Earlier this week, ministers for health from 23 European Union countries convened in Valletta under the auspices of the Maltese presidency of the Council of the European Union. The Informal Health EPSCO meeting provides a unique opportunity for European health ministers to discuss current issues in the health sector.
This meeting took place at a moment that is of critical importance for the future of European health policy. One scenario put forward for consideration in the paper on the Future of Europe is that the EU will do less on matters of public health. We beg to differ.
We believe that, on the contrary, an EU that is striving to re-engage with its citizens should actually be more visible in those areas that really matter to people. In our minds, there is no question that health is one of them.
Formally, the EU acquired its health mandate less than 25 years ago under the Maastricht Treaty. During this period, there were several success stories for European public health. Among them were the legislation on tobacco and the creation of the European Centre for Disease Control (ECDC). Much more remains to be achieved.
During the informal meeting of European health ministers, we discussed a number of areas in which European action is considered not only to bring added value but to be necessary if we want to make headway in continuing to improve people’s health and life expectancy.
As the world has changed, determinants of health have changed too. Increasingly, the health of European citizens is influenced by the commercial determinants of health organised at global levels. It is therefore quite obvious that success in tackling these determinants requires concerted action beyond the remit of a single individual country.
Malta has placed childhood obesity at the top of the European agenda. But Malta is not the only member state where childhood obesity is an important public health issue.
Children’s food consumption is increasingly determined by global producers with access to digital marketing across borders.
Children’s food consumption is increasingly determined by global producers with access to digital marketing across borders
To address this phenomenon, we need to share experiences and learn from local success stories. We need to work on upstream factors and collaborate more meaningfully if we really wish to reverse this trend. All in all, to succeed in reducing obesity, we need concerted action at all levels – local, regional, national, European – and across sectors, including education, marketing and agriculture.
Admittedly, Europe has made huge strides in improving health and well-being. This does not mean we should be complacent.
A good example of the need to remain vigilant and proactive in preventing and treating disease comes from the epidemiology of HIV.
Across many parts of the EU, a resurgence in HIV is being documented, particularly in men who have sex with men (MSM). Coordinated action at the European level in the fields of prevention and affordable access to treatment can be valuable to address HIV more effectively than single-country initiatives.
We recognise that European health systems are culturally diverse and that their historical development has differed. However, increasingly, we see that European health systems are converging. The main differences, at least where outcomes are concerned, tend to be more related to socioeconomic levels of development, rather than system architecture.
Some of the principal reasons for this convergence are the globalisation of medicine, healthcare education and the industry supply chain. The added value of health system cooperation, particularly in areas such as rare diseases and highly specialised services, is now undisputed.
Nevertheless, when it comes to health services, the concept laid out in the Future of Europe paper regarding voluntary cooperation is one which makes sense.
The Maltese presidency had the foresight to place voluntary, structured cooperation between health systems as a priority for the presidency well before Brexit and all the EU reassessment that followed it.
It did so because where health systems are concerned, a one-size-fits-all approach is not the best solution. But this is no excuse to close our eyes to the fact that strengthening European cooperation brings better outcomes for patients, improved training and working conditions for healthcare professionals and enhanced system efficiency for funders.
Voluntary cooperation in ensuring that equitable access to expensive, innovative medicines and technologies is fully in line with the European ideals of justice, solidarity and fairness.
European health ministers recognise that voluntary cooperation mechanisms can play an important role in assisting Member States to overcome difficulties with access and sustainability.
The European Reference Networks launched a few days ago in Vilnius are a prototype of the new mechanisms of cross-border cooperation between health systems. They depend on strong links between science, people and technology to deliver the best possible outcomes for European citizens.
Far from less health policy at the European level, now is the time to reflect and chart the way forward for the health priorities, objectives and working methods we wish to see within the European Union post-2020. In Valletta this week, European health ministers have started this discernment process.
Vytenis Andriukaitis is European Commissioner for Health and Food Safety and Christopher Fearne is Minister for Health.