It is an exciting time for Public Health in Europe because of the many interesting and fast moving issues involving policy making, training and service provision, which are of local, European and global nature. Among the many stakeholders involved in the process, the population is taking an active role in inducing changes to the system, which were never possible only a few years back. 

Populations, more conscious of their rights, are requesting more and better health services and care in order to attain a higher quality of life. In the meantime, progressively, they require that services be based on scientific evidence and, sometimes, they themselves provide the evidence.  

Health systems are confronted with new and constantly emerging needs. The ageing of the population, with the heavy load of chronic and degenerating diseases, cancer and other costly health problems, require ongoing monitoring and adjustments. To meet the increasing needs Managers, require highly skilled personnel, advanced, effective and efficient health and information technologies, and conspicuous financial resources. Personnel must be capable, not only to deal effectively with clinical cases but, also, to manage human, financial, technological and material resources. Meanwhile, technologies keep on evolving, driven on by research and by the market, while health institutions often lack the evaluation experience that is necessary to effectively manage the offer and the demand for new technologies. At the same time, an increased need for funds faces diminishing financial availability due to a rampant economic conjuncture, hence the need to rationalize scarce resources.  

Yet, the “health universe” is a very fragmented space, with each institution working in isolation, sometimes in competition with one another, and certainly, growing more and more distant from the real problems of the community they serve. This results in un-coordinated, ineffective and inefficient services with high economic, but also social, costs to the system and to the population. The latter certainly bears the heaviest burden.  

To add to the complexity, the free movement of persons, services and professionals in Europe poses some exciting challenges and yet some destabilising dilemmas. Global movements of populations, through legal or illegal immigration and massive tourism, still present unsolved ethical, economic and public health questions of growing importance. 

Fortunately, politicians are gradually starting to appreciate that health is not a “medical product” and that most health determinants originate in other life spheres, a good portion of these deriving from socio-economic areas. Therefore, most politicians’ and administrators’ decisions can affect the health of populations, even though these deal with employment, industry, the environment, transport, land tenure, city plans, immigration, to name a few. Therefore, the need is becoming more manifest for scientific evidence, also in the political and administrative decision-making process.  

These are some of the signs, or results, of macro and micro changes affecting Public Health in Europe. The question is whether Schools of Public Health are ready to meet the many challenges posed by these old and new paradigms on time. Do Schools of Public Health in Europe patiently wait till they are surprised by changes before they react or do they anticipate changes and support their evolution through training and research? Do they move fast enough to keep up with innovations? This conference offers a superb opportunity to discuss what our institutions are doing in meeting these challenges.  

Are Schools of Public Health in Europe ready to undertake courageous renovations, from joining the quality innovators, to re-engineering curriculum development and training methods and tools? It is springtime for our Schools, a time to assume an enthusiastic and proactive role in foreseeing and in creating changes for better policy, for excellent training and for a higher quality of life for our populations. Some of these roles are the subjects of this conference. Additionally, a reflection is proposed regarding insularity and Public Health. Islands face additional burdens about which not much is being said or done. This conference will set the stage for islands to voice their concern, to share their experience and to propose sustainable solutions.