Health Ministers in Europe Sign New Charter on Future of Healthcare

European Health Ministers Sign "Tallinn" Charter

Health Ministers from 53 countries that fall under the World Health Organization's (WHO) European Region have signed a new charter in the Estonian capital, Tallinn, on the future of their healthcare systems, the WHO reports. The Tallinn Charter commits individual countries to strengthening healthcare systems in such a way that their citizens and the international community could hold them to account. The most important aspect of this new Charter is in the values that it promotes, which include improving access to healthcare, addressing costs, and making information more readily available. The Charter states: "We, the member states, commit ourselves to: promote shared values of solidarity, equity and participation through health policies, resource allocation and other actions, ensuring due attention is paid to the needs of the poor and other vulnerable groups."

In committing, the member states must:

• promote share values of solidarity, equity, and participation through health policies;
• invest in health systems and foster investment across sectors that influence health;
• promote transparency and be accountable;
• make health systems more responsive to people's needs;
• engage stakeholders in policy development;
• foster cross-country learning and co-operation; and
• ensure that health systems can respond to crisis.

The WHO's regional director for Europe, Dr March Danzon, said: "It is in the interest of all governments to invest in the health of their populations, as improving the health of the population makes a material contribution to the wealth of the nation."

According to WHO statistics, health expenses create financial difficulties for 150 million people in the region, of which around 100 million are below the poverty line.

As part of the preparations for the charter, the WHO has conducted a number of studies that have provided the evidence for the link between the health and the wealth of populations. The charter was signed by other health ministers by Estonian minister of social affairs Maret Maripuu and Danzon.

Outlook and Implications

Even within the European Union (EU), there is a great heterogeneity, not only in the amount each country allocates to healthcare, but also significant discrepancies in the access and quality of healthcare that patients receive. As pharmaceuticals are an integral part of healthcare treatments, the access to new innovative medicines and their affordability across Europe reveals striking differences. One of the measures that even older EU states are increasingly adopting is promoting and boosting the use of cheaper generic medicines to keep state health expenditure under control. In Spain, for example, the Spanish National Healthcare Service (SNS) has saved 7.9 billion euro (US$11.4 billion) on pharmaceutical expenditure through the use of generic medicines since 1999 (see Spain: 13 February 2008: Generics Have Triggered Savings of US$11.7 bil. for Spain's SNS Since 1999).

The experience of the healthcare reforms that have recently been adopted by new EU member states in strengthening their health systems (e.g., Slovakia, Poland, the Czech Republic, Romania) have so far produced mixed results. The introduction of medical co-payments had to be scrapped in Hungary following an overwhelming opposition in a national referendum. In March, the referendum organised by the opposition Fidesz party resulted in an overwhelming support to put an end to co-payments for doctors' visits and hospital stays (see Hungary: 12 March 2008: Hungarian Voters Oppose Healthcare Fees in Referendum). The new Charter is an important step in gaining commitment from individual European governments to tackle insufficient access to healthcare.

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