Ms Suzanne Costello:

I thank the Chair, Deputies, Senators and Members of Parliament for the opportunity to attend the committee and discuss our work. It is our first opportunity to do so, and we are delighted to be here. The IPH was set up as a North-South agency prior to the signing of the Good Friday or Belfast Agreement in 1998, and in 2023 we marked 25 years of helping to shape public health policy in Ireland and Northern Ireland. The impetus to establish the institute came from public health officials who recognised that a geographical border offered no protection against disease or ill health, and that policymakers, North and South, faced similar challenges in promoting and supporting public health.

Public health is often described as the science and art of preventing disease, prolonging life and promoting health at population level. This requires expertise across a range of specialist domains, including health improvement, infectious disease control, screening and service development. The remit of the institute is to inform public policy with the aim of improving population health and reducing health inequalities. Health inequalities are the unfair and avoidable differences in people's health across different groups in society caused by social, economic, and environmental factors, for example, differences in life expectancy or the prevalence of chronic diseases. As such, we work across a range of public health policy areas, including, but not limited to, alcohol harm, tobacco control, skin cancer prevention, physical activity, ageing and gambling harm, as well as the broader socioeconomic and environmental determinants of health.

The IPH is jointly funded by the departments of health in Ireland and Northern Ireland and supports both in the development and evaluation of policy. The institute has an annual budget of just over €2 million, and a staff team of 20 people between Belfast and Dublin.

We have included some examples of our all-island work, the first of which is the joint public health conference. IPH has hosted the Joint North South Public Health Conference for several years, bringing together over 1,000 academic, policy and public health partners from North and South each year. The 2025 event, which took place a number of weeks ago, focused on tackling the commercial and political determinants of health through policy and practice, while previous conferences addressed health inequalities and climate change and health.

IPH is a co-lead in a four-year PEACEPLUS cross-Border partnership to improve air quality and health across the island. The €6.5 million PEACE-Air partnership, announced by the Special EU Programmes Body, involves academic institutions, councils and environmental policy leads in both jurisdictions. IPH will translate research findings into tangible policy recommendations to reduce the impact of poor air quality on health, improve quality of life and reduce avoidable mortality.

IPH contributes to specialist training in public health and currently offers training opportunities for public health specialist registrars in Northern Ireland. My colleague, Dr. Mack, is a registered supervisor for public health specialty registrars in both the UK and Ireland.

While great work is being done, there remains potential for enhanced all-island co-operation. There is scope to build on the existing North-South co-operative arrangements in health within the Good Friday, or Belfast, Agreement. While the emphasis to date has been on healthcare co-operation, such as the successful arrangements for cardiac, paediatric and ambulance services among other treatment agreements, there is potential to address shared public health challenges by enhancing co-operation on island-wide approaches to population health and well-being. Developing an all-island public health dataset is a critical tool for future public health initiatives, as the lack of comparable local-level data presents significant challenges in designing all-island solutions to key public health challenges. There is also an opportunity to build on the impact and value for money delivered by North-South agencies and government-funded programmes through the use of EU border solutions and governance frameworks. For example, this could involve developing a unified governance framework for non-implementation entities, the application of the BRIDGEforEU regulation, and wider support of the b-solutions mechanism for cross-Border challenges.

Our health and well-being are shaped by many factors or determinants of health, such as social, economic, environmental, and commercial factors that are often outside of the control of individuals. However, many of these factors can be addressed through a health-in-all-policies approach and our work seeks to ensure public policies in both jurisdictions safeguard health and are based on the best available evidence. The institute is prioritising several programmes of work to address shared public health challenges, such as alcohol harm, air pollution, skin cancer prevention and specialist training. In summary, we wish to make the following recommendations with respect to enhancing North-South co-operation, namely, that we should build on the existing North-South co-operative arrangements to address shared public health challenges, develop an all-island public health dataset and to avail of the EU border solutions and governance frameworks to optimise how all-island agencies operate.

I thank members for their time; we are happy to answer any questions.