MIETULIS ARTURS

MD, MPH, research assistant at Erasmus School of Health Policy& Management, Erasmus Rotterdam University, the Netherlands

DEVELOPING EVIDENCE-BASED PUBLIC HEALTH LEGISLATION:
CASE STUDY OF UKRAINE

Current Ukrainian legislation in the field of public health is not evidencebased.
Evidence-based legislation is seen as a trigger to improvement in public
health. Using several internationally accepted public health frameworks in
law-making process makes legislation evidence-based and helps revealing
shortcomings of current legislation.
Ukraine lacks public health law as an entity: current public health legislation
consists of multiple legal acts, with several articles in different laws
duplicating each other. Apart from that Ukrainian legislation is not evidenceinformed.
Law-making is a prerogative of Verkhovna Rada (unicameral
parliament of Ukraine). During the law drafting procedure, the committee of
Verkhovna Rada may create special working groups consisting of researchers,
NGOs and other stakeholders. Nevertheless, this requirement is not mandatory.
Thus, Ukraine is a good model to illustrate the possibility of creating a
single evidence-based national public health legislative act. Apart from that
Ukraine and the European Union have signed an Association Agreement in
2014. Multiple articles of the Association Agreement focus on public health.
Ukraine shall redesign its public health legislation in accordance with the
Association Agreement’s requirements. Redesigning Ukrainian legislation in
accordance with the Agreement and using several public health frameworks
to synthesize the new legislative act shall be seen as a trigger for positive
change in Ukrainian public health. In order to ensure high transferability
study focused exclusively on disease prevention. Current national and some
European Union legialtive acts were used as a basis, and several internationally
accepted public health frameworks were used as a source of evidence.
Nine national laws were used representing national legislation. Nine Directives,
two Decisions, and three CJEU case-laws were used representing
European Union legislation. Frameworks used were the SWOT analysis, the
2007 WHO framework for action, and the 2000 WHO framework for health
performance assessment. Using SWOT analysis allowed to pick strengths
and opportunities from national legislation. The result of the study was a
chapter of a green paper (consultative document representing a draft of a
law) that was synthesized using Ukrainian and EU legislation. This chapter
was tested against the 2007 WHO framework that demonstrated that such document covers all healthcare system’s building blocks. Testing against the
2000 WHO frameworks revealed that some health goals cannot be satisfied
even by such synthetic chapter, yet recommendations on improvement were
provided. Virtually, all criterions shall be satisfied if frameworks are used as
a routine method in legislative activities. In such a manner implementation
of used methodology is recommended to national legislative power authorities
as a standard of legislative activities, since it provides a trigger for changes
within public health.

Key words: public health, health law, development of law, health systems
and policy.

Література:

1. Acheson D. Public health in England. The report of the committee of inquiry into the future development of the public health function. London: Her Majesty’s Stationery Office; 1988.

2. Botezar D, Oprea L, Gavrilovici C. The integration of health services. Health networks. Social Research Reports. 2013; 23:68-81.

3. Law: an underused tool to improve health and wellbeing for all. The Lancet.
2017;10067(389):331.

4. World Health Organization. Advancing the right to health: the vital role of law. Geneva: World Health Organization; 2017. 308 p.

5. The Right to Health. Fact Sheet No. 31. Geneva: WHO Press; 2008. [Accessed on 20th of January 2017] Available from: http://www.ohchr.org/Documents/Publications/Factsheet31.pdf

6. Greer SL, Fahy N, Elliott HA, Wismar M, Jarman H, Palm W. Everything you always wanted to know about European Union health policies but were afraid to ask. London: European Observatory on Health Systems and Policies; 2014.

7. Association Agreement between the European Union and its Member States, of the one part, and Ukraine, of the other part. Brussels: European Commission.

8. Calvelli and Ciglio v. Italy. Stsrasbourg: The European Court of Human Rights; 2002.

9. Vo v. France. Strasbourg: The European Court of Human Rights; 2004.

10. Health and human rights, Fact sheet No 323. Geneva: WHO Media centre; 2015 [Accessed on 30th of April 2017] Available from: www.whi.int/mediacentre/factsheets/fs323/en/

11. Wilson J. REPORT 2015. From science to policy: how to improve the dialogue. Oslo: Centre for International Climate and Environmental Research; 2015.

12. Draft political declaration of the high-level meeting of the General Assembly on antimicrobial resistance. Ney York: United Nations; 2016.

13. Outcome document of Summit for adoption of the post-2015 development agenda. Geneva: World Health Organization; 2015.

14. «Ukrainian Energy». Analysis. Law-making process in Ukraine; 2012 [Accessed on 23 of May 2017] Available from: ua-energy.org/en/post/26466.

15. European Centre for Disease Prevention and Control. Competent Bodies [Internet]. Stockholm: European Centre for Disease Prevention and Control; 2017 [Accessed on the 4th of May 2017] Available from: http://ecdc.europa.eu/en/aboutus/governance/competent-bodies/Pages/Competent_bodies.aspx

16. Arksey H, O’Malley L. Scoping studies: towards a methodological framework. International Journal of Social Research Methodology. 2005;8(1):19-32.

17. Ordinary Legislative Procedure «Step By Step» [Internet]. Brussels: European Commission; 2012. [Accessed on 20th of January 2017] Available from: http://ec.europa.eu/codecision/stepbystep/text/index_en.htm

18. Health and food safety. Who we are. Brussels: European Commission [Internet]. [Accessed on 4th of May 2017] Available from: http://ec.europa.eu/dgs/health_food-safety/about_us/who_we_are_en.htm

19. 2013/329/EU: Commission Implementing Decision of 26 June 2013 providing the rules for the establishment, management and transparent functioning of the Network of national authorities or bodies responsible for health technology assessment. Brussels: European Commission.