"The only way that chronic disease can be addressed is through [understanding] connections." Christopher Murray, Director, Institute for Health Metrics and Evaluation (IHME), University of Washington, USA

Health is an essential concern. Massive progress in healthcare was made in the 20th Century but reversals including looming pandemics and HIV/ AIDS appeared late in the Century. Today's healthcare challenges are very complex. The need to reduce maternal and infant mortality and other objectives are listed in the Millennium Development Goals but different, more recent phenomena including a decline in fertility rates and an increasingly ageing population place additional burdens on healthcare systems. In addition, mental health and injuries require greater attention.

Health is also critical to the economy. One-tenth of economic activity is attributed to healthcare; productivity and economic growth are affected by health. Yet the five Global Agenda Councils concerned with health issues identified a key paradox which they translated into an important message for all: cheap preventive strategies that guard against bad health exist - but they are undervalued and underinvested. One example given by Rapporteur Christopher Murray, Director of the Institute for Health Metrics and Evaluation (IHME), University of Washington, USA, to illustrate this point is the vision of a world without HIV/ AIDS through preventative measures and campaigns. Despite such efforts, the vision has not been achieved. Greater prevention through health promotion is necessary and requires better consideration and appreciation. Against chronic diseases, simple, effective solutions are at hand, such as tobacco control, salt reduction and regular physical exercise, all of which are manageable prevention tactics.

Along with underappreciated preventive medicine, another key concern the group highlighted are the enormous inefficiencies within the healthcare system. A new social compact embedded in national constitutions is needed, one that lists available health interventions and entitlements that can then be measured and accounted for. A related element is the critical need for information. Such information would answer the questions, "What's happening in the field? Are we making progress?" Enhanced communication on issues of health would generate a culture of evidence and accountability.

The group had three calls to action:

•	Build capacity foresight by stressing preventive medicine and measures
•	Create a set of entitlements that are actionable and measurable
•	Build the ingredients of knowledge, an information base that informs and educates

Councils focusing on Health

Global Agenda Council on: •  The Challenges of Gerontology •  Chronic Diseases and Malnutrition •  Healthcare Systems •  HIV/ AIDS •  Pandemics

Related initiatives recommended by Council Members in this area include:

•	Health professionals must engage others to prepare for pandemics by connecting with diverse multistakeholders and sectors (government, civil society, business). Health issues should be considered as societal and not exclusively as health related challenges. They are interconnected, requiring a multistakeholder approach and stronger private sector involvement.
•	Preparations against pandemics have been initiated in most countries but have far to go before they prove adequate. If nations are not prepared when the pandemic starts, its social and economic impacts will last for several months, even years. This impact can be mitigated through the scaling up of worldwide preparedness at a cost that is a fraction of the potential disruption induced by the pandemic.
•	Information on health - the collection, aggregation and analysis of data on health and its determinants - is critical to allow prioritization, benchmarking and accountability in the field. An international charter on health data would help make the information a public good accessible to all potential actors in the sector. Enhanced information can challenge vested interests.

Councils focusing on Health