Terms of reference for a scoping paper on the opportunities for engagement on European policies related to the health systems and the economy of wellbeing


The current COVID-19 pandemic has put public health and health systems at centre stage on the EU political agenda. While health systems across the EU and the world have been drained throughout the pandemic, lessons to rebuild better, more effective, and resilient are surfacing. Growing challenges need to be addressed as well, such a shortages of healthcare workforce. There is increasing consensus around the fact that health is of crucial importance to the well-being of the economy and that health investments offer high returns for society. Nonetheless, the war in Ukraine and the subsequent energy crisis threaten to push health again at the back of the policy agenda and to give space to narratives that describe health investments as irreconcilable with economic growth.

The European Public Health Alliance (EPHA) is a leading European NGO alliance advocating for better public health. It is a member-based organisation made up of public health NGOs, patient groups, health professionals and disease groups, working to improve health and strengthen the voice of public health in Europe.

Over the last years, EPHA has advocated in favour of the implementation of the Health in All Policies, sustained investments in health and health systems including (or in particular) during crises. This work has followed wider EU and international trends, including the “Economy of Wellbeing” Finnish Council conclusions (2019), the implementation of “an economy that works for people” as an EU priority, and the Sustainable Development Goals (SDGs).

In line with its 2021-2025 strategic plan, EPHA is set to explore deeper and wider engagement in European policies at the intersection of health and the economy with emphasis on health systems and post-COVID recovery.

Last year, EPHA has developed a short scoping paper reviewing literature and key policy developments on:

  • Healthcare systems and related investments
  • The economy of wellbeing and considerations on beyond GDP
  • Post-COVID-19 trends
  • Health workforce considerations

The paper also referenced past EPHA work and briefly listed potential opportunities for future work.

To support future work on this this part of its strategy, EPHA is seeking to contract a scoping study to identify promising entry points for health advocacy on health systems and the economy. The study should cover the above-mentioned areas while building synergies with EPHA’s work on other policy areas, such as healthy environments, politics and health, health inequities, healthcare delivery, digital health, and global health. The purpose of the study is to inform EPHA, its members and partners about the main opportunities for engagement in European policy processes (e.g., EU4Health programme, European Green Deal, the European Care Strategy, the EU Child Guarantee, the European Pillar of Social Rights, and the use of the Multiannual Financial Framework 2021-2027 and the Recovery and Resilience Facility), potentially allowing new partnerships to be built and opportunities to advance better health to be seized while avoiding duplications, in particular with other civil society organizations (CSOs). It should also identify the main actors, including CSOs, international organizations, EU policymakers and networks that EPHA would need to mobilise and/or engage with.


Scope of work

Building on last year’s short paper, this scoping paper should identify and describe main opportunities for health engagement in policy processes related to health systems and the economy at the EU and global level. It should consider ongoing and upcoming political developments, such as the mid-term review of the EU’s Multiannual Financial Framework (MFF), and the upcoming European elections. Additionally, the issue of healthcare workforce shortage and the recent WHO Bucharest Declaration should also be considered, regarding health systems resilience.

To identify the opportunities for health engagement, particular attention should go to areas where EPHA’s advocacy can deliver additional added value and where current gaps in health narratives and/or organisational engagement is found. The paper should also look to provide a public health perspective on how promoting wellbeing and preventing ill health via primary health care and health promotion can lead both to economic gains as well as reduced health expenditure.

The paper should also identify opportunities for projects and funding in the related fields.

EPHA intends to use the scoping paper to identify where EPHA, and potentially its members and partners in the European public health community, could put their future advocacy efforts in the health systems and the economy space, and forge synergies with those areas where EPHA is already active.


Expected output

A briefing paper featuring the contents described in the Scope of work above.

The paper should be delivered in a format ready to be made public (i.e., simple but understandable and well supported by evidence).



  • Final draft: expected by October 2023.
  • Interim stages: two interim stages are foreseen, including at the stage of:
    • outline of the paper; and
    • the pre-final draft version of the paper.

A more detailed timeline is to be agreed with the contractor.



EPHA offers a service contract with a maximum amount of 15,000 EUR (VAT included).


Application/ Expression of interest

To express your interest please contact Clémentine Richer ( by 15 July 2023 at the latest.

The communication should be accompanied by:

  • an initial outline of the proposed plan of action with reference to the scope of work; and
  • a rough budget.

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