Thursday

18th Jan 2018

Focus

EU wakes up to its chronic disease problem

  • Vytenis Andriukaitis - in position to become the next EU commissioner with responsibility for health (Photo: Mark & Becs)

The European Union is beginning to take the problem of chronic diseases seriously - the recent EU summit on Chronic Diseases is an indication.

But commitment to dealing properly with the new epidemic varies hugely across the region and health specialists worry that current developments could undermine public health in Europe.

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Widespread advances in medical care over the past century and increasing life expectancy, is contributing to a growth in chronic conditions to the extent tha the World Health Organisation now considers it an epidemic.

Chronically ill patients need long-term and coordinated medical care, puting a growing strain on health care systems.

Between 70 and 80 percent of annual health care costs are spent on chronic diseases, the vast majority of which is spent on treatment (97%) with the remainder spent on prevention.

EU policy on chronic diseases

The European Union has no legislative power in the area of health. The organisation and financing of health care is the responsibility of national governments. However, the European Union can encourage and support cooperation and coordination.

Although EU member states have different approaches and levels of experience in tackling the chronic disease epidemic, the challenges to the respective health systems are common across most of the 28 EU member states. This means action on chronic disease manage at the EU level makes sense.

The European Innovation Partnership on Active and Healthy Aging (EIP-AHA) is a specific EU initiative on prevention and managing chronic diseases. It is one of the flagship initiatives of the Europe 2020 strategy - an economic plan meant to turn Europe into a smart economy. But one precondition is a population in good health.

The EIP-AHA partnership sets a target of increasing the healthy lifespan of citizens by two years by 2020 and it aims to improve health and quality of life of older people, improving the sustainability and efficiency of health care and, from that, creating growth and job opportunities.

The partnership emphasises on prevention, screening and early diagnosis; on integrated care and cure; and on active ageing and independent living.

Brussels also promotes other different approaches to lessen the chronic disease burden in Europe, by addressing major risk factors such as smoking, alcohol abuse, unhealthy diet and lack of physical activity.

Policy strategies and approaches are already in place to get to terms with risk factors. Examples include: two tobacco legislations; an EU strategy to support member states in reducing alcohol related harm; a Strategy for Europe on Nutrition, Overweight and Obesity related health issues.

Studies show that there is clear inequality in the burden of chronic diseases and in access to prevention and management of the disease.

EU action on health inequalities, cancer, HIV/AIDS and mental health, therefore, also help towards dealing with chronic diseases in Europe. Some types of cancers and HIV/AIDS can now be better managed and they are therefore included in the chronic diseases category.

This year saw the start of a new project - the Joint Action CHRODIS-JA - that focusses on chronic diseases and promoting healthy aging across the life cycle and aims to identify and promote innovative solutions. The three year initiative - from 2014 to 2017 - is led by the Spanish Ministry of Health together with the Health Institute Carlos III in Madrid and involves 60 organisations from across the EU.

CHRODIS-JA aim to pull together experience on preventing and treating chronic diseases to identify the best approaches. It will also look at how to provide more holistic rather than disease-specific care, as many older patients face two or more chronic conditions at the time.

The initiative aims to set up a knowledge platform to work as a resource for member states seeking authoritative advice on how to best prevent and treat chronic diseases.

In April, the European Commission organised a first EU Summit on Chronic Diseases. The summit conclusions called for a stronger political leadership; a focus on societal changes; enhanced prevention policies; and more citizens’ involvement. But the summit fell short of setting specific targets for tackling chronic diseases.

New European Commission - what can we expect

As the new European Commission takes office later this autumn, under the leadership of Jean-Claude Juncker, it is not exactly clear what the next steps are.

But public health advocates are worried the new internal set-up in the commission, with responsibility for the regulation of medicines moved from the health department to the industry department. This

“This is a potential disaster,” warns Peggy Maguire, head of the European Public Health Alliance (EPHA). “It sends a terrible message during times when criticism is being levelled at Europe: the College of Commissioners should work for the interest of citizens and not anonymous corporate masters,” she added in a press release.

Socialist MEP Glenis Willmott also criticised the move. “Medicines and medical devices are first and foremost about improving and protecting people’s health. Of course Europe’s pharmaceutical and medical technology industries are important to our economy, but our first priority must be health,” she stated on her website.

Another area of concern are the ongoing negotiations between the European Union and the United States - the Transatlantic Trade and Investment Partnership (TTIP).

Public health advocates fear that the trade deal would mean deregulation and introduce free market rules at the cost of health - particularly in such areas as environmental protection, tobacco and alcohol control policies and food labelling, all important for combating the risk factors for chronic diseases.

The Commisioner-designate for Health and Food Safety Vytenis Andriukaitis - a surgeon and former Health Minister in Lithuania - will in two weeks time present his plan for the next five years as a Commissioner in a hearing in the European Parliament.

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