a wealth of new data on iodine status has become available, particularly concerning vulnerable population groups. This report reviews the iodine status in the WHO European Region, as well as current scientific knowledge on the consequences of mild iodine deficiency, dietary sources of iodine and the present effectiveness of iodine deficiency prevention measures. This report is also unique as it combines information sourced not only from scientific publications and public health reports, but also animal husbandry science and reporting, and the food industry.

Prevention and control of iodine deficiency in the WHO European Region: adapting to changes in diet and lifestyle. web annex C: dietary data for the WHO European Region

Iodine deficiency, especially mild deficiency, is still a widespread problem in the WHO European Region. Since the last WHO report on iodine deficiency in the Region was published 15 years ago, a wealth of new data on iodine status has become available, particularly concerning vulnerable population groups. This report reviews the iodine status in the WHO European Region, as well as current scientific knowledge on the consequences of mild iodine deficiency, dietary sources of iodine and the present effectiveness of iodine deficiency prevention measures. This report is also unique as it combines information sourced not only from scientific publications and public health reports, but also animal husbandry science and reporting, and the food industry.

Prevention and control of iodine deficiency in the WHO European Region: adapting to changes in diet and lifestyle: web annex B: nationally representative (or equivalent) cross-sectional studies in the WHO European Region

Iodine deficiency, especially mild deficiency, is still a widespread problem in the WHO European Region. Since the last WHO report on iodine deficiency in the Region was published 15 years ago, a wealth of new data on iodine status has become available, particularly concerning vulnerable population groups. This report reviews the iodine status in the WHO European Region, as well as current scientific knowledge on the consequences of mild iodine deficiency, dietary sources of iodine and the present effectiveness of iodine deficiency prevention measures. This report is also unique as it combines information sourced not only from scientific publications and public health reports, but also animal husbandry science and reporting, and the food industry.

Prevention and control of iodine deficiency in the WHO European Region: adapting to changes in diet and lifestyle: web annex A: legislation and/or regulation for salt iodization in the WHO European Region

Iodine deficiency, especially mild deficiency, is still a widespread problem in the WHO European Region. Since the last WHO report on iodine deficiency in the Region was published 15 years ago, a wealth of new data on iodine status has become available, particularly concerning vulnerable population groups. This report reviews the iodine status in the WHO European Region, as well as current scientific knowledge on the consequences of mild iodine deficiency, dietary sources of iodine and the present effectiveness of iodine deficiency prevention measures. This report is also unique as it combines information sourced not only from scientific publications and public health reports, but also animal husbandry science and reporting, and the food industry.

Roadmap for health and well-being in Central Asia (2022–2025): progress and opportunities

The report evaluates the progress made from 2022 to mid-2024 under the Roadmap for health and well-being in Central Asia (2022–2025) (CARM) across five central Asian countries (CACs). Endorsed by the presidents of Kazakhstan, Kyrgyzstan, Tajikistan and Uzbekistan and supported by the ministers of health of all CACs, the CARM addresses 11 key action areas and 32 reform initiatives. The report highlights individual and collaborative achievements for CACs amid a polycrisis (climate change, COVID-19 pandemic and political instability), emphasizing the need for partnerships and coordinated action to meet the CARM’s political, investment and technical objectives. The WHO Regional Office for Europe has facilitated discussions, provided political engagement and offered technical assistance, thereby elevating health as a driver of socioeconomic progress in the region. Specific accomplishments demonstrate CACs’ dedication to health and well-being, paving the way for an inclusive and sustainable future. The youthful population of Central Asia positions it to become a leader in health and economic success, in collaboration with the European Union and WHO. However, achieving these ambitions requires further investment in health, focusing on all 11 action areas of CARM. Increased collaboration and funding are essential to improve health outcomes and safeguard the region’s economic future.

The health of school-aged children in North Macedonia and the status of health-promoting schools: situation analysis

Health-promoting schools – the whole-school approach to promoting health in schools – was developed conceptually in the late 1990s, but a fully embedded, sustainable system has not yet been achieved. This research assessed the health status of school-aged children (needs assessment) and the existing policy environment (landscape analysis) in the context of the eight global health-promoting schools standards in North Macedonia, in order to establish implementation status and collect the data needed to create an implementation plan. Over 95% of primary school-aged children and over 80% of those of lower secondary school age are enrolled in schools. Noncommunicable diseases are prevalent as causes of both mortality and morbidity, with most being preventable (e.g. injuries). Priority behavioural risk factors (e.g. physical inactivity, inappropriate nutrition, alcohol use, violence and bullying) can be addressed through school health interventions. Health promotion is carried out in educational institutions and included in curricula, but no separate national strategies or plans exist to scale up health promotion in schools. Proposed ways forward include a national strategy and standards for health-promoting schools, building on previous positive experiences, along with better coordination among relevant ministries and stakeholders, increasing parent and student involvement, allocating budgets appropriately, and building technical capacity on human resources and training.

Building a public health innovation ecosystem in the WHO European Region: meeting report, 11–12 March 2024, Copenhagen

This meeting report highlights the pressing health challenges faced by the WHO European Region, including noncommunicable diseases, tobacco use, vaccine-preventable diseases, vector-borne diseases, HIV, multidrug-resistant tuberculosis, antimicrobial resistance and an aging population. It emphasizes the need for innovative solutions to address these challenges, ranging from remote monitoring and artificial intelligence to novel vaccination strategies and advanced surveillance systems. The meeting aimed to create a collaborative platform for stakeholders to collectivelytackle these challenges using innovative approaches and emerging technologies. Discussions revolved around innovation policies, governance,public-private relations and the financing of public health innovation. Key takeaways stressed the importance of collaboration, patient involvement and leveraging resources to scale up innovation. The meeting report underscores the urgency for bold WHO guidance, streamlined regulatory processes and collaborative efforts with governments to effectively deploy innovative solutions for public health impact.

Joint bimonthly surveillance report on SARS-CoV-2 and mpox in animals in the European Region, March and April 2024

Strengthened surveillance using a One-Health approach in at-risk animal populations and at the animal-human-environment interface is required to timely detect SARS-CoV-2 and mpox (previously known as monkeypox) in new animal hosts, to monitor for potential virus evolution and to detect potential spill-back to the human population. Both SARS-CoV-2 and mpox had been declared Public Health Emergencies of International Concern (PHEIC) and continue to pose public health challenges. The WHO Regional Office for Europe and the World Organisation for Animal Health (WOAH) in Europe are monitoring notified cases of SARS-CoV-2 and mpox in the animal populations.