Make “Health in All Policies” a global and national priority to improve health and reduce healthcare spending long-term, says a senior Saudi health official, Dr Nouf Al Numair.

The health of a nation’s population is a critical determinant of its economic productivity, educational outcomes, and the sustainability of its healthcare systems. Yet health considerations are often overlooked in policymaking as many view them solely as the duty of the healthcare system, not recognizing that health is a shared responsibility shaped largely by policies beyond the healthcare sector.

 As a result, healthcare costs continue to rise, outpacing economic growth. A report from the World Health Organization (WHO) shows that global spending on health increased to $9.8 trillion (10.3% of global GDP) in 2021. Similarly, PwC’s Health Research Institute (HRI) projects an 8% year-on-year global increase in medical costs by 2025. This immense increase in expenditure is a result of global and national inaction.

Evidence suggests that integrating health considerations across all policy areas – commonly referred to as the Health in All Policies (HiAP) approach – yields significant benefits for population health, health equity and socioeconomic resilience. 

By addressing the root causes of poor population health and well-being, commonly known as risk factors and the underlying drivers behind the burden of disease, HiAP can reduce healthcare spending in the long run. Therefore, HiAP must become a global priority to reduce spending on treatment and shift the focus from treatment to prevention.

 HiAP is a framework that acknowledges the multidimensional influences on health, extending beyond the healthcare sector to areas such as education, employment, urban planning, and environmental policy. Health is a shared responsibility that requires collaboration across all sectors to address its social, economic, and environmental determinants.

Proactive primary prevention

Research shows that socioeconomic factors such as income, housing, and access to education play a substantial role in shaping health outcomes. For example, a 2021 study published in The Lancet demonstrates a clear correlation between cross-sector policy integration and improvements in population health indicators, particularly in non-communicable diseases and health equity.

Demographic projections and trends further emphasize the urgency of adopting the HiAP framework that promotes proactive primary prevention over reactive treatment. By 2030, an estimated 1.4 billion people–approximately one in six globally–will be aged 60 or older, with this figure expected to reach 2.1 billion by 2050.

As longevity increases, policymakers are shifting their focus from extending lifespan to enhancing health span– the number of years lived in good health while remaining economically and socially productive. 

Initiatives such as the UK’s National Health Service program, Adding Years to Life and Life to Years, and Finland’s National Health Promotion Policy underscore this transition, prioritizing primary prevention and quality-of-life improvements.

Finland’s North Karelia Project, launched in the 1970s, is a leading example of a prevention-first approach, helping reduce cardiovascular disease mortality by over 80% in four decades through dietary improvements, tobacco control, and physical activity promotion.

Multi-sectoral approach

Saudi Arabia, through Vision 2030, has made significant progress in population health over recent decades. Life expectancy has increased from 46 years in the 1960s to 76 years in 2020. 

The Saudi Ministerial Committee for HiAP, established in 2018 under a Royal Decree and chaired by the Minister of Health, institutionalizes this approach. It brings together over 10 ministries, spanning Education, Labor, Environment, Economy, Sport, Housing, and Urban Development, to align policies that promote health and to ensure they do not harm population health and health equity across sectors.

This multi-sectoral approach has made progress across the Kingdom, delivering concrete results. One example is Saudi Arabia’s initiative to reduce salt consumption, a key risk factor for hypertension and cardiovascular disease. Recognized by the World Health Organization, this initiative–led by the Saudi Food and Drug Authority in collaboration with the Ministry of Health, manufacturers, and importers–demonstrates how policy interventions targeting both supply and dietary habits can contribute to improved cardiovascular health outcomes.

These measures align with WHO recommendations for reducing premature mortality from NCDs by one-third by 2030, a key Sustainable Development Goal (SDG 3.4) as well as Saudi Vision 2030’s goal of fostering a thriving society.

The economic benefits of health-conscious policymaking are well-documented. A healthier population contributes to increased labour productivity and reduced healthcare expenditures. A 2020 analysis by the Organization for Economic Cooperation and Development (OECD) found that investments in preventive health measures generate an average return of 4:1 in economic benefits by reducing healthcare costs and improving workforce efficiency.

Sustainable health improvements

Despite these advantages, challenges remain in fully integrating health into all sectors of policymaking. Effective implementation requires a whole-of-government approach, sustained inter-ministerial coordination, governance, robust data collection and analysis, capacity building, and long-term financial commitments, strong legislative and regulatory frameworks, and continuous advocacy efforts.

However, evidence from countries with established HiAP frameworks, such as Finland and South Australia, suggests that the systematic integration of health into public policy decisions can reduce health disparities and improve national resilience. Saudi Arabia’s HiAP model provides a valuable case study for other nations seeking to implement similar frameworks.

 As healthcare systems worldwide contend with rising demands, adopting a multi-sectoral, primary preventive approach is increasingly recognized as a viable strategy for sustainable health improvements.

 Ongoing monitoring and data-driven analysis will be essential for refining and scaling such frameworks to ensure that healthy public policymaking remains a central component of national development strategies at both regional and global levels.

Governments worldwide must prioritize HiAP to enhance population health, curb rising healthcare costs and build resilient societies. Policymakers must collaborate across sectors to create long-term policies that protect and promote health. HiAP practitioners should engage in global discourse, share best practices, and invest in evidence-based strategies that advance health equity and well-being.

The time to act is now – to secure a healthier, more prosperous future for generations to come.

Dr Nouf Al Numair is the Secretary General of Saudi Arabia’s Ministerial Committee for Health in All Policies

Image Credits: Department of Labor, Saudi Arabia, World Bank Tanzania/Twitter , WHO/S. Volkiv.