, https://www.europarl.europa.eu/news/en/press-room/20201211IPR93639/
Turning the tide: Slovenia’s success story of fighting cervical cancer
Slovenia has come a long way to become one of the most successful countries in the WHO European Region in the fight against cervical cancer. From having had one of the worst statistics in Europe on cervical cancer incidence, Slovenia has managed to turn the tide thanks to political will, cooperation and a robust screening programme.
A shared vision for change
Slovenia established its national cancer registry in the 1960s, which enabled Slovenian health authorities to track cancer incidence. A notable increase in cervical cancer rates in the 1990s sounded the alarm among experts, and led to the establishment of ZORA, Slovenia’s national cervical cancer screening programme.
“We used to have statistics among the worst of Europe – our cervical cancer incidence was really high,” explains Dr Urska Ivanuš, Head of ZORA. “With ZORA, managed by the Institute of Oncology Ljubljana, we built a population-based, centralized and comprehensive programme which soon delivered very concrete, tangible results: cervical cancer incidence has almost halved since we established ZORA.”
Dr Ivanuš describes one of the keys to such a remarkable accomplishment: “One of the important factors for success is a shared vision of the stakeholders, which should be led by the example of the core team. Believing in evidence, believing in the cause, working hard and with enthusiasm, listening and understanding all the stakeholders, monitoring and adjusting – all of this is crucial for the successful implementation of change.”
Regular rather than opportunistic screenings
Through ZORA, the practice of opportunistic screening – offering ad hoc screening tests to women visiting health centres for other reasons – was abandoned. Opportunistic screening has proven to have very limited impact on cervical cancer incidence. Instead, ZORA started screening women once every 3 years.
“There were some concerns we might miss out on cancers, but it turned out to be quite the contrary,” explains Dr Ivanuš. As the changes to the screening frequency were implemented, the rate of women with positive results requiring a call-back dropped from 15% to 5%.
“In short: we managed to screen more women, monitor results more efficiently, report back better to screening providers and also back to women themselves, and achieve better overall results,” says Dr Ivanuš. “Our ZORA team had a dream. Now that dream is a concrete plan: a plan to eliminate cervical cancer!”
Never wait for the first signs
The ZORA programme has been well accepted among Slovenian women, and more than 70% now attend screenings regularly.
“Women should think about screenings as part of a healthy lifestyle. Just as they do their daily exercise or try to eat healthy, they should make sure they are screened regularly. This is an important message we should convey to all women. Don’t wait for the first signs, as they will come late,” stresses Dr Ivanuš.
“Cervical cancer is one of the rare cancers where we can actually detect what is called ‘pre-cancer’. It can be a very small change in the cervix, limited to the surface, and if we catch it and treat it, we can prevent cancer from developing,” says Dr Ivanuš. “Cervical cancer is also the only cancer where we have 2 important, safe and effective public health interventions available: screening and vaccination.”
The 90–70–90 targets
“We can see global momentum, and we have the necessary tools for success. But to eliminate cervical cancer, we must achieve 3 crucial targets,” explains WHO Representative in Slovenia Dr Aiga Rurane:
- 90% of girls fully vaccinated with the human papillomavirus (HPV) vaccine by 15 years of age;
- 70% of women screened using a high-performance test by age 35 and again by age 45; and
- 90% of women identified with cervical cancer treated.
“For maximum impact, these 90–70–90 targets must be implemented simultaneously,” adds Dr Rurane.
With remarkable results for 2 of the targets – 70% of women screened and 90% of women identified with cervical cancer treated – Slovenia could very well become one of the first European countries to reach all 3 targets.
“We have not yet reached the benchmark of vaccinating 90% of girls. Slovenia has been vaccinating girls in the 6th grade of primary school against HPV free of charge since 2009. But the routine vaccination programme is attended by 60% of these girls, which is not enough to achieve the desired population-wide effects of the vaccination,” explains Dr Ivanuš.
“We need to increase coverage, implement primary HPV screening with more accurate tests that enable longer screening intervals, and strengthen the monitoring system,” she adds.
