European Health Policies

EU - WhichwayThe World Health organisation and more recently the European Union have been the key bodies developing European health policies. Work with Organisation for Economic Co-operation and Development has also been influential in relation to health care systems.

World Health Organisation

WHO The UK was a founding member of the World Health organisation which began in 1948 and set up the WHO European office in 1953.The European Region also has a governing body - the Regional Committee which meets once a year.The Chief Medical Officer typically leads the UK representation.
WHO Health for All policy

Targets for Health for All. The European version of the WHO global Health for All policy was agreed by the European member states of WHO in 1982 and has been revised every 7 years since. The current version was last updated in 2005 and can be downloaded here. By agreeing to the WHO health for all policy  member states make a non binding undertaking to contribute to a number of European health targets and to develop their own national policies taking into account the guidance contained in the document.

Despite its voluntary nature Health for All has contributed to many national policies throughout Europe. Key influences have been: to underscore that improving health should be a fundamental purpose of government; to stimulate interest and action on health inequalities and to emphasise the importance of other actions to promote health as well as the provision of health services.
WHO also influences policy through:

  • ministerial conferences - for example on mental health,
  • technical meetings and publications,
  • networks and projects such as Healthy Cities
  • and most recently through leading work on the Framework Treaty on Tobacco Control - which once it comes into force will be legally binding .

European Union

A concern for health has been part of the European Community responsibilities from the outset in areas such as:

  • Taking health concerns into account in implementation of the internal market
  • Health and safety of workers
  • Mechanisms for accessing health care for people visiting or working in other member states

Specific activities on health have been supported for several decades including work on safety of medicines, health care of people visiting or working in other member states and the Europe Against Cancer Programme.

But it is only since the treaty of Maastricht added a clause on public health which entered into force in 1993 that the EU has been concerned with the broader public health agenda. See EU Health Competencies. Between 1993 and 2002 public health work was carried out in 8 areas: health promotion, cancer, drug dependence, AIDS and other communicable diseases, health monitoring, rare diseases, accidents and injuries, and pollution-related diseases.

EU health strategy and action

The European Commission adopted a new EU health strategy in 2007.

The Strategy focuses on four principles and three strategic themes for improving health in the EU. The principles include taking a value-driven approach, recognising the links between health and economic prosperity, integrating health in all policies, and strengthening the EU's voice in global health. The strategic themes include Fostering Good Health in an Ageing Europe, Protecting Citizens from Health Threats, and Dynamic Health Systems and New Technologies.

The strategy is implemented through three main mechanisms: EU policies on health, which include influencing health through policies in other areas such as the internal market, regional policy and trade; collaborative work with Member States and other stakeholders and through the Community Health Programme.  

The Health Programme 2008-2013

The Health Programme is a funding instrument with a total budget over 7 years of approximately EUR  320 million. It replaced  the first EU Public Health Programme which ran between 2003 and 2008. 

The main objectives are:

To improve citizens' health security:

  • Developing EU and Member States' capacity to respond to health threats, for example with health emergency planning and preparedness measures;
  • Actions related to patient safety, injuries and accidents, risk assessment and community legislation on blood, tissues and cells.

To promote health, including the reduction of health inequalities:

  • Action on health determinants - such as nutrition, alcohol, tobacco and drug consumption, as well as social and environmental determinants;
  • Measures on the prevention of major diseases and reducing health inequalities across the EU;
  • Increasing healthy life years and promoting healthy ageing.

Health information and knowledge:

  • Action on health indicators and ways of disseminating information to citizens;
  • Focus on Community added-value action to exchange knowledge in areas such as gender issues, children's health or rare diseases.

Priorities for allocating funding are  described in annual work plans linked to calls for proposals. The EU Executive Agency for Public Health and Consumers is responsible for managing implementation of the programme.

A huge range of projects are underway or have been carried out under the first programme. Collectively these provide an important contribution to European public health knowledge and networks.

Health policy areas

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Tobacco advertising, subsidies for butter production, air quality standards, pharmaceutical licensing, alcohol taxation , recognition of professional qualifications, entitlement to health care in other countries - just a few of the issues where decisions at the EU level have a major impact.

  • Items on the current EU agenda include:
  • a strategy on health inequalities,
  • patient safety
  • cancer
  • alzheimers disease,
  • cross border access to healthcare
  • the health workforce
  • pandemic preparedness
  • blood and organ donation
  • Health impact assessment

Examples and links on selected EU health policy areas are given below:

Tobacco

One of the most active policy areas. Since 1989 the European Community tobacco-control strategy has produced:

  • three directives on tobacco taxation;
  • three directives on tobacco advertising;
  • two directives on labelling;
  • one directive on tar yields;
  • a re-casting of three earlier directives into one directive called the Tobacco Products Directive;
  • eight health and safety at work directives restricting smoking in the work place;
  • five non-binding resolutions and recommendations;
  • two conferences organised jointly with the WHO;
  • three EU Presidency conferences;
  • support for three other European tobacco-control conferences;
  • adoption of the WHO Framework Convention on Tobacco Control (FCTC);
  • and effective action against tobacco smuggling in some Member States.

(reference Tobacco or Health in The European Union -4.5mebabytes)

And EU subsidies for growing tobacco are being phased out.

Health Information

alt A huge amount of work over many years has gone into the development of health information systems which can bring together comparable information on health status across the EU. Some of the fruit of these efforts is now available.

Communicable Disease Control

A European Union network for the epidemiological surveillance and control of communicable diseases was established in 1999.

This now has agreed definitions and reporting mechanisms for a wide range of communicable disease at EU level.

The European Centre for Disease Prevention and Control was establshid in 2005 with a mandate to identify, assess and communicate current and emerging threats to human health from its headquarters are in Stockholm.

A wide variety of development networks are working in this area

  • Basic Surveillance Network (BSN)
  • European Antimicrobial Resistance Surveillance System (EARSS)
  • European Influenza Surveillance Scheme (EISS)
  • European Laboratory Working Group on Diphtheria (ELWGD)
  • European Network for Diagnostics of Imported Viral Diseases (ENIVD)
  • International surveillance network for the enteric infections (ENTER-NET)
  • European Programme for Intervention Epidemiology Training (EPIET)
  • Scientific Evaluation on the Use of Antimicrobial Agents in Human Therapy (ESAC)
  • European Surveillance of Sexually Transmitted Infections (ESSTI)
  • European Union Invasive Bacterial Infections Surveillance (EU IBIS)
  • European bulletin on communicable disease (EUROSURVEILLANCE)
  • European Centre for the Epidemiological Monitoring of AIDS (EUROHIV)
  • Surveillance of tuberculosis in Europe(EUROTB)
  • Surveillance Community Network for Vaccine Preventable Infectious Diseases ( EUVAC.NET )
  • The European Working Group for Legionella Infections (EWGLI)
  • Hospitals in Europe Link for Infection Control through Surveillance (HELICS)
  • Inventory of Resources for Infectious Diseases in Europe (IRIDE)

Health Inequalities  

The EU has supported work examining the distribution of health inequalities across the EU and on the identification of effective action to combat health inequalities. The European Commission is producing a communication on health inequalities in autumn 2009.

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