The European Commission has published a reflection paper on how to achieve ‘a more sustainable Europe by 2030’. This paper is welcome as urgent action on sustainability is needed to protect the health of both people and the planet. However, the much delayed paper indicates that actions to deliver sustainability have been too slow, too variable, too weak, and too top-down. Opportunities have been missed to improve health though inter-sectorial action, and the integration of indicators into wider planning and measurement systems.
The paper is a promising sign of progress. This promise should be quickly followed up with policy and legislative measures at European and national levels, based on an integrated, collaborative approach that places the interconnections between the environment, health and wellbeing at the forefront of our efforts to support the most vulnerable members of our societies.
Protecting and promoting human health and wellbeing is inextricably linked to achieving sustainability. The reflection paper acknowledges that ‘the costs of not implementing existing EU environmental legislation are broadly estimated at around EUR 50 billion a year in health costs and direct costs to the environment.’ Our health is intimately interdependent on our environment, the food we eat, our security, our prosperity, education, and much more. These all need to be addressed in a coherent way. Policies and interventions which simultaneously improve health, protect the environment, and reduce inequalities are the focus of comprehensive research by the INHERIT programme.
Health systems and the wider systems that influence health, such as education and social protection, are themselves large employers and make significant contributions to economies and prosperity. The sustainability transition must apply to those systems too. The WHO Director General has stated that health and care system actions for achieving the Sustainable Development Goals (SDGs) are too slow. In stepping up work on tackling the risks and challenges cited in the Reflection Paper around Antimicrobial resistance (AMR), Non Communicable Diseases (NCDs), obesity and other factors, EuroHealthNet can contribute to equitable solutions both in Europe and globally. Its REJUVENATE framework outlines how the transition to sustainability can be made in health and health promoting systems. It should also be implemented more widely.
Throughout the report, references are made to the 10th SDG, 'Reducing Inequalities' which is indeed key to a prosperous future for all. High and persistent levels of health inequalities are evidence of the wider inequalities which exist within and among Member States. As the Reflection Paper states ‘The transition to ecologically sustainable economic growth and competitiveness can only be successful if it is inclusive at the same time’. However, there is no concrete proposal to integrate key indicators in, for example, the European semester which would drive meaningful change in the systems that influence equity. This must be addressed with urgency.
The Reflection Paper specifically praises stakeholder inputs and foresees multi-agency working and new forms of cross-sectoral governance and investments as being crucial to the needed transformations. This is what EuroHealthNet has long advocated for. We need evidence-based approaches that address health and the determinants of health. This means more engagement in health by other sectors and more social investment. The Partnership has in this vein contributed to the European Pillar of Social Rights, the implementation of the European Semester, and planning of the Multi Annual Financial Framework 2021-27. It has also contributed to efforts to achieve more sustainable and healthy EU Food Policies.
Where to go from here?
The EuroHealthNet Partnership proposes the following next steps:
- Follow the good promises in the reflection paper with concrete policy and legislation.
- Integrate health, equity, and sustainability – and the indicators that measure them into the European Semester.
- Consider the health and equity impacts of all policy and action.
- Use social investment to effectively target the underlying determinants of health.
- Implement objective measures of effectiveness of actions towards SDG3 (Ensure healthy lives and promote well-being for all at all ages).
- Amplify and scale up policy and actions which simultaneously address human and planetary health while reducing inequalities.
- Bring everyone with us. The shift to sustainability must be inclusive and support the most vulnerable members of our society.
- Create true collaboration through multi-agency working and cross-sectorial governance.