Middle School Project - WHO France & Healthcare System

8/6/2019 Middle School Project - WHO France & Healthcare System

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History & Civics Project

World Health OrganisationFrance

May 2011

Ram Hattikudur

X B, Vidya Shilp Academy


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Table Of Contents:

Introduction

Background & Facts

Country Health Profile France

Current Challenges facingWHO in France

WHO Plans for the future in

France & EuropeSummary

References


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Introduction:

(a) The UN:

The United Nations (UN) is an international organization whose stated aims arefacilitating cooperation in international law, international security, economicdevelopment, social progress, human rights, and achievement of world peace.

The UN has many organizations and agencies that function to work on particularissues. Some of the most well-known agencies are the International Atomic EnergyAgency, the Food and Agriculture Organization, UNESCO (United NationsEducational, Scientific and Cultural Organization), the World Bank and the WorldHealth Organization.

It is through these agencies that the UN performs most of its humanitarian work.Examples include mass vaccination programs (through the WHO), the avoidance offamine and malnutrition (through the work of the WFP) and the protection ofvulnerable and displaced people (for example, by the UNHCR).

The United Nations Charter stipulates that each primary organ of the UN canestablish various

specialized agencies to fulfill its duties.

(b)WHO:

The World Health Organization (WHO) is a specialized agency of the United Nations(UN) that acts as a coordinating authority on international public health. Establishedon 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited themandate and resources of its predecessor, the Health Organization, which was anagency of the League of Nations.

The WHO's constitution states that its objective "is the attainment by all people ofthe highest possible level of health."[2] The flag features the Rod of Asclepius as a

symbol for healing.

The World Health Organization (WHO) is one of the original agencies of the UnitedNations, its constitution formally coming into force on the first World Health Day, (7April 1948), when it was ratified by the 26th member state. Jawaharlal Nehru, thefirst prime minister of India, was a big supporter of starting WHO, because Indianeeded its services.


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The epidemiological service of the French Office International d'Hygine Publiquewas incorporated into the Interim Commission of the World Health Organization on 1

January 1947, and this became WHO France.

Regional offices and regions of the WHO:

Africa; HQ: Brazzaville, Congo Americas; HQ: Washington, D.C., USAEastern Med.; HQ: Cairo, EgyptEurope; HQ: Copenhagen, DenmarkSouth East Asia; HQ: New Delhi, IndiaWestern Pacific; HQ: Manila, Philippines

France falls within WHOs European operations, headquartered in Copenhagen. Inaddition, two liaison organizations of WHO are in France. These are:

IARC, International Agency for Research on Cancer (Lyon, France) WHO Lyon Office for National Epidemic Preparedness and Response (LYO)

(Lyon, France)
http://en.wikipedia.org/wiki/Brazzavillehttp://en.wikipedia.org/wiki/Republic_of_Congohttp://en.wikipedia.org/wiki/Pan_American_Health_Organizationhttp://en.wikipedia.org/wiki/Washington,_D.C.http://en.wikipedia.org/wiki/United_Stateshttp://en.wikipedia.org/wiki/Mediterraneanhttp://en.wikipedia.org/wiki/Cairohttp://en.wikipedia.org/wiki/Egypthttp://en.wikipedia.org/wiki/Copenhagenhttp://en.wikipedia.org/wiki/Denmarkhttp://en.wikipedia.org/wiki/New_Delhihttp://en.wikipedia.org/wiki/Indiahttp://en.wikipedia.org/wiki/Manilahttp://en.wikipedia.org/wiki/Philippineshttp://en.wikipedia.org/wiki/International_Agency_for_Research_on_Cancerhttp://en.wikipedia.org/wiki/Republic_of_Congohttp://en.wikipedia.org/wiki/Pan_American_Health_Organizationhttp://en.wikipedia.org/wiki/Washington,_D.C.http://en.wikipedia.org/wiki/United_Stateshttp://en.wikipedia.org/wiki/Mediterraneanhttp://en.wikipedia.org/wiki/Cairohttp://en.wikipedia.org/wiki/Egypthttp://en.wikipedia.org/wiki/Copenhagenhttp://en.wikipedia.org/wiki/Denmarkhttp://en.wikipedia.org/wiki/New_Delhihttp://en.wikipedia.org/wiki/Indiahttp://en.wikipedia.org/wiki/Manilahttp://en.wikipedia.org/wiki/Philippineshttp://en.wikipedia.org/wiki/International_Agency_for_Research_on_Cancerhttp://en.wikipedia.org/wiki/Brazzaville


