Foreword
The last two years have seen multiple crises considerably impacting citizens’ physical and mental health, as well as posing a significant threat to the global economy and societal well-being. As EU and OECD economies gradually recover from the critical phase of the COVID-19 pandemic, their economic and social outlooks have become more uncertain following Russia’s war of aggression against Ukraine. Major hikes in energy and commodity prices have aggravated inflationary pressures at a time when a cost-of-living crisis was already taking a heavy toll on economies and societies everywhere, and especially low-income households.
It is in this uncertain geopolitical, economic and public health environment that we are releasing this 2022 edition of Health at a Glance: Europe, a visible output of the continued strong collaboration between the European Commission and the OECD. Promoting better public health and stronger health systems in Europe and around the world remain strategic priorities for both the European Commission and OECD. Moreover, for the first time, this edition of Health at a Glance: Europe reports key ind+ icators of health and health systems for Ukraine and Moldova. The focus of this edition is on:
Strengthening the resilience of health systems, crisis preparedness and response capacity through targeted investments;
Promoting better prevention and treatment of cancer and other non-communicable diseases;
Preventing and addressing mental health challenges in the aftermath of the pandemic and in the current context of multiple crises;
Supporting the digital transformation of health systems to make the most out of health data and new digital tools; and
Recognising the importance of regional, national, European and broader international efforts to address global public health threats.
The pandemic has exposed weaknesses and vulnerabilities in health systems created by years of underfunding across the board, as well as the inadequacy of planning and co-ordination mechanisms for developing effective responses to cross-border public health emergencies. In response, and building on the experiences of the COVID-19 pandemic, the European Commission and Member States have begun the process of building a strong European Health Union. This includes an ambitious package of measures aimed at providing the EU with better instruments for detecting and responding to future infectious disease outbreaks, which is underpinned by a new EU health security framework to manage serious cross-border health threats.
The OECD has highlighted the urgent need for smart investments in health systems to protect people’s health, strengthen the foundations of health systems, and empower health professionals working on the frontline. According to OECD estimates, the costs of deploying these necessary investments in prevention, health workforce and health system digitisation would amount to around 1.4% of pre-pandemic GDP, on average across OECD countries. Targeted spending must be combined with effective prevention interventions and measures to reduce wasteful spending to ensure that health systems remain fiscally sustainable in the medium to long term.
The Recovery and Resilience Facility is the EU’s direct response to the COVID-19 crisis, which focuses on accelerating the green and digital transitions as well as building health system resilience. To date, EUR 40 billion have been set aside in EU Member States’ Recovery and Resilience Plans to support health investments and reforms. In parallel, the ambitious and standalone EU4Health programme will fund actions aimed at building stronger and more sustainable health care systems that deliver better care for EU patients.
We cannot allow the pandemic to distract us from the fact that non-communicable diseases (NCDs) continue to account for 80% of the overall burden of disease in Europe. In February 2021, the European Commission launched Europe’s Beating Cancer Plan, setting out a new EU approach to cancer prevention and treatment. The plan is designed to address the entire disease pathway, from prevention to quality of life of cancer patients and survivors, focusing on actions where the EU can add the most value for patients and their families. In this context, the OECD is collaborating closely with the European Commission to launch the Cancer Inequalities Registry, a flagship initiative of the Europe’s Beating Cancer Plan to monitor trends and inequalities in cancer prevention and care throughout Europe.
Maximising people’s health and minimising the burden of NCDs are critical to mitigating the effects of any health crisis. During the acute phase of the pandemic, people with chronic conditions were more vulnerable to complications and more likely to die from COVID-19, while they also experienced disruptions in ongoing care.
In June 2022, the European Commission presented the Healthier Together initiative to address other major NCDs in the EU, such as cardiovascular diseases, diabetes and respiratory diseases, as well as mental health and neurological disorders. Tackling these conditions requires both greater prevention and improved disease management. Historically, there has been an under-investment in prevention – OECD data shows that only about 3% of health spending on average in EU and OECD countries were allocated to prevention activities before the pandemic. The OECD has for many years made the economic case for investing in disease prevention and tackling risk factors, and it is encouraging that as much of 20% of the EU4Health programme budget is allocated to health promotion and disease prevention. The OECD is also working with countries to more systematically measure the experiences and outcomes of people with chronic conditions in primary care through the Patient-Reported Indicators Surveys (PaRIS).
Together, EU Member States and OECD countries can reduce the burden of cancer and other NCDs and strive to achieve the UN Sustainable Development Goals (SDGs) and in particular SDG 3.4 which aims to reduce NCD-related premature mortality by one-third by 2030.
Anxiety and depression have significantly increased in all EU countries during the pandemic, affecting young people especially young women and those facing financial difficulties. Symptoms of anxiety and depression amongst young people more than doubled in several European countries during the pandemic. Disruptions in, and growing demand for, mental health support have challenged already-stretched mental health care services, resulting in nearly half of all young Europeans reporting unmet needs for mental health care in the spring of 2022.
We need to take better care of each other, across all generations. This edition of Health at a Glance: Europe makes a strong case for taking bold actions to respond to the mental health needs of young people and ensure the pandemic does not leave permanent scars on the aspirations and outcomes of the new generation. Following the call of the President of the European Commission Ursula von der Leyen in her 2022 State of the Union address for a more comprehensive approach to mental health for the EU, the European Commission has started necessary preparatory work so that we are well equipped to tackle this multifaceted challenge. OECD work setting a new benchmark for mental health systems highlights critical areas where better evidence needs to be developed and new effective mental health strategies put in place. The OECD Council Recommendation on Integrated Mental Health, Skills and Work Policy calls for governments to promote the provision of early and fully integrated services to improve the social and labour market outcomes of people with mental health issues.
We don’t know when the next crisis will be, but we know that better data and greater use of digital tools in the health sector will be vital to prepare for future shocks. The COVID-19 pandemic has highlighted the need to improve the timeliness of health data to provide the right information to the right people at the right time. To unleash the full potential of health data, in May 2022 the European Commission proposed a regulation to set up a European Health Data Space. Under this framework, citizens’ control of their own health data will be strengthened, and the secure use of health data for purposes of research, innovation, policy making and regulatory activities will be enabled. Likewise, the 2017 OECD Council Recommendation on Health Data Governance laid out a framework to encourage greater availability of timely health data within countries and across borders, while ensuring the protection of patients’ privacy and the security of sensitive data. The OECD is supporting countries’ progress to implement national Health Data Governance frameworks.
New digital technologies, such as teleconsultations and other forms of telemedicine, have already transformed people’s experiences of health care. The number of teleconsultations with doctors nearly doubled during the first year of the pandemic, and will undoubtedly play a crucial role in making health services more accessible also in the future.
The pandemic has clearly highlighted that health is the foundation upon which resilient, productive and fair economies and societies are built. However, emerging pathogens, climate change and other public threats know no borders. To secure the health of all people, we must tackle health globally. The new EU Global Health Strategy is fully aligned with the OECD strategic objective of improving health systems to more effectively prevent and respond to global health threats, as well as combat infectious and non-communicable diseases. The European Commission and the OECD will continue to work with the WHO and other partners to promote robust actions to secure the health of people in Europe and around the world – actions rooted in the universal values of inclusive growth and equal opportunities for all, human rights and co-operation.
