The new normal is ‘dual track healthcare’

Press statement by WHO Regional Director for Europe, Dr Hans Henri P. Kluge
Tel Aviv, 14 September 2022
Shalom, good morning, thank you all for being here today.
A heartfelt thank you to Israel and its Ministry of Health, Minister Horowitz and team, and all who have helped make our WHO Europe Regional Committee – RC72 – a reality. Your support and hospitality have helped ensure that our first in -person Regional Committee in three years has been a genuine success.
My appreciation as well to Israel for its continued commitment to public health, including its strong handling of the pandemic as articulated by the Minister – along with innovations in digital health, one of the flagship pillars of our WHO/Europe Programme of Work, whose action plan was formally adopted by Member States here yesterday. My Regional Office looks forward to collaborating strongly with you.
New normal: dual track
Media colleagues, before we take your questions, I have two main messages today, both linked.
First, the overarching takeaway message I conveyed to all delegates when RC72 began – one I really want to convey far and wide.
My message is this: In a world of ever-rising health crises, at a time of economic turmoil, we must accept and work within the reality of a New Normal – requiring a Dual Track approach to health ( -track-address-by-and-report-of-the-who-regional-director-for-europe-at-the-72nd -who-regional-committee-for-europe).
This means, on the one hand, we must significantly invest in preparedness for mounting and often overlapping emergencies. On the other hand, we must ensure that we maintain and strengthen day-to-day, essential health services all the more.
Equal emphasis and priority for both. A Dual Track approach for the New Normal.  And this is really a lesson learnt from COVID-19.
Now to current emergencies:
The pandemic itself is far from over. Too many people are still dying unnecessarily – more than 3,000 last week in our Region. And we’re expecting a surge in the autumn and winter, with many people still unvaccinated. Moreover, at least 17 million individuals across the European Region may have experienced long COVID in the first two years of the pandemic ( -people-in-the-who-european-region-experienced-long-covid-in-the-first-two-years -of-the-pandemic–millions-may-have-to-live-with-it-for-years-to-come). This week’s meeting discussed how we could better address this long-term crisis.
The number of monkeypox cases is reducing in some countries, but we cannot be complacent ( -european-commissioner-for-health-and-food-safety-stella-kyriakides-and-who -regional-director-for-europe-dr-hans-henri-p.-kluge-on-preventing-monkeypox -from-becoming-endemic-in-europe). We have many tools to control the outbreak; but we need greater political will. And, not least, we must target the stigma against affected populations – in this case primarily men who have sex with men. I truly commend Israel for putting LGBTQI rights and dignity as a key pillar of health policy.
Polio has resurfaced in unexpected ways, in our Region and elsewhere.  There are genetic linkages between the virus recently found in the US to the virus found in some parts of our Region, including Israel, which in turn is linked to poliovirus in South Asia.
Basically, a threat anywhere can be a threat everywhere. Not acting now to get ready can prove disastrous in the future. We’ve had robust discussions with countries and health partners this week – including on how regional and global responses can be better aligned.
Now to maintaining and strengthening health systems and essential services.
The pandemic, as we know, overwhelmed health systems. Many essential programmes and services were thrown off track. As we recover, we need increased investments on multiple fronts – using the best science, tools and technologies available.
This week’s Regional Committee has clearly shown the way.
We have introduced ambitious yet practical roadmaps and frameworks to eliminate cervical cancer ( -can-eliminate—who-europe-urges-member-states-to-consign-cervical-cancer-to -history), and end tuberculosis (, HIV, sexually transmitted infections ( and viral hepatitis (
We also have action plans to reduce alcohol consumption ( and target a range of non-communicable diseases ( that kill millions.
As well, countries have adopted a WHO European framework for action to achieve the highest attainable standard of health for persons with disabilities ( – another landmark achievement.
The Oslo Medicines Initiative ( -medicines-initiative) has led to growing partnerships between governments, civil society and the pharmaceutical industry to increase affordable access to high-priced innovative medicines – a process that will be led by WHO/Europe as the neutral broker.
I’m especially thrilled to note that Member States have adopted two of WHO/Europe’s four flagship initiatives: The Behavioural and Cultural Insights (or BCI) Action Framework ( -understanding-human-behaviour-at-the-heart-of-effective-health-policies) and the Digital Health Action Framework (
BCI helps us better understand how individual behaviour and social circumstances can impact people’s health, helping us design and implement more impactful and tailored health programmes and initiatives.