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Ms. Zsuzsanna Jakab is the WHO Regional Director for Europe. The head for WHO Francedoes not seem to be in the public domain.

Background & Facts:

According to the World Health Organization (WHO), France has the best health caresystem in the world. It has been reported that the WHO found the French system tobe number 1 while the US is at number 37.

WHO rankings actually contain multiple rankings and the numbers generally quotedare the ranking based on the measure that the WHO calls the OP ranking. OP is saidto measure "overall performance" adjusted to reflect a country's performance basedon how well it theoretically could have performed. When reporting the rankings of 1for France, 30 for Canada and 37 for the United States, it is the OP ranking being

used.

Why did the French system do so well in the WHO rankings? The Frenchsystem excels in 4 areas:

It provides universal coverage It has responsive health care providers Patients have freedom of choice

Country Statistics(France)

Total population

61,330,000

Gross national income per capita (PPP international $)

32,240

Life expectancy at birth m/f (years)

77/84

Healthy life expectancy at birth m/f (years, 2003)

69/75

Probability of dying under five (per 1 000 live births) 5

Probability of dying between 15 and 60 years m/f (per 1 000 population)

124/57


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The health and longevity of the population

Countries such as India should be looking more closely at the French systembecause it is successful, and because it has some similarities with the Indian system

The French system relies on both private insurance and government insurance.Also, just like in India, people generally get their insurance through their employer.What is different is that everyone in France has health insurance. Every legalresident of France has access to health care under the law of universal coveragecalled la Couverture maladie universelle.

Under the French system, health insurance is a branch of Social Security or theScurit Sociale. The system is funded primarily by taxing the salaries of workers.An employee in France will pay about 20% of their salary to fund the ScuritSociale. These taxes represent about 60% of the cost of the health insurance plan.

The balance of the funding comes from the self employed, who pay more than

salaried workers, and by indirect taxes on alcohol and tobacco. Finally, additionaltaxes are levied against other income, both direct and indirect.

The French share the same distaste for restrictions on patient choice as Americando. The French system relies on autonomous private practitioners rather than aBritish-style national health service. The French are very dismissive of the Britishsystem which they call "socialized medicine." Virtually all physicians in Franceparticipate in the nation's public health insurance, Scurit Sociale.

Perhaps it's time for us to take a closer look at French ideas about health carereform.

Country Health Profile:

Highlights on health give an overview of a countrys health status, describing recentdata on mortality, morbidity and exposure to key risk factors along with trends overtime. The reports link country findings to public health policy considerationsdeveloped by the WHO Regional Office for Europe and by other relevant agencies.Highlights on health are developed in collaboration with Member States and do notconstitute a formal statistical publication.

Each report also compares a country, when possible, to a reference group. Thisreport uses the 27 countries with very low child mortality and very low adultmortality, designated Eur-A by WHO, as the reference group. Eur-A comprisesAndorra, Austria, Belgium, Croatia, Cyprus, the Czech Republic, Denmark, Germany,Greece, Finland, France, Iceland, Ireland, Israel, Italy, Luxembourg, Malta, Monaco,the Netherlands, Norway, Portugal, San Marino, Slovenia, Spain, Sweden,Switzerland and the United Kingdom.

To make the comparisons as valid as possible, data, as a rule, are taken from onesource to ensure that they have been harmonized in a reasonably consistent way.Unless otherwise noted, the source of data in the reports is the European health for


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all database of the WHO Regional Office for Europe. Other data and information arereferenced accordingly.

The above statistics show that the country currently has a robust and self sufficienthealth care system.

