The life-course approach through the Andorra statement

At the beginning of July 2015, the 8 Member States of the WHO small countries initiative signed the Andorra Statement to reiterate their commitment to implementing the Health 2020 framework and its principles and approaches into national policies, strategies and plans. The occasion was the Second High-level Meeting of the WHO small countries initiative, which took place in Soldeu, Andorra. The meeting participants were the WHO Regional Director for Europe, Dr Zsuzsanna Jakab, and ministers and delegates of the eight countries in the WHO European Region with a population of less than 1 million people: Andorra, Cyprus, Iceland, Luxembourg, Malta, Monaco, Montenegro and San Marino.

This annual meeting represents a unique opportunity for small countries to share their national experiences and actions, and to build common strategies. The main idea of the initiative is that small countries, despite having diverse circumstances and because of their unique social ecology, provide the ideal settings to carry forward this 21st-century concept, based on a life-course approach to health promotion and prevention.

The Andorra Statement states that "we are aware of equally convincing evidence which indicates that health promotion and disease prevention programmes in early stages of life are not only cost-effective, but are also investments which bring high returns in terms of economic, social, development and equity." "We are to ensure that every opportunity for health enhancement and disease prevention is taken starting from pre-conception, to pregnancy and other critical periods in one's life." (1).

The goal of the Andorra Statement is to reconfirm the key messages of the San Marino Manifesto, signed during the first high-level meeting hosted by San Marino in 2014: from the whole-of-government approach to health promotion to the main goal of reducing health inequities. To do that, the small countries will focus on collecting "high-quality evidence and data to report on and monitor progress and to explore innovative forms of governance", involving people, health professionals and media in the process. "Small countries can provide crucial elements to foster best practices for the life-course approach with our structural, strategic and innovative strengths – setting an example for other countries." (1).