Gastein health forum: Making the case for health in all policies

Health affects all policy areas, which is why Vytenis Andriukaitis looks forward to discussing how to successfully make the case for mainstreaming health into all policies.

Vytenis Andriukaitis | Photo credit: Natalie Hill

By Vytenis Andriukaitis

28 Sep 2017

The rationale for a horizontal approach to improve health and ward off disease is as solid as it gets. Whether tackling the risk factors of noncommunicable diseases, dealing with health threats such as antimicrobial resistance (AMR), or improving the vaccination uptake or the efficiency of health systems, we can no longer work in silos. 

Collaborating across policy areas is necessary at all levels of government: international, EU, national, regional and local. I am therefore delighted that this is the headline topic at this year’s European Health Forum Gastein.

Take AMR, a serious and growing health threat that already costs the EU 25,000 lives and €1.5bn a year. This June, the Commission presented a new EU action plan on AMR built on three main pillars: making the EU a best practice region; boosting research, development and innovation and shaping the global agenda.


The action plan is underpinned by a One Health approach, which recognises that human and animal health are inextricably linked and that action is required in both areas simultaneously. It also addresses the role of AMR in the environment, as the environment is increasingly acknowledged as a contributor to the development and spread of AMR in humans and animals.

Many Commission colleagues working across a wide-range of policies - human health, animal health, food safety, agriculture, research, environment and more - have been involved in shaping the action plan, as have the full spectrum of stakeholders who aired their views in the public consultation and during meetings and debates. We will now concentrate our e¬ orts on the implementation of the action plan, where our aim is to raise the level of all member states to that of the highest performing country.

This will require better evidence, better coordination and surveillance and better control measures so as to help member states establish, implement and monitor their national One Health action plans. 

Equally, we count on all these actors to help ensure its success, and on international partners to collaborate on the third pillar - shaping the global agenda.

I am also working on a digital health and care initiative with my digital single market colleagues, Vice-President Andrus Ansip and Commissioner Mariya Gabriel. 

I believe that eHealth can improve health, boost patient empowerment and enable better disease monitoring and treatment. I therefore want to seize every opportunity to ensure that practical, innovative, and cost-effective eHealth solutions can thrive. 

A public consultation on a Commission communication in the area of digital health is open until mid-October, gathering views from stakeholders spanning a multitude of sectors. 

They are invited to comment on areas such as secure access and cross-border sharing of data, using data to advance research and using digital services to promote citizen empowerment and integrated person-centred care. The aim is to adopt the communication before the end of the year.

Let me highlight a crucial area where we can no longer a¬fford to work in silos - non-communicable diseases (NCDs). An estimated €700bn per year is already spent on treating NCDs in the EU, and with an ageing population this figure could rise significantly if we do not seriously step up multi-sectoral action now.

EU countries have taken a positive step by committing to reach, by 2025, the nine voluntary global targets set out in the World Health Organisation’s global action plan on non-communicable diseases. These include reducing the harmful use of alcohol by 10 per cent, intake of salt by 30 per cent, and tobacco use by 30 per cent. 

The Commission has already developed actions and initiatives that support member states in reaching these targets, including legislation (on tobacco, for example), funding instruments, and platforms for cooperation on nutrition, physical activity and alcohol.

Within the Commission, I often stress the need for a ‘health in all policies’ approach to tackle the risk factors of NCDs. I constantly seek more ways to achieve synergies with other sectors such as agriculture, the environment, education, social policy, employment, research, growth and investment, and cohesion and regional policy. I would also encourage civil society organisations to make more of an impact with their advocacy e¬fforts by speaking with one voice. 

The EU health policy platform is designed for this purpose. It encourages a range of stakeholder organisations to group together to propose and agree joint statements that help keep their key health policy concerns high on the European political agenda.

We all have a role to play in bringing the public health message outside of our health silo and into the wider world. There is no point in just preaching to the converted, we need to make a solid and convincing case for health in other policies so that constructive solutions can be reached.

We need to convince policymakers that small, cost-e¬ffective changes in education, employment and social policies, etc., can have major positive e¬ffects on health. We can point to many examples: urban planning can increase physical activity; marketing controls can reduce the intake of fat, sugar and salt; and taxation can help prevent smoking and harmful drinking. 

Even public procurement can improve public health. For example, this year, the Commission published technical guidance for public authorities, advising them on how to apply procurement rules to provide healthier meals for school children. If applied widely, this could be an e¬ffective tool in the fight against childhood obesity.

I believe there must be similar untapped opportunities in other policy areas. I look forward to hearing about success stories from EU countries and regions at this year’s European Health Forum Gastein, and discussing with likeminded people how we can successfully make the case for mainstreaming health into all policies.

As all policy areas are inevitably underpinned by the need to ensure the cost e¬ffectiveness of public expenditure, I am particularly interested to discuss how we can make the economic case for integrating health objectives across policies. In the EU we still only spend an average of three per cent of healthcare budgets on health promotion strategies. 

This fact shows how far we have to go in our e¬ orts to convince decision makers in all policies that health is a smart investment in terms of wellbeing, social cohesion, growth and jobs. I hope that together we can find some workable solutions.


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