But this was not always the case. Most of the countrys infrastructure was destroyeddue to World War II. While Paris itself was spared bombing by both the Allies as wellas Axis forces, key battles raged across France in both 1939-40, when the Germansinvaded, as well as in 1944-45 during the Allied counter-offensive.

World Health Organisation was instrumental in building up the countrys health

infrastructure & more importantly, in helping the government to devise a publichealth structure that is now ranked amongst the best in the world.


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France falls within WHOs European area. Even within the European system, theFrench public health system is being studied carefully for best practices. In its 2000assessment of world health care systems, the World Health Organization found thatFrance provided the "best overall health care" in the world. In 2005, France spent11.2% of GDP on health care, or US$3,926 per capita. Of that, approximately 80%was government expenditure.
http://en.wikipedia.org/wiki/World_Health_Organizationhttp://en.wikipedia.org/wiki/World_Health_Organization


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Country

Life

expectan

cy

Infant

mortality

rate

Physician

s per

1000

people

Nurses

per 1000

people

Per capita

expenditure on

health (USD)

Healthcare

costs as a

percent of

GDP

%of government

revenue spent on

health

%of health costs

paid by government

Australia 81.4 4.2 2.8 9.7 3,137 8.7 17.7 67.7

Canada 81.3 5 2.2 9 3,895 10.1 16.7 69.8

France 81 4 3.4 7.7 3,601 11 14.2 79

Germany 79.8 3.8 3.5 9.9 3,588 10.4 17.6 76.9

Japan 82.6 2.6 2.1 9.4 2,581 8.1 16.8 81.3Norway 80 3 3.8 16.2 5,910 9 17.9 83.6

Sweden 81 2.5 3.6 10.8 3,323 9.2 13.6 81.7

UK 79.1 4.8 2.5 10 2,992 8.4 15.8 81.7

USA 78.1 6.7 2.4 10.6 7,290 16 18.5 45.4

WHO France: Current Challenges:

WHO faces entirely different challenges in developed countries like France, whichare very different from those it faces in sub-Saharan Africa or East Asia.

Nevertheless, there are challenges and WHO has programs in place to addressthese.

(a) Lifestyle-related issues:

France, with a population of nearly sixty million people, has a high health ranking bythe World Health Organization, taking into account healthy life expectancy (withoutdisability or incapacity), child and adult mortality rates, among other indicators.Although some of the data show a relatively healthy population in France, othercore health indicators reveal a high rate of premature mortality, primariy lamongmales, as a result of tobacco and alcoholconsumption and accidental deaths.

(b) The financial burdens of longevity, unemployment, and new therapies

France, like many other Western countries, is facing difficulties in sustaining ahealthcare infrastructure that is under growing pressure from increasingexpenditures, with no guarantees of additional funding. Approximately ten millionpersons in France are sixty-five years or older, representing a growing segment ofthe population that often requires long-term healthcare. In contrast, the total birthrate in France is comparatively low . Additional burdens on the healthcare systemare increasing levels of unemployment and increased health costs for newtherapies.

Both the above issues are addressed in WHOs plan via Millenium DevelopmentGoals (or MDGs)

WHO Plans for the future in France & Europe:

To quantify and objectivise its future plans, WHO has drawn up a set of parameterson which it measures itself from time to time. These 8 parameters are called


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Millenium Development Goals (or MDGs). The MDGs are the highest-profilearticulation of internationally agreed development goals. They are the worldsquantified, time-bound targets for addressing extreme poverty, hunger and disease,and for promoting gender equality, education, environmental sustainability and aglobal partnership for development. Most importantly, the MDGs are an expressionof basic human rights.