One example of BCI in action comes from the United Kingdom, where BCI has been used to address anti-microbial resistance or AMR, one of the top global public health threats. If antibiotics are misused, pathogens can develop resistance to them, leading to the creation of ‘superbugs’ that don’t respond to treatment. Globally, antibiotics are often over-prescribed by doctors, contributing to AMR.
In the UK, health authorities used a pilot BCI project to address this. The Chief Medical Officer sent a letter to primary care physicians, or GPs, who were prescribing more antibiotics than one would normally expect. So, the letter was developed using BCI, with a social norms approach. The aim was to make these particular GPs aware of their behaviour as compared to their peers and reduce such over-prescribing by 4 percent. The result: Over 73,000 fewer antibiotic prescriptions over six months, a 3.3 percent reduction in antibiotic prescribing, saving taxpayers close to 100-thousand pounds sterling in prescription costs. The successful pilot project was scaled up in the UK, and some other countries have now adopted the same BCI approach too.
Digital health offers us cutting-edge tools to better deliver health across diverse platforms in various settings, truly enabling us to transform the healthcare landscape in so many ways – and as noted Israel will be a key partner in this, working with us, sharing its expertise with the Region and the world.
Allow me, Minister Nitzan, to provide an Israeli example of digital health in action. The work being done at the Center for Digital Innovation at the Sheba Medical Center, where new tools are being developed – for example an app that allows pregnant mothers to see their doctors from home, and for midwives to check vitals on the fetus remotely, so that women in rural areas don’t have to travel long distances. And we know that this specific tool is being rolled out to benefit both Israeli and Palestinian women.
We are truly excited about the potential that collaboration on digital health – and our other achievements at the Regional Committee this week – holds to benefit millions.
Now for my second main message today. And it is a warning:
There is a ticking time-bomb that threatens all of these aspirations from being fulfilled.
Our health and care workforce were already challenged before COVID-19. Personnel shortages, insufficient recruitment and retention, migration of qualified workers, unattractive working conditions, a lack of professional development opportunities. The pandemic only made things worse. If not addressed urgently, this could spell disaster. We absolutely need an optimal health and care workforce in place, on all fronts.
That’s why I am choosing this opportunity to release a new report urgently calling on governments and health authorities to act now. (–without -immediate-action–health-and-care-workforce-gaps-in-the-european-region-could -spell-disaster)
Consider the current reality.
In one-third of the 53 countries in our Region, 40% of medical doctors are close to retirement age. Adequately replacing them – and other health and care workers – will be a significant challenge for governments and health authorities in the near future. Countries must move quickly and strategically to train, recruit, and retain the next generation of health professionals.
This means innovative and flexible approaches – such as welcoming professionals trained in other countries without unnecessarily cumbersome protocols even as we ensure quality assurance.
Another key finding in the report is the worryingly poor mental health of so many of our health workers.
Long working hours, inadequate professional support, serious staff shortages as well as high COVID-19 infection and death rates among frontline workers-especially during the pandemic’s early stages-all have left a mark to this day.
Health worker absences in our Region increased by 62% amid the first wave and mental health issues were reported in almost all countries.
Our report lays out a practical ten-point action plan to address these gaps.
This includes making health sector jobs more attractive by increasing salaries, developing future healthcare leaders, supporting professional development and mental health, improving data-gathering, and making better use of digital tools.
Tackling the health and care workforce crisis is absolutely critical to successfully navigate the Dual Track in our New Normal.
I urge all countries to take this seriously; WHO/Europe is your partner in this, all the way.
Optimism despite the challenges
Despite these challenges, I would like to end on an optimistic note – because optimism is also a form of medicine.
Just look at what we can accomplish if we put our minds to it. This week’s Regional Committee has proven that beyond a doubt. – it may not always be smooth, but it is not impossible.
Let me conclude with a quote in the beautiful Hebrew language from a famous singer in Israel, Arik Einstein, beloved both by the Jewish and the Arab communities. Ani ve’ata neshaneh et ha’olam. Together, you and I, we’ll change the world. Thank you. Toda raba.
Bhanu Bhatnagar,
WHO/Europe Press Office,

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