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Smart Governance for Health and Well-Being the Evidence Smart governance for health and well-being: the evidence Edited by: Ilona Kickbusch, Director, Global Health Programme, Graduate Institute of International and Development Studies, Geneva, Switzerland and David Gleicher, Project Offi cer, Global Health Europe, Graduate Institute of International and Development Studies, Geneva, Switzerland Abstract Governance for health describes the attempts of governments and other actors to steer communities, whole countries or even groups of countries in the pursuit of health as integral to well-being. This study tracks recent governance innovations to address the priority determinants of health and categorizes them into five strategic approaches to smart governance for health. It relates the emergence of joint action by the health and non-health sectors, public and private actors and citizens, all of whom have an increasing role to play in achieving seminal changes in 21st century societies. The chapters presented here were initially commissioned as papers to provide the evidence base for the new European policy framework for health and well-being, Health 2020. Calling for a health-in-all-policies, whole-of-government and whole-of-society approach, Health 2020 uses governance as a lens through which to view all technical areas of health. Keywords HEALTH MANAGEMENT AND PLANNING HEALTH POLICY PUBLIC HEALTH SOCIAL MEDIA SOCIOECONOMIC FACTORS Address requests about publications of the WHO Regional Offi ce for Europe to: Publications WHO Regional Offi ce for Europe UN City Marmorvej 51 DK-2100 Copenhagen Ø, Denmark Alternatively, complete an online request form for documentation, health information, or for permission to quote or translate, on the Regional Offi ce web site (http://www.euro.who.int/pubrequest). ISBN 978 92 890 5066 1 © World Health Organization 2014 All rights reserved. The Regional Offi ce for Europe of the World Health Organization welcomes requests for permission to reproduce or translate its publications, in part or in full. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or con- cerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specifi c companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. How- ever, the published material is being distributed without warranty of any kind, either express or implied. The responsibility for the interpre- tation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. The views expressed by authors, editors, or expert groups do not necessarily represent the decisions or the stated policy of the World Health Organization. Text editing: Alex Mathieson Design and photography: Christophe Lanoux, Paris, France Contents Foreword iv Contributors v Abbreviations and acronyms vii Part 1. Introduction 1 1. Governance for health and well-being 2 Part 2. Interdependence 11 2. From government to AG: responding to the challenges of innovation and emerging technologies 12 3. Engagement in health: roles for the public and patients 34 Part 3. Complexity 49 4. The challenges of multilevel governance: the impact of global and regional processes on health and health systems in Europe 50 5. Bridging the gap: governance challenges for the health sector in CCEE and former Soviet Union countries 70 Part 4. Coproduction 95 6. Partnering for health governance transformation 96 7. Social media and Web 2.0: eff ect on governance for health 106 Part 5. Conclusions 129 8. Value base, ethics and key challenges of health governance for health protection, prevention and promotion 130 9. Smart governance for health 141 iii Smart governance for health and well-being: the evidence Foreword As our societies change and face new challenges, they need to revisit approaches to governance. My goal as WHO Regional Director for Europe is to ensure that health is positioned as an overarching goal shared by the whole of government and the whole of society. That is why the WHO Regional Offi ce for Europe commissioned a study on governance for health in the 21st century. Mind-sets on how we view and address health and its determinants have shifted. Two challenges go hand in hand: • the governance of the health system and health systems strengthening (what we refer to as health governance); and • the joint action of health and non-health sectors, the public, private sector and citizens in common interest (what we call governance for health). The latter is the subject of this study. As WHO’s constitution makes clear, governments have a responsibility for the health of their people. Ministries of health have a strong leadership role to play, particularly in providing evidence for policies that make the healthier choice the easier choice. But living in a knowledge society means that power and authority are no longer concentrated in governments. Informed citizens, conscientious businesses, independent agencies and expert bodies increasingly have a role to play. The health system alone does not have the tools to solve all our health challenges; the highest levels of government and society must recognize that health is a common objective and that achieving it requires coherence. The governance for health in the 21st century study informed the WHO European policy framework for health and well-being, Health 2020. This book provides access to background papers for the study prepared by eminent experts, which provide further detail on the issues raised, and culminates in a comprehensive depiction of what constitutes smart governance for health in the 21st century, based on examples and insights from the book. Zsuzsanna Jakab WHO Regional Director for Europe iv Contributors Contributors Editors Ilona Kickbusch, a political scientist with a PhD from the University of Konstanz, Germany, is recognized throughout the world for her contribution to health promotion and global health. She is currently Adjunct Professor at the Graduate Institute of International and Development Studies, Geneva and Director of the Global Health Programme. She advises organizations, government agencies and the private sector on policies and strategies to promote health at national, European and international levels, has published widely and is a member of a number of advisory boards in academic and health policy arenas. Her career with WHO at regional and global levels is long and distinguished and includes initiating the Ottawa Charter for Health Promotion and a range of settings projects, such as Healthy Cities. David Gleicher is Senior Programme Manager at the World Economic Forum, where he is responsible for all science and technology-related sessions at the Forum’s annual meetings in Davos and China. He has held research positions in the Forum’s global risks and scenario-planning teams and managed the work of the Forum’s global agenda councils on personalized and precision medicine, and space security. Prior to joining the Forum, he worked in WHO’s offi ces at the European Union and for Global Health Europe. Authors Edward Andersson (Chapter 3) works for, and helped set up, the Involve Foundation, a British think tank specializing in participative decision-making. He helped set up Participationcompass.org – one of Europe’s public engagement sites – and has advised a number of organizations on public engagement strategies. He is a professional facilitator (certifi ed by the International Association of Facilitators) and a board member of the international not-for-profi t e-Democracy.org. Anders Diseberg (Chapter 4) has an MSc in Biotechnology from Chalmers University of Technology and is enrolled in the transdiciplinary Master’s programme, Ecosystems, Resilience and Governance, at the Stockholm Resilience Centre, Stockholm University, Sweden. He is an intern at the Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institute, Stockholm. Armin Fidler (Chapter 5) is Lead Adviser, Health Policy and Strategy, Global Health Practice at the World Bank Group, Washington DC, United States. Eva Jané-Llopis (Chapter 6) has a PhD in Health Sciences from the University of Nijmegen, Netherlands. She has held several senior positions in the Netherlands, the WHO Regional Offi ce for Europe, the Government of Catalonia, Spain and the European Commission. She is currently Director, Head of Health Programmes, World Economic Forum, Geneva. Maged N. Kamel Boulos (Chapter 7) is Associate Professor of Health Informatics at Plymouth University, United Kingdom. In addition to his medical degree and Master’s in Dermatology, he holds a Master’s in Medical Informatics from King’s College, University v Smart governance for health and well-being: the evidence of London and a PhD in Measurement & Information in Medicine from City University London. He teaches and has over 100 publications on a specialist range
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