European Union

In the European Union, Health in All policies was first established in the context of Public Health Article 152, which in the Lisbon Treaty became Article 168 in the context of ensuring a high level of health protection in all policies. This was a reflection of the previous BSE crisis and other public health problems, which had caused difficulties in the implementation of internal markets. Health in All Policies became explicitly articulated during the Finnish Presidency in 2006. This included Council conclusions on the matter. 

Since then the challenge of Health in All Policies has been its implementation as part of overall policies in the European Union. Discussion and debate has been raised in relation to the lack of health considerations as part of the European Union integrated impact assessment procedures. Further concerns have been drawn to the ways in which this process prioritises the assessment of costs to industries in comparison to health and social impacts (Ståhl, Smith), the relationship of these efforts to creating further barriers to the establishment of health and environmental regulation, as well as the role of the tobacco industry in this process.

HiAP is thus still a major challenge in the European Union. For example, the Common Agricultural Policy (CAP) has been successful in acquiring improved food security in terms of chemical and microbiological food safety, and has recently decided to remove the subsidies on tobacco; yet in the light of rising European health challenges – such as those linked to obesity, high cholesterol and increasing prevalence of diabetes, as well as increased use of alcohol in some countries – plenty of room still exists for strengthening the ways in which health implications are taken into account in relation to CAP stability and growth. 

It is of crucial importance that HiAP is taken seriously in the context of internal markets, EU industrial policies and in relation to commercial policies and bilateral and multilateral trade and investment negotiations. This may require a further focus on political accountability and the necessity to inform policy-makers as a separate and broader avenue for the articulation of health and health policy concerns than simply undertaking or contracting out the undertaking of an integrated impact assessment.