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WORLD HEALTH ORGANIZATION ORGANISATION MONDIALE DE LA SANTÉ REGIONAL OFFICE FOR EUROPE BUREAU RÉGIONAL DE L'EUROPE WELTGESUNDHEITSORGANISATION ВСЕМИРНАЯ ОРГАНИЗАЦИЯ ЗДРАВООХРАНЕНИЯ REGIONALBÜRO FÜR EUROPA ЕВРОПЕЙСКОЕ РЕГИОНАЛЬНОЕ БЮРО European Regional Consultation on the WHO Global Strategy on the Economics of Health for All. Concept Note During the Seventy-Seventh World Health Assembly, Member States unanimously adopted the 2024 WHO Resolution on the Economics of Health for All (EHfA) (A77/A/CONF./2), which was sponsored by more than 20% of WHO European Member States. The resolution urges WHO “to support and strengthen the capacity of national health authorities … to better engage and negotiate with finance and other sectors, towards an economics of health for all in national policies” enhancing well-being and health equity outcomes for current and future generations. Further, in the WHO European region “enabling value-based economies for health for all” is recognized as a ‘foundational action’ in the proposed second WHO European Programme of Work (EPW2) with the aim of supporting countries to shape and advance a stronger, more systematic alignment of health, economic and fiscal policies and decisions that leverage improved health, well-being and equity, across sectors and borders, through scaling up and implementing well-being economy approaches. The potential of well-being economy approaches to reorientate public policies, shape business priorities, and harness spending and investments decisions for prevention, improving health and reducing inequalities, whilst delivering positive social, economic, and environmental outcomes, is recognized in the outcome statement of the WHO European Regional High-level Forum on Health in the Well-being Economy (2023). This has been piloted through the start-up work of the WHO European Well-being Economy Initiative. The European Regional Consultation on the WHO Global Strategy on the Economics of Health for All (GSEHfA) builds upon the above commitments and work in the European Region and aims to engage Member States, partners and academic institutions, to inform the priorities of the strategy and to identify the needs of Member States for effective implementation. Objectives of the consultation: 1. Share the foundational principles and objectives of the GSEHfA, including its vision, guiding principles, and strategic directions; 2. Present the annotated outline of the GSEHfA and solicit technical inputs and feedback from Member States on its content and structure;  European Regional Consultation on the WHO Global Strategy on the Economics of Health for All. Concept Note 3. Collect suggestions, comments, and questions from Member States to finalize the draft strategy before formal consultations with external experts and Member States. 4. Orient economic systems and processes towards HfA to substantially improve the health and well-being of all, now and in the future, by addressing the structural determinants of health and health equity, as defined by their populations. 5. Empower countries to make informed choices around action and investment, balancing prosperity and HfA through innovative frameworks, analyses and tools, evidence and technical advice. 6. Coordinate global, regional and domestic health and economic actors behind the common mission of designing economies that promote the health and well-being for all. Expected Outcomes: At the end of the consultation, the following results are expected: 1. Refined Global Strategy: Incorporation of regional inputs to enhance the relevance and effectiveness of the GSEHfA for the European Region. The strategy will include the distinctive opportunities and challenges of the European context. 2. Stakeholder Engagement: Strengthened collaboration and engagement among regional stakeholders in the implementation of the GSEHfA. This will cultivate a sense of ownership and dedication to the strategy's objectives. 3. Actionable Recommendations: Clear and actionable recommendations to guide the finalization of the strategy. This roadmap will facilitate the implementation of the strategy and its objectives. Saatja: "BROWN, Christine Elisabeth" <[email protected]> Saaja: "BROWN, Christine Elisabeth" <[email protected]> Teema: European Regional Consultation on the WHO Global Strategy on the Economics of Health for All Kuupäev: 2025-05-30 09:34 Tähelepanu! Tegemist on välisvõrgust saabunud kirjaga. Tundmatu saatja korral palume linke ja faile mitte avada. Dear Colleagues, During the Seventy-Seventh World Health Assembly, Member States unanimously adopted the 2024 WHO Resolution on the Economics of Health for All (EHfA) (A77/A/CONF./2), which was sponsored by more than 20% of WHO Europe Member States. The resolution urges WHO “to support and strengthen the capacity of national health authorities … to better engage and negotiate with finance and other sectors, towards an economics of health for all in national policies” enhancing well-being and health equity outcomes for current and future generations. The GSEHfA aims to transform how health is valued, measured, produced, and distributed across economies. It promotes coordinated actions across all sectors and levels of government to develop and implement economic and health policies that mutually strengthen each other while minimizing bi-directional harm. The global strategy recognizes the importance of accounting for the economic and health context in different countries for its effective uptake and implementation. The World Health Organization (WHO) Regional Office for Europe is organizing a regional consultation for the European Region to discuss the draft global strategy (enclosed). This consultation aims to gather inputs from regional stakeholders to refine the current strategy and ensure it addresses the unique challenges and opportunities within the European context, a concept note of the consultation is attached. Consultation process: The consultation will begin with a webinar on 6 June 2025 to present the GSEHfA, providing an overview of its vision, guiding principles, and strategic directions, followed by an opportunity for questions and answers. A programme for the webinar is attached. Language: The working language will be English with direct interpretation in Russian. A Russian language version of the draft strategy document and of the feedback form will follow. Date: Friday 06 June 2025 Time: 11:15 – 12:30 pm (CET) Venue: Virtually using Zoom at the following link: https://who.zoom.us/j/98135188912 Meeting ID: 981 3518 8912 Passcode: WHOVen-25 After the webinar, the following link will be active for provision of feedback on the strategy until 15 June 2025: <https://app.smartsheet.com/b/form/0196f728f6c075c1a9310605363c5e5e> https://app.smartsheet.com/b/form/0196f728f6c075c1a9310605363c5e5e Participation needed: Identified focal points in all WHO European member states in a position to provide technical guidance and support incorporating EHfA in national policies. Looking forward to working together. Best regards, Chris Chris Brown Head WHO European Office for Investment for Health and Development Venice, Italy [email protected] <mailto:[email protected]> +39 3475382758 DRAFT OUTLINE: GLOBAL STRATEGY ON THE ECONOMICS OF HEALTH FOR ALL Draft 0 This document is an outline for regional consultation and experts prior to member state consultation . None of the text is decided, the aim is to present a cohesive document that provokes questions, comments and suggestions . Please note that WHO strateg ies are high level 5 000 word- documents that outline broad areas of work, for member states , WHO and other stakeholders, but do not describe the detailed actions under each , which remain context specific . For an example of a previous strategy please see: https://www.who.int/publications/i/item/9789240080515 This document lists all the areas to be included with a short description of each in preparation for member state consultation . It builds on instructions to WHO from the EHfA resolution and will be used as the basis for a WHO-wide work programme to support member states . In this case the EHfA brings together action across WHO, and therefore it is important that all relevant areas are included in the strategy . The important inputs sought at this stage are : Does the strategy represent the core objectives and mandate established in the resolution? Does the strategy include all the relevant directions for countries to achieve its objectives, considering current global guidance and resources in this space ? Are there important actions that are missed under each direction? TABLE OF CONTENTS TOC \o "1-3" \h \z \u TABLE OF CONTENTS PAGEREF _Toc196465236 \h 2 Foreword PAGEREF _Toc196465237 \h 3 Acknowledgements PAGEREF _Toc196465238 \h 3 Abbreviations PAGEREF _Toc196465239 \h 3 Executive Summary PAGEREF _Toc196465240 \h 3 Introduction PAGEREF _Toc196465241 \h 4 Why we need a global strategy on the economics of health for all? PAGEREF _Toc196465242 \h 4 Foundations PAGEREF _Toc196465243 \h 5 Audience PAGEREF _Toc196465244 \h 6 Strategy development PAGEREF _Toc196465245 \h 6 A global strategy to lead us to 2030. PAGEREF _Toc196465246 \h 7 Vision PAGEREF _Toc196465247 \h 7 Guiding principles PAGEREF _Toc196465248 \h 7 Objectives PAGEREF _Toc196465249 \h 8 Strategic Directions PAGEREF _Toc196465250 \h 9 Economic Policy for HfA PAGEREF _Toc196465251 \h 10 Value and invest in HfA PAGEREF _Toc196465252 \h 14 Financing for HfA PAGEREF _Toc196465253 \h 17 Capacity for EHfA PAGEREF _Toc196465256 \h 20 Evidence for EHfA PAGEREF _Toc196465257 \h 23 Strategy implementation PAGEREF _Toc196465258 \h 25 References PAGEREF _Toc196465259 \h 26 Foreword Acknowledgements Abbreviations E xecutive Summary Introduction Why we need a global strategy on the economics of health for all ? Persistent inequalities challenge the achievement of Agenda 2030 . Despite improvements in Universal Health Coverage (UHC) under S ustainable D evelopment G oal 3 (SDG 3) “Ensure healthy lives and wellbeing for all ”, more than half of the global population still lacks access to essential health services , and one in four people experience s financial hardship due to out-of-pocket health costs ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"1yCep7cB","properties":{"formattedCitation":"{\\i{}(1)}","plainCitation":"(1)","noteIndex":0},"citationItems":[{"id":521,"uris":["http://zotero.org/users/local/KFpzm6Se/items/TGHRYNRR","http://zotero.org/users/16750821/items/TGHRYNRR"],"itemData":{"id":521,"type":"book","edition":"1st ed","event-place":"Geneva","ISBN":"978-92-4-008037-9","language":"eng","number-of-pages":"1","publisher":"World Health Organization","publisher-place":"Geneva","source":"K10plus ISBN","title":"Tracking Universal Health Coverage: 2023 Global Monitoring Report","title-short":"Tracking Universal Health Coverage","author":[{"literal":"WHO"},{"literal":"World Bank"}],"issued":{"date-parts":[["2023"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (1) . Equally worrisome is weak progress made in other SDGs that underpin the many other determinants of health. Global poverty reduction , and related indicators ha ve stalled and ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"wrKB8ytV","properties":{"formattedCitation":"{\\i{}(2)}","plainCitation":"(2)","dontUpdate":true,"noteIndex":0},"citationItems":[{"id":533,"uris":["http://zotero.org/users/local/KFpzm6Se/items/A3NS4D2V","http://zotero.org/users/16750821/items/A3NS4D2V"],"itemData":{"id":533,"type":"report","collection-title":"Poverty, Prosperity, and Planetary Report 2024","event-place":"Washington D.C","language":"en","publisher":"World Bank","publisher-place":"Washington D.C","source":"Zotero","title":"Pathways Out of the Polycrisis: Main Messages","author":[{"literal":"World Bank"}],"issued":{"date-parts":[["2024"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} one-fifth of the world ’s population liv e in countries with high inequality ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"OsFAIWSs","properties":{"formattedCitation":"{\\i{}(2)}","plainCitation":"(2)","noteIndex":0},"citationItems":[{"id":533,"uris":["http://zotero.org/users/local/KFpzm6Se/items/A3NS4D2V","http://zotero.org/users/16750821/items/A3NS4D2V"],"itemData":{"id":533,"type":"report","collection-title":"Poverty, Prosperity, and Planetary Report 2024","event-place":"Washington D.C","language":"en","publisher":"World Bank","publisher-place":"Washington D.C","source":"Zotero","title":"Pathways Out of the Polycrisis: Main Messages","author":[{"literal":"World Bank"}],"issued":{"date-parts":[["2024"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (2) . These challenges are unfo lding in a world