by Sherry Merkur, Anna Maresso, David McDaid

Since the health of a population is affected by policies and programmes originating beyond the health sector, governments need to employ a strategy that fosters intersectoral action. Health in All Policies (HiAP) is a dual process – it consists of fostering health considerations in other policy areas and taking into account the potential impact of other sectoral policies on the health of the population (the wider social determinants of health) – thus leading to several policy coordination challenges and the need for targeted intersectoral governance mechanisms.

When successfully implemented, HiAP can contribute positively to key aims in promoting public health, such as ameliorating population health status and it can also help to diminish health inequalities both within countries and throughout the wider region. It is not surprising therefore, that recently intersectoral governance and HiAP have gained high level attention as a priority of WHO’s Health2020 strategy, while the EU is also promoting it as a strategic policy tool.

This is the focus of the 4thissue of volume 18 of Eurohealth, which has just been published by the European Observatory on Health Systems and Policies (in which LSE Health is a partner).  

The first article in the Eurohealth Observer section explores key intersectoral structures used by governments, parliaments and the civil service to promote HiAP. The authors also identify which structures can trigger different governance actions or outcomes and summarise some key conditions for their successful implementation. We then present four case study articles which focus on specific intersectoral governance structures – parliamentary committees, inter-departmental units and committees, joint budgeting and industry engagement. These articles explore in greater detail how such intersectoral mechanisms operate in practice and their strengths and weaknesses in achieving HiAP objectives.

In the Eurohealth International section, Willy Palm and colleagues discuss the concept of European reference networks to connect health centres to share knowledge and expertise in diagnosing and treating specific health problems. They contend that under the Cross-border Care Directive, such networks can work to improve patient care, but should build on existing practices in Member States to be successful. In her article, Elizabeth Zanon identifies the deficiencies with the current Clinical Trials Directive, analyses the proposals for new EU legislation and argues that an improved and streamlined EU regulation on clinical trials is essential. Next, Jim Attridge and David Nutt approach the topic of innovation in medicines for severe mental illness. They argue that unless the tide of declining investment for these types of medicines turns, this area may be the next innovation desert.

In this issue’s Eurohealth Systems and Policies section, Alexandr Katsaga and colleagues discuss health system reforms in Kazakhstan. Since 2005, two comprehensive national reform programmes have endeavoured to change health care financing and provision, while improving prevention and quality of care. The article then identifies areas of the Kazak health system still in need of further development.

Finally, the Eurohealth Monitor section draws attention to three new HiT (Health Systems in Transition) profiles for Northern Ireland, Scotland and Wales and a new book called Intersectoral Governance for Health in All Policies, while the news section keeps you up to date on health policy developments across Europe and beyond.

We hope that you enjoy this issue and we welcome your comments and feedback to the editors.

Read the full issue: Eurohealth Vol 18 No.4 : Intersectoral governance (PDF)