Abstract

Growing levels of obesity (including among children), continued harmful consumption of alcohol, and the growing threat of antimicrobial resistance (AMR) are some of the greatest contemporary challenges to the health of European populations. While their magnitude varies from country to country, all are looking for policy options to contain these threats to population health.

It is clear that public health organizations must play a part in any response, and that intersectoral action beyond the health system is needed. What is less clear, however, is what role public health organizations currently play in addressing these problems.

This is the gap that this volume aims to fill. It is based on detailed country reports from nine European countries (England, France, Germany, Italy, the Republic of Moldova, the Netherlands, Poland, Slovenia and Sweden) on the involvement of public health organizations in addressing obesity, alcohol and antimicrobial resistance. These reports explore the power and influence of public health organizations vis-a-vis other key actors in each of the stages of the policy cycle (problem identification and issue recognition, policy formulation, decision-making, implementation, and monitoring and evaluation).

A cross-country comparison assesses the involvement of public health organizations in the nine countries covered. It outlines the scale of the problem, describes the policy responses, and explores the role of public health organizations in addressing these three public health challenges.

This study is the result of close collaboration between the European Observatory on Health Systems and Policies and the WHO Regional Office for Europe, Division of Health Systems and Public Health. It accompanies two other Observatory publications: Organization and financing of public health services in Europe and Organization and financing of public health services in Europe: country reports.

Contents

• List of figures, tables and boxes
• List of contributors
• Acknowledgements
• I. Cross-country analysis
  • 1. Introduction
    Bernd Rechel, Elke Jakubowski, Martin McKee, and Ellen Nolte.
    • The political and administrative context in the nine countries
    • Structure of the book
    • References
  • 2. Obesity
    Cristina Hernández-Quevedo and Bernd Rechel.
    • Introduction
    • Scale of the problem
    • The role of public health organizations in addressing obesity in the selected countries
    • References
  • 3. Alcohol
    Anna Sagan and Bernd Rechel.
    • Introduction
    • Scale of the problem
    • Policy responses and policies affecting alcohol consumption at the European level
    • The role of public health organizations in alcohol control in the selected countries
    • Conclusions and outlook
    • References
  • 4. Antimicrobial resistance
    Saskia Nahrgang, Ellen Nolte, and Bernd Rechel.
    • Introduction
    • Scale of the problem
    • Policy response at the European level
    • National action plans and strategies
    • National surveillance efforts
    • The role of public health organizations in addressing AMR in the selected countries
    • Conclusion and outlook
    • References
  • 5. Key policy lessons
    Bernd Rechel, Elke Jakubowski, Martin McKee, and Ellen Nolte.
    • The role of public health organizations in addressing obesity, alcohol and AMR
    • Recognizing public health challenges as such
    • The role of industry
    • Intersectoral collaboration
    • Partnerships and networks involving public health organizations
    • The need for coordination mechanisms
    • International organizations can be crucial
    • National strategies and action plans are needed …
    • … but they are often incomplete …
    • … and lack funding
    • National plans or strategies can be embedded in wider strategies
    • Even well performing countries can do better
    • Little is known about the nitty-gritty of implementation
    • Strengthening monitoring and evaluation
    • Conclusions
    • References
• II. Country reports

The European Observatory on Health Systems and Policies supports and promotes evidence-based health policy-making through comprehensive and rigorous analysis of health systems in Europe. It brings together a wide range of policy-makers, academics and practitioners to analyse trends in health reform, drawing on experience from across Europe to illuminate policy issues.

The European Observatory on Health Systems and Policies is a partnership between the WHO Regional Office for Europe; the Governments of Austria, Belgium, Finland, Ireland, Norway, Slovenia, Sweden, Switzerland, the United Kingdom and the Veneto Region of Italy; the European Commission; the World Bank; UNCAM (French National Union of Health Insurance Funds); the London School of Economics and Political Science; and the London School of Hygiene & Tropical Medicine. The Observatory has a secretariat in Brussels and it has hubs in London (at LSE and LSHTM) and at the Berlin University of Technology.

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