The Dynamic Relationship Between Health And Wealth

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“You are using evidence about the dynamic link between health and economic prosperity to make the case for giving serious political attention to the performance of health systems. This is a smart move. I am pleased to note that ministers of finance and economic affairs are also present at this event. This is also a smart move. You are using evidence to show how performance assessment can work as a tool to improve health systems in targeted ways. You are using evidence to argue that investment in health systems brings results that can be measured, as better health and as greater wealth.
This is a visionary meeting, and a strategic one. I have every confidence that this conference will yield significant insights, policy options, assessment tools, and practical guidance on what works best in different settings… By stressing the dynamic relationship between health and wealth, you tell a watchful world that work to improve health systems is indeed worthy of high-level political attention. You are saying: the health sector should not be viewed as a mere drain on resources. It is also a producer of economic gains.”

In welcoming the 500 delegates to the WHO European Ministerial Conference on Health Systems organized in Tallinn, Estonia in June 2008, Dr. Margaret Chan, Director-General of the World Health Organization, encouraged the members of WHO European Region States to continue their efforts in promoting a clearer understanding of the link between health and wealth. This conference was described as a major turning point in the evolution of public health and was attended by ministers responsible for health, civil affairs, finance, and economic affairs from 52 of the 53 Member States in the WHO European Region, internationally recognized experts on health systems, representatives of international and civil-society organizations, and the mass media . The aim of the conference was to lead: a) to a better understanding of the impact of health systems on people's health and therefore on economic growth in the WHO European Region; b) to took stock of recent evidence on effective strategies to improve the performance of health systems, given the increasing pressure on them to ensure sustainability and solidarity.

The participants explored the dynamic relationships between health systems, health and wealth and discussed the four functions of health systems (service delivery, financing, creation of the health workforce and other inputs, and stewardship/governance). The conference concluded by detailing how WHO, Member States, and a range of international partners made political commitments to strengthen health systems, ultimately adopting the Tallinn Charter: Health Systems for Health and Wealth.

The welcome address by Dr. Margaret Chan and the signed Tallinn Charter are found below. The Charter states that the WHO European Region Member States commit themselves, to:

• invest in health systems and foster investment across sectors that influence health and
• ensure the health systems are prepared and able to respond crises...

( accessed on February 2009, WHO European Ministerial Conference on Health Systems “Health Systems, Health and
Wealth,” Tallinn, Estonia 25–27 June 2008: Report; see also “Health systems, health and wealth: assessing the case fore investing in health systems,” Ed J. Figueras et al. on behalf of the European Observatory on Health Systems and Policy)

Welcome by Margaret Chan:



Tallin Charter:



In Brussels, one year prior to the conference representatives from the European Commission, the European Society of Cardiology – ESC, and the European Heart Network met in June of 2007 and signed another Charter: European Hearth Health Charter- EHHC. The objective of the Charter was to encourage EU Member States Institutions to commit themselves to supporting policies and programs devoted to decreasing the impact of CVD ( The stated purpose of the Charter (February 2009) is:
“The European Heart Health Charter: For the hearts of our children”. The aim of the European Heart Health Charter is to substantially reduce the burden of cardiovascular disease in the European Union and the WHO European Region and to reduce inequities and inequalities in disease burden within and between countries. In fact the EHHC has made the following commitment:
“Every child born in the new millennium has the right to live until the age of at least 65 without suffering from avoidable cardiovascular disease”.
The questions now are:
How much is the recent worldwide financial crisis impacting health systems in Europe?
Are there intervention measures, at the country level, to ensure the health systems of each country are able to respond to this crisis?
“Health and wealth are means of achieving societal wellbeing, situated at the centre of the model, which, in turn, means that policies pursued are equitable and sustainable and, since Europe is part of a global system, the gains should not be at the expense of other parts of the world. WHO sees this model as a historic opportunity to bring about major change. Yet, this is only the beginning. The next step will be to deliver on the commitments that are being made, developing coordinated policies and establishing systems to monitor whether they achieve what they promise”. (Lancet 2009;373:349-51)

23 February 2009

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3.26 Copyright (C) 2008 / Copyright (C) 2007 Alain Georgette / Copyright (C) 2006 Frantisek Hliva. All rights reserved."

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