London School of Hygiene & Tropical Medicine

South Eastern Europe is facing an imminent public health crisis that can be averted only with urgent intervention, a new report warns.

Healing the crisis: a prescription for public health action in South Eastern Europe (published by the Open Society Institute, the London School of Hygiene and Tropical Medicine, the United Kingdom Department for International Development, and UNICEF) outlines the need for increased attention to the region's failing health infrastructure. The prospects for rebuilding a functioning public health care system have never been better, as for the first time in history, the countries of South Eastern Europe all enjoy democratically-elected governments that are open to reform and keen to join the European Union.

The international community has invested billions of dollars to bring peace, and help reconstruct the region and build public institutions. "Too much effort has gone into rebuilding South Eastern Europe to allow the public health system to fall through the cracks," said Open Society Institute Chairman George Soros. "With a minimum amount of funding, the state of health in the region can be turned around."

South Eastern Europe - including Albania, Bosnia and Herzegovina, Bulgaria, Croatia, Macedonia, Moldova, Romania, Serbia and Montenegro, and the UN-administered province of Kosovo - is emerging from a painful decade of transition. The collapse of communism, wars, instability and organised crime have exacted a huge toll. Poverty is widespread, drug use is on the rise, and the health disparities between South Eastern Europe and EU countries are stark. People in Moldova, for example, can expect to die ten years earlier than their counterparts in the EU while in Romania, the death rate is six times higher than in the EU.

"The health sector in South Eastern Europe is too often ignored," said Professor Martin McKee of the London School of Hygiene and Tropical Medicine, one of the report's authors. "Yet the region must not be forgotten. Without a healthy population, the region cannot move forward. Improving public health will help ensure that it becomes a vital contributor to Europe."

The report calls for increased capacity to overcome health challenges at the national, district and local levels, and emphasizes the need for a more comprehensive public health model that incorporates a preventive approach.

The report recommends the establishment of country-level public health plans, funded by central governments and developed by multidisciplinary teams that include civil society organisations. It also gives recommendations as to how to reorient training for health professionals, implement reliable surveillance and health information systems, target health promotion efforts to engage and empower the public, improve health care delivery systems so that the entire population has access to basic health services, and develop mechanisms for sharing best practices.

To read the full report, go to: www.lshtm.ac.uk/ecohost/see/index.htm

Martin McKee (London): martin.mckee@lshtm.ac.uk
Sarah Miller-Davenport (New York): sdavenport@sorosny.org