EUGLOREH project
THE STATUS OF HEALTH IN THE EUROPEAN UNION:
TOWARDS A HEALTHIER EUROPE

FULL REPORT

PART IV - PROTECTING AND PROMOTING  PUBLIC HEALTH AND TREATING  DISEASES: HEALTH SYSTEMS, SERVICES AND POLICIES

12. INSTITUTIONAL AND POLICY DEVELOPMENTS AT EU AND MEMBER STATE LEVEL

12.4. Co-ordination mechanisms for EU health activities

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12.4. Co-ordination mechanisms for EU health activities

 

There are several health links with European Commission general directorates other than D.G. SANCO (Table 12.6).

 

Table 12.6. Health across the European Commission

 

Directorate General

Key Health Links

AGRI

 

Nutritional aspects in promotional campaigns for EU agricultural products,

information campaigns on smoking (funded up to 2008)

AIDCO

External aid for health

BEPA

Investing in youth

COMP

Competition rules in health markets

 

DEV

Health in EC and EU development policy, ACP country and regional

programmes, and thematic programmes for all regions

EAC

Education on healthy lifestyles; Lifelong learning; Young people and health,

Promotion of sport

ECFIN

Economic projections re: demographic change, healthcare spending

ECHO

Humanitarian aid operations. Access to healthcare in crisis situations and

rapid response to life-threatening epidemics and other health hazards.

 

ELARG

Assisting EU accession countries to put in place the health acquis

 

EMPL

Safety and Health at work; coordination of Social security schemes including

the EHIC card; access of people with disabilities to social and health services;

European Social Fund; Open Method of Coordination on Healthcare and

Long Term Care

ENTR

Pharmaceuticals; Medical Devices; Biotechnology; Safety of Cosmetics;

Chemicals; Innovation

ENV

Environmental health e.g. air quality, water quality, noise; 'European Environment and Health Strategy', COM(2003)338, and 'European Environment and Health Action Plan 2004-2010', COM(2004)416

EUROSTAT

Data collection in field of health and safety

INFSO

Development and deployment of e-Health tools and services.

JLS

Illegal Drugs; Immigration policy and integration, protection of personal data

concerning health

JRC

Scientific and Technical Support in areas which may have an impact on health directly or indirectly (chemicals, air pollution, deteriorated water quality, food, genetically-modified organisms, nanotechnology, consumer products.

MARKT

Benefits of Internal market to patients and healthcare providers; recognition of professional qualifications; Intellectual property rights and access to medicines; legal framework for public private partnership.

OLAF

trade in tobacco products

REGIO

Regional Policy actions to support health policy, including through 'Regions

for Economic Change'

RELEX

Relations with third countries, including European Neighbourhood countries

on health

RTD

RTD Research framework programmes FP6, FP7

 

SANCO

Public health, consumer policy, food safety, animal health

 

SG

Coordination policy on Biotech and sustainable development

 

TAXUD

Policy on enforcement to combat introduction of products with a health risk

TRADE

Trade negotiations re: Health and social services and services of health

Professionals

TREN

Road safety, Energy, Ionising radiation, Working and Driving Hours

 

Source: European Commission

http://ec.europa.eu/information_society/activities/health/index_en.htm

Last Access: 20.02.08

 

In the early nineties, the European Commission had established the High Level Committee on Health to enable key representatives from health Ministries to exchange views and provide strategic advice to Commission services. Following the mad cow crisis, a portfolio was created for the first European Commissioner in charge of Health: David Byrne in 1999, succeeded by Markos Kyprianou in 2004 and Androulla Vassiliou in 2008. Most health activities were then regrouped in a new Health and Consumer Protection Directorate General of the Commission (DG SANCO), to cover in particular public health, animal health and food safety. Other Commission departments continue to deal with certain aspects of health policies such as:

 

·         pharmaceuticals and health products (DG ENTR)      

·         e-Health and Telematics (DG INFSO)

·         health care for migrant workers, health insurance (DG EMPL)

·         health research (DG RTD)

·         health aspects of development aid (DG DEV)

 

In parallel, the presence and authority of Health Ministers in Council was reinforced, with the creation of a special Council formation (EPSCO) in charge of all health related decisions. Similarly, the work of the European Parliament Committee on Environment and Health became more focused on health issues. Several committees were progressively set up by DG SANCO to deal with health security and bio terrorism, the health programme or to help implement the new Community legislative measures.

