Ελληνικό Δίκτυο για την Αντιμετώπιση του Διαβήτη. Χριστίνα Παπανικολάου Γενική Γραμματέας Δημόσιας Υγείας 11 Απριλίου 2014

Transcript

1 Ελληνικό Δίκτυο για την Αντιμετώπιση του Διαβήτη Χριστίνα Παπανικολάου Γενική Γραμματέας Δημόσιας Υγείας 11 Απριλίου 2014

2 ΜΙΑ ΚΟΙΝΩΝΙΚΟ-ΟΙΚΟΝΟΜΙΚΗ ΜΑΣΤΙΓΑ ΓΙΑ ΤΗΝ ΕΥΡΩΠΗ Chronic Diseases are interrelated, have common risk factors and are largely preventable Yet, in Europe, 9 people out of 10 die of a Chronic Disease Chronic diseases carry significant human costs (human suffering, reduced workforce, social exclusion, health inequalities etc.) 70% to 80% of healthcare costs are spent on chronic diseases. This corresponds to 700 billion in the European Union and this number is expected to rise in the coming years 97% of health expenses are presently spent on treatment, only 3% is invested in prevention

3 ΠΟΛΛΑ ΚΥΡΙΑΡΧΑ ΧΡΟΝΙΑ ΝΟΣΗΜΑΤΑ ΜΟΙΡΑΖΟΝΤΑΙ ΚΟΙΝΟΥΣ ΠΑΡΑΓΟΝΤΕΣ ΚΙΝΔΥΝΟΥ CVD Hypertension Diabetes Cancers CKD Liver Diseases Respiratory Diseases Allergic Diseases Poor nutrition habits x x x x x x x Tobacco use x x x x x x Obesity x x x x x x Physical inactivity x x x x x x x x Alcohol consumption x x x x Environmental factors x x x x

4 ΠΟΛΛΑ ΧΡΟΝΙΑ ΝΟΣΗΜΑΤΑ ΔΙΑΣΥΝΔΕΟΝΤΑΙ ΜΕ ΑΛΛΕΣ ΑΣΘΕΝΕΙΕΣ (ΣΥΝΝΟΣΗΡΟΤΗΤΑ) Diabetes Respiratory Diseases (Asthma, COPD etc Cardiovascular Diseases (CVD) Kidney Diseases (CKD) Hypertension Allergic Diseases Cancers Liver Diseases

5 ΚΛΙΝΙΚΕΣ ΕΠΙΠΤΩΣΕΙΣ ΤΟΥ ΣΑΚΧΑΡΩΔΗ ΔΙΑΒΗΤΗ The leading cause of new cases of ESRD A 2- to 4- fold increase in cardiovascular risk Diabetes The leading cause of new cases of blindness in working- age adults The leading cause of nontraumatic lower extremity amputations

6 Σε συνεργασία με τα κ-μ, ο Π.Ο.Υ ολοκληρώνει την εργασία για τη διαμόρφωση των όρων λειτουργίας για την ανάπτυξη ενός παγκόσμιου συντονιστικού μηχανισμού για τα Μη Μεταδιδόμενα Νοσήματα UN Organizations Member States Non- State Actors Objectives: Advocate for the urgency to implement the WHO Global NCD Action Plan Disseminate knowledge on best practices Provide a platform to identify barriers and share innovative solutions Advance multisectoral action Share information on existing and potential sources of finance and cooperation mechanism

7 Συστάσεις Επιταχύνοντας την πρόοδο σε τοπικό επίπεδο Action Area Governance Recommended actions for governments Set national targets for 2025 based on national situations (taking into account the 9 global targets for NCDs and WHO s efforts to collect data on outcome and process indicators in 2015) Develop national multisectoral policies and plans to achieve these targets in 2025, taking into account the WHO Global NCD Action Plan Prepare for the United Nations General Assembly NCD Review in 2016 Reduce exposure to risk factors for NCDs Implement very cost- effective and affordable interventions (included in Appendix 3 of the WHO Global NCD Action Plan ) as part of national NCD plans Enable health systems to respond Implement very cost- effective and affordable interventions (included in Appendix 3 of the WHO Global NCD Action Plan ) as part of national NCD plans Measure results Strengthen national surveillance systems for NCDs Integrate surveillance systems for NDCs into the national health information systems, to ensure collection of data on the 25 indicators and progress toward the 9 voluntary global targets for NCDs Contribute information on trends in NCDs to WHO coordinating country reporting with global analyses.