“Our success so far has been possible thanks to the continued efforts and dedicated work for many years of many health professionals in Slovenia, multiple partnerships, and the continued commitment of the Government,” says Dr Rurane. “Slovenia can be proud of what has been achieved, and it sets an example for countries across the Region and globally.”
Algernon Pharmaceuticals Provides Additional Information on Phase 2b/3 Ifenprodil COVID-19 Study Interim Data
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New: European Parliament paves way for emergency Brexit session
The European Parliament ‘stands ready’ to convene an emergency session before the end of the year if the United Kingdom and the European Union can strike a deal by midnight Sunday.
In a statement, bosses said if a deal was struck by “midnight on Sunday 21December” and though this is not in fact the date – it is Sunday 20 – it is believed the document is referring to the end of the weekend.
The body, which will need to grant consent to any future trade deal, released a statement this lunchtime welcoming efforts “to avoid a no deal scenario” which it says would have a “huge negative impact… on citizens and businesses.”
Talks are ongoing over the future relationship but many watchers seem to think the odds are moving towards a deal being struck in the coming days.
A Parliamentary session would take place “towards the end of December” if a deal is struck this weekend.
The Parliament has also demanded that the European Commission provide it with a full report into the UK’s implementation of the Withdrawal Agreement, which has become a bone of contention in recent days.
The UK Parliament will also have to be convened in some form, either digitally or physically, to ratify any deal before the transition period expires at 11pm GMT on New Year’s Eve.
Earlier today, Chancellor Rishi Sunak suggested that the worst of any Brexit turbulence could be mitigated via the use of existing Covid support schemes, including the furlough scheme.
European Parliament awards Sakharov prize to Belarus opposition
Belarusian opposition leader Sviatlana Tsikhanouskaya and other leaders of the country’s democratic opposition were awarded the European Parliament’s 2020 Sakharov Prize for Freedom of Thought in a ceremony on December 16 in Brussels, the Voice of America reported.
Tsikhanouskaya received the prize from European Parliament President David Sassoli on behalf of the Coordination Council, a body set up by Belarus’s political opposition to facilitate a transfer of power in the country.
“An invisible wall of fear had been built around us,” Tsikhanouskaya told European lawmakers in her acceptance speech. “But this year, united, we believe that this wall of fear could be taken down, brick by brick. The dream of a better Belarus keeps us going.
“Without a free Belarus, Europe is not truly free,” the opposition leader said. “Long live Europe, long live Belarus!”
The source reminded, Tsikhanouskaya has been in Brussels this week for talks with European Union leaders ahead of the ceremony to present the prestigious prize.
WHO analytical tool helps Ukraine monitor how regions respond to COVID-19
A new monitoring tool, developed by WHO and the Public Health Center of Ukraine (UPHC), is revealing how the different regions in Ukraine responded to COVID-19. Launched in October 2020, the Public Health Response Monitor (PHRM) was developed based on a regional tool, WHO/Europe’s Health System Response Monitor (HSRM).
The PHRM allows Ukraine to systematically monitor the policies and epidemiological situation across the different regions of the country. Using the findings, national and regional authorities can adjust the country’s COVID-19 response.
“We welcome tools that facilitate coordination and help us to respond effectively to the virus,” said Ukraine’s Deputy Minister of Health, Viktor Liashko, who added, “We are discovering the opportunities of regional monitoring, which we will consider integrating into the daily work of emergency coordination centres to support our public health response”.
Providing insights into new outbreaks
Several rounds of data collection began in the regions in May 2020. The WHO Representative in Ukraine, Dr Jarno Habicht, highlights the importance of this information in helping national and regional authorities to coordinate health-related interventions, policies and messages to support Ukraine’s COVID-19 response.
“The tool could also be a useful resource to help investigate a new outbreak in a given region,” he adds, “illustrating, for instance, how relaxing public health measures and allowing people to congregate, results in high infection rates in subsequent weeks”.