facing social, economic and environment transformation that is reshaping the foundations of health and wellbeing for all: rapid technological change , debt and fiscal constraints , altering demographics , urbanization , changing nature of work, and climate and environmental crisis . Systematic national and globally coordinated change in the economics of health is needed to create the conditions for sustainable, inclusive and healthy societies. Interdependence between health and economic systems. Health and prosperity are key to individual and collective wellbeing: they allow individuals and societies to pursue the many goals they value. The enjoyment of the highest attainable standard of health is a human right without distinction of race, religion, political belief, economic or social condition. Just like for some other rights, progress depends, to some extent, on conditions and resources provided by economic systems. A healthy population is an asset for meaningful economic growth and long-term stability and resilience of communities and societies. Economic growth generates resources to invest in health and living conditions conducive to better health but may not always benefit the health of all equitably . Transformative potential of an Economics of Health for All approach To realize Health for All (H f A) – a state in which health and wellbeing are within the reach of every person through their lives - an Economics of Health for All approach (EH f A) is needed . HfA depends on how resources are generated, distributed and invested. Mission-orientated economic policies and actions should be driven by their capacity to support sustainable, inclusive economic growth and by their ability to promote, protect and ensure health and wellbeing across all segments of society. This approach recognizes health, wellbeing and economic welfare as interdependent and inseparable dimensions of societal progress . Health and wellbeing are elevated as goals that shape how economies function, deliver value and define success, both as means and as ends. EH f A shapes how economic systems , governments and corporations influence health, and reposition s health within core economic objectives , providing a foundation for effective policy , investment and action s towards societal progress . It promotes coordinated actions across all levels of government and sectors to de sign , assess and implement economic policies aligned with HfA . E H f A requires fundamental shifts for the long-term transformation of economic systems, but immediate actions as proposed in this Strategy can make a difference now and for future generations. Foundation s The Global Strategy on the EH f A ( GSEHfA ) builds and complements other WHO resolutions ( Figure 1), providing a guiding mission that links HfA to economic polic y-making , investments and actions by governments and other actors. It draws on work from the WHO Council on the Economics of Health for All ( Figure 2 ), urg ing for fundamental shifts in economic thinking and put ting forward recommendations to change the way health is valued, measured, distributed and governed ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"k33yyinK","properties":{"formattedCitation":"{\\i{}(3)}","plainCitation":"(3)","noteIndex":0},"citationItems":[{"id":512,"uris":["http://zotero.org/users/local/KFpzm6Se/items/ZVMFJ8A7","http://zotero.org/users/16750821/items/ZVMFJ8A7"],"itemData":{"id":512,"type":"report","event-place":"Geneva","page":"88","publisher":"World Health Organization","publisher-place":"Geneva","title":"Health for All - transforming economies to deliver what matters: Final report of the WHO Council on the Economics of Heallth for All","author":[{"literal":"WHO Council on the Economics of Health for All"}],"issued":{"date-parts":[["2023"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (3) . Figure SEQ Figure \* ARABIC 1 : Examples of related, recent WHA resolutions Figure SEQ Figure \* ARABIC 2 : Preliminary framework for building up an economy for health ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"oiILKjxh","properties":{"formattedCitation":"{\\i{}(4)}","plainCitation":"(4)","noteIndex":0},"citationItems":[{"id":527,"uris":["http://zotero.org/users/local/KFpzm6Se/items/NCP56TQZ","http://zotero.org/users/16750821/items/NCP56TQZ"],"itemData":{"id":527,"type":"manuscript","genre":"Brief","number-of-pages":"24","title":"Valuing Health for All: Rethinking and building a whole-of-society approach","author":[{"literal":"WHO Council on the Economics of Health for All"}],"issued":{"date-parts":[["2022"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (4) -2540 0 EHfA recognises the interaction between the economy and health at structural, social, systemic and household level s . It emphasizes that economic factors at various levels fall under government jurisdiction, encompassing ministries, parliaments, legal systems, and other institutions that influence finance and economic policies, as well as within other sectors, including civil society and the private sector. EHfA also builds on other WHO’s initiatives in collaboration with Member States and partner s t o promote HfA through actions on their determinants ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"KLLs6BKC","properties":{"formattedCitation":"{\\i{}(5\\uc0\\u8211{}10)}","plainCitation":"(5–10)","noteIndex":0},"citationItems":[{"id":1085,"uris":["http://zotero.org/users/16750821/items/V8YN9YBJ"],"itemData":{"id":1085,"type":"webpage","abstract":"The new strategy is timely – it responds to and is in line with the 2030 Sustainable Development Agenda and the GPW13.","language":"en","title":"WHO global strategy on health, environment and climate change: the transformation needed to improve lives and wellbeing sustainably through healthy environments","title-short":"WHO global strategy on health, environment and climate change","URL":"https://www.who.int/publications/i/item/9789240000377","author":[{"literal":"WHO"}],"accessed":{"date-parts":[["2025",4,29]]},"issued":{"date-parts":[["2020"]]}}},{"id":1084,"uris":["http://zotero.org/users/16750821/items/MBEZC9X4"],"itemData":{"id":1084,"type":"webpage","abstract":"On 13–15 December 2021, WHO will hold the 10th Global Conference on Health Promotion.","language":"en","title":"Tenth Global Conference on Health Promotion","URL":"https://www.who.int/teams/health-promotion/enhanced-wellbeing/tenth-global-conference-on-health-promotion","author":[{"literal":"WHO"}],"accessed":{"date-parts":[["2025",4,29]]},"issued":{"date-parts":[["2021"]]}}},{"id":1083,"uris":["http://zotero.org/users/16750821/items/NLMQQMU7"],"itemData":{"id":1083,"type":"webpage","language":"en","title":"Multi-Country Initiative: Action on Social Determinants of Health for Advancing Health Equity (SDHE)","URL":"https://www.who.int/initiatives/action-on-the-social-determinants-of-health-for-advancing-equity/about","author":[{"literal":"WHO"}],"accessed":{"date-parts":[["2025",4,29]]},"issued":{"date-parts":[["2021"]]}}},{"id":518,"uris":["http://zotero.org/users/16750821/items/5EPVKH2T"],"itemData":{"id":518,"type":"webpage","abstract":"Commercial determinants of health are the conditions, actions and omissions by corporate actors that affect health. 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They can have beneficial or detrimental impacts on health.","language":"en","title":"Commercial determinants of health","URL":"https://www.who.int/news-room/fact-sheets/detail/commercial-determinants-of-health","author":[{"literal":"WHO"}],"accessed":{"date-parts":[["2025",3,13]]},"issued":{"date-parts":[["2023"]]}}},{"id":1081,"uris":["http://zotero.org/users/16750821/items/JZB3IMMS"],"itemData":{"id":1081,"type":"book","edition":"1st ed","event-place":"Geneva","ISBN":"978-92-4-008485-8","language":"en","number-of-pages":"33","publisher":"World Health Organization","publisher-place":"Geneva","source":"K10plus ISBN","title":"Achieving Well-Being: a Global Framework for Integrating Well-being into Public Health Utilizing a Health Promotion Approach","title-short":"Achieving Well-Being","URL":"https://www.who.int/publications/i/item/9789240084858","author":[{"literal":"WHO"}],"issued":{"date-parts":[["2024"]]}}},{"id":526,"uris":["http://zotero.org/users/local/KFpzm6Se/items/95JPFL7X","http://zotero.org/users/16750821/items/95JPFL7X"],"itemData":{"id":526,"type":"manuscript","abstract":"This Operational framework for monitoring social determinants of health equity provides countries with critical guidance on monitoring the social determinants of health and actions addressing them, and using data for policy action across sectors to improve health equity.","language":"en","number-of-pages":"100","title":"Operational framework for monitoring social determinants of health equity","URL":"https://www.who.int/publications/i/item/9789240088320","author":[{"literal":"WHO"}],"accessed":{"date-parts":[["2025",3,13]]},"issued":{"date-parts":[["2024"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (5–10) . A udience The GS EH f A is primarily intended for us e by heads of state, ministers , governmental officials , central bank leaders and politicians who design, shape or influence economic policies that affect HfA either directly or indirectly at subnational, national, regional and global levels. The GSEHfA also concerns the wide array of stakeholders who can promot e the adoption of an EH f A approach, including citizens, civil society organizations, labour unions, statistical offices, think-tanks and academia, international organizations, development banks, aid actors, medias, an d private sector and industry representatives. Strategy development The GS EH f A was developed by WHO ’s Health Financing and Economics d epartment in collaboration with the Organization ’s three levels and through global and regional consultation s with Member States and external stakeholders . A global strategy to 203 0 The GSEHfA has been developed as a guiding framework for the health sector to engage in economic and financial policy and sectors , on the request of member states . The GSEHfA proposes a n overarching framework that position s health and wellbeing at the centre of economic policy and investment . It redefines the purpose of the economy as serving people and describes an EHfA to orient and align economic policies with the goal of promoting, protecting and restoring HfA , offering a new approach grounded in equity and sustainability. While not exhaustive, it addresses major upstream structural determinants of health and supports ongoing policy innovation for reducing health inequities at s ubnational , national, regional and global levels. Vision ‘ A world in which the economy serves health for all ’ EH f A envisions the economy as a people- centred system where e conomic p olicies prioritize the health and wellbeing of all , both now and in the future . These policies go beyond average measures to address disparities ; reflect the values of the population s they serve and guide public and private investments toward secur ing a healthy future for current and future generations . Guiding principles Seven guiding principles underpinned the development of the GSEHfA . People centred E conomic p olicies and actions are designed with and for people, recognizing their diverse needs and lived experiences , and acknowledging a gency as a central aspect of health and wellbeing. Social participation People actively participate in policy and investment decisions that affect their lives. Inclusive, transparent and meaningful social participation across all layers of collective actions builds trust and ensure policies and services reflect the needs and aspirations of all communities, especially those most excluded. Equity The pursuit of inclusive and equitable approaches for H4A , aligned with justice for all . Special attention is given to the social gradient in health, implying universalism across the whole population and to factors that affect population s in vulnerable or marginalized situations , including migrants, refugees and displaced persons . Gender equality Economic systems and policies should actively promote equal rights, opportunities, and outcomes for people regardless of gender by addressing structural inequalities and enabling full and equitable participation in all spheres of life and across the life course. Country-led Sustainable development and progress towards HfA must be driven by country leadership with national and subnational governments and institutions at the centre of planning, decision-making and accountability using a whole of government approach . External support should align with national priorities, strengthen local capacity and respect country contexts to ensure ownership, effectiveness