Karin Kadenbach: All policy initiatives pursued by the EU take public health into account
Last year’s European Health Forum Gastein highlighted the need for ‘health in all politics’. Here, Austrian MEP Karin Kadenbach, the Forum’s Vice-President, talks about why the idea still holds true, the importance of bold political choices, and how Parliament is standing up for our health.
Karin Kadenbach | Photo credit: Bea Uhart
Health is not an EU competence - despite this, what can the EU contribute to this policy area?
Even although health falls outside the legislative scope of the European institutions, there is still a key role for the EU in improving the health of European citizens. All policy initiatives pursued by the EU take public health into account. Therefore, the EU can lead by example when it comes to developing policies that are driven by the aim of improving and protecting the health of citizens.
The EU can help member states to pool resources and facilitate the exchange of good practice and knowledge between countries. In Europe, we have learned through practice that joining forces often presents unforeseen opportunities for growth and sustainability, which is exactly what Europe’s health systems need. Working together across countries also helps to connect the dots and to be able to look at health in Europe holistically.
Getting the big picture right, and knowing where resources are needed most, is the first step towards creating efficient and sustainable systems and ensuring that we do not waste valuable resources through reinventing the wheel.
Age-related diseases such as dementia are increasing and are now the leading cause of death in women. They are soon expected to overtake heart disease to become the biggest killer of men too. How should Europe’s policymakers aim to tackle this growing health threat?
First, policymakers across Europe could work together in helping to set up an evidence-base with a structure that allows Europe’s epidemiological data to be gathered and analysed. This will help to better understand and anticipate the trends and dynamics at play when it comes to these diseases, and tailor prevention eff orts more accurately.
However, this is just a start; what lies beneath is more complex. Disease prevention and diagnosis can only happen when people have timely access to healthcare, and Europe is still marked by significant inequalities in access to dementia care and treatment. Addressing the threat of age-related diseases, or any disease for that matter, demands access to good quality care.
Finally, policymakers could work towards empowering patients and their caregivers, either through more traditional ways or by promoting the uptake of digital technologies and robotics, helping people with dementia to live autonomously for an extended period of time.
People are living longer, but not always in good health. Does this suggest that EU active ageing initiatives have had little impact? What should be done to ensure that living longer means living in good health?
Ageing populations present a significant challenge to all European societies. It will take time to see the benefits of these initiatives across a continent as diverse as Europe - also bearing in mind that healthy and active ageing starts at birth.
Nevertheless, there are indeed opportunities to move the healthy ageing agenda forward. Healthy and active ageing, as well as health more broadly, is a matter that should be tackled across the board of policymaking, not just by health ministers alone. Our health is at the heart of everything we do and encounter on a daily basis, from the air we breathe to the food that we eat.
This demonstrates the relevance of health as an issue that should be discussed in all political arenas, from those that deal with climate change, to those that address food packaging. The ‘health in all politics’ was introduced at the European Health Forum Gastein last year, and combined with ‘health in all policies’, it can ensure people are living longer in good health.
The occurrence of heart attacks and strokes has fallen, while diabetes, obesity and mental health issues are increasing. With Europe facing changing health demands, where should health systems prioritise?
The emergence of non-communicable diseases (NCDs) like diabetes, cancer and mental health issues, is indeed one of the greatest contemporary challenges. Only last month, the World Health Organisation issued worrying figures that indicate that Europe accounts for 23.4 per cent of global cancer cases and 20.3 per cent of cancer deaths worldwide. This is despite Europe accounts for only nine per cent of the global population.
There is an urgent need for solutions. Of course, prevention is an important priority, but we should also focus on the transformation of our health systems. We need to ensure our health systems can meet the increasing burden of NCDs, both financially, and in terms of the availability of a skilled health workforce.
We need to ensure that health systems are sustainable, fit for the longer term, and sufficiently resilient to meet unknown demands in the future. This implies making sure that we use our resources effectively, in a personalised manner and reduce wasteful expenditure.
We also need to ensure that hospitals are equipped with the latest technologies and available data so that professionals can properly understand a patient’s individual condition and offer appropriate care.
Sustainability and health in the EU is therefore the leading focus at this year’s European Health Forum Gastein. And it is a timely discussion if we want to achieve the Sustainable Development Goals by 2030 and ahead of the institutional changeover next year.
This year’s Gastein Forum is about ‘bold political choices for Agenda 2030’. What bold choices do you believe policymakers should be making on health? Do you believe Europe is contributing enough to reaching the Agenda 2030 goals?
I believe that the bold political choices for Agenda 2030 embody practical reforms, the courage to pragmatically move forward and the readiness to do away with outdated structures. It is important to realise that health should not be only discussed in a health silo but in all sectors of policies. We need to demonstrate clearly that there is a quantitative cost of inaction when it comes to health policy.
With the upcoming European elections, our citizens can make sure that health moves to the top of Europe’s agenda and that we can proactively work to achieve the Sustainable Development Goals. Reaching the Sustainable Development Goals is a strong component of the European policy agenda.
The goals have guided the work of the European Parliament over recent years and they are integrated into the EU’s overall work programme. The EU is also working together with member states on realising Agenda 2030.
In its communication of November 2016 on a sustainable future for Europe, the European Commission also emphasises that reforms and fiscal policies can strengthen the sustainability of European healthcare and pension systems.
Is Brexit a threat to public health and research?
Brexit is a challenge, including when it comes to health and research. We need to ensure that the health and safety of patients and citizens is safeguarded in any scenario. Brexit also means that we have to guarantee certainty for individuals, despite the turbulent political climate.
We need to ensure that their access to medicines and treatment will not be compromised and that the arrangements between the United Kingdom and the European Union on these matters are watertight. This pertains to the entire process; from the supply of medicines, to the regulation of the market, and pharmacovigilance.
We also need to make sure that ongoing research efforts can continue without disruption and that patients, both in the EU and the UK, will continue to benefit from the latest innovations.
The current hot topic is populism, and there is some fearmongering over immigration. Is this distracting policymakers from dealing with important health issues?
With the European elections taking place in May 2019, it is vital to safeguard the position of health on the European agenda. If anything, the topic of populism and immigration illustrates the need to tackle health at European level - in all politics and across all policy areas.
We need to tackle health inequalities across Europe and ensure that all citizens have access to quality healthcare. It is inequalities that contribute to the dissatisfaction of citizens with their political parties and governments, fuelling the agenda of populists.
I am certain that, in the European Parliament, we are able to deal with all important issues, including migration and health, without being distracted by fear mongering. Some of the key legislative files passed in recent months demonstrate our focus and commitment to better the lives of European citizens.
We are almost at the end of this legislature. What do you believe has been this Parliament’s biggest achievement in terms of health policy?
Over the past few years, the European Parliament has not only managed to maintain momentum on a wide range of complex health issues, it has also raised sensitive concerns to salience. The own initiative report on ‘EU options for improving access to medicines’ illustrates that the European Parliament will not shy away from confrontation and is ready to stand up for the health and fundamental rights of Europeans.
The report demonstrates that Parliament is committed to addressing those issues that touch Europe at its core: citizens’ access to treatment and the availability of medical care, as well as the issue of high prices of innovative treatments and the challenge of unmet needs. In this regard, Parliament has laid the groundwork for the future of health in Europe.
It’s time to scratch the surface, and recognise that advanced plant breeding methods, including GM crops, can really make a positive impact, writes Julian Little.
Outcomes of the H2020 EUREST-PLUS project will be presented on October 18, 2018 at the European Parliament in Brussels
There's a conflict of interest at the heart of post-authorisation vaccine evaluation research, argues Jim McMenamin.