 

In April 2004, the Commission set out its response to the report of the reflection process in two communications, making proposals for European co-operation and extending the open method of coordination on healthcare and long-term care. These activities have been taken forward through the new High Level Group on Health Services and Medical Care established in July 2004, with regular reports to Council, in several areas:

 

·          cross-border healthcare purchasing and provision, and patientsrights and responsibilities;

·          health professionals (continuing development and migration within the EU);

·          centres of reference, that could pool resources, for example on tackling rare diseases;

·          health technology assessment, with a network supported by the public health programme;

·          e-health and information strategies for health services;

·          hospital performances (waiting time and nosocomial diseases); and

·          patient safety.

 

 

Independent scientific advice plays an important role in the EU decision-making process. Three Scientific Committees have been established by DG SANCO to provide scientific advice on non-food related risks to consumer products, health and the environment, emerging and newly identified health risks. These Committees have adopted a wide range of opinions covering possible cancer risks from certain hair dyes, the safety of tooth whitening agents, the assessments of possible risks from nanotechnologies; several key opinions were finalised after a wide consultation on the Internet.

 

In many sectors where health and safety of patients, consumers or workers is at stake, EU agencies were created to advise European Institutions and Member States on health related measures, or to collect and disseminate relevant information for health policy makers (Table 12.7). Working as technical secretariats rather than big centralised bodies, these agencies are generally able to mobilise a significant number of scientists across Europe.

 

In addition, there is a growing interest in collaboration among member states and between these and the European bodies for what concerms independent scientific advise on border-crossing health issues. In this context, for example, the Science Advice Network for Health (EuSANH) was established in 2006.


Table 12.7. Community agencies directly relevant to health

 

Abbreviation

 

Agency

 

Mission/Role

 

EAHC

Executive Agency for Health and Consumer (Luxembourg city, Luxembourg) – Established in 2005

http://ec.europa.eu/eahc

Formerly PHEA, Public Health Executive Agency. The Agency provides professional service in performing the tasks entrusted to it by the European Commission, and it works closely with Directorate General for Health and Consumers. The EAHC manages relations with some 2200 beneficiaries involved in more than 200 projects in the field of health; it has about 40 staff members based in Luxembourg.

ECDC

 

European Centre for Disease Prevention and Control (Stockholm, Sweden) – Established in 2005

http://www.ecdc.europa.eu

To identify, assess and communicate current and emerging threats to human health posed by infectious diseases.

 

ECHA

 

European Chemicals Agency (Helsinki, Finland) – Established in 2007

http://echa.europa.eu/

To manage and carry out technical, scientific and administrative aspects of REACH (an EC regulation on the safe use of chemicals, No 1907/2006) and to ensure consistency at Community level in relation to these aspects To provide the Member States and the institutions of the Community with the best possible scientific and technical advice on questions relating to chemicals which fall under REACH

To manage IT based guidance documents, tools and data bases To support national helpdesk and run a helpdesk for registrants To make information on chemicals publicly accessible

EEA

 

European Environment Agency (Copenhagen, Denmark) - Established in 1990

http://www.eea.europa.eu

To support sustainable development and to help achieve significant and measurable improvement in Europe's environment through the provision of timely, targeted, relevant and reliable information to policy making agents and the public.

EFSA

 

European Food Safety Authority (Parma, Italy) - Established in 2002

http://www.efsa.europa.eu

To provide objective scientific advice on all matters with a direct or indirect impact on food and feed safety, contribute to a high level of protection of human life and health through taking account of animal health and welfare, plant health and the environment, in the context of the operation of the internal market.

EMCDDA

 

European Monitoring Centre for Drugs and Drug Addiction (Lisbon, Portugal) - Established in 1993

http://www.emcdda.europa.eu

To provide the Community and its Member States with objective, reliable and comparable information at European level concerning drugs and drug addiction and their consequences.

 

EMEA

 

European Medicines Agency (London, UK) - Established in 1995

http://www.emea.europa.eu

To foster scientific excellence in the evaluation and supervision of medicines, for the benefit of public and animal health.