and long-term impact. Evidence-informed Policy and actions should be grounded in the best available evidence – combining data, research and local knowledge to inform decisions responsive to real-world needs. An evidence-informed approach values continuous learning, rigorous analysis, multidisciplinary collaboration , adaptability in the face of complex challenges and commitment to impact . Environment al sustainability Decisions and actions by governments and stakeholders must protect and sustain the natural environment for current and future generations. Objectives The GSEHFA ’s objectives are to : Orientate economic systems and institutions to the benefit of health and prosperity of populations Improve health and r educe health inequalit y by ensuring economic policies and investments value health . Empower countries to make informed policy choices and take concrete actions that consider both health and the economy . Coordinate global , regional and domestic health and economic actors behind the common goal of health and wellbeing f o r all. S trategic Directions EHfA requires action across five interconnected strategic directions (Fig. 3 ). Under each direction, priority actions are proposed for consideration , adaptation and prioritization by countries depending on their own context s . S ome of these actions may require international coordinat ed actions and country support. Figure SEQ Figure \* ARABIC 3 : V ision and strategic directions . Economic Policy for H fA Economic policy on taxation, trade, industry, labour and social protection are key levers for shaping the broader enabling environment needed to achieve HfA ( B ox 1 ). This strategic direction focuses on reviewing and realigning core economic policies to actively promote HfA . Table SEQ Table \* ARABIC 1 : Scope of economic polic y areas considered Figure SEQ Figure \* ARABIC 4 : Overview of priority actions Re view and assess the impact of tax policy on HfA . Tax ation is key to both mobilize revenues to finance for health services and s hap e inclusive and sustainable economies (Box 1 ). Analyses of the economic and social costs of current tax systems can help reprogramme tax polic y in a way that strengthen s domestic revenue mobilisation and ensure s social justice ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"wXFNK5gf","properties":{"formattedCitation":"{\\i{}(11\\uc0\\u8211{}13)}","plainCitation":"(11–13)","noteIndex":0},"citationItems":[{"id":508,"uris":["http://zotero.org/users/local/KFpzm6Se/items/D5DRH264","http://zotero.org/users/16750821/items/D5DRH264"],"itemData":{"id":508,"type":"report","page":"49","publisher":"commissioned by the Brazilian G20 presidency","title":"A blueprint for a coordinated minimum effective taxation standard for ultra-high-net-worth individual","URL":"https://gabriel-zucman.eu/files/report-g20.pdf","author":[{"literal":"Gabriel Zucman"}],"issued":{"date-parts":[["2024"]]}}},{"id":1079,"uris":["http://zotero.org/users/16750821/items/35238YKG"],"itemData":{"id":1079,"type":"webpage","container-title":"Tax Justice Network","language":"en-US","title":"Take back control","URL":"https://taxjustice.net/take-back-control/","author":[{"literal":"The Tax Justice Network"}],"accessed":{"date-parts":[["2025",4,29]]},"issued":{"date-parts":[["2024"]]}}},{"id":1124,"uris":["http://zotero.org/users/16750821/items/AYSGB2AJ"],"itemData":{"id":1124,"type":"webpage","abstract":"In an earlier blog post, we argued that rationalizing tax expenditures (TEs)—comprising exemptions, deductions, and reduced rates providing preferential tax treatments for specific groups of individuals, regions, or sectors—is critical to enhancing the capacity of low- and low-middle income countries (LMICs) for domestic resource mobilization (DRM) and to finance development. When we wrote it, these countries were recovering from the COVID-19 pandemic and beginning to feel the effects of Russia’s war with Ukraine, which intensified over time. In this blog, we argue that the case for streamlining and reforming TEs has become even more urgent.","container-title":"Center For Global Development","language":"en","title":"A Renewed Urgency to Rationalize Tax Expenditures in Low- and Middle-Income Countries","URL":"https://www.cgdev.org/blog/renewed-urgency-rationalize-tax-expenditures-low-and-middle-income-countries","author":[{"literal":"Sanjeev Gupta"},{"literal":"Agustin Redonda"}],"accessed":{"date-parts":[["2025",5,1]]},"issued":{"date-parts":[["2025"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (11–13) . Well designed and implemented excise taxes for reduc ing unhealthy goods consumption (including tobacco, alcohol and sugar and sweet beverages) may also substantially improve population health and generate additional revenue ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"epSmmINX","properties":{"formattedCitation":"{\\i{}(14,15)}","plainCitation":"(14,15)","noteIndex":0},"citationItems":[{"id":519,"uris":["http://zotero.org/users/local/KFpzm6Se/items/9GGU2DCV","http://zotero.org/users/16750821/items/9GGU2DCV"],"itemData":{"id":519,"type":"article-journal","container-title":"The Lancet","DOI":"10.1016/S0140-6736(23)00011-9","ISSN":"01406736","issue":"10383","journalAbbreviation":"The Lancet","language":"en","page":"1229-1240","source":"DOI.org (Crossref)","title":"Commercial determinants of health: future directions","title-short":"Commercial determinants of health","volume":"401","author":[{"family":"Friel","given":"Sharon"},{"family":"Collin","given":"Jeff"},{"family":"Daube","given":"Mike"},{"family":"Depoux","given":"Anneliese"},{"family":"Freudenberg","given":"Nicholas"},{"family":"Gilmore","given":"Anna B"},{"family":"Johns","given":"Paula"},{"family":"Laar","given":"Amos"},{"family":"Marten","given":"Robert"},{"family":"McKee","given":"Martin"},{"family":"Mialon","given":"Melissa"}],"issued":{"date-parts":[["2023",4]]}}},{"id":1078,"uris":["http://zotero.org/users/16750821/items/WFNRBCQI"],"itemData":{"id":1078,"type":"webpage","abstract":"Higher taxes on tobacco, alcohol, and sugary drinks can raise vital funds for development","container-title":"International Monetary Fund","language":"ENG","title":"The Case for Health Taxes","URL":"https://www.imf.org/en/Publications/fandd/issues/2025/03/point-of-view-the-case-for-health-taxes","author":[{"literal":"Masood Ahmed"},{"literal":"Minouche Shafik"}],"accessed":{"date-parts":[["2025",4,29]]},"issued":{"date-parts":[["2025"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (14,15) . Integrate HfA considerations into trade policy . G overnments can create enabling conditions to ensure public health is incorporated in trade policies . Trade policy can both impact public revenues for health services and help en hance access to essential good s (Box 1) . Various approaches may influence trade policymaking , including gathering and providing evidence , notably from health impact assessment s around trade policies , form ing multi - country or/and civil society coalitions to protect and enhance access to essential health goods or other commodities that enhance health ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"wk2ekEx3","properties":{"formattedCitation":"{\\i{}(16)}","plainCitation":"(16)","noteIndex":0},"citationItems":[{"id":1077,"uris":["http://zotero.org/users/16750821/items/RJ9NGEFJ"],"itemData":{"id":1077,"type":"article-journal","abstract":"Despite accumulating evidence of the implications of trade policy for public health, trade and health sectors continue to operate largely in silos. Numerous barriers to advancing health have been identified, including the dominance of a neoliberal paradigm, powerful private sector interests, and constraints associated with policymaking processes. Scholars and policy actors have recommended improved governance practices for trade policy, including: greater transparency and accountability; intersectoral collaboration; the use of health impact assessments; South-South networking; and mechanisms for civil society participation. These policy prescriptions have been generated from specific cases, such as the World Trade Organization’s Doha Declaration on TRIPS and Public Health or specific instances of trade-related policymaking at the national level. There has not yet been a comprehensive analysis of what enables the elevation of health goals on trade policy agendas. This narrative review seeks to address this gap by collating and analysing known studies across different levels of policymaking and different health issues.","container-title":"Globalization and Health","DOI":"10.1186/s12992-023-00960-7","ISSN":"1744-8603","issue":"1","journalAbbreviation":"Globalization and Health","page":"60","source":"BioMed Central","title":"Public health advocacy strategies to influence policy agendas: lessons from a narrative review of success in trade policy","title-short":"Public health advocacy strategies to influence policy agendas","volume":"19","author":[{"family":"Townsend","given":"Belinda"},{"family":"Tenni","given":"Brigitte Frances"},{"family":"Goldman","given":"Sharni"},{"family":"Gleeson","given":"Deborah"}],"issued":{"date-parts":[["2023",8,23]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (16) . Use industrial policy as lever to shape and co-create markets for HfA. Governments can orient industrial strategies towards reducing the production and consumption of health-harming products and services. They may use regulation, marketing and advertising restrictions (e.g. nutrition labelling policies) and subsidies tied to decent work conditions and sustainable practices, amongst others ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"Gl9EgNpI","properties":{"formattedCitation":"{\\i{}(17)}","plainCitation":"(17)","noteIndex":0},"citationItems":[{"id":1115,"uris":["http://zotero.org/users/16750821/items/6K5CFPQH"],"itemData":{"id":1115,"type":"report","event-place":"Geneva, Switzerland","publisher":"World Health Organization","publisher-place":"Geneva, Switzerland","title":"Global Report on the Commercial Determinants of Health (Forthcoming)","URL":"https://www.who.int/teams/social-determinants-of-health/economic-and-commercial-determinants-of-health/global-report","author":[{"literal":"WHO"}],"issued":{"date-parts":[["2025"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (17) . Equally important is the regulation of industries which products or services may not be inherently harmful, but which commercial practices may negatively impact public health (e.g. regulating vehicle emissions standards, social media). As major purchasers of goods and services, governments can leverage public procurement to shape markets in support of HfA, for example, by selecting suppliers based on social and environmental criteria ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"9cmETz4w","properties":{"formattedCitation":"{\\i{}(18)}","plainCitation":"(18)","noteIndex":0},"citationItems":[{"id":1070,"uris":["http://zotero.org/users/16750821/items/LXS3V8PQ"],"itemData":{"id":1070,"type":"report","event-place":"Geneva - Switzerland","language":"en","publisher":"World Health Organization","publisher-place":"Geneva - Switzerland","title":"World Report on Social Determinants of Health Equity","URL":"https://www.who.int/initiatives/action-on-the-social-determinants-of-health-for-advancing-equity/world-report-on-social-determinants-of-health-equity","author":[{"literal":"WHO"}],"accessed":{"date-parts":[["2025",4,29]]},"issued":{"date-parts":[["2025"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (18) . Finally, governments can review how to channel public investments more purposively toward HfA, developing public-private innovation ecosystems, ensuring attractive conditions for private investors in public health goods, whilst setting the terms for accessing public funding and market opportunitie s around product affordability and equitable access ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"LKFNELik","properties":{"formattedCitation":"{\\i{}(19,20)}","plainCitation":"(19,20)","noteIndex":0},"citationItems":[{"id":530,"uris":["http://zotero.org/users/local/KFpzm6Se/items/N25S5L3L","http://zotero.org/users/16750821/items/N25S5L3L"],"itemData":{"id":530,"type":"manuscript","genre":"Brief","number-of-pages":"15","title":"Governing health innovation for the common good","author":[{"literal":"WHO Council on the Economics of Health for All"}],"issued":{"date-parts":[["2021"]]}}},{"id":1071,"uris":["http://zotero.org/users/16750821/items/CY7X7XZQ"],"itemData":{"id":1071,"type":"report","abstract":"This case study, conducted in 2022-2023, builds on the vision of the WHO Council on the Economics of Health for All to put health, well-being and equity at the centre of the economy, and adopts the Council’s