Emergency coordination centres at the Ministry of Health and the UPHC can also use the tool to compare governance and financing arrangements by region, and see whether these differ from national standards and policies.
Reflecting capacity and leadership
The PHRM consists of a questionnaire with six blocks of questions covering areas including regional management and coordination, funding, planning of services, case management and supporting essential health services during the pandemic. Public health data is supplemented with data on the epidemiological situation in each specific region.
The findings so far show a considerable variation in the implementation of COVID-19 measures in the regions of Ukraine, reflecting regional capacity and leadership. The next step will be a detailed study of the measures taken by the regional authorities in critical areas, such as school reopening and ensuring access to basic medical services.
The tool facilitates in-depth analysis of public health information alongside epidemiological data. It builds on a joint initiative between WHO/Europe, the European Commission, the European Observatory on Health Systems and Policies and the HSRM.
New publication outlines practical steps for refugee and migrant health data collection
In collaboration with Uppsala University, WHO/Europe has published new technical guidance that outlines why and how Member States should collect refugee and migrant-specific health data through their national health information systems (HIS).
As a result of increased mobility, societies have become more diverse – as have their health needs. The principle of leaving no one behind in the Sustainable Development Goals (SDGs) and the advancement towards universal health coverage, one of the European Programme of Work’s core priorities, promote the inclusion of refugees and migrants in public health goals.
Progress towards these goals cannot be measured without systematically collected data on both health and health-related indicators for refugees and migrants.
Inclusion of core variables promotes effective public health programmes targeting refugees and migrants
The new publication suggests integrating a set of core variables into HIS, which will facilitate disaggregation of data by migratory status, offering insights into the health status of refugees and migrants, which can then be translated into evidence-informed policies. These core variables include:
- country of birth
- country of citizenship
- year and month of arrival
- country of birth of both parents.
The publication is an important example of WHO/Europe collaborating closely with partners including the International Organization for Migration (IOM) Global Migration Data Analysis Centre, the United Nations High Commissioner for Refugees (UNHCR), the European Centre for Disease Prevention and Control (ECDC) and members of academia, to develop evidence-based documents that can guide Member States’ efforts to ensure the right to health for all.
Statement by Eva Åkesson, Vice-Chancellor of Uppsala University
“The International Maternal and Child Health (IMCH) Unit of the Department of Women’s and Children’s Health at Uppsala University, is a leading research and education division committed to disseminating knowledge that can contribute to creating a more just and equitable society. Translating knowledge into strategies and practical action for global health and migration is one of IMCH’s goals.
“Recently, IMCH has been working with WHO/Europe to promote the health and well-being of refugees and migrants. The latest output of the current collaboration is the development of the ‘Collection and integration of data on refugee and migrant health in the WHO European Region. Technical guidance’.
“Reliable and good quality data is essential to reduce health inequality among all, including refugees and migrants, and to achieve the SDGs. Consistent data is needed to ensure policies are sound and that operational and legislative responses effectively reach those they are intended to help. The publication aims to assist decision-makers in developing evidence-informed policies and actions to ‘leave no one behind’.
“The technical guidance highlights the current status quo and offers practical solutions to address the gaps related to migration health data and HIS in the European Region. It provides practical guidance to integrate migration health data into national HIS, which present a valuable mechanism and offer information to develop targeted health interventions not only for refugees and migrants, but for the entire population, including other vulnerable groups.
“Uppsala University is honoured to support WHO/Europe in its efforts to safeguard and promote the health of refugees and migrants.”
Migration: EU return policy must be better implemented | News | European Parliament
, https://www.europarl.europa.eu/news/en/headlines/society/20201210STO93501/
Asylum: more solidarity among EU member states and funds for frontline countries | News | European Parliament
, https://www.europarl.europa.eu/news/en/press-room/20201211IPR93630/
Rule of Law mechanism applies without further delay as of 1 January, MEPs stress | News | European Parliament
, https://www.europarl.europa.eu/news/en/press-room/20201215IPR94024/