 

ESA

 

European Space Agency (Paris - France) – Established in 1975

http://www.esa.int

To ensure that investment in space continues to deliver benefits to the citizens of Europe and the world, including satellite technology which can help to provide the information needed to manage the environment, understand and mitigate the effects of climate change, and ensure civil security for Europe.

EUROFOUND

 

European Foundation for the Improvement of Living and Working Conditions (Dublin, Ireland) – Established in 1975

http://www.eurofound.europa.eu

To provide information, advice and expertise – on living and working conditions, industrial relations and managing change in Europe – for key actors in the field of EC social policy on the basis of comparative information, research and analysis.

EU-OSHA

 

European Agency for Safety and Health at Work (Bilbao, Spain) - Established in 1993 http://www.osha.europa.eu

To make Europe's workplaces safer, healthier and more productive by bringing together and sharing knowledge and information, and by promoting a culture of risk prevention.

 

FRA

 

European Union Agency for Fundamental Rights (Vienna, Austria) – Established in 1975

http://www.fra.europa.eu

To collect information and data, provide advice to the European Union and its Member States, and promote dialogue with civil society to raise public awareness of fundamental rights. Article 35 of the Charter of Fundamental Rights enshrines the right to healthcare.

 

 

The “health in other policiesobjective is achieved through quarterly meetings of the Commission Inter-service Group on Health, chaired by the director for public health, and very well attended by many other Commission departments. Several subgroups were created to deal with international affairs, nutrition, health and environment, pandemic threats.

 

Specific and constant links have been made by DG SANCO with Health Research activities, with a budget of € 6 billion under the 7th Framework Programme (2007/2013), with DG Employment on health insurance and health care issues and With DG information Society on e-Health and the reliability of health information on the Web. Pharmaceuticals is another area of close involvement with DG Enterprise and the European Medicines Agency (EMEA) on the development of vaccines, anti-virals and on antimicrobial resistance, on the evaluation of new medicines and the launch in 2006 of the Pharmaceutical Forum to better combine competitiveness and health objectives.

A list of financial community instruments relevant for health is provided in Table 12.8.

 

 

Table 12.8. Financial community instruments relevant for health

 

DG

Financial instrument

AGRI

Nutrition aspects of promotion campaigns under CAP; Tobacco Fund information campaigns (ending 2008)

DEV

Development cooperation instrument, European development fund

EAC

Lifelong Learning Programme (2007-2013)

Youth programme

ECHO

Humanitarian aid operations

ELARG

Instrument for Pre-accession AssistanceIPA

Technical Assistance and Information Exchange InstrumentTAIEX

EMPL

European Social Fund (2007-2013), projects/actions under the Safety and Health at Work Strategy 2007-2012

ENTR

Competitiveness and Innovation Framework Programme (CIP) (2007-13)

ENV

LIFE - supporting environmental and nature conservation projects

EUROSTAT

Statistical Programme

INFSO

eTEN Programme (http://ec.europa.eu/information_society/activities/eten/index_en.htm); Competitiveness and Innovation Programme, Ambient Assisted Living Programme (http://ec.europa.eu/information_society/activities/einclusion/research/aal/index_en.htm)

JLS

Programme Security and Safeguarding Liberties

Framework programme on Solidarity and the management of migration flows

Drugs Prevention and Information Programme (Council Common position July 2007)

Daphne III (combating violence against women, young people and children)

OLAF

Hercules programme

REGIO

Regional Policy programmes co-financed with the European Regional Development Fund (2007-2013)

 

RELEX

European Neighbourhood and Partnership Instrument including

RTD

Research Framework Programmes FP6, FP7 ( research on health and treatment including public health and health systems, food safety, eHealth, Innovative Medicines Initiative, actions related to global health, road safety)

SANCO

Programme of Community Action in the field of Public Health (2003-2008)

Programme for Community Action in the field of Health (2008-2013)

Programme of Community action in the field of consumer policy (2007-2013)

Council Decision of 26 June 1990 on expenditure in the veterinary field

(90/424/EEC)

TAIEX

Development and Cooperation Instrument (DCI), Stability Instrument (SI), Humanitarian Assistance Instrument, and other thematic instruments including 'Investing in People', 'Cooperation with Non-State Actors', etc.

TREN

Intelligent Energy Europe, actions under the EURATOM Framework Programmes (radiation protection)