core themes of rethinking value, finance, innovation and capacity in the economy. The study puts forward a bold new value proposition that frames the mRNA TT Programme as a collective effort among participating stakeholders towards resilient epidemic preparedness and response capacity for the common good.","genre":"Council case study","language":"en","page":"48","title":"The mRNA Vaccine Technology Transfer Hub: a pilot for transformative change for the common good?","title-short":"The mRNA Vaccine Technology Transfer Hub","URL":"https://www.who.int/publications/m/item/the-mrna-vaccine-technology-transfer-hub--a-pilot-for-transformative-change-for-the-common-good","author":[{"literal":"WHO Council on the Economics of Health for All"}],"accessed":{"date-parts":[["2025",4,29]]},"issued":{"date-parts":[["2023"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (19,20) ( Boxes 2 &amp; 3) . Box SEQ Box \* ARABIC 1 : Tax policy reforms in Rwanda ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"63CwwHNq","properties":{"formattedCitation":"{\\i{}(21,22)}","plainCitation":"(21,22)","noteIndex":0},"citationItems":[{"id":1108,"uris":["http://zotero.org/users/16750821/items/V8JLMVHW"],"itemData":{"id":1108,"type":"report","event-place":"Rwanda","page":"15","publisher":"Rwanda Revenue Authority","publisher-place":"Rwanda","title":"Taxes for Growth and Development: New Changes in Tax Laws","URL":"https://www.rra.gov.rw/fileadmin/user_upload/CHANGES_IN_TAX_LAWS_Oct_2023.pdf","author":[{"literal":"RRA"}],"issued":{"date-parts":[["2023"]]}}},{"id":1109,"uris":["http://zotero.org/users/16750821/items/Q6T6NNVP"],"itemData":{"id":1109,"type":"webpage","language":"en-US","title":"Key tax policy reforms for 2024/2025","URL":"https://www.rra.gov.rw/en/details?tx_news_pi1%5Baction%5D=detail&amp;tx_news_pi1%5Bcontroller%5D=News&amp;tx_news_pi1%5Bnews%5D=2166&amp;cHash=ff3830e143baefbe9bbd0802837e4c8e","author":[{"literal":"RRA"}],"accessed":{"date-parts":[["2025",4,30]]},"issued":{"date-parts":[["2024"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (21,22) Box SEQ Box \* ARABIC 2 : An investment framework for promoting local antibiotics manufacturing in Ethiopia ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"xM3QjNVW","properties":{"formattedCitation":"{\\i{}(23)}","plainCitation":"(23)","noteIndex":0},"citationItems":[{"id":1112,"uris":["http://zotero.org/users/16750821/items/ETNM7LCK"],"itemData":{"id":1112,"type":"report","event-place":"Geneva, Switzerland","language":"en","page":"45","publisher":"United Nations Conference on Trade and Development","publisher-place":"Geneva, Switzerland","source":"Zotero","title":"Improving the investment landscape for local production of essential antibiotics in Ethiopia","URL":"https://unctad.org/system/files/official-document/tcsdiaeinf2023d6_en.pdf","author":[{"literal":"UNCTAD"}],"issued":{"date-parts":[["2023"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (23) Box SEQ Box \* ARABIC 3 : How government action shaped private sector investment in Austria ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"Cq5mHL8A","properties":{"formattedCitation":"{\\i{}(23)}","plainCitation":"(23)","noteIndex":0},"citationItems":[{"id":1112,"uris":["http://zotero.org/users/16750821/items/ETNM7LCK"],"itemData":{"id":1112,"type":"report","event-place":"Geneva, Switzerland","language":"en","page":"45","publisher":"United Nations Conference on Trade and Development","publisher-place":"Geneva, Switzerland","source":"Zotero","title":"Improving the investment landscape for local production of essential antibiotics in Ethiopia","URL":"https://unctad.org/system/files/official-document/tcsdiaeinf2023d6_en.pdf","author":[{"literal":"UNCTAD"}],"issued":{"date-parts":[["2023"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (23) Reform labour policy to strengthen the health and care sector. ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"ivgRiPtJ","properties":{"formattedCitation":"{\\i{}(24,25)}","plainCitation":"(24,25)","noteIndex":0},"citationItems":[{"id":511,"uris":["http://zotero.org/users/local/KFpzm6Se/items/C7M4SW6F","http://zotero.org/users/16750821/items/C7M4SW6F"],"itemData":{"id":511,"type":"post-weblog","container-title":"Centre for the New Economy and Society","genre":"World Economic Forum","title":"The future of the care economy","author":[{"literal":"WEF"}],"issued":{"date-parts":[["2024"]]}}},{"id":523,"uris":["http://zotero.org/users/local/KFpzm6Se/items/7GLU6KVR","http://zotero.org/users/16750821/items/7GLU6KVR"],"itemData":{"id":523,"type":"book","edition":"1st ed","event-place":"Geneva","ISBN":"978-92-4-008285-4","language":"en","number-of-pages":"1","publisher":"World Health Organization","publisher-place":"Geneva","source":"K10plus ISBN","title":"Fair Share for Health and Care: Gender and the Undervaluation of Health and Care Work","title-short":"Fair Share for Health and Care","author":[{"literal":"WHO"}],"issued":{"date-parts":[["2024"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (24,25) Governments need to prioritize labour policy that address health workforce shortages, skills mismatches and enabling conditions f or high-quality, stable jobs in the health and care sector ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"X6ZyUEnz","properties":{"formattedCitation":"{\\i{}(26)}","plainCitation":"(26)","noteIndex":0},"citationItems":[{"id":529,"uris":["http://zotero.org/users/local/KFpzm6Se/items/2RETIPY9","http://zotero.org/users/16750821/items/2RETIPY9"],"itemData":{"id":529,"type":"report","abstract":"High-Level Commission on Health Employment and Economic Growth","collection-title":"Report of the High-Level Commission on Health Employment and Economic Growth","language":"en","page":"74","title":"Working for health and growth: investing in the health workforce","title-short":"Working for health and growth","URL":"https://www.who.int/publications/i/item/9789241511308","author":[{"literal":"WHO"}],"accessed":{"date-parts":[["2025",3,13]]},"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (26) . This may include reviewing how labour market policies interact with health, education and trade policy to identify structural barriers and opportunities for improvement. Key reforms may include easing demand and supply constraints through better workforce planning, investing in education and training and aligning service delivery models to support decent employment. Non-health workers in health facilities and i nformal care workers , predominantly women, play a critical yet often unrecognized role in supporting health systems and advancing HfA . Government can address these gaps by integrating these groups into data and planning systems to ensure visibility in national labour and health strategies whilst enacting inclusive labour policies that recognize and protect informal care work, ensure decent work standards, and promote occupational health and training. Ensure social protection policies cover populations from the risks of ill-health across the life course. Social protection policies must be designed or adapted to offer adequate and reliable support through all stages of life ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"R9xcKgl0","properties":{"formattedCitation":"{\\i{}(27)}","plainCitation":"(27)","noteIndex":0},"citationItems":[{"id":528,"uris":["http://zotero.org/users/local/KFpzm6Se/items/JUUMNW9X","http://zotero.org/users/16750821/items/JUUMNW9X"],"itemData":{"id":528,"type":"report","page":"132","title":"Role of social protection in reducing the burden of public health and social measures during the COVID-19 pandemic","URL":"https://www.who.int/publications/i/item/9789240100831","author":[{"literal":"WHO"}],"accessed":{"date-parts":[["2025",3,13]]},"issued":{"date-parts":[["2024"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (27) , with benefit levels that meaningfully contribute to health and well-being. Their integration into national security frameworks can strengthen resilience during health and economic crises, ensuring continuity of income and access to essential services. Finally, p rogressing towards UHC demands robust financial protection to prevent individuals and families from falling into poverty due to health-related costs. Box SEQ Box \* ARABIC 4 : National system of care in Uruguay ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"Ej3iZWuf","properties":{"formattedCitation":"{\\i{}(28)}","plainCitation":"(28)","noteIndex":0},"citationItems":[{"id":1113,"uris":["http://zotero.org/users/16750821/items/JP7ZDW7Z"],"itemData":{"id":1113,"type":"report","event-place":"Geneva - Switzerland","page":"104","publisher":"World Health Organization","publisher-place":"Geneva - Switzerland","title":"Long-term care for older people: package for universal health coverage","URL":"https://www.who.int/publications/i/item/9789240086555","author":[{"literal":"WHO"}],"issued":{"date-parts":[["2023"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (28) Value and i nvest in H fA This strategic direction focuses on aligning strategic planning and decisions on economic policies and public investments with H fA Figure SEQ Figure \* ARABIC 5 : Overview of priority actions Ensure health is included in dashboards of economic indicator s to inform strategic investment People place value on health, wellbeing and economic welfare . However, the relative importance of these dimensions can differ across populations based on cultural , social and economic contexts. Member states can develop their own dashboard of multidimensional indicators , drawing on the SDGs or the WHO’s Operational framework for Health Equity ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"OvJZd1wY","properties":{"formattedCitation":"{\\i{}(10)}","plainCitation":"(10)","noteIndex":0},"citationItems":[{"id":526,"uris":["http://zotero.org/users/local/KFpzm6Se/items/95JPFL7X","http://zotero.org/users/16750821/items/95JPFL7X"],"itemData":{"id":526,"type":"manuscript","abstract":"This Operational framework for monitoring social determinants of health equity provides countries with critical guidance on monitoring the social determinants of health and actions addressing them, and using data for policy action across sectors to improve health equity.","language":"en","number-of-pages":"100","title":"Operational framework for monitoring social determinants of health equity","URL":"https://www.who.int/publications/i/item/9789240088320","author":[{"literal":"WHO"}],"accessed":{"date-parts":[["2025",3,13]]},"issued":{"date-parts":[["2024"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (10) and lesso n s learnt from other countries ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"kyMv7fsY","properties":{"formattedCitation":"{\\i{}(4,29)}","plainCitation":"(4,29)","noteIndex":0},"citationItems":[{"id":527,"uris":["http://zotero.org/users/local/KFpzm6Se/items/NCP56TQZ","http://zotero.org/users/16750821/items/NCP56TQZ"],"itemData":{"id":527,"type":"manuscript","genre":"Brief","number-of-pages":"24","title":"Valuing Health for All: Rethinking and building a whole-of-society approach","author":[{"literal":"WHO Council on the Economics of Health for All"}],"issued":{"date-parts":[["2022"]]}}},{"id":507,"uris":["http://zotero.org/users/local/KFpzm6Se/items/XANZKS8C","http://zotero.org/users/16750821/items/XANZKS8C"],"itemData":{"id":507,"type":"article-journal","container-title":"The Lancet Planetary Health","DOI":"10.1016/S2542-5196(24)00147-5","ISSN":"25425196","issue":"9","journalAbbreviation":"The Lancet Planetary Health","language":"en","page":"e695-e705","source":"DOI.org (Crossref)","title":"Beyond GDP: a review and conceptual framework for measuring sustainable and inclusive wellbeing","title-short":"Beyond GDP","volume":"8","author":[{"family":"Jansen","given":"Annegeke"},{"family":"Wang","given":"Ranran"},{"family":"Behrens","given":"Paul"},{"family":"Hoekstra","given":"Rutger"}],"issued":{"date-parts":[["2024",9]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (4,29) to support the goal of improving wellbeing in public investments (Box 5 ) . Position H f A as a cornerstone of strategic planning and medium - term expenditure frameworks HfA needs to be embedded in medium - and long-term development plans within and beyond the 2030 SDG Agenda (Box 5 ) . C oordinated action across all levels of government through Health in All Policies and whole-of-government approaches such as interministerial committees and interdepartmental units is key , supplemented by active engagement with the private sector ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"hW7BdZuI","properties":{"formattedCitation":"{\\i{}(30)}","plainCitation":"(30)","noteIndex":0},"citationItems":[{"id":524,"uris":["http://zotero.org/users/local/KFpzm6Se/items/6MDGIDPY","http://zotero.org/users/16750821/items/6MDGIDPY"],"itemData":{"id":524,"type":"article-journal","abstract":"Introduction While health is one of the Sustainable Development Goals (SDGs), many other ‘health-­related’ goals comprise determinants of health. Integrated implementation across SDGs is needed for the achievement of Agenda 2030. While existing literature is rich in normative recommendations about potentially useful approaches, evidence of implementation strategies being adopted by countries is limited.