Public Health in Europe: The 2007-2009 Financial Crisis and UNECE Activities

The economic and financial crisis of 2007-2009 had a serious impact on the larger European region. For western Europe this was the deepest economic downturn since the Second World War. Given the well-developed safety nets for this region the immediate impact on health is likely to be minor. However the crisis will negatively affect the long-run level of per capita income and has left government fiscal positions’ in a poor state; both of these developments will likely have some minor impact on health outcomes for years to come. The deterioration of government finances also raises a concern that the region’s contribution to global public health through its assistance programs may be negatively impacted. In the coming years, pollution control, including of green house gas emissions, is a major challenge for the region. Providing health care for an aging population is also a fundamental challenge for economies with problematic public finances. Eastern Europe and the European CIS were the most severely affected regions of the world. Despite the large economic downturns in these economies, this crisis was still not as great as that that occurred during the 1990s with their transition from planned economies to market economies. Although significant progress has been made in establishing social safety nets and public health programs in these countries over the last decade, these remain inadequate and as a result this economic crisis is likely to have a noticeable negative impact on public health throughout eastern Europe and the CIS. Even before the current economic downturn, there were a number of significant health concerns for eastern Europe and the CIS that were continuing to deteriorate which could have been significantly improved with realistic levels of public expenditures and the implementation of proper policies. The health care systems (often enterprise-based) and institutions collapsed during the transition due to the breakup of the economic and political systems and even the countries themselves (i.e., the Soviet Union and Yugoslavia). The poor health outcomes for the region are due to the fact that a number of diseases and social behaviors became established during the turmoil of the 1990s transition and did not recede as prosperity retuned after 2000. The increase in inequality that developed during the transition is reflected in growing inequalities for access to health care and in health care outcomes. Today, the region is characterized (relative to other regions with similar levels of income) by its high death rates from noncommunicable diseases. The issues of alcoholism and traffic fatalities are highlighted in this paper. For communicable diseases, the European CIS are central in the global fight against TB and HIV/AIDS.