Speech on closing the health gap in Europe at the Informal Meeting of Ministers of Health

5–6 July 2011, Sopot, Poland

“Closing the gap in health in Europe” is a very important public health priority in the WHO European Region and in the European Union (EU). We at WHO/Europe are very grateful that the Polish Presidency of the EU is putting this matter high on its agenda.

As you know, WHO/Europe has undertaken a very important process to develop a new health policy for Europe, named Health 2020, with the main aim of addressing and hopefully reducing health inequalities among and within countries.

This process was initiated at the sixtieth session of the WHO Regional Committee for Europe in 2010, and a first draft of the new European health policy will be presented and discussed at the sixty-first session of the Regional Committee in September 2011, during the Polish EU Presidency. The final policy document will be presented to the Regional Committee in September 2012.

Health 2020 aims to strengthen health systems, revitalize public health infrastructures and institutions, and develop coherent and evidence-based policies and governance solutions capable of tackling health threats and sustaining improvements over time.

The strategy will be underpinned by the review of the social determinants of health and the health divide in the WHO European Region, carried out by a consortium chaired by Professor Sir Michael Marmot of the United Kingdom and supported by leading scientists in Europe. This review is investigating gaps in Europe’s capacity and knowledge to improve health through action on social determinants. It will also make a synthesis of the evidence supporting concrete and implementable policy options and interventions.

A few basic principles form the basis of our approach towards “closing the gap”. First, it is necessary to generate public and political support for action within and outside the EU. The initiative of the Polish Presidency indeed gives a very powerful signal in this direction. Health and reduction of inequities have to be positioned and advanced as public goods and assets to social and economic development, rather than pure generators of cost to the health system.

Second, addressing health inequities requires a “whole-of-government approach” because responsibility for health rests with the whole society and many different sectors. Tackling issues such as smoking, diet, alcohol consumption and physical activity (which effectively means addressing the social determinants) requires actions in the political, social and economic environments that are the basis of lifestyle differences.

Health ministries have a tremendous leadership role in advocating health within the government and to other sectors. A study on governance for health, being prepared as part of the Health 2020 process, is investigating the different forms of governance that in modern societies may facilitate and operationalize other sectors’ role in health, interaction with the health authorities and health actions.

Third, inequalities need to be addressed not only among countries but also within countries. We know which sections in our societies are most at risk of poor eating habits, less physical activity, continued smoking and increased alcohol consumption, therefore policies and interventions can be designed to address the needs of those most at risk and create solutions that make healthy choices the easiest choices and the fairest ones. For example, working with urban and rural planners, the transport sector and ministries of culture, local development agencies and communities may facilitate the design of living and working environments that promote physical activity as part of everyday life.

Fourth, health ministries and the public health community have a key role to play in championing action and strengthening partnership solutions. We are very committed to developing Health 2020 to contribute closing the gap in Europe, and we will work with the Polish Presidency to strengthen and develop this process, to enhance support for action on health and health equity at the national and local levels.