Countries across Europe and the World are faced with growing health, inequity, social security, economic and environmental challenges. We need urgent, innovative and priority-focused investment to ensure sustainable development for the present and future generations. Doing business as usual is unsustainable with high costs for individuals, families, communities, society, the economy and the planet. Governments can have a major impact on all factors influencing health and wellbeing, on the way people live and on their everyday choices. The interconnected nature of current challenges and possible solutions needs strong leadership, strategic and political commitment, and coherent action. It also requires new approaches and financing mechanisms building on cross-sector collaboration and citizen involvement in decision-making, i.e. participatory governance for health.