8 ΠΑΓΚΟΣΜΙΟΙ ΣΤΟΧΟΙ ΓΙΑ ΤΑ ΜΗ ΜΕΤΑΔΙΔΟΜΕΝΑ ΝΟΣΗΜΑΤΑ Για να επιτευχθούν ως το 2015 Προκαταρκτικές ανεπίσημες εκτιμήσεις για το 2030 Harmful use of alcohol 10% reduction (13%) Premature mortality from NCDs 25% reduction (32-34%) (100%) Essential NCD medicines and technologies 80% coverage Physical inactivity 10% reduction (13%) 2025 (2030) (67%) Drug therapy and counseling 50% coverage Salt/Sodium intake 30% reduction (40%) (40%) Tobacco use 30% reduction (33%) Raised blood pressure 25% reduction (0%) Diabetes/ Obesity 0% increase

9 ΔΙΑΣΚΕΨΗ ΚΟΡΥΦΗΣ Ε.Ε. ΒΑΣΙΚΑ ΣΤΟΙΧΕΙΑ ΤΗΣ ΠΟΛΙΤΙΚΗΣ ΓΙΑ ΤΑ ΧΡΟΝΙΑ ΝΟΣΗΜΑΤΑ (3-4 Απριλίου 2014) Ευρωπαϊκή Συμμαχία για τα Χρόνια Νοσήματα (European Chronic Disease Alliance- ECDA) Five key Recommendations for the EU Summit Declaration 1. The EU must adopt a comprehensive framework on chronic diseases that leverages EU and MS regulatory competences and resources in all policies. 2. The EU must support MS in adapting health care systems to respond to the growing burden of chronic diseases, ageing population and increasing prevalence of co-morbidities. 3. The EU should introduce population-wide measures to reduce the key risk factors. 4. Successful and proven harm reduction policies should also remain in place in the MS and be properly resourced. 5. Monitoring and evaluating actions for chronic diseases should encompass establishing EU-wide surveillance and screening programmes (EU registries).

10 ΕΝΑ ΕΥΡΩΠΑΪΚΟ ΠΛΑΙΣΙΟ ΓΙΑ ΤΑ ΧΡΟΝΙΑ ΝΟΣΗΜΑΤΑ ΑΠΑΙΤΕΙ: Incorporate targets as set out in the Global NCD Monitoring Framework Intervene on health determinants such as tobacco, nutrition, alcohol, environment, health inequalities and physical inactivity Invest in prevention such as early detection and diagnosis; population- based screening; and population- wide measures to reduce smoking, alcohol, salt, fat and sugar consumption, and increase physical activity Encourage citizens to make healthy choices and build an environment that promotes health and individual responsibility

11 Αποτελεσματικά Πλαίσια για την πρόληψη και Διαχείριση Σημαντικών Χρόνιων Νοσημάτων ενδυνάμωση της ολιστικής αντιμετώπισης- πρόληψη Any policy relating to health care system reform and rehabilitation should put patients at the centre of goal oriented care = Patient empowerment = decision making powers in decisions related to health care policies, self- management of medical symptoms and playing an active social and economic role in society: getting back to work, being free from stigma and discrimination High quality healthcare services should be restructured to be universally accessible to all socio- economic groups = quality of care AND qualified medical staff open to integration of services Primary and Secondary care should be integrated at the resource level by bundled payments and linear structures of referral replaced with organic paths through the healthy system dependent on individual needs Determinants of health embedded in our societies should be addressed to PREVENT disease: Poverty reduction Close proximity of tobacco, alcohol, (unhealthy) food and (sugary) soft drink industries to policy makers Prevention of industry interference in hindering healthy choices by making harmful products readily available EU Added Value: Stakeholder coordination via EU Strategy on Chronic Diseases including all of the above points

12 Επενδύοντας στην Υγεία- οικονομικές και κοινωνικές πτυχές της πρόληψης και διαχείρισης χρόνιων νοσημάτων Recommendations 1. An EU policy on chronic diseases is needed, incorporating a science framework and funding for research 2. The EU should foster an integrated, multidisciplinary approach which is patient centered for the delivery of cost- effective solutions 3. The regulatory framework must allow access to innovation for patients 4. The EU can create an effective exchange forum for best practice and collaboration between member states and stakeholders 5. Policies must balance quality with cost control 6. Evidence must be provided for an outcome based approach to evaluate investments in health 7. Ministries of education, social affairs and finance should be involved in the policy-making process given the relevance for economic growth in Europe

13 Patient decision aids Information prescriptions Measuring outcomes Health coaching Follow up and review Supporting behavior change Informatio n sharing Patient and provider working together to co-produce health Patient education Goal setting, action planning Coordinated/ integrated care Patient access to EMRs Self help and peer support Risk stratification Measuring experience Shared results Integrated team working Community directories Staff training and supervision

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