WHO’s Health 21 Strategy: 21 Targets for Global Public Health
Global Health Development and the ‘Health for All’ Movement
- In 1977, the World Health Assembly established a major social goal for governments and the WHO: the attainment by all people of the world by the year 2000 of a level of health that would allow them to lead a socially and economically productive life.
- In 1981, the Assembly unanimously adopted the Global Strategy for ‘Health for All’ by the Year 2000. This marked the birth of the “Health for All” movement.
- “Health for All” does not mean an end to disease and disability or that doctors and nurses will care for everyone. It means that resources for health are evenly distributed and that essential healthcare is accessible to everyone.
- It also means that health begins at home, in schools, and in the workplace, and that people use better approaches to shape their own lives and those of their families.
- In 1994, WHO’s member states acknowledged that significant global changes had occurred, calling for a strategy renewal to meet the challenges, expand opportunities, and overcome the obstacles of the 21st century with 21 new ‘targets’.
The Two Main Aims of Health 21
- Promote and protect people’s health throughout their lives.
- Reduce the incidence of the main diseases and injuries and alleviate the suffering they cause.
Proposals within Agenda 21
The proposals focus on:
- Meeting primary healthcare needs.
- Controlling communicable diseases.
- Coping with urban health problems.
- Reducing health risks from environmental pollution.
- Protecting vulnerable groups.
Note: A new public health agenda is emerging, addressing the links between environmental quality and health, tackled within the context of both national sustainable development strategies and the ‘Health of the Nation’ Programme.
Three Broad Areas for Health Action
- Enabling people to develop and maintain their health on a day-to-day basis through individual and community action.
- Preventing people from becoming ill by regulating hazards and providing information on risks.
- Treating people when they are ill or injured, including providing support to manage their illness.
UK Government White Paper: ‘Saving Lives – Our Healthier Nation’
The 1999 Government White Paper, ‘Saving Lives – Our Healthier Nation’, identified four key areas for illness reduction programs to focus on:
- Heart and circulatory disease
- Cancer
- Mental illness
- Accidents
The 21 Targets of the Health 21 Strategy
1. Solidarity and Equity in Health Between Countries
- Poverty is a major cause of ill health and a lack of social cohesion.
- Aims to close the health gap between the western and eastern parts of the European Region.
2. Equity in Health Within Countries
- Focuses on closing the health gap within individual countries.
3. A Healthy Start in Life
- Policies should create a supportive family environment with wanted children and good parenting capacity, for example, through:
- Genetic and dietary counseling
- Smoke-free pregnancies
- Evidence-based prenatal care
- Health-promoting childcare
4. Health of Young People
Addresses key issues such as:
- Accidents
- Drug use
- Unwanted pregnancies
- Sexually transmitted diseases
- Helping children and young people achieve the best possible education and employment.
5. Healthy Aging
- Promotion and protection of health throughout life.
- Providing social, educational, and occupational opportunities.
- Encouraging physical activities.
6. Improving Mental Health
- Reducing suicide rates.
- Promoting early detection of depression.
- Establishing departments of acute psychiatry in general hospitals.
- Protecting the mental health of socially and economically disadvantaged groups.
- Addressing conditions of work and unemployment.
7. Reducing Communicable Diseases
- Improving basic hygiene, water quality, and food safety.
- Implementing sustainable immunization programs for diseases like poliomyelitis, measles, diphtheria, and hepatitis.
- Combating tuberculosis, malaria, and HIV/AIDS.
8. Reducing Non-communicable Diseases
- Tackling the greatest health problems: cardiovascular diseases, cancer, diabetes, and chronic obstructive lung disease.
9. Reducing Injury from Violence and Accidents
- Improving emergency services.
- Implementing preventive measures for accidents on the roads, at work, and in the home.
- Addressing domestic violence and alcohol-related harm.
10. A Healthy and Safe Physical Environment
- Promoting health by reducing pollution.
- Acknowledging that the cost of cleaning up health-damaging pollution is high.
11. Healthier Lifestyles
- Encouraging healthier behavior in fields such as nutrition, physical activity, and sexuality.
- Increasing the availability, affordability, and accessibility of safe and healthy food.
12. Reducing Harm from Alcohol, Drugs, and Tobacco
- Recognizing tobacco as the biggest cause of harm to health in the European Region.
- Promoting smoke-free public places.
- Increasing the prices of tobacco products.
- Providing services for drug users.
13. Settings for Health
- People should have greater opportunities to live in healthy physical and social environments at home, at school, at the workplace, and in the local community.
- Creating smoke-free and safe environments.
- Implementing programs for separate waste collection, recovery, and recycling.
14. Multisectoral Responsibility for Health
- Applying legislation to all sectors of society.
- Developing policies and programs that promote and protect health.
15. An Integrated Health Sector
- Centering care around a family health physician and nurse.
- Providing specialized health services.
- Ensuring access to secondary and tertiary healthcare.
- Maintaining flexibility in the development of hospital services.
- Guaranteeing early and effective treatment for all patients.
16. Managing for Quality of Care
- Measuring health outcomes.
- Using internationally standardized quality indicators.
- Allowing outcomes to be compared with those of peers.
- Applying diagnostic and curative interventions more effectively.
17. Resources for Health
- Ensuring the system achieves high-quality outcomes.
- Promoting the cost-effective use of resources.
18. Developing Human Resources for Health
- Creating educational programs for healthcare providers and managers.
- Developing educational programs for other professional groups, such as architects, engineers, economists, and sociologists.
19. Research and Knowledge for Health
- Applying new knowledge to health development.
- Establishing national and local health information systems.
- Monitoring for effective health policy.
20. Mobilizing Partners for Health
- Involving partners such as politicians, managers, non-governmental organizations, the private sector, and individual citizens.
21. Policies and Strategies for Health for All
- Developing policies at country, regional, and local levels (e.g., schools and workplaces).
- Planning national policies and programs.