Public Health in the EU

— last modified 24 August 2006

In a world where people regularly travel between countries and continents, threats to the health of EU citizens from communicable diseases cannot be quarantined within national borders. Diseases caused by smoking, poor nutrition or pollution are a matter of concern in all EU countries. In the EU single market, the safety of pharmaceuticals or blood products is seen as a shared responsibility. While the primary responsibility for health care lies with EU member states, many public health issues are best dealt with through a concerted EU response.

The European Commission’s public health goals are to:

tackle the major health inequalities that exist within the Union;
protect citizens against health threats;
promote policies that lead to healthier lifestyles;
contribute to reducing the incidence of major diseases in the EU;
contribute to the development of more effective and efficient health systems;
provide health information and analysis which support these goals;
give citizens a say in the health issues that affect them.

The public health programme

The EU is spending EUR 50 million annually from 2003 to 2008 to improve the collection of data, the exchange of information and our understanding of how EU policies affect health. Other priorities include strategies for dealing with the impact on health of nutrition, physical activity, tobacco, alcohol, drugs, genetic factors, age and gender, and improving mental health.

The EU also funds research into ways of ensuring that everyone enjoys the best possible level of health. The incidence of major health problems, such as obesity or some forms of cancer, often varies widely across the EU. Enlargement of the EU presents particular challenges in tackling inequalities because generally speaking life expectancy is lower in the new member states and infant and maternal mortality rates are higher.

Disease prevention and control

In recent years, the EU has stepped up its ability to deal with international health threats, including communicable diseases and bio-terrorism. When a pandemic threatens, the EU draws up a co-ordinated response plan as it has done, for example, for avian influenza.

A major step was the start-up in May 2005 of the European Centre for Disease Prevention and Control headquartered in Stockholm. By having a central agency to replace the previous informal networking arrangements, the EU can react faster to these threats – and acting fast can make the difference between a minor outbreak and a serious epidemic. On an everyday basis, the Centre provides information, advice and training in dealing with priority threats. These are influenza, HIV/AIDS, drug-resistant microbes (e.g. MRSA) and tuberculosis.

The Commission also assesses health risks from substances, such as hair dyes, or new technologies. In 2005, it began evaluating the risk from nanotechnology.

The environment and health

Between one quarter and one third of illness and disease in industrial countries is the result of environmental factors. Those hit hardest are children and other vulnerable groups, such as the elderly. A new strategy launched in mid-2003 is making a start on tackling some environmental factors responsible for public health problems. The key elements of this strategy, known as SCALE, are Science, a focus on Children, Awareness-raising, Legislation and continuous Evaluation. The priorities for 2004-2010 have been incorporated in an Environment and Health Action Plan. They include study of the links between environmental factors and asthma, allergies and respiratory diseases in children, childhood cancer, and neurodevelopmental disorders, such as autism and speech problems.

Smoking and health

The EU is also pro-active in the campaign to combat smoking. EU governments have agreed to ban most forms of tobacco advertising and event sponsorship by tobacco companies no later than 1 August 2005. EU rules already limit the use of additives and addictive substances, make health warnings compulsory, forbid misleading claims, and set maximum levels of tar, carbon monoxide and nicotine in cigarettes.

Drugs and health

The EU action plan to combat drug related problems complements the fight against drug trafficking and drug-related crime through EU policy on justice and home affairs. Over the period 2000-2004, the EU aims to substantially reduce the use of illegal drugs, including “ecstasy”, heroin and amphetamines, and to combat drug-related diseases (such as hepatitis C, tuberculosis, and HIV/Aids) and drug-related deaths. The watchwords are prevention, education and awareness.

Safe medical treatments

Safe medical treatment for all to the same quality standards is a primary EU concern, either as part of its public health or single market policies. So there are measures in place to provide:

safe medicines and rapid dissemination throughout the EU of information on any problems;
streamlined procedures for approving new drugs;
development of ‘orphan’ drugs needed in small quantities for rare diseases;
safe medical devices. These range from implants for hip replacements and pacemakers to bandages and spectacles.

The EU has agreed a single EU-wide quality and safety standard for the use, distribution and storage of blood products, tissues and cells used in medical treatment, and organs for transplants. The European Commission is also looking at whether it would make sense to have common rules for technologies which make life easier for people with disabilities.

Access to medical treatment everywhere

The right to travel freely, or to live and work anywhere in the EU, would make no sense if EU citizens could not be sure of obtaining health care wherever they go. Mutual recognition of social security rights ensures that health care is readily available for anyone falling ill while in another member state, and in some other European countries as well. The European health insurance card makes it easier for business travellers and holidaymakers to claim these rights. In some circumstances, EU citizens are also entitled to go to another member state for treatment. This is particularly important to people living in border regions or needing specialist treatment.

Harnessing information technology for health

Concern for health has therefore long cut across a wide range of EU policies, such as social and employment policy (including health and safety at work), the single market and environment policy. More recently, the EU has been developing the relationships between the information society and health. High-speed data links make it possible to network health professionals across the EU or provide patients with access to specialists located many kilometres away. By promoting e-health programmes and by funding related research, the EU is pursuing its goal of prioritising spending on patient health.