Prevention is first line of action against chronic diseases

Written by Tonio Borg on 31 March 2014 in Feature

With 97 per cent of member state medical budgets being spent on treatment, there is a need for a serious reshuffle of spending priorities, writes Tonio Borg

In the run-up to the summit on chronic diseases on 3-4 April, I urge a broader uptake of prevention as a cost-effective approach to tackling chronic diseases. I also point to the European commission’s recent achievements and upcoming initiatives that focus on prevention and on helping member states address chronic diseases.

Chronic diseases account for 77 per cent of the disease burden in the European region, and 86 per cent of all deaths. Every year, health systems in the EU spend €700bn on treating chronic diseases, which amounts to between 70-80 per cent of all healthcare costs in the EU. Moreover, as the population ages, the current trend is set to rise in the coming decades, stretching healthcare resources even further.

"There are four major risk factors for developing chronic diseases, all of them lifestyle related: smoking, alcohol abuse, unhealthy diet and sedentary living"

No wonder, therefore, that tackling chronic diseases, such as cardiovascular diseases, diabetes, cancers, or respiratory diseases, is at the top of the ‘must-do’ list for member states’ health agendas. If EU countries are to tackle chronic diseases efficiently, however, they first need to reshuffle priorities. Currently, member states allocate a whopping 97 per cent of their healthcare budgets to treatment, leaving prevention with the scraps – a mere three per cent of their budgets. Member states can no longer afford to go down this route. The time has come to turn things around and put prevention, health promotion and early detection higher up on the priority list.

There are four major risk factors for developing chronic diseases, all of them lifestyle related: smoking, alcohol abuse, unhealthy diet and sedentary living. Tackling them efficiently could help prevent 80 per cent of all heart diseases, strokes and type two diabetes.

Over the years, the commission has championed prevention and early detection in the fight against chronic diseases. In this respect, 2014 got off to a flying start with the adoption by parliament and council of the revised tobacco products directive. By ensuring that tobacco products look and taste like tobacco products, the new rules aim to reduce the number of new smokers in the EU. In five years from now, we expect a drop of two per cent in consumption of tobacco, which will translate into 2.4 million fewer smokers. In turn, this translates into fewer people developing diseases caused by smoking such as lung cancer. Our target audience is mostly young people, as 70 per cent of smokers start before their 18th birthday and 94 per cent before the age of 25.

This will also be the year of the updated European code against cancer directly aimed at citizens. The code provides a set of catchy recommendations on how to reduce the risk of cancer, mainly by making healthier choices in life. Talking of healthy choices, the EU holds a long-lasting record of addressing nutrition and physical activity. In Europe, one in two adults, and one in three children aged between six and nine years old are overweight or obese, and therefore at risk of developing diabetes, cardiovascular diseases and mental health disorders.

"The increasing burden of chronic diseases calls for a sustained debate on how member states can adapt their health policies, change their strategies and empower their citizens"

Over the last year, the commission supported the member states in shaping a new action plan for 2014-2020 on childhood obesity, which was launched in February. Its goal is to halt the rise in numbers of overweight and obese children and young people by 2020, by putting forward voluntary initiatives to support a healthy start in life, promote healthier environments – especially in schools and preschools – restrict marketing and advertising to children, inform and empower families, encourage physical activity and support research. As such, it substantially adds to related ongoing initiatives aimed at reducing salt, fats and added sugar in processed food, and promoting balanced diets and active lifestyles.

Our action does not stop here. The commission has recently kicked off Chrodis – a three-year joint action involving public and private stakeholders that addresses chronic diseases and promotes healthy ageing. The joint action aims to support member states in their efforts both towards more efficient prevention and also management and care of chronic conditions. Take type two diabetes for example. To fight type two diabetes you need first and foremost to reduce obesity. And you also need to see how to improve care for those who already have the disease. This is why member states will also be encouraged to cooperate and develop guidance to improve care.

The increasing burden of chronic diseases calls for a sustained debate on how member states can adapt their health policies, change their strategies and empower their citizens. The upcoming EU summit on chronic diseases will enable them to partner up with numerous stakeholders to explore ways of tackling chronic diseases. Member states can rely on the European commission to back them up so that together we find solutions to address the challenge of chronic diseases in Europe.

About the author

Tonio Borg is European health commissioner


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