Contribution from the EFC – European Partnership for ...

Contribution from the EFC ? European Partnership for Global Health to:

"Health in Europe: A Strategic Approach" ? Discussion Document for a Health Strategy

Introduction: The European Foundation Centre (EFC) ? European Partnership for Global Health (EPGH)1 commends the discussion document "Health in Europe: A Strategic Approach", prepared by Directorate General Health and Consumer Protection (December 2006), and welcomes the opportunity to provide input towards the development of a new and overarching European Health Strategy.

Set up in 2004, EPGH aims to initiate, facilitate and implement actions that aim to mobilise political will, knowledge and resources to address global health challenges from a European perspective which is founded on European values, experience and understanding of health as a basic human right for all. The EPGH was created in recognition by group of EFC Members of the importance of health in a global, interconnected and interdependent world, the need for a more coherent European approach to global health and a reflection on the role European foundations can play in advancing such an agenda.

Given its mission, the partner foundations are particularly pleased that for the first time the reflection on the future health strategy fully recognises the importance of the global dimension of health and express their belief that this would add real value to the EU level ? as in an age of globalisation and interdependence, health knows no borders.

The EFC EPGH is supportive of the proposal to focus the Strategy around three broad strands - addressing core public health issues across the EU; mainstreaming health, and global health. While recognising the importance of all, the comments below seek to provide specific input towards elaborating the global health dimension. They reflect a position which has been elaborated within the Partnership over the last couple of years with significant input from experts in the field of global health. As part of this process, EPGH published at the end of 2006 "European Perspectives on Global Health: A Policy Glossary"2.

EFC EPGH Comments and Recommendations:

1. Europe both needs to be well prepared for the health challenges that arise from globalisation as well as give a coordinated and coherent response with regard to its engagement for health in a global world. Europe's responsibilities for its own citizen and its global responsibilities can merge productively to benefit both. "Global" is no longer "out there" but "in here"; most policy arenas now have global dimensions. It is therefore very important that

1 EFC European Partnership for Global Health core partners: Deutsche Stiftung Weltbev?lkerung Funda??o Calouste Gulbenkian - Fundaci?n BBVA - Global Forum for Health Research - Johnson & Johnson Europe - Institut Pasteur - Madariaga European Foundation - The Nuffield Trust - Stiftelsen Riksbankens Jubileumsfond - The Universal Education Foundation

2 European Perspectives on Global Health: A Policy Glossary, EFC 2006,

European Foundation Centre, AISBL ? 51, rue de la Concorde ? 1050 Brussels, Belgium tel.: +32.2.512.8938 ? fax: +32.2.512.3265 ? email: efc@efc.be

web: efc.be, ,

the future Strategy shows clearly how its three areas of action interface ? the core issues, the mainstreaming of health and the global health dimension. The budget should also reflect this interface.

2. EFC EPGH recommends that the Strategy explains in greater depth what is global health and which dimensions of global health the Strategy wishes to prioritise. The definition provided in the EPGH Policy Glossary might be helpful in this respect. It refers to global health as those health issues which transcend national boundaries and governments and call for actions to influence the global forces that determine the health of people; health issues that require new forms of governance at national and international level which seek to include a wide range of actors.

3. EFC EPGH also recommends that the Strategy spells out clearly the underlying European values and experience. For example, the EFC EPGH has identified three fundamental values in its Policy Glossary which might offer a good basis: health as a human right, health as a key dimension of security and development and health as a global public good.

4. EFC EPGH believes that the European Commission would add value by supporting Members States in developing coherent approaches to global health that engage different parts of government and all stakeholders concerned from the non-profit and business sectors, and that recognise the interface between domestic, European and global dimensions of health policy. The experience in the tobacco area is exemplary for a global ? regional ? national interface that implies regulation; the platform on obesity is an example of an approach that at this stage focuses on cooperation. Drawing on such experiences, the Strategy could propose the development of a "method of open coordination" for the global health dimension to encourage and enable European countries to engage in developing national global health strategies to interface with the global dimension of the European health strategy.

5. EFC EPGH considers coordination within the various policy areas of the Commission and a commitment towards greater policy coherence another critical element that should be addressed. EFC EPGH recommends that the future Strategy should outline possible mechanisms and ways to measure progress in this respect.

6. Furthermore, the "way" Europe interfaces with developing countries must in itself signal cooperation rather than conditionalities and offer real support for building health systems and capacity rather than funding for individual projects. "Do no harm" becomes an important policy principle in the global health arena. The Strategy could propose actions to identify and disseminate good practice and lessons learned ? among donors, as well as other actors in health, including foundations.

7. Establishing priorities within the global health agenda should reflect priority areas for the EU. EFC EPGH believes that the European neighbourhood and cooperation with Africa; the interface of trade, agriculture and health, represent critical areas from a European perspective. Furthermore, the issue of migration of health professionals, and in particular the brain drain to the developed world, requires urgent attention. With respect to the latter, the Strategy should envisage actions aimed at raising awareness of this issue at all levels and establishing a process towards addressing the "brain drain" challenge.

8. The crisis in global health is a governance crisis. Europe must reflect on its wider contribution to global health governance and should support the establishment of mechanisms for good global governance for health,

European Foundation Centre, AISBL ? 51, rue de la Concorde ? 1050 Brussels, Belgium tel.: +32.2.512.8938 ? fax: +32.2.512.3265 ? email: efc@efc.be

web: efc.be, ,

including increased transparency and accountability. One approach for measuring progress in this area could be to benchmark four major gaps3: the participation gap; the regulatory gap; the incentive gap; and the knowledge gap. Narrowing or closing these gaps could be a measure of success. It would imply action across different functional policy arenas of the Commission, and suggests a possible research agenda. 9. Health research is essential for achieving and maintaining a state of good health and Europe is well positioned to lead in research and knowledge management for global health. EFC EPGH recommends that the future Strategy should envisage measures aimed at raising awareness of the global health research agenda; encouraging greater commitment to all dimensions of global health research including the strengthening of the research capacity of developing countries; and promoting better cooperation among public and private actors, including foundations, in this area. 10. European foundations are important actors in the field of health, and increasingly taking a global view in their health grantmaking and operating programmes4. The distinctive characteristics of foundations allow them to add value by convening non-traditional stakeholders and promoting diversity of thought; by investing in raising the profile and public awareness of issues "at the horizon"; by supporting research, as well as the generation and dissemination of new and innovative approaches addressing societal issues; and promoting cross-border cooperation. The European Foundations participating in EPGH are keen to see global health firmly set within the new European Health Strategy and are committed to contributing with their knowledge, convening power and resources towards advancing this field and encouraging more foundations to play an active role in global health. We trust that this contribution will be taken into account in the development of the new Health Strategy and look forward to continuing our involvement in this process. EFC EPGH would be pleased to provide further details or clarification on any of the points raised above.

12 February 2007

3 Kaul et al: Global Public Goods. New York 1999 4 For example, over 80 of EFC's members support health issues; in addition, many foundations include health as one dimension of other programmes such as education, environment, children and youth.

European Foundation Centre, AISBL ? 51, rue de la Concorde ? 1050 Brussels, Belgium tel.: +32.2.512.8938 ? fax: +32.2.512.3265 ? email: efc@efc.be

web: efc.be, ,

About the European Foundation Centre The European Foundation Centre (EFC) is a membership association that promotes and underpins the work of foundations and corporate funders active in and with Europe. Established in 1989 by seven of Europe's leading foundations, the EFC today serves a core membership of more than 200 members, associates and subscribers; 350 community philanthropy initiatives; as well as a further 50,000 organisations linked through a network of 58 information and support centres worldwide. The EFC hosts the WINGS Global Fund for Community Foundations, a programme that promotes the growth and sustainability of community foundations in developing and transitioning countries. The Centre is an independent international non-profit association under Belgian law. Membership of the Centre implies commitment to the EFC brand. All members subscribe to the EFC Principles of Good Practice, which constitute a general recommendation to reinforce good practice, openness and transparency in the European foundation and independent funding community.

About the EFC European Partnership for Global Health European Partnership for Global Health (EPGH), an EFC member-led network, aims to create a strong European voice and strategy on global health. EPGH will initiate, facilitate and implement actions that aim to mobilise political will, and to address global health challenges from a European perspective which is founded on European values, experience and understanding of health as a basic human right for all. The Partnership seeks to become a reliable and innovative broker and catalyst of ideas towards its goals, bringing together European and national-level policy makers, health professionals' networks, non-profit organisations and business. Core participating organisations: Deutsche Stiftung Weltbev?lkerung - Funda??o Calouste Gulbenkian - Fundaci?n BBVA - Global Forum for Health Research - Johnson & Johnson Europe - Institut Pasteur - Madariaga European Foundation - The Nuffield Trust Stiftelsen Riksbankens Jubileumsfond - The Universal Education Foundation

European Foundation Centre, AISBL ? 51, rue de la Concorde ? 1050 Brussels, Belgium tel.: +32.2.512.8938 ? fax: +32.2.512.3265 ? email: efc@efc.be

web: efc.be, ,

This paper represents the views of its author on the subject. These views have not been adopted or in any way approved by the Commission and should not be relied upon as a statement of the Commission's or Health & Consumer Protection DG's views. The European Commission does not guarantee the accuracy of the data included in this paper, nor does it accept responsibility for any use made thereof.

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