EU Policy on Health Promotion and Chronic Disease

Vilnius, 24 November 2015

Michael Hübel, Head of Unit Programme Management and DiseasesDG Health and Food safety

30 years of EU action against cancer

• 1985 - European Council in Milan, the Heads of State decide to launch the first "Europe Against Cancer" programme

• The first 'European Action Plan Against Cancer' adopted for 1987-1989 and the Second for 1990-1994

Major chronic diseases

Musculo-skeletaldiseases

Cardiovascular diseasesDiabetes

Lack of physical activity

Neuro-degenerative

diseases

Cancer

GeneticBackground

EnvironmentHealth systems

Communicable diseasesSocial factors

Tobacco Alcohol

Mental diseases

Respiratory diseases

Obesity Over nutrition

Healthy life years are not increasing

Economic impact

Chronic diseases and the economy - changing the paradigm

• 70% to 80% of all healthcare costs, €700 billion, spent on chronic diseases in the EU

• Yearly cost of disease related absenteeism estimated at 2.5% of GDP

• Early retirement: Chronic diseases (Musculo-skeletal, mental disorders,…)

• Labour market reintegration – 'survivorship'

International goals, targets•UN General Assembly High Level Meeting on

Non-communicable diseases• Integrated approach across diseases• Behavioral risk factors• Environmental factors• Health systems response, primary care• Overall socio-economic development

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Global NCD Action Plan, targets by 2015

• 25% relative reduction in risk of premature mortality from cardiovascular diseases, cancer, diabetes, or chronic respiratory diseases.

• At least 10% relative reduction in the harmful use of alcohol, as appropriate, within the national context.

• 10% relative reduction in prevalence of insufficient physical activity.• 30% relative reduction in mean population intake of salt/sodium.• 30% relative reduction in prevalence of current tobacco use in persons aged 15+

years.• 25% relative reduction in the prevalence of raised blood pressure or contain the

prevalence of raised blood pressure, according to national circumstances.• Halt the rise in diabetes and obesity. • At least 50% of eligible people receive drug therapy and counselling (including

glycaemic control) to prevent heart attacks and strokes.• An 80% availability of the affordable basic technologies and essential medicines,

including generics, required to treat major non-communicable diseases in both public and private facilities.

Article 168 of the EU TreatyA high level of human health protection shall be ensured in the definition and

implementation of all Union policies and activities.

Union