Meeting of small countries takes the life-course approach forward in the context of Health 2020


Health promotion and disease prevention throughout the life course was one of the main themes at the meeting of countries of the WHO European Region with a population of less than 1 million held in Andorra on 2–3 July 2015, "Taking forward Health 2020: small countries at the forefront of the whole-of-government approaches to health". These eight countries—Andorra, Cyprus, Iceland, Luxembourg, Malta, Monaco, Montenegro and San Marino—have a significant advantage in promoting and implementing policies and strategies for health and well-being by contributions of many sectors. They are ideal settings for aligning national policies and programmes for implementation of Health 2020, and their experience can provide useful lessons for use at regional level.

Small countries and the life-course approach to health

The life-course approach focuses on how the health outcomes of individuals and the community depend on the interaction of multiple protective and risk factors throughout people's lives. This approach provides a comprehensive vision of health and its determinants. Pregnancy, the transition to adolescence, choosing a life companion, becoming a parent, retiring from the workforce: each is an opportunity to promote and protect health, with immediate and long-term impacts on the present and the next generation.

After an introduction by Dr Gunta Lazdane on the life-course approach, one of the priorities of Health 2020, ministers and representatives of the eight countries participated in a panel discussion, to discuss:

  • good practices in the life-course approach and lessons learnt for actions in the small countries within whole-of-society approaches to create supportive environments and resilient communities;
  • reducing the health divide and increasing multisectoral cooperation, with a focus on investing in health throughout the life course; and
  • the involvement of the small countries in the upcoming WHO European Ministerial Conference on the Life-course Approach in the Context of Health 2020, including reviewing common actions on health promotion and disease prevention throughout the life course.

A broad range of examples was covered, from national health policy for the life course, with specific attention to maternal, newborn, child and adolescent health, healthy ageing, policies related to gender, the disabled and migrant populations and development of national Internet portals to improve population understanding of various health topics. 

In her closing remarks, Dr Zsuzsanna Jakab, the Regional Director of WHO/Europe, cited promoting breastfeeding as an example of a life-course approach to health. She said that improving health literacy should be a goal in all national policies, assisting Member States in using health promotion settings such as schools, regions, cities, workplaces and families. Dr Jakab noted the importance of focusing on child development before 5 years of age for life-long health gains and said that the programme of the life-course conference in Minsk, Belarus, would include intergenerational processes.

Andorra Statement, to be read at the opening ceremony of the life-course conference in Minsk, Belarus

Following the example of the San Marino Manifesto endorsed in 2014 at the end of the first high-level meeting, small countries have united their voices in the Andorra statement on health promotion and disease prevention throughout the life course as one of the key elements of Health 2020. Small countries will share the messages of the Andorra statement with other countries of the WHO European Region during the Regional Committee meeting in Vilnius, Lithuania, on 14–17 September 2015 and the WHO European Ministerial Conference on the Life-course Approach in the Context of Health 2020 to be held in Minsk, Belarus, on 21–22 October 2015.