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Financial sustainability for health promotion and health equity

Investing in health promotion and prevention is an efficient way to reduce the burden on health care services. However, the rate of investment on prevention is persistently low – the latest figures suggest 3% of health budgets in 2017. There is a clear need to improve understanding of how health promotion can be financed, and build bridges between financial decision makers, investors, policy makers, and project implementors and designers.

Over the last year, much of EuroHealthNet’s work has focused on how to ensure financial sustainability for health promotion. Our activities include:

  • A seminar on innovative financing and investments for health
  • A statement on the need to improve approaches to financing
  • Building members’ capacity to use novel finance instruments for health promotion
  • Contributing to the Steering Board of partners for social infrastructure investment
  • Developing a Guide to Financing Health Promoting services
  • Collaborating on the European Structural and Investment Funds for Health project.
Country Exchange Visit
Sofia, Bulgaria. 13- 14 November 2018

Health Inequalities, de-institutionalisation and social inclusion of people with chronic diseases and mental ill-health

This exchange, hosted by the Bulgarian National Centre of Public Health and Analyses, covered four topics: health and social inclusion, including current work in Bulgaria on health promotion and prevention; mental health and wellbeing, including an exchange on best practices and a visit to a centre for psychosocial rehabilitation; the inclusion of people with chronic non-communicable diseases, looking at how to strengthen existing and innovative approaches; and action on chronic diseases at the EU level. The discussions also involved the WHO Europe Country Office and considered relevant examples from the Netherlands, Portugal, Italy, France, Hungary and Slovenia.

Read the report

Exploring modern financing for health promotion and prevention

EuroHealthNet’s Annual Meeting including a Seminar is an opportunity for the entire Partnership to discuss priorities. During the General Council meeting we discuss our own strategy, programme of work, and how to tackle shared challenges. The seminar, open to the public, highlights one key issue and explores how progress can be made. In June 2018, the events took place in Brussels, with a specific focus on financing.

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Smart Investments – Let’s talk prevention: Innovative financing and investments for health promotion.

The 2018 seminar addressed strategic investments for health promotion and disease prevention in Member States and at EU level.  How can the shift to prevention and promotion be financed? How can available funds and untapped resources be used for health promotion? What actions within and outside the health system could support system change? The seminar was hosted by the Permanent Representation of the Federal Republic of Germany to the European Union, Brussels. A total of 121 participants from 22 countries took part.

The seminar was divided into four sessions covering

  1. The need for the shift in funding to health promotion and disease prevention
  2. How to ensure clever use of available funds for health promotion?
  3. How to set up innovative structures for funding health promotion?
  4. How to encourage Member States to take specific actions within their powers to advance investment shifts?
Read the about the presentations and results in the seminar report.


The speakers included Vytenis Andriukaitis, European Commissioner for Health, as well as representatives from the OECD, a WHO Collaborating Centre, the European Policy Centre, the European Commission Directorate General for Employment and Social Affairs, the Council of Europe Development Bank, and the German Ministry of Health. Representatives from EuroHealthNet members SALAR, BZgA, and Public Health Wales also spoke.

Smart Invest ConferenceSmart Invest ConferenceSmart Invest ConferenceSmart Invest ConferenceSmart Invest ConferenceSmart Invest Conference

Calling for new and improved approaches to financing for health promotion and health equity

Following the seminar, the General Council issued a call for investors to focus and increase their attention on benefits of health promotion, disease prevention, and social equity.

Read the statement

Building knowledge and capacity for better financing

Financing is a persistent issue for health prevention and promotion, which attract only around 3% of health budgets7. To improve the situation, health professionals need to better understand the world of finance, and finance professionals need to understand the world of health. A common language needs to be found, along with better ways to measure value and returns on investments in prevention initiatives.

Building capacity on novel finance instruments for Health Promotion

EuroHealthNet organised a capacity-building workshop 17 October 2018 to engage our partners in exploring new forms of finance. Some financial instruments, such as social impact bonds or crowdfunding initiatives, have the potential compliment funding for health, wellbeing, and equity in Europe. Their use, however, will require new competencies and investment in human resources, knowledge, and collaborations with the financial sector. The workshop included practical sessions on different financial tools.