\nMethods We conducted a systematic review with qualitative synthesis of findings using peer reviewed and grey literature from key databases. We included publications examining implementation of health and health-r­elated SDGs (HHSDGs) at national or subnational level published between June 2013 and July 2019.\nResults Of the 32 included publications, 24 provided information at the national level while eight provided information for multiple countries or regions. Our findings indicate that high-­level political commitment is evident in most countries and HHSDGs are being aligned with existing national development strategies and plans. A multisectoral, integrated approach is being adopted in institutional setups but evidence on effectiveness of these approaches is limited. Funding constraints are a major challenge for many countries. HHSDGs are generally being financed from within existing funded plans and, in some instances, through SDG-­specific budgeting and tracking; additional funding is being mobilised by increasing domestic taxation and subsidisation, and by collaborating with development partners and private sector. Equity is being promoted by improving health service access through universal health coverage and social insurance schemes, especially for disadvantaged populations. Governments are collaborating with development partners and UN agencies for support in planning, institutional development and capacity building. However, evidence on equity promotion, capacity building initiatives and implementation approaches at subnational level is limited. Lack of coordination among various levels of government emerges as a key challenge.\nConclusion strengthening implementation of multisectoral work, capacity building, financial sustainability and data availability are key considerations to accelerate implementation of HHSDGs.","container-title":"BMJ Global Health","DOI":"10.1136/bmjgh-2019-002273","ISSN":"2059-7908","issue":"8","journalAbbreviation":"BMJ Glob Health","language":"en","page":"e002273","source":"DOI.org (Crossref)","title":"Implementation of health and health-related sustainable development goals: progress, challenges and opportunities – a systematic literature review","title-short":"Implementation of health and health-related sustainable development goals","volume":"5","author":[{"family":"Aftab","given":"Wafa"},{"family":"Siddiqui","given":"Fahad Javaid"},{"family":"Tasic","given":"Hana"},{"family":"Perveen","given":"Shagufta"},{"family":"Siddiqi","given":"Sameen"},{"family":"Bhutta","given":"Zulfiqar Ahmed"}],"issued":{"date-parts":[["2020",8]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (30) . Institutionalis e the use of H f A indicators within public financial management processes Public financing processes can contribute to effective H f A investment . This includes budgeting strategies that focus on priority indicators and outcomes (Box 5 ) , that fully incorporate health improvement generated by all sectors, informing synergies in cross-sectoral investment for health ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"GdSoBYHy","properties":{"formattedCitation":"{\\i{}(30)}","plainCitation":"(30)","noteIndex":0},"citationItems":[{"id":524,"uris":["http://zotero.org/users/local/KFpzm6Se/items/6MDGIDPY","http://zotero.org/users/16750821/items/6MDGIDPY"],"itemData":{"id":524,"type":"article-journal","abstract":"Introduction While health is one of the Sustainable Development Goals (SDGs), many other ‘health-­related’ goals comprise determinants of health. Integrated implementation across SDGs is needed for the achievement of Agenda 2030. While existing literature is rich in normative recommendations about potentially useful approaches, evidence of implementation strategies being adopted by countries is limited.\nMethods We conducted a systematic review with qualitative synthesis of findings using peer reviewed and grey literature from key databases. We included publications examining implementation of health and health-r­elated SDGs (HHSDGs) at national or subnational level published between June 2013 and July 2019.\nResults Of the 32 included publications, 24 provided information at the national level while eight provided information for multiple countries or regions. Our findings indicate that high-­level political commitment is evident in most countries and HHSDGs are being aligned with existing national development strategies and plans. A multisectoral, integrated approach is being adopted in institutional setups but evidence on effectiveness of these approaches is limited. Funding constraints are a major challenge for many countries. HHSDGs are generally being financed from within existing funded plans and, in some instances, through SDG-­specific budgeting and tracking; additional funding is being mobilised by increasing domestic taxation and subsidisation, and by collaborating with development partners and private sector. Equity is being promoted by improving health service access through universal health coverage and social insurance schemes, especially for disadvantaged populations. Governments are collaborating with development partners and UN agencies for support in planning, institutional development and capacity building. However, evidence on equity promotion, capacity building initiatives and implementation approaches at subnational level is limited. Lack of coordination among various levels of government emerges as a key challenge.\nConclusion strengthening implementation of multisectoral work, capacity building, financial sustainability and data availability are key considerations to accelerate implementation of HHSDGs.","container-title":"BMJ Global Health","DOI":"10.1136/bmjgh-2019-002273","ISSN":"2059-7908","issue":"8","journalAbbreviation":"BMJ Glob Health","language":"en","page":"e002273","source":"DOI.org (Crossref)","title":"Implementation of health and health-related sustainable development goals: progress, challenges and opportunities – a systematic literature review","title-short":"Implementation of health and health-related sustainable development goals","volume":"5","author":[{"family":"Aftab","given":"Wafa"},{"family":"Siddiqui","given":"Fahad Javaid"},{"family":"Tasic","given":"Hana"},{"family":"Perveen","given":"Shagufta"},{"family":"Siddiqi","given":"Sameen"},{"family":"Bhutta","given":"Zulfiqar Ahmed"}],"issued":{"date-parts":[["2020",8]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (30) and reorienting budgeting in ways that expenditures to priority goals are traceable . Box SEQ Box \* ARABIC 5 : Measuring what matters in Canada ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"g8eABgtE","properties":{"formattedCitation":"{\\i{}(31,32)}","plainCitation":"(31,32)","noteIndex":0},"citationItems":[{"id":1067,"uris":["http://zotero.org/users/16750821/items/E8VG3XAP"],"itemData":{"id":1067,"type":"report","event-place":"Canada","language":"eng","note":"Last Modified: 2022-03-03","page":"36","publisher-place":"Canada","title":"Measuring What Matters: Toward a Quality of Life Strategy for Canada","title-short":"Measuring What Matters","URL":"https://www.canada.ca/en/department-finance/services/publications/measuring-what-matters-toward-quality-life-strategy-canada.html","author":[{"literal":"Department of Finance Canada"}],"accessed":{"date-parts":[["2025",4,29]]},"issued":{"date-parts":[["2021",4,19]]}}},{"id":1068,"uris":["http://zotero.org/users/16750821/items/I2D886XG"],"itemData":{"id":1068,"type":"book","event-place":"IE","language":"en","number-of-pages":"73","publisher":"Institute of Public Health","publisher-place":"IE","source":"DOI.org (CSL JSON)","title":"Creating an Impactful and Sustainable Wellbeing Economy","URL":"https://doi.org/10.14655/11971-1084919","author":[{"literal":"EuroHealthNet"},{"literal":"Institute of Public Health (IPH)"}],"accessed":{"date-parts":[["2025",4,29]]},"issued":{"date-parts":[["2024",3,28]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (31,32) Adapt investment impact and evaluation frameworks to capture the full value of HfA and m ainstream participatory quantitative health impact assessment across sectors Comprehensive evaluation frameworks are needed to assess how investments enable people to lead lives they value. Participatory h ealth impact assessments that include equity considerations need to be integrated into economic and sectoral policymaking alongside economic or environmental assessments to ensure health and health equity outcomes are systematically considered. A nalytical frameworks commonly used to inform economic policy may also need to be adapted (Box es 6 &amp; 7) . Box SEQ Box \* ARABIC 6 : Examples of potential joint health and economic analytical frameworks ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"F0ktRjLB","properties":{"formattedCitation":"{\\i{}(25,33\\uc0\\u8211{}36)}","plainCitation":"(25,33–36)","noteIndex":0},"citationItems":[{"id":523,"uris":["http://zotero.org/users/local/KFpzm6Se/items/7GLU6KVR","http://zotero.org/users/16750821/items/7GLU6KVR"],"itemData":{"id":523,"type":"book","edition":"1st ed","event-place":"Geneva","ISBN":"978-92-4-008285-4","language":"en","number-of-pages":"1","publisher":"World Health Organization","publisher-place":"Geneva","source":"K10plus ISBN","title":"Fair Share for Health and Care: Gender and the Undervaluation of Health and Care Work","title-short":"Fair Share for Health and Care","author":[{"literal":"WHO"}],"issued":{"date-parts":[["2024"]]}}},{"id":505,"uris":["http://zotero.org/users/local/KFpzm6Se/items/7JP42HHG","http://zotero.org/users/16750821/items/7JP42HHG"],"itemData":{"id":505,"type":"article-journal","abstract":"Since publication of the report by the Panel on Cost-Effectiveness in Health and Medicine in 1996, researchers have advanced the methods of cost-effectiveness analysis, and policy makers have experimented with its application. The need to deliver health care efficiently and the importance of using analytic techniques to understand the clinical and economic consequences of strategies to improve health have increased in recent years.To review the state of the field and provide recommendations to improve the quality of cost-effectiveness analyses. The intended audiences include researchers, government policy makers, public health officials, health care administrators, payers, businesses, clinicians, patients, and consumers.In 2012, the Second Panel on Cost-Effectiveness in Health and Medicine was formed and included 2 co-chairs, 13 members, and 3 additional members of a leadership group. These members were selected on the basis of their experience in the field to provide broad expertise in the design, conduct, and use of cost-effectiveness analyses. Over the next 3.5 years, the panel developed recommendations by consensus. These recommendations were then reviewed by invited external reviewers and through a public posting process.The concept of a “reference case” and a set of standard methodological practices that all cost-effectiveness analyses should follow to improve quality and comparability are recommended. All cost-effectiveness analyses should report 2 reference case analyses: one based on a health care sector perspective and another based on a societal perspective. The use of an “impact inventory,” which is a structured table that contains consequences (both inside and outside the formal health care sector), intended to clarify the scope and boundaries of the 2 reference case analyses is also recommended. This special communication reviews these recommendations and others concerning the estimation of the consequences of interventions, the valuation of health outcomes, and the reporting of cost-effectiveness analyses.The Second Panel reviewed the current status of the field of cost-effectiveness analysis and developed a new set of recommendations. Major changes include the recommendation to perform analyses from 2 reference case perspectives and to provide an impact inventory to clarify included consequences.","container-title":"JAMA","DOI":"10.1001/jama.2016.12195","ISSN":"0098-7484","issue":"10","journalAbbreviation":"JAMA","page":"1093-1103","source":"Silverchair","title":"Recommendations for Conduct, Methodological Practices, and Reporting of Cost-effectiveness Analyses: Second Panel on Cost-Effectiveness in Health and Medicine","title-short":"Recommendations for Conduct, Methodological Practices, and Reporting of Cost-effectiveness Analyses","volume":"316","author":[{"family":"Sanders","given":"Gillian D."