Governance for health: how do we respond to today’s complex health challenges?

New WHO study introduces five smart approaches to governance for health in the 21st century

Baku, 12 September 2011

The WHO Regional Office for Europe today announced the findings of a comprehensive study that explores current thinking and innovative practices related to governance for health in the 21st century. The study also makes recommendations on how governments can strengthen governance for health through collaboration. Ministers of health and other high-ranking health officials from the 53 countries of the WHO European Region will discuss the study’s findings and recommendations at the WHO Regional Committee for Europe meeting in Baku, Azerbaijan from 12 to 15 September 2011.

“We commissioned this study to better understand the interdependent nature of the complex problems that are reshaping our health landscape both here in Europe and beyond, and identify how to address them,” noted Zsuzsanna Jakab, WHO Regional Director for Europe. “Health systems alone do not have the tools to tackle all our health challenges. The clear and compelling findings of this study will play a vital role in guiding the further development of WHO’s new European health policy, Health 2020.”

The study defines governance for health as “the attempts of governments or other actors to steer communities, countries or groups of countries in the pursuit of health as integral to well-being through both a ‘whole-of-government’ and a ‘whole-of-society’ approach.” The concepts of intersectoral action, healthy public policy and health in all policies are integrated in both these approaches to health and well-being.

“How societies view and address health is changing,” said Professor Ilona Kickbusch, Director of the Global Health Programme at the Graduate Institute of International and Development Studies in Geneva, Switzerland and the study’s coordinator and joint author. “Health has become an overarching goal: a joint responsibility of governments, businesses, communities and individuals. It determines what constitutes a successful society and a vibrant economy, as well as an individual’s well-being. The aim of smart governance is to promote joint action on health among different groups – supranational, national and local governments, civil society organizations, the private sector and citizens.”

Key to the new models of governance explored in the study is recognition of the shift in Europe from industrial to knowledge-based societies. Using knowledge in different forms pervades the five smart governance approaches, which are:

• synergistic: understanding the value of collaboration across sectors and stakeholders at all levels and the need for whole-of-government and whole-of-society approaches;
• mixed: using a mix of regulation and persuasion fit for purpose;
• adaptable: adapting quickly and anticipating future needs through improved forecasting, and promoting multiple small-scale interventions at local and community levels;
• respectful: proactively engaging citizens to encourage participation, accountability and improved outcomes;
• transparent: providing evidence and monitoring for ethics and accountability through independent agencies and expert bodies such as federal agencies, commissions, regulators and auditors.

The study is based on a set of background papers by eminent international experts, and will move into a second phase of providing specific tools and case studies.
Other related studies, commissioned by the WHO Regional Office and still under way, include a European review of the social determinants of health and the health divide, led by Sir Michael Marmot of University College London, United Kingdom (an interim report of which has been produced for the sixty-first session of the WHO Regional Committee for Europe), as well as studies on the economics of prevention and an anticipatory analysis of drivers of and trends affecting health.

Altogether, these studies underpin and inform the work on the new WHO European policy for health, Health 2020.

This policy aims to:

• reframe the way people look at health and well-being;
• agree on evidence-informed actions that foster whole-of-government and whole-of-society approaches to health; and
• ensure that all people are enabled and supported in achieving their full health potential and well-being, and that all countries individually and collectively reduce inequalities in health within the European Region and beyond.

The policy is being developed through a process of consultation and collaboration among high-level government officials, health experts, representatives of international organizations, patient groups and local governments, as well as with citizens through online consultation.

For further information, please contact:

Agis Tsouros
Head, Policy and Cross-cutting Programmes and Regional Director’s Special Projects
WHO Regional Office for Europe
Tel.: + 45 39 17 15 09
Mobile: +45 23 39 14 84
E-mail: ats@euro.who.int

Viv Taylor Gee
Communications Adviser
WHO Regional Office for Europe
Tel.: +45 39 17 12 31
Mobile: +45 2272 3691
E-mail: vge@euro.who.int