Principles for a health strategy for Malta

"Good health is an integral part of thriving modern societies, a cornerstone of well-performing economies, and a shared principle of European democracies", EU Comissioner for Health, David Byrne said.

In his paper "A reflection process for a new EU Health Strategy" (July 2004) he stressed that achieving good health for all means not just reacting to ill-health, but proactively promoting health, preventing diseases and helping people make healthy choices.

Until quite recently, public health practice has been guided almost exclusively by evidence drawn from medical epidemiology. The notion that public health decisions must be profoundly linked to wider social and economic goals to ensure sustainable benefits is still not widely appreciated.

The World Health Organisation (WHO) stresses that the roots of health must be addressed through a broadly-based health promotion strategy. There is increasing evidence of the effectiveness of health promotion.

However, in most societies health promotion still awaits the organisation and resources necessary to achieve its full potential. A vital link has often been missed - a pro-active effort to harness the health of the population to positive economic and social changes.

WHO calls this vital link invest-ment for health (IFH). The IFH is an approach that develops policies and programmes based on and addressing key determinants of health that are mainly linked to economic and social factors.

This approach tackles not only bio-medical risk factors but also unhealthy life conditions like poverty, inequalities and social exclusion.

Commissioner Byrne states that health expenditure is too often viewed as a short-term cost, not as a long-term investment, and is only now starting to gain recognition as a key driver of economic growth.

He adds that one way to ensure that money is well spent is to focus on prevention and reduce lifestyle-related diseases such as those linked with obesity or tobacco consumption.

The EU and WHO both stress that good health must become a driving force behind all policy-making. Governments have great potential to improve or worsen people's health through their policy decisions.

Policies must address the behavioural, social and environmental factors that determine health. Also policies should be intersectoral - across areas such as education, income maintenance, workplace regulation, housing, transport, agriculture and communications - as well as private initiatives