},{"family":"Neumann","given":"Peter J."},{"family":"Basu","given":"Anirban"},{"family":"Brock","given":"Dan W."},{"family":"Feeny","given":"David"},{"family":"Krahn","given":"Murray"},{"family":"Kuntz","given":"Karen M."},{"family":"Meltzer","given":"David O."},{"family":"Owens","given":"Douglas K."},{"family":"Prosser","given":"Lisa A."},{"family":"Salomon","given":"Joshua A."},{"family":"Sculpher","given":"Mark J."},{"family":"Trikalinos","given":"Thomas A."},{"family":"Russell","given":"Louise B."},{"family":"Siegel","given":"Joanna E."},{"family":"Ganiats","given":"Theodore G."}],"issued":{"date-parts":[["2016",9,13]]}}},{"id":506,"uris":["http://zotero.org/users/local/KFpzm6Se/items/PFRTIPYQ","http://zotero.org/users/16750821/items/PFRTIPYQ"],"itemData":{"id":506,"type":"article-journal","container-title":"Applied Health Economics and Health Policy","DOI":"10.1007/s40258-019-00481-8","ISSN":"1175-5652, 1179-1896","issue":"5","journalAbbreviation":"Appl Health Econ Health Policy","language":"en","page":"577-590","source":"DOI.org (Crossref)","title":"Striving for a Societal Perspective: A Framework for Economic Evaluations When Costs and Effects Fall on Multiple Sectors and Decision Makers","title-short":"Striving for a Societal Perspective","volume":"17","author":[{"family":"Walker","given":"Simon"},{"family":"Griffin","given":"Susan"},{"family":"Asaria","given":"Miqdad"},{"family":"Tsuchiya","given":"Aki"},{"family":"Sculpher","given":"Mark"}],"issued":{"date-parts":[["2019",10]]}}},{"id":515,"uris":["http://zotero.org/users/local/KFpzm6Se/items/47HMTPTY","http://zotero.org/users/16750821/items/47HMTPTY"],"itemData":{"id":515,"type":"webpage","abstract":"Reforming Harmful Subsidies has been a common goal of the trade and environment communities and strongly features the WTO Doha agenda. UN Environment Programme has long engaged in multilateral efforts for subsidies reform. It supports phasing out subsidies for fossil fuels, unsustainable fisheries, and other environmentally and socially harmful activities. In addition, UNEP assists governments and other stakeholders in developing national and international social, inclusive, and sustainable reforms. Energy subsidies On energy subsidies, UNEP focuses on reforming subsidies leading to overproduction and aligning fiscal incentives with sustainable development objectives. UNEP has organized jointly with the International Energy Agency (IEA) a series of thematic workshops on reforming energy subsidies to further the dialogue on energy subsidies and their implications for sustainable development. Fisheries Subsidies Fish is the most traded animal protein commodity. However, a growing global population and increased demand for food have amplified unsustainable fisheries practices. As a result, the sustainability of global fishery resources continues to decline, having dropped from 90 per cent in 1974 to 65.8 per cent in 2017. The UNEP Environment &amp; Trade Hub has a key role in helping countries deliver upon SDG (Sustainable Development Goal) 14, to trade-related targets 14.4 (regulating illegal unregulated or unreported - IUU - fishing activities), 14.6 (prohibiting certain forms of fisheries subsidies) and 14. b (market access for small-scale artisanal fishers). Responses to the need for fisheries subsidies reform UNEP's work focuses on promoting responses to fisheries subsidies reform. The book Fisheries Subsidies, Sustainable Development and the WTO serves as a comprehensive reference manual for policymakers and academics by providing a historical overview of fisheries subsidies reform key issues under WTO negotiations. Under the common objective of \"Reforming trade and fisheries policies, reshaping supply chains and enhancing consumer demand for sustainable fisheries management\", country teams in Ecuador, South Africa and Vietnam explored public policy reforms related to fisheries management, subsidies and trade, private sector voluntary actions, and supply chain interventions. Newmarket-based approaches and incentives UN Environment Programme plays a lead role in promoting new market-based approaches and incentives to improve the sustainability of industrial and small-scale fisheries, such as the implementation of sustainability certification schemes. The project \"Establishing sustainable, resource-efficient agri-food supply chains\" focused on improving resource efficiency, including ecosystem services underpinning agricultural and fisheries production, as well as energy and water consumed in production, processing and trade. High-level events representing the UNEP Environment &amp; Trade Hub In July 2016 UNEP, the UN Conference on Trade and Development (UNCTAD) and the Food and Agriculture Organization of the UN (FAO) made an international call to the Member States and the International Community to deliver trade-related targets in SDG 14. Ninety-one countries, four intergovernmental organizations, and 15 civil society groups declared their support for a global roadmap to eliminate harmful fisheries subsidies by 2020. In June 2017, at a side event on reforming fisheries subsidies at the high-profile Oceans Conference in New York, UNEP, FAO and UNCTAD, launched a new voluntary commitment to provide joint policy advice and technical support to countries. The latest draft of the agreement on fisheries subsidies is due to be negotiated at the 12th Ministerial Conference, which has been postponed multiple times due to the Covid-19 pandemic. Support countries to make trade and investment activities more sustainable by assessing adverse environmental, social, and health impacts related to trade practices, and developing alternative solutions. More on Outputs on Reforming Harmful Subsidies.","language":"en","title":"Reforming harmful Subsidies | UNEP - UN Environment Programme","URL":"https://www.unep.org/explore-topics/green-economy/what-we-do/environment-and-trade-hub/our-work/reforming-harmful","author":[{"literal":"UNEP"}],"accessed":{"date-parts":[["2025",3,13]]},"issued":{"date-parts":[["2017",11,20]]}}},{"id":1114,"uris":["http://zotero.org/users/16750821/items/7QDUXLFZ"],"itemData":{"id":1114,"type":"webpage","abstract":"Insight from the WHO Council on the Economics of Health for All","language":"en","title":"Time-use data can clarify crucial inputs to Health for All","URL":"https://www.who.int/publications/m/item/time-use-data-can-clarify-crucial-inputs-to-health-for-all","author":[{"literal":"WHO Council on the Economics of Health for All"}],"accessed":{"date-parts":[["2025",4,30]]},"issued":{"date-parts":[["2022"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (25,33–36) Box SEQ Box \* ARABIC 7 : Modelling the COVID-19 pandemic at the Bank of Italy ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"gyAnt4d2","properties":{"formattedCitation":"{\\i{}(37)}","plainCitation":"(37)","noteIndex":0},"citationItems":[{"id":1066,"uris":["http://zotero.org/users/16750821/items/W5R56QZM"],"itemData":{"id":1066,"type":"report","language":"en","page":"102","publisher":"World Health Organization, the Organisation for Economic Co-operation and Development and/or the International Bank for Reconstruction and Development/The World Bank","source":"Zotero","title":"Strengthening pandemic preparedness and response through integrated modelling","URL":"https://iris.who.int/bitstream/handle/10665/376712/9789240090880-eng.pdf?sequence=1","author":[{"literal":"WHO"},{"literal":"OECD"},{"literal":"The World Bank"}],"issued":{"date-parts":[["2024"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (37) Develop d igital infrastructure for EHfA Developments in d igital infrastructure should be explored that to improve the data available to inform investments related to EHfA. Initiatives may include , for example, linking datasets on economic indicators with health indicators , both at aggregate and market levels and developing publicly available dashboards supplemented with a digital architecture to consult and engage communities and society . Identify priorities for investments in HfA innovation To secure future gains for HfA , countries invest in health science , technology and innovation . These investments can impact the economy more broadly. G overnments will need to set priority investment areas and working with their research funding bodies to provide catalytic investments to ensure returns to both health and the economy . These priorities will need to align to the EH4A value structures and may require new metrics in terms of how successful research is defined to reflect those values , together with examining and defining the balance between private and public value of those investments . Fi nancing for H fA This strategic direction contains actions to strengthen both domestic and international financing for HfA . Th is re positions Ministries of Finance as guarantors not only of macro-economic stability and growth, but as enablers of healthy and equitable societies . Figure SEQ Figure \* ARABIC 6 : Overview of priority actions Assess the potential for domestic resource mobilisation for HfA In many countries, m obilizing domestic resources for primary health care (PHC) is needed to ensure an inclusive pathway to achieving UHC and HfA. As above, a key strategy involves increasing general tax revenue by broadening the tax base and reviewing rates (Box 1 ) . To ensure resources effectively reach frontline service providers and communities, ministries of health may establish a dedicated P H C team responsible to mobilize political support during budget negotiation ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"vQsMuWIg","properties":{"formattedCitation":"{\\i{}(38)}","plainCitation":"(38)","noteIndex":0},"citationItems":[{"id":1121,"uris":["http://zotero.org/users/16750821/items/JXQGYSWH"],"itemData":{"id":1121,"type":"article-journal","container-title":"The Lancet Global Health","DOI":"10.1016/S2214-109X(22)00005-5","ISSN":"2214-109X","issue":"5","journalAbbreviation":"The Lancet Global Health","language":"English","note":"publisher: Elsevier\nPMID: 35390342","page":"e715-e772","source":"www.thelancet.com","title":"The Lancet Global Health Commission on financing primary health care: putting people at the centre","title-short":"The Lancet Global Health Commission on financing primary health care","volume":"10","author":[{"family":"Hanson","given":"Kara"},{"family":"Brikci","given":"Nouria"},{"family":"Erlangga","given":"Darius"},{"family":"Alebachew","given":"Abebe"},{"family":"Allegri","given":"Manuela De"},{"family":"Balabanova","given":"Dina"},{"family":"Blecher","given":"Mark"},{"family":"Cashin","given":"Cheryl"},{"family":"Esperato","given":"Alexo"},{"family":"Hipgrave","given":"David"},{"family":"Kalisa","given":"Ina"},{"family":"Kurowski","given":"Christoph"},{"family":"Meng","given":"Qingyue"},{"family":"Morgan","given":"David"},{"family":"Mtei","given":"Gemini"},{"family":"Nolte","given":"Ellen"},{"family":"Onoka","given":"Chima"},{"family":"Powell-Jackson","given":"Timothy"},{"family":"Roland","given":"Martin"},{"family":"Sadanandan","given":"Rajeev"},{"family":"Stenberg","given":"Karin"},{"family":"Morales","given":"Jeanette Vega"},{"family":"Wang","given":"Hong"},{"family":"Wurie","given":"Haja"}],"issued":{"date-parts":[["2022",5,1]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (38) a nd ensure sufficient resources from health sector budget are allocated to PHC interventions (see next section) . Equally important is the pooling o f resources across sectors, a central approach to a whole-of-government approach for HfA . Ministries can develop joint sectoral strategies with budget proposal s showing contributions to HfA and co-benefits for each sector or/and establish public-priva t e and community collaboration . Similar initiatives can also be undertaken at local levels (Box 8 ) . Box SEQ Box \* ARABIC 8 : Financing Healthy Cities Initiatives ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"3JBW1YQS","properties":{"formattedCitation":"{\\i{}(39)}","plainCitation":"(39)","noteIndex":0},"citationItems":[{"id":1065,"uris":["http://zotero.org/users/16750821/items/6L723N84"],"itemData":{"id":1065,"type":"report","event-place":"Copenhagen","page":"62","publisher":"World Health Organization","publisher-place":"Copenhagen","title":"How to develop and sustain healthy cities in 20 steps","URL":"https://iris.who.int/bitstream/handle/10665/364675/WHO-EURO-2022-6646-46412-67222-eng.pdf","author":[{"literal":"WHO Regional Office for