The Bologna Manifesto for Sustainability and Health


The Bologna Manifesto for Sustainability and Health
Italian Network for Sustainability and Health


The present prevailing paradigm based on unlimited growth, indiscriminate pursuit and accumulation of capital without fair redistribution of wealth or upholding of human rights is not sustainable from an economic, social and environmental point of view, moreover, it is unable to safeguard the health of present and future generations.

The Italian Network for Sustainability and Health founding associations agreed upon the following statements:

  • 1) A healthcare system in isolation is insufficient to protect, promote and safeguard health; equal consideration must be given to the environmental, social, economic and cultural determinants of health. In order to achieve these goals, an alternative model, not only aimed at growth, is necessary;
  • 2) Health care is intended not only as a right to be protected, but also as common good to actively defend, through the direct and responsible participation of people and communities, and through the development and implementation of public health policies;
  • 3) Health, healthcare systems and delivery of care models must be person-centred, continuous and respond to the physical and social environment in which they are implemented. They must promote participation, enhance independence and self-determination of the individual and the community, adopt an approach that promotes treating those in illness, caring for those in need, not merely treating the disease, focussing more on “salutogenesis” (producing health) and health determinants than on the disease;
  • 4) Health and healthcare related topics must be addressed systematically to enhance the integration of different types of knowledge, health professionals and organizations. In this context we highlight the importance of promoting synergies and dialogue between (the so called) Biomedicine and Traditional and Non-Conventional Medicine;
  • 5) It is necessary to limit the prescription of inappropriate health services, to recognize the limits of medicine and science in general and to avoid the usual assumption that doing more means doing better, to prevent the medicalization of health and disease mongering;
  • 6) It is important to support the fight against fraud, corruption and conflicts of interest. It is equally essential to ensure independence and transparency in the health system and in research, in particular regarding the supply chain and marketing of medicines, medical devices and other relevant health technologies;
  • 7) Forms of organization and management of the health services based on primary health care and integration of services, social networks and non-profit organizations need to be adopted. Only this approach will promote an enabling system for the provision of safeguard and guarantees within communities;
  • 8) In compliance with the dictate of article 32 of the Italian Constitution and the Italian National Health Service Law, it is mandatory for the National Health System to preserve its universal character and to be adequately funded by the general taxation, in order to avoid disparities of access to health care. The funding criteria must be based on results in terms of health and not on “productivity” performance. It is therefore mandatory to modify the standards for the identification of the so-called Essential Levels of Assistance and the criteria of reimbursement of the services.

Taking into account the above statements, the signatory associations commit to:

a) Engaging in a process of mutual-reciprocal knowledge, integration and cooperation on topics concerning health, its determinants and conditions for sustainability;

b) Developing possible synergies, consistent with the agreed statements, in order to benefit from the specific contributions of each participating association, e.g. common project of good practices in the fields of research, education, care and cultural change;

c) Organising events of reciprocal interest;

d) Promoting specific actions, aimed at sensitizing and involving national and international institutions on topics of sustainable health care;

e) Promoting the exchange and sharing of information, experiences and documents among the members and contacts of the different signatory associations;

f) Establishing a network, named “Sustainability and Health” to promote the fulfilment of the agreed statements

Bologna, June, 14th 2014


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