These are:

Part I. MDGs on healthMDG 4 Reduce child mortalityMDG 5 Improve maternal healthMDG 6 Combat HIV/AIDS, malaria and other diseases [including TB]

Part II. MDGs on key determinants of healthMDG 1 Eradicate extreme poverty and hungerMDG 2 Achieve universal primary educationMDG 3 Promote gender equality and empower womenMDG 7 Ensure environmental responsibilityMDG 8 Develop a global partnership for development

The Millennium Development Goals (MDGs) are a historic framework providing focusand accountability in addressing some of the worlds most pressing developmentchallenges. The 53 Member States in the WHO European Region, including Francehave made some significant advances in meeting the MDG. Nevertheless, actionhas stagnated in some areas and inequities in progress persist between and withincountries, primarily because Europe, though largely developed economies, has hadits own challenges during the economic downturn and also due to poorer and lesserdeveloped countries like Albania, Bosnia etc.

Strong health systems are crucial for maintaining and scaling up progress towardsthe MDGs on health. Achievement of health targets depends on equitable access toa health system that delivers high-quality services, including the stewardship ofcooperation with other sectors and at cross-government levels to address thedeterminants of health and health inequities. The values and principles of primaryhealth care including equity, solidarity, social justice, universal access to services,multisectoral action, transparency, accountability, decentralization, and communityparticipation and empowerment provide a basis for strengthening health systemsto ensure improved progress towards the MDGs.

These same principles are vital for tackling other health challenges in France & the

European Region, such as adult morbidity and mortality linked to non-communicable diseases and external causes. While the configuration of healthsystems depends on country contexts, in all cases MDG progress requires: strong national capacities for adequate financing with pooling of risk; a well-trained and adequately remunerated workforce; information on which to base policy and management decisions; logistics that get medicines and vaccines to where they are needed; well-maintained facilities organized as part of a referral network; and


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leadership that provides clear direction and harnesses the energies of allstakeholders, including communities.

Scaling up progress towards MDG targets will be among the challenges addressedby the new European health policy, which Member States and the WHO RegionalOffice for Europe are developing with input from partners. The policy will promote

the Regions values and aims for health, provide a coherent and integratedframework and roadmap for health action, and specify ways through which healthsystems can be strengthened and the wider determinants of health and healthinequities can be tackled.

Summary:

(Ram to complete this)

References:

1. World Health Organisation website, www.who.int/countries/fra/en2. World Health Organization. (2000). World Health Report 2000 - Health

systems: improving performance. Geneva, WHO3. WHO Statistical Information System". World Health Organization

4. http://en.wikipedia.org/wiki/Health_in_France5. Businessweek article:

http://www.businessweek.com/magazine/content/07_28/b4042070.htm6. http://en.wikipedia.org/wiki/World_Health_Organization7. WHO Millenium Development Goals for Europe:

http://www.euro.who.int/__data/assets/pdf_file/0006/95595/E93723.pdf8. http://www.vhpb.org/files/html/meetings_and_publications/viral_hepatit

is_newsletters/vhv13n2.pdf
http://www.who.int/countries/fra/enhttp://www.who.int/whosis/data/Search.jsphttp://en.wikipedia.org/wiki/Health_in_Francehttp://www.businessweek.com/magazine/content/07_28/b4042070.htmhttp://en.wikipedia.org/wiki/World_Health_Organizationhttp://www.euro.who.int/__data/assets/pdf_file/0006/95595/E93723.pdfhttp://www.vhpb.org/files/html/meetings_and_publications/viral_hepatitis_newsletters/vhv13n2.pdfhttp://www.vhpb.org/files/html/meetings_and_publications/viral_hepatitis_newsletters/vhv13n2.pdfhttp://www.who.int/countries/fra/enhttp://www.who.int/whosis/data/Search.jsphttp://en.wikipedia.org/wiki/Health_in_Francehttp://www.businessweek.com/magazine/content/07_28/b4042070.htmhttp://en.wikipedia.org/wiki/World_Health_Organizationhttp://www.euro.who.int/__data/assets/pdf_file/0006/95595/E93723.pdfhttp://www.vhpb.org/files/html/meetings_and_publications/viral_hepatitis_newsletters/vhv13n2.pdfhttp://www.vhpb.org/files/html/meetings_and_publications/viral_hepatitis_newsletters/vhv13n2.pdf


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Middle School Project - WHO France & Healthcare System