WHO EU region - European Programme of Work
The WHO Region Office for Europe has recently published its European Programme of Work (EPW) 2020-2025. United action for better health in Europe – which focuses on the recovery, resilience and robustness of public health and health systems in the wake of the COVID-19 pandemic. The WHO Regional Office for Europe outlines, in this Europe Programme of Work, its ideas on how to support European countries and better fulfil citizens’ expectations about health. Furthermore, it is an invitation to engage with all international, national and local CSOs, NGOs, academia, health service providers, and the private sector.
EUROCAM joined the virtual briefing for non-State actors which was held on 26 June 2020 and sent a letter with the following reaction to the WHO Regional Director for Europe.
Three core priorities of the European Programme of Work
EUROCAM fully endorses the programme’s focus on the three core priorities:
(1) moving towards universal health coverage;
(2) protecting people better against health emergencies;
(3) ensuring healthy lives and well-being for all at all ages.
Proposals for amendments on the European Programme of Work
EUROCAM’s comments and proposals for the amendments are as follows:
Core priority 1. Moving towards universal health coverage (UHC)
1. People-centred services
The relationship between biomedicine and Traditional and Complementary Medicine (T&CM)  has moved from open hostility, where the total exclusion of all traditional T&CM practices from mainstream health care was sought by the biomedical profession, to a tacit acknowledgement, and in some cases open endorsement, by biomedicine for a number of T&CM therapies. This change has been driven largely by the need for biomedicine to respond to consumer expectations in a health care system that has become increasingly market-driven.
Integrative Medicine has become a paradigm shift in the way that primary medical doctors deliver healthcare to patients. Currently, there is a Consortium of over 60 academic health centres for Integrative Medicine and Health established in association with academic hospitals in North America – the Academic Consortium for Integrative Medicine and Health  – and a growing number of centres in Australasia and Europe. The term “integrative” is used to indicate a collaborative, multidisciplinary approach that requires the application of the best options from different healing systems. In this model of healthcare delivery, practitioners from a variety of biomedical and T&CM fields combine the diagnostic and therapeutic strengths of different modalities into a comprehensive and individualized treatment strategy, which also encourages patient participation.
EUROCAM suggests the following amendment (in italics)
(b) Bridge the divide between primary health care and public health and between biomedicine and traditional and complementary medicine (T&CM), guided by a review of contemporary models of collaboration, their effectiveness and potential.
4. Medicines and supplies
The United Nations Political Declaration of the high-level meeting on universal health coverage  demonstrates a strong recommitment “to achieve universal health coverage by 2030, with a view to scaling up the global effort to build a healthier world for all, and in this regard” to (measure 47) “explore ways to integrate, as appropriate, safe and evidence-based traditional and complementary medicine services within national and/or subnational health systems, particularly at the level of primary health care, according to national context and priorities.”
The promotion of universal health coverage by integrating Traditional and Complementary Medicine (T&CM) services into health care service delivery and self-health care is also one of the strategic objectives of the WHO Traditional Medicine Strategy 2014–2023 , which was developed and launched in response to the World Health Assembly resolution on traditional medicine (WHA62.13). This strategy aims to support Member States in developing proactive policies and implementing action plans that will strengthen the role traditional medicine plays in keeping populations healthy. Other strategic objectives are
- To build the knowledge base for active management of T&CM through appropriate national policies.
- To strengthen the quality assurance, safety, proper use and effectiveness of T&CM by regulating products, practices and practitioners.
EUROCAM suggests the following amendment will build on these objectives:
Add item (d)
(d) Accelerate the implementation of World Health Assembly resolution WHA62.13, reinforced by WHA67.18, on the integration of Traditional and Complementary Medicine (T&CM) services within national healthcare systems by developing and implementing national T&CM policies and programmes.
Core priority 2. Protecting against health emergencies
Protecting against health emergencies aims to prevent, eliminate or reduce the occurrence or the severity of communicable disease outbreaks. When it comes to prevention, the burden of communicable disease has greatly and undeniably been reduced by vaccination. We would like to emphasize an additional point: that prevention is not only about vaccines, but also, and mainly, about enhancing the resilience of the population in order to cope successfully with infections. We know that there are many infections for which no vaccine exists. The scientific literature shows us that there is growing evidence that lifestyle interventions can contribute to an improved resistance against infections and a reduced risk of a serious course of disease. Infection is always the result of two factors: exposure to an infective agent and the person’s immune system. Pathological viruses and bacteria take root as a disease when the person’s immune system is inadequate and susceptible to them. We know that anyone can be exposed and infected with a pathological virus/bacterium, but only relatively few people get seriously ill, a smaller number get complications, and an even smaller number of people die. This is illustrated in the current COVID-19 pandemic. When it comes to a person’s ability to resist infection, basic requirements to strengthen the immune system include quality sleep, regular exercise, healthy food, and relaxation practice. These will help reduce the risk of acquiring the microbe or reduce the severity or duration of an infection.
EUROCAM suggests the following amendment (page 10):
2. Enhance country preparedness and response capacity:
Add item (e)
(e) Build capacity and assist in public campaigns to promote healthy lifestyles, which include quality sleep, regular exercise, healthy food, and relaxation practice, in order to enhance citizens’ resilience to infectious diseases.
Core priority 3. Promoting health and well-being
EUROCAM fully endorses the focus of the Regional Office on (1) local living environments that enable health and well-being and on (2) safer, healthier and better lifestyles.
As far as (3) safer health care is concerned we would like to mention the growing use of many European citizens of more natural, less drug-oriented therapies, sometimes as an alternative to conventional medicine, sometimes in a team approach alongside conventional medicine. According to a recent pan-European study, 25.9% of the general population had used Complementary and Alternative Medicine (CAM) during the last 12 months. The use of complementary medicine was two to fourfold greater among those with health problems, compared to those in good health.
The most common ‘push’ motivation in consulting CAM practitioners is the patient’s dissatisfaction with biomedical treatment, often after exhausting biomedical treatments.
A number of factors influence that decision:
- biomedicine has been ineffective,
- patients have conditions where biomedicine has achieved only limited success
- biomedicine produced adverse side effects (a medication or treatment that is perceived to be worse than the condition for which biomedical care was sought).
CAM treatment options are generally and intrinsically safe and can diminish the need of high-tech, high-cost treatments with their related adverse effects.
EUROCAM suggests the following amendment (page 12):
3. Safer health care
Horizon-scan, identify and assess complementary and alternative medicine treatment options, self-care practices and interventions, including those implemented digitally and over the counter.
 United Nations, Resolution adopted by the General Assembly on 10 October 2019
 Kemppainen LM et al. (2018). Use of complementary and alternative medicine in Europe: Health-related and sociodemographic determinants. Scandinavian Journal of Public Health, 46(4):448-455
 Furnham A (2004). The psychology of complementary and alternative medicine. Health Psychology Update, 13:2-12