Building the European Observatory on Health Systems and Policies
This series of interviews reflects on the founding and first decade of the European Observatory on Health Systems and Policies, as told by two of its founders, Josep Figueras and Elias Mossialos interviewed by Annabel Fenton. It traces the ideas, political setting and institutional tensions behind an organisation designed to connect academia, policymaking and comparative health-systems evidence.
The focus here is deliberately on the beginnings: roughly the first ten years, from the mid-1990s to the Tallinn Charter and the early consolidation of the Observatory’s model in 2008-2009. Nearly three decades on, those first years still matter because they established the basic architecture of the Observatory: rigorous comparative analysis, country monitoring, policy dialogue, and a partnership model that could connect governments, international agencies and academic institutions.
What emerges is more than a historical narrative. It is a candid account of the vacuum in comparative health policy, the tensions inside WHO and universities, the dynamics of EU policymaking, and the evolving role of evidence in political life. Together, these reflections provide a rare, firsthand account of how an idea developed in London became an influential international partnership, and why the Observatory has shaped, and continues to shape, the practice of health policy across Europe.
The Observatory’s establishment also depended on many others whose roles deserve fuller treatment than a two-person interview allows: Martin McKee, as co-founder and research director; Suszy Lessof, who helped build the institution, its governance, management and quality systems; Reinhard Busse, who joined the Observatory and became a co-director; Charles Normand, who chaired the Steering Committee for many years; Richard Saltman, who worked with Josep on the first cross-European health systems study; and a much wider network of colleagues, partners and country experts.