Europe"}],"issued":{"date-parts":[["2022"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (39) Improv e the equity and efficiency of domestic financing for HfA Equity require s that health financing mechani sms are based on ability to pay and need for services, ensuring that the poorest and most vulnerable populations are protected from financial hardship. As above, t his demands greater reliance on progressive taxation and pooled financing . At the same time , improving efficiency requires ensuring the allocation of resources is well aligned with HfA alongside the analytics described above, strategic purchasing and better public financial management . For both equity and efficiency, institutionalising participatory decision-making processes such as health technology assessment in health sector and health equity impact assessment are needed to improve domestic financing for HfA. Develop and implement effective global financing instruments aligned with H f A Further advocacy and co-ordination are required to ensure that global and regional financial instruments assist countries in the strengthening the financing of HfA . The Lusaka agenda is a n example of a non-binding agreement supporting unified planning, budgeting and monitoring . T he IMF Resilience and Sustainability Facility is an example of a financing facility supporting public health functions for pandemic preparedness. Other opportunities may exist at the level o f development banks (e.g. safeguards, HFA as matters of attention for policy-based loans) and at international level (e.g. global tax rules to prevent tax competition and the subsequent erosion of national tax base) . Review and design incentives for private financing for HfA , domestically or globally. Private investors and financiers play a vital role in both funding for health, and health care delivery sector in many countries. There are a range of different policy options that can increase private sector investment in services that have a social impact (eg. social impact bonds) , but many have yet to deliver substantial funding . A range of measures (e.g. health-oriented venture capital funds, socially responsible investment certification) may be considered , with due attention to their efficiency and distributive effects . In some of these countries, there is a trend of increasing financialization of health care delivery with concentration through merger, sale to private equity and eventually enlisting on the stock market ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"sFS85Mke","properties":{"formattedCitation":"{\\i{}(40)}","plainCitation":"(40)","noteIndex":0},"citationItems":[{"id":514,"uris":["http://zotero.org/users/local/KFpzm6Se/items/K9DXQAZY","http://zotero.org/users/16750821/items/K9DXQAZY"],"itemData":{"id":514,"type":"report","note":"DOI: 10.37941/RR/2025/1","publisher":"United Nations University - International Institute for Global Health","source":"DOI.org (Crossref)","title":"Private Financial Actors and Financialisation in Global Health","URL":"http://collections.unu.edu/eserv/UNU:10084/Financialisation_in_Global_Health.pdf","author":[{"family":"M. Hunter","given":"Benjamin"},{"family":"McCoy","given":"David"},{"family":"Carolina Cordilha","given":"Ana"},{"family":"Marriott","given":"Anna"},{"family":"Roy","given":"Victor"},{"family":"Stein","given":"Felix"},{"family":"Wood","given":"Benjamin"}],"accessed":{"date-parts":[["2025",3,13]]},"issued":{"date-parts":[["2025"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (40) . These market dynamic s need to be apprais ed for their impact on H f A, including their distributional effect s . Financing for health science s and industry Governments are active investors in science, technology, and innovation for health ; and some have built strong ecosystems for health sciences and industry. Such strategic investments and innovation , which can , mobilize both public and private funds, domestic and international, c an produce substantial benefit, but may also come with risks and challenges , particularly in ensuring equitable access to essential health products . Throught the sharing of experiences, g overnments can create successful enterprise environments, build capacities , lever policy tools (e.g., tax credits) to ensure foster investment in health science, which reflects their economic and health priorities. C apaci ty for EH f A Ministries of Health and other health actors need to develop capacity in EH4A to eng age with economic actors . Moreover, p ublic authorities at all levels and across key economic sectors must deepen their understanding of how economic policies , financing and investment impact HfA and strengthen capacity to engage across ministries , agencies, and sectors. This includes developing collaborative approaches for planning , implementation and accountability that harness the expertise of actors across health, finance, trade, industry, labour and social protection , and communities (Box 9 ). Figure SEQ Figure \* ARABIC 7 : Overview of priority actions Assess and develop a plan to s trengthen EHfA capacities across civil service Health authorities may need to strengthen expertise to engage more effectively with economic authorities during strategic planning , economic policymaking and resource allocation processes . Key capacities for health authorities includes identifying and quantifying key arguments to make more robust investment case in health , understanding the role of health impact assessment across sectors , as well as using economic evidence and participatory decision-making processes to inform resource allocation and investment within the health sector . At both national and subnational levels , public health and clinical workers need to be equipped by a strong understanding of how economic systems influence the effectiveness of their actions . It may also involve training health wo r kers in identify ing and addressing social factors , promot ing not only behavioural change to reduce exposure to disease risk factors but facilitating access to social services . Capacity building efforts in EHfA should also target civil servants working outside the health sector , providing them with better understanding of the co-benefits of improving health equity for their own sector and the implications of their policy on HfA , amongst others (Box 9 ) . Many of these capacities may already exist but may do so in silos, limiting their impact. Mapping existing capacities and identifying gaps can help inform the development of a targeted pan to build and pool capacities at the country or regional level ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"tHxAtCNV","properties":{"formattedCitation":"{\\i{}(41)}","plainCitation":"(41)","noteIndex":0},"citationItems":[{"id":1073,"uris":["http://zotero.org/users/16750821/items/FDF8DBVV"],"itemData":{"id":1073,"type":"report","event-place":"Geneva","page":"79","publisher":"World Health Organization","publisher-place":"Geneva","title":"Economic and commercial determinants of health in Small Island Developing States (SIDS): noncommunicable diseases, mental health conditions, injuries and violence.","URL":"https://cdn.who.int/media/docs/default-source/ncds/sids-event/draft-discussion-paper-ced-in-sids-ncds-mental-health-conditions-injuries-violence.pdf?sfvrsn=b852033e_6","author":[{"literal":"WHO"}],"issued":{"date-parts":[["2025"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (41) . Box SEQ Box \* ARABIC 9 : Illustrative EHf A capacities Develop a n engagement strategy to strengthen the governance of HfA Meaningful engagement between health and economic sectors needs to ensure joint policies are socially legitimate, rooted in shared values and responsible to diverse needs across society. It requires a coordinated and inclusive approach to policy development, implementation and accountability. An effective engagement strategy needs to bring together government institutions, civil society organization, private sector actors, academic institutions and community groups around the shared vision of HfA. Government can play a key convening role facilitating dialogue across sectors and levels of governance to co-design priorities and align incentives . Civil society can contribute valuable local knowledge , advocacy and accountability mechanism while the private sector can drive innovation and investment aligned with HfA. The strategy should include structured mechanism for participation such as national dialogues, citizen assemblies, patient council as well as clear communication plans, feedback loops and capacity building efforts. Domestic and international platforms should provide mutually supportive networks and community of actors committed, through original solutions, processes, and interventions, to HfA ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"2jHmvHfR","properties":{"formattedCitation":"{\\i{}(42)}","plainCitation":"(42)","noteIndex":0},"citationItems":[{"id":1116,"uris":["http://zotero.org/users/16750821/items/ZD234EN3"],"itemData":{"id":1116,"type":"post-weblog","title":"Global Knowledge Network for Health Equity (GKNHE): Key activities","URL":"https://www.who.int/groups/global-knowledge-network-for-health-equity","author":[{"literal":"WHO"}],"issued":{"date-parts":[["2025"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (42) . Support learning systems for EH f A EHfA requires a transition towards new collective goals which will require constant attention to generating intelligence both on new challenges (e.g. healthy ageing) and on what works to address them. In every country, establishing a learning health system - defined as a health system skilled at creating, acquiring, interpreting, transferring, and retaining knowledge, and at purposefully modifying its behaviour to reflect new knowledge and insights – should be an area of investment ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"JmsE2Mt3","properties":{"formattedCitation":"{\\i{}(43)}","plainCitation":"(43)","noteIndex":0},"citationItems":[{"id":522,"uris":["http://zotero.org/users/local/KFpzm6Se/items/8FR7JCYU","http://zotero.org/users/16750821/items/8FR7JCYU"],"itemData":{"id":522,"type":"book","abstract":"_Hlk62644904 -- _Hlk62936474 -- _Ref69901250 -- _Ref69903529 -- _Hlk69986883 -- _Hlk63410043 -- _Hlk69984816 -- _Hlk57649355 -- _Hlk57648958 -- _Hlk69889473 -- _1phytgo3klz8 -- _Hlk43936417 -- _lmex9u15okaw -- _8i7biwwqnv2q -- _v1n0be7c2gc6 -- _9rgrx3ey0hqr -- _f9ewydokl2pa -- _ig94x9dt8y46 -- Barbados - Co-developing a climate-informed dengue early warning system in Barbados -- Benin and Guinea - Using digital tools to advance learning among health district management teams in Benin and Guinea -- Burkina Faso - Learning from experience for the abolition of user fees for women's and children's health care in Burkina Faso -- China - A learning approach to strengthen neonatal care in poor counties of China -- Georgia - Deployment of evidence in Georgia's national response to COVID-19 -- Ghana - Health systems learning at sub-national level to establish nurse anaesthesia training in Ghana -- Guatemala - Learning for participatory governance in Guatemala's health system -- India - Learning from the Nipah virus outbreak to inform the COVID-19 response in Kerala, India -- Indonesia - Learning for health equity: the DaSK dashboard for universal health coverage in Indonesia -- Lebanon - Learning to get a fair deal for hospital care in Lebanon -- Mozambique - Addressing neonatal mortality in Mozambique through a peer-to-peer learning intervention at district level -- Nigeria - How Nigeria's experience with Lassa fever helped the country prepare for COVID-19 -- Republic of Korea - Learning from the MERS experience for a rapid response to COVID-19 in the Republic of Korea -- Box 1. Individual- and team-level learning in Benin and Guinea: visualization and collective interpretation of district health management data","edition":"1st ed","event-place":"Geneva","ISBN":"978-92-4-003221-7","language":"eng","number-of-pages":"154","publisher":"World Health Organization","publisher-place":"Geneva","source":"K10plus ISBN","title":"Learning Health Systems: Pathways to Progress. Flagship Report of the Alliance for Health Policy and Systems Research","title-short":"Learning Health Systems","author":[{"literal":"Sheikh K"},{"literal":"Abimbola S"}],"issued":{"date-parts":[["2021"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (43) . A large array of actions can be considered. For instance, member states can establish ‘policy labs’ that experiment with integrated solutions relevant for the HfA agenda . Globally WHO can work with other partners to strengthen normative products and evidence informed global public goods, sharing knowledge and expertise and enabling countries to learn from one