European Commission’s action on health priorities
In an exclusive interview with Government Gazette, Vytenis Andriukaitis, European Commissioner for Health and Food Safety, discusses the EU action on cancer, diabetes and healthcare technology
The incidence of prostate cancer and diabetes has significantly increased over the past two decades and continued growth is expected, due to an aging population. While greater awareness of the causes and earlier diagnosis can provide hope for these two major non communicable diseases, they continue to impose a heavy financial burden on our health services. Government Gazette interviews the European Commissioner for Health and Food Safety to find out more about the European Commission’s action on the deadly diseases.
Commissioner Andriukaitis, it is often said that the EU action on cancer is one of its earliest policies in the field of health. After thirty years of EU action in the field of cancer can you tell us where we are at the moment?
As European Commissioner for health, contributing to cancer prevention, screening and care, is a major concern for me. I personally lost family members to this terrible disease, and I am not alone – most of us have been affected by cancer in some way. This year, we celebrate thirty years of EU action in the field of cancer. Since the European Community leaders first met in 1985 and committed to take action to fight against cancer, EU policy has helped save lives through its four pillars of action: early diagnosis, prevention, research and partnership.
First, the EU has, since 2003, recommended population-based cancer screening for breast, cervical and colorectal cancer, and has produced European Guidelines for all three types of cancer screening. Now a quality assurance scheme for breast cancer units is underway to recognise the best places where women in Europe can get high quality care. Early detection of cancer is vital as it gives patients the chance to receive timely and often life-saving treatment. This is true for all types of cancer – prostate, lung, skin, etc. – and I urge anyone who suspects symptoms to promptly consult their physician.
Second, addressing the risk factors is the Commission’s first line of attack to help reduce the burden of cancer. Actions in the past thirty years include supporting the “European Code Against Cancer” which provides user friendly advice to avoid cancer. It also includes action on cancer risk factors, in particular laws on tobacco products and on their marketing, on pesticides, air quality, and protecting workers against exposure to carcinogens, as well as action on alcohol, nutrition and physical activity.
Third, during the past seven years, the EU has invested nearly € 1.44 billion notably in international collaborative research and coordination of national cancer research efforts. This funding aims to find new ways to understand and fight cancer, and to help patients.
Lastly, a new Joint action was launched in 2014 on Comprehensive Cancer Control (“CANCON”) to deliver a European Guide on Quality Improvement in Cancer Control. By presenting evidence-based recommendations for all stages of cancer control and care, this guide aims to reduce inequalities in cancer between EU countries.
Commissioner, you indicated in several occasions that your priorities in public health could be summed up by the three words: “promotion, prevention, and protection”. What is the EU action doing on obesity and diabetes, for instance?
With an estimated thirty-two million adults aged 20-79 living with diabetes in the EU, we are facing one of the biggest healthcare challenges of our time. If left untreated, diabetes can lead to heart disease, kidney failure, nerve damage and eye complications. Some forms of diabetes are lifestyle-related and obesity is a key risk factor.
This is why we must put our efforts into preventing diabetes, starting with our youngest citizens. We must also help people who are living with diabetes. In 2008, one in four children aged six to nine were overweight or obese. By 2010 this figure rose to one in three children. In 2013, this worrying trend forced several European countries to jointly develop a European action plan targeting childhood obesity. The action plan puts forward initiatives to: support a healthy start in life, promote healthier environments – especially in schools and preschools, restrict marketing and advertising for children, encourage physical activity and increase research.
In addition, we are also working with Member States through a Joint action (“CHRODIS”) on chronic diseases launched in 2014 and co-financed by the EU Health Programme. It promotes healthy ageing across the life cycle and aims to help EU countries and regions to exchange good practices in tackling chronic diseases. A special focus will be given to health promotion and disease prevention, multi-morbidity (people with more than one long-term condition) and diabetes.
Beyond public health, I understand that one of your priorities is healthcare technology assessment. Could you explain how you see the development of EU action in this field?
A rapid increase in health technology is a sign of our times. There are more innovative medicines, medical devices and cutting-edge diagnostic tools than ever, and patients’ expectations are rising in parallel. This is challenging as it increases the pressure on national healthcare budgets, already under intense strain. Decision-makers are seeking answers to essential questions: is this innovative new medicine worth the money, or will an existing, cheaper medicine be as effective? Will buying this new machine save my hospital money in the long-run? Will it be more or less labour intensive?
This is where Health technology assessment (HTA) comes into the picture. HTA informs decision makers on comparative effectiveness and efficiency of treatments. Cooperation on HTA at EU level will benefit patients by providing them with better access to innovative technologies. This is a challenging and important task on which the Commission will be concentrating its work in 2016, under my request and guidance.
The EU support of HTA cooperation over the past twenty years has delivered tangible results on methodologies and information exchange. It has now paved the way for efficient use of HTA resources in Europe and the creation of a sustainable system of HTA knowledge sharing. In the coming months, I want to harness the commitment of EU countries and stakeholders to accelerate progress in this area, which will pay dividends for all of us.
We live in a connected world, especially in the area of health. I understand that the Commission is preparing the EU for future developments in the field of electronic health notably. Can you elaborate please?
Speaking of chronic diseases and healthcare technology, I am convinced that the right eHealth tools that offer safe and efficient care can also help alleviate the burden on our healthcare systems. Of course, the EU is made up of twenty-eight separate health systems, which themselves are not uniform. This is why interoperability within and between the countries is vital. The latter is a key aim of the eHealth Action plan 2012-2020, which sets out a long term vision for eHealth in Europe. The eHealth Network plays a central role in solving interoperability challenges between electronic health systems.
Since it was launched in 2011, the Network has for instance adopted ePrescription guidelines in 2014, laying out the type of data needed for sharing prescriptions across borders and giving patients the possibility to get the medication they need anywhere in the EU, which is particularly important for people with chronic medical conditions. In addition, the Network also produced patient summary guidelines in 2013, giving patients the possibility to have, on request, a summary of their electronic health record when visiting another MemberState. The benefit is that for unplanned or emergency care, the doctor in the country of treatment will have an electronic overview of the patient, and a set of basic administrative and medical information, which will improve patient safety.
The concrete building of the links between the countries is now starting, supported by the EU funds from the Connecting Europe Facility programme. I call upon EU countries to embrace the opportunity and join the real work of providing citizens and patients easier and better health services when travelling.
Interoperability is also vital in the establishment of European Reference Networks (ERNs) which should constitute a major step forward for patients and health professionals. By the end of next year, ERNs will be operational and will bring together highly specialised healthcare providers from different EU countries in areas where expertise is rare, thereby pooling knowledge on rare diseases. They will be an additional example of the importance of eHealth as their functioning will involve the use of an integrated IT platform (e.g. exchanging electronically clinical information, tests and diagnostic tools between professionals). Indeed, it is the application of interoperable eHealth solutions which will allow the Networks to interact and fulfil their objectives for the benefit of patients in the EU.