Congress report - European Health Forum Gastein

74
Luigi Bertinato
European Health Forum Gastein 2001
Abstract
All too often, discussions on health policy and healthcare focus on cutting costs and not on
improving health. The Verona Initiative: Investment for Health, in contrast, took a lesson
from the economic and financial sectors and proposed a new approach to health policy, one
based on the principle that the right investments can benefit all sectors and all citizens.
With solid evidence from the past years that most of the determinants of health lie outside
the health sector, it follows that to change health status, governments must invest (time,
effort and money) wisely and carefully to have the desired impact on health status. This was
the case of the Regional Government of the Veneto, one of the twenty Italian regions
situated in the north-east of Italy, with a population of 4.5 million inhabitants.
The First Milestone: Appraisal and Benchmarking
The Verona Initiative revolved around three Arena meetings that served as a forum for
debate and consensus. Meetings were held in Verona, one of the seven major cities of the
Veneto Region, in 1998, 1999 and in July 2000, bringing together an unusually broad
spectrum of participants in person and via satellite TV and the Internet for a non-traditional
conference.
The first meeting established the Verona Benchmark, which identified characteristics of
systems that support Investments for Health.
A document called the “Verona Benchmark” was developed for health and health system
appraisal in a number of pilot projects. The objective was to determine what systems would
need to exist at national, regional or local level for a government to implement the IFH
approach.
The appraisal examined the overall situation in the country or region, undertaking a sectorby-
sector analysis of policy options for intersectoral considerations, and explores structural,
organizational and institutional issues.
Policy-Making and the Verona Challenge
The second Arena meeting established the characteristics of the decision and policy-making
process needed to promote IFH. Essentially, the process can be viewed as an investment
triangle where social and economic development anchor two points of the triangle and
health promotion holds the third spot, illustrating the main principle of IFH: that investments
intended to improve health must also add economic and/or social value.
The third and final meeting focused on how to persuade policy makers to take action. It
issued a series of “challenges” that define the next steps and in effect suggest priorities for
health:
Highlights of the challenges include:
• For national governments: establish a clear mechanism for coordinating policy
development across government departments; establish a communication strategy;
publish regular reviews of health improvement progress against indicators.
• For local and regional authorities: establish targets for health improvement linked
to sustainable economic and social development; engage the population in
decisions about health; ensure integrated local and regional investment plans.
• For industry and commerce: work with government to support initiatives
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