another. Likewise , linking networks with global economic f ora (such as the G20) can be facilitate emerging approaches for EHfA to inform global co-ordination around health and economic policy. Learning systems must also reflect the local , informing solutions at grassroots and community level , and ensuring those lessons reach those designing policy action and investment . New platforms may need to be developed to encourage policy makers, researchers and experts (mayors, civil servants, staff of specialised agencies, representatives of labour unions, researchers, etc.) to participate to transnational peer-to-peer learning. It is important to fully document experiences (e.g., case studies) and share lessons, supported by international meetings and study tours. Evidence for EHfA P lacing H f A at the centre of national, regional, and global economic policy and action will require a strong commitment to science. It will require the generati on of new evidence exploring and further understanding and establishing the linkage EH f A policy and impact . Interdiscip linary research particularly between health, economics and social sciences is key for success, but may require new funding streams, in both academic and operational research communities , in the light of disciplinary silos ( Box 10 ) . Figure SEQ Figure \* ARABIC 8 : Overview of priority actions Define a research agenda towards EHfA The EH f A approach is broad and requires further de termin a tion and prioritisation of global and national evidence needs . A clear research agenda will help advocate for research funding to inform EHfA as a research priority . The definition of this research agenda must be conducted together with both policy makers and those stakeholders and communities potentially impacted by the research or policies the research is aimed to inform . The research agenda should be closely linked to and contribute to a structured emergence of the evidence and provide a roadmap for the joint effort by policymakers , funders, academics and the civil society . Some examples of potential priority research gaps are presented in B ox 1 0 . Develop approaches to engage stakeholders at different steps of the EHfA research process Engaging stakeholders at different stages of the research process is essential for ensuring that evidence is relevant, trusted and used effectively. Approaches should be developed to involved policymakers, practitioners, civil society, affected communities and the private sector throughout the research cycle. Inclusive engagement helps align research with real world needs and builds shared ownership of results. Approaches may include, for example, co-design workshops, advisory groups, policy dialogues and community consultations. Box SEQ Box \* ARABIC 10 : Example s of research gaps Understanding experiences in developing and using dashboard of multidimensional indicators for policymaking Developing composite metrics of social progress to supplement traditional economic metrics Reviewing the impact of fiscal, monetary, industrial and trade policies and of economic structures on HfA Review experiences in transitioning towards EHfA and wellbeing economies at subnational and national levels. Reviewing experiences and lessons learnt in public-private partnerships and investment models for HfA at national and subnational levels Developing a health taxonomy to classify economic activities based on their impact against a common set of public health priorities and inform the financing of HfA ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"b62pxCGL","properties":{"formattedCitation":"{\\i{}(44)}","plainCitation":"(44)","noteIndex":0},"citationItems":[{"id":1118,"uris":["http://zotero.org/users/16750821/items/RJIPS69D"],"itemData":{"id":1118,"type":"article-journal","container-title":"Bulletin of the World Health Organization","DOI":"10.2471/blt.24.291362","ISSN":"0042-9686, 1564-0604","issue":"5","journalAbbreviation":"Bull World Health Organ","language":"en","note":"publisher: WHO Press","page":"360-362","source":"Crossref","title":"A taxonomy for the financing of health for all","volume":"102","author":[{"family":"Huang","given":"Vanessa"},{"family":"Obrizan","given":"Maksym"},{"family":"Jardon-Pina","given":"Juan"}],"issued":{"date-parts":[["2024",5,1]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (44) D eveloping a m atu r ity framework to assess country capacities on EHfA Explore whether monetary p olicy is fit for purpose during health shocks Policy solutions and processes for countries to transition away from health-harming industries and fossil fuels . Exploring how aging, health and the economy interact and how different sector contribute to health and wellbeing at different life stages Protect science and evidence informed policy Manipulating evidence and public messaging is one of the strategies adopted by some industrie s and interest groups to preserve market dominance, protect profits or delay regulation ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"TYvvC5IG","properties":{"formattedCitation":"{\\i{}(45)}","plainCitation":"(45)","noteIndex":0},"citationItems":[{"id":1072,"uris":["http://zotero.org/users/16750821/items/6PJDIY22"],"itemData":{"id":1072,"type":"book","abstract":"This report highlights the substantial impact of commercial determinants on noncommunicable diseases (‎NCDs)‎ in the WHO European Region. Nearly 7500 deaths per day in the Region are attributed to commercial determinants, such as tobacco, alcohol,processed food, fossil fuels and occupational practices. These commercial products and practices contribute to 25% of all deaths in the Region. The report’s chapters systematically explore various facets of how commercial interests exacerbate NCDs and key strategies used by commercial actors to negatively influence NCD-related policies at the national and international level. The reportalso provides selected case studies from the Region to illustrate key strategies and outcomes of industry influence on health policies.The report then calls for urgent and coordinated action to address the commercial determinants of NCDs. It advocates for building coalitions based on the values of equity, sustainability, and resilience. Public health actors are urged to develop competencies in economic and legal frameworks, enforce transparency, and manage conflicts of interest effectively. The report underscores the need for robust financial reforms and strict regulation to curb industry power and protect public health. By implementing these strategies, the Region can accelerate progress towards global NCD targets and Sustainable Development Goals by 2030.","ISBN":"978-92-890-6116-2","language":"en","license":"CC BY-NC-SA 3.0 IGO","note":"Accepted: 2024-06-04T21:30:23Z","publisher":"World Health Organization. Regional Office for Europe","source":"iris.who.int","title":"Commercial Determinants of Noncommunicable Diseases in the WHO European Region","URL":"https://iris.who.int/handle/10665/376957","author":[{"literal":"WHO European Region"}],"accessed":{"date-parts":[["2025",4,29]]},"issued":{"date-parts":[["2024"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (45) . Governments must strengthen transparency, support independent research, invest in public research institutions and limit industry participation in policymaking for health-harming products. Clear communication guidelines, media monitoring and support for evidence-based public health messaging are essential to counter disinformation , eng aging civil society and independent experts further ensures accountability and public trust in science informed policies. Identify existing databases, surveys, actors and processes to better understand the economic determinants of ill health , and effects of existing or new policies Exploring relationships between individual health and economic activity can benefit from further linkage of research capacity and datasets. G roups exposed to risks (e.g. farmers, adolescents) should be groups of attention and equity a dimension of analysis. Insights on the impact of economic practices or policies on HfA may gain from greater interoperability across national anonymised individual databases generated by different sectors and schemes (e.g., by connecting income tax, employment, social health insurance, invalidity datasets) and by combining them with more contextual data for instance, through geolocation. Strategy i mplementation Successful implementation of the GSEHfA will require decisive action by the WHO Secretariat, strong engagement from national and international stakeholders, and support from key actors working with Member States, especially those targeted by the strategy. C ross-cutting normative, technical, analytical, and engagement components—subject to available resources—will be developed , building on existing guidance in health economics and financing, to strengthen WHO’s capacity in E HfA, and support national authorities to adopt an EHfA approach. Implementation will vary across Member States, aligning with their specific needs, priorities and contexts . WHO will also build on its existing guidance and technical capacity in economics and financing to coordinate activities support in a more structured and strategic way. However, the centre of EHfA is collaboration across sectors, so while WHO can act to support Ministries of Health, it will need to work with other multi-lateral agencies focussed on economic policy and investment in health. Countries will want to work at a different pace, but broad p riorities for the WHO will be: Coordinate across WHO to w ork with Member States to develop actions and assess capacities to implement EHfA . This agenda entails a broadening of the scope and deepening of the support that WHO provides , through economic analyses and guidance , to its member states . I t is anticipated that Member States will develop and implement their EHfA strategy at different speed s . Establish a network of stakeholders working on economic policy, investment and financing . These stakeholders include but are not limited to other bodies in the United Nations system; other intergovernmental and international organizations; donors and aid agencies; non-State actors such as foundations, nongovernmental and civil society organizations; development banks; universities and research institutions; the private sector, including the financial sector. To develop relevant normative products . The WHO will , subject to resources, provide global public goods to support EHfA. These p ro grams of work will reflect priorities identified jointly with member states and stakeholders . To balance shorter term deliverables with longer-term impact. WHO . within its action plan subject to resources, will support countries with varying fiscal capacities and governing structures on ways to adapt the strategy, given social, economic and political opportunities to advance this agenda. 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WORLD HEALTH ORGANIZATION ORGANISATION MONDIALE DE LA SANTÉ REGIONAL OFFICE FOR EUROPE BUREAU RÉGIONAL DE L'EUROPE WELTGESUNDHEITSORGANISATION ВСЕМИРНАЯ ОРГАНИЗАЦИЯ ЗДРАВООХРАНЕНИЯ REGIONALBÜRO FÜR EUROPA ЕВРОПЕЙСКОЕ РЕГИОНАЛЬНОЕ БЮРО WHO Global Strategy on the Virtual Meeting Economics of Health for All https://who.zoom.us/j/98135188912 European Regional Consultation Meeting ID: 981 3518 8912 Passcode: WHOVen-25 06 June 2025 11:15-12:30 CET Provisional programme Friday 06 June 2025 Time (CET) Programme information 11:15–11:25 Welcome and introductions from the Co-chairs • Taru Koivisto, Deputy Director General, Ministry of Social Affairs and Health, Finland • Chris Brown, Head, WHO European Office for Investment for Health and Development 11:25–1150 Presentation of the Global Strategy on the Economics of Health for All • Bruno Meessen, Senior Health Financing Adviser, Health Financing & Economics Department, WHO HQ • Edith Patouillard, Senior Health Economist, Health Financing & Economics Department, WHO HQ 11:50–12:00 Practical examples from the WHO European Region • Chris Brown, Head, WHO European Office for Investment for Health and Development 12:00–12:10 Presentation of the consultation feedback process for the Global Strategy for the Economics of Health for All • Sabere Traore, Technical Officer – International Health Partnerships for UHC2030, Health Financing & Economics Department, WHO HQ 12:10–12:20 Questions & Answers • Chris Brown, Head, WHO European Office for Investment for Health and Development – facilitator 12:00–12:30 Wrap-up and closing remarks on next steps • Taru Koivisto, Deputy Director General, Ministry of Social Affairs and Health, Finland • Chris Brown, Head, WHO European Office for Investment for Health and Development