Dr. Carole Maignan WHO European Office for Investment for Health and Developmen, Venice, Italy

1. Empowering the health system: what new challenges and opportunities in Europe? Dr. Carole Maignan WHO European Office for Investment for Health and Developmen, Venice, Italy *The findings, interpretations, and conclusions expressed in this paper are entirely those of the author and do not necessarily reflect the views of the World Health Organisation.

2. The WHO European Region is composed of 52 Member States

3. 900 million people are the population of the WHO European Region < 3 millions > 5 millions < 5 millions

4. 15%low income <756$ 47% high income >9.265$ 38% medium income The income level varies widely within the WHO European Region

5. 80 75 70 65 1970 1980 1990 2000 There are wide variations in life expectancy between countries Life expectancy at birthin years United Kingdom EU 15 members before May 2004 EU 10 new members since May 2004 CIS

6. Glasgow, Scotland 8 years difference in life expectancy

7. Torino, Italy 8 years difference in life expectancy

8. Outline of this presentation Challenges and Opportunities The power of health systems A quick look at WHO Venice Office

9. The WHO European Office for Investment for Health and Development Venice, Italy

10. The Venice Office has two main functions: • To monitor, review and systematize the policy implications of emerging research findings on the social and economic determinants of health. • To provide a set of services to increase the European capacity to promote population health.

11. Determinants of health Strategic questions • Where is health produced? • What investment strategies might have a greater impact on population’s health? • What strategies can contribute to reduce health inequalities and have an added value for the social and economic development?

12. GENETICS ENVIRONMENT HEALTH DETERMINANTS SOCIAL ECONOMICS

13. Challenges and Opportunities The power of health systems A quick look at WHO Venice Office

14. Health system’s role: health for development • Health system definition • Health care: cure illnesses • Health promotion: keep population healthy

15. Health system’s role: health for development • Health as a resource for development • Positive effects on earnings, labour force participation and job choice • An extra year of life expectancy can improve labour market productivity by about 1% • Health is an important form of human capital and as such a productive asset • There is a strong argument for extra investment in health over and above the direct welfare benefits that good health brings

16. Health system’s role: development for health • Health systems are also employers and buyers • Health systems contribute to local employment of skilled and non-skilled staff • Health systems contribute to local economy by buying local goods • Health systems contribute to reduction of inequalities and poverty by taking special actions towards poverty, immigration, ageing… • Role of health in Research and Development

17. Challenges and Opportunities The power of health systems A quick look at WHO Venice Office

18. What can the health system do? If the health system wants to: • be part of the development agenda • contribute to reduction of health inequalities It needs to demonstrate its role in: • economic development in terms of employment, purchases • reducing health inequalities

19. What can the health system do? • Employment opportunities • Innovative Recruitment • Local procurement

20. What do we need ? • Good examples of “good practice” in different countries • Documentation of actions and their impacts on the regional development • Case-studies and pilot studies on regional initiatives and hospital policies • New knowledge, know-how and skills!