Guide to Financing Health Promoting Services

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In collaboration with the WHO Coalition of Partners

‍A Guide to Financing Health Promoting Services in collaboration with the WHO and IUHPE. The guide will include advice and case studies to encourage the uptake of innovative financial tools that can contribute to the sustainability of services. It is designed for line managers, decision makers and lead practitioners who are responsible for the design, organisation and overseeing of the delivery of public health and health promoting services at different levels (local, regional, and national). In addition, it will target health planners and decision makers who deliver services and influence policies in other sectors that contribute to health and wellbeing, and other professionals in sectors which influence health.

COP November 2018

Contributing to the Steering Board for social infrastructure investment

EuroHealthNet, alongside representatives of organisations from social services, education, social housing, and ageing sectors, has formed the Steering Board for Social Infrastructure investment. The Steering Board is specially focused on monitoring of and engagement with plans for InvestEU and in particular its 4th window on social infrastructure investments. Outputs of the steering board include a one-day symposium on 18 October 2018 on the role of the European Union in unlocking the much-needed investment into local innovative social infrastructure projects, solutions to current funding bottlenecks, and how the future InvestEU programme can be used. On 22 October the Board presented a scoping note and statement to the cabinets of Commissioners Thyssen (Employment, Social Affairs, Skills and Labour Mobility) and Katainen (Jobs, Growth, Investment and Competitiveness). In addition, direct feedback on the ‘social window’ in the new InvestEU plan has been given to the Commission.

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Participating in Structured Dialogue with European Structural and Investment Funds’ partners group of Experts.

To ensure that we are at the forefront of developments with the field of finance, funds, and investment, we have actively participated in a series of workshops and dialogues throughout the last year. Structured dialogues on the European Structural and Investment funds have been and will continue to be an opportunity for us to speak on our members’ behalf and to make sure that health promotion is considered by policymakers, advisors, and groups within in Brussels and wider European networks.

7. European Commission, State of health in the EU Companion Report 2017 https://ec.europa.eu/health/sites/health/files/state/docs/2017_companion_en.pdf

Making the connections with health promotion and innovative finance

The European Structural and Investment Funds for Health (ESI Funds for health)

ESIFunds logo

For the ESI Fund for Health project we explored the impacts of ESIF on health in the 2014-2020 period by mapping Member State programming and project spending. The aim was to uncover the extent to which the funds are supporting different types of health-related interventions. The project also compared spending trends with the main EU policy objectives, as well as relevant national objectives set out in the European Semester process. A review of funded projects found 7,404 health-relevant projects, of which 2,535 projects across twenty-three Member States addressed health promotion and disease prevention. This includes projects that focused on active and healthy ageing and healthy workforce. The value of these projects amounts to EUR 1.9 billion. The average size of the funded projects was EUR 0.8 million, which is low compared to projects in eHealth or Health system reform. Information about many of the projects studied can be found in the ESI Funds for Health Database.

A workshop focused on ESIF for health promotion was held in Croatia in June, led by EuroHealthNet President Dr Mojca Gabrijelčič-Blenkuš. The conclusions stressed the need to take a health equity approach to future funded projects.  At the final conference, 6 and 7 November, discussions centred around how to use ESI Funds to support health investments and implications for the proposed Multiannual Financial Framework for 2021-2027. Director Caroline Costongs made the closing presentation, focussing on the new EU Programme plans and the opportunities for strengthening funding for health promotion projects and activities. Policy Advisor Clive Needle moderated a Ministerial Panel, plus a public follow up session at the EC headquarters in Brussels featuring the European Commissioners for both Health and Regional Policies. Find out more at esifundsforhealth.eu.

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This publication is supported by the European Commission, through the programme for Employment and Social Innovation (EaSI 2014-2020). This publication does not necessarily reflect the position or opinion of the European Commission.

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