Securing funds for health promotion: lessons from health promotion foundations based on experiences from Austria, Australia, Germany, Hungary and Switzerland

Abstract

Worldwide, countries face the challenge of securing funds for health promotion. To address this issue, some governments have established health promotion foundations, which are statutory bodies with long-term and recurrent public resources. This article draws on experiences from Austria, Australia, Germany, Hungary and Switzerland to illustrate four lessons learned from the foundation model to secure funding for health promotion. These lessons are concerned with: (i) the broad spectrum of potential revenue sources for health promotion foundations within national contexts; (ii) legislative anchoring of foundation revenues as a base for financial sustainability; (iii) co-financing as a means to increase funds and shared commitment for health promotion; (iv) complementarity of foundations to existing funding. Synthesizing the lessons, we discuss health promotion foundations in relation to wider concerns for investment in health based on the values of sustainability, solidarity and stewardship. We recommend policy-makers and researchers take notice of health promotion foundations as an alternative model for securing funds for health promotion, and appreciate their potential for integrating inter-sectoral revenue collection and inter-sectoral funding strategies. However, health promotion foundations are not a magic bullet. They also pose challenges to coordination and public sector stewardship. Therefore, health promotion foundations will need to act in concert with other governance instruments as part of a wider societal agenda for investment in health.

Financing Public Health in Europe

“…The problem is particularly acute where funding mechanisms are not linked to health financing as a whole, but rather ad hoc or based on external funding [14,34]. Several countries, including Austria and Switzerland, have established foundations for health promotion [35,36]. Both foundations pursue co-financing, which may have increased health promotion expenditure from other sectors [36].…”

“…Several countries, including Austria and Switzerland, have established foundations for health promotion [35,36]. Both foundations pursue co-financing, which may have increased health promotion expenditure from other sectors [36]. Some of the most successful health promotion activities have been implemented in the Nordic countries [37], such as the oftencited North Karelia project in Finland [22].…”

“…The Austrian Health Promotion Foundation, for example, has since 2009 offered full financing to projects by small-and medium-sized companies, as these were perceived to be most affected by the economic crisis [36]. It is also noteworthy that the share of total health expenditure spent on public health has changed little in most countries in the years 2008-2010 (Table 1).…”

Comparing selected countries using sin tax policy in sustainable health financing: Implications for developing countries

“…The first goal of this law was to increase the price of tobacco and thus to reduce its consumption. The second goal was to allocate tobacco tax revenue to health promotion activities . The health department supports increased tobacco tax as an important mean for reducing tobacco use and its health effects.…”

The case of national health promotion policy in Australia: where to now?

“…16 Funding by and action through state and commonwealth governments, health promotion foundations, non-government organisations and local government was, and still is, seen as an important contribution in this regard. 1,14,17 Other considerations included moving beyond rhetoric; committing to sound, long-term investment; tackling perceived priority issues such as obesity, alcohol misuse and smoking; and a greater investment in efforts to 'close the gap' in Indigenous health outcomes. 16 Advocating for further action in health promotion was not necessarily a new concept.…”