Topics | Achievement | Missed opportunity | Failure |
---|---|---|---|
Treaty | Inclusion of the health mandate as enshrined in Article 129 of the Treaty of the European Union. | Missing implementation of a connection/share of power between economic and social EU policy. | |
Directorate general for health and consumers (DG SANCO) | Existence and persistence of DG SANCO. | DG SANCO is not strong enough to push health in other DGs. | DG SANCO set-up: Missing link to social policy. |
Public health programme. | Public health did not become a key aspect of EU policy. | ||
Sustainability development strategy: DG SANCO is not playing an active role in the marketing of the strategy. | |||
Cooperation | Cooperation between EU, WHO and OECD. | Missing connection and joint forces between EC and WHO. | |
EC agencies | Development of agencies: ECDC, EFSA, EMA, EMCDDA. | ||
ECDC | Legislation on infectious disease control. | ECDC mandate should include responsibilities in risk management of infectious diseases. | |
European Programme for Intervention Epidemiology Training (EPIET). | ECDC profile should cover also non-communicable diseases and SDoH. | ||
EMA | Coordination of the approval of efficacy, safety and quality of drugs. | Cost-effectiveness of pharmaceuticals is not taken into account. | Problem of not being able to tackle pharmaceutical pricing. |
Reversal of the approval of already approved drugs not handled on EU-level. | |||
EFSA | Control of health claims of food products. | EFSA mandate should include/be stronger on health promotion aspects of nutrition (e.g. regulation of advertisement of unhealthy food products). | |
Food safety Directive. | |||
Health in All Policies (HiAP) approach | Health mandate assures that health protection should be guaranteed in all EU policies. | HiAP and Health Impact Assessment have never been implemented fully (tick box exercise). | |
Leads to the discussion of health in other sectors. | |||
Lifestyle factors | Common tobacco legislations in Europe (WHO Framework Convention of Tobacco Control; tobacco product-; tobacco advertising Directive). | The tobacco regulations could have been designed stronger (e.g. more harmonized realisation of smoking prohibition on public places). | Tobacco regulation has some aspects of failure since a strict, general ban is not reached. |
Food safety measures and regulations on health claims. | Missing political will to tackle obesity and related life style factors like unhealthy food products. | ||
Health Research Programme | EU health research budget and outcomes of the programme. | Missing integration of the research programme and EU health research outcomes in public health. | |
EU budget | Largest budget proportion shifted in the Multiannual Financial Framework 2007–2013 from agriculture financing to the funding of cohesion and sustainable growth policies. | ||
Health research budget. | |||
The use of Structural Funds for investments in health (2007–2013). | |||
Internal market provisions | Internal market rules as source for legislation should be more attentive to health concerns. | Internal market provisions cause problems if member state regulation is more protective regarding health threats than EU regulation. | |
Patients’ rights directive | The patients’ rights Directive in general. | Negotiations on patients’ rights Directive failed to include a strong emphasis on the development of common standards. | |
Effect on cross-border cooperation. | |||
Gives legal certainty to policy makers. | |||
Common Agriculture Policy | Policy field which starts to recognize health, e.g. in its white paper on the CAP after 2013 (2009/2236(INI)). | Unrecognized potential for health of the CAP by public health sector. | |
Health information | Health life years as indicator in the Lisbon strategy. | Missing health information system. | |
Lack of morbidity data. | |||
Different public health topics | |||
health inequalities | EC communication: solidarity in health: reducing health inequalities in the EU. | ||
HTA | Strengthening of the HTA approach in the EU. | Coordinating cross-country level health technology assessments. | |
Rare diseases | Coordinated management of rare diseases. | ||
Tuberculosis | Existing drug resistance of tuberculosis as indicator for lacking disease management. | ||
Health of minorities | Health of minorities (e.g. Roma) as part of the European agenda. | ||
Social care | Social care is hardly seen as EU competence. | ||
Environment (and health) | Environmental standards set by the EU. | Missing follow-up process on the Environment and Health Action Plan (2004–2010). | |
Information to patients | Blocking of direct to consumer advertising of prescription-only pharmaceuticals. | ||
Governmental issues | White paper on governance (2001) increased transparency. | ||
More standardisation of methods (evaluation of indicators, outcomes, policies) and common language. | |||
Increased understanding of the public health community about the impact of EU policies on public health. | |||
Industry involvement | Cooperation with industry influences the health research agenda and policy-making. | ||
Evidence-based policy-making: the interest of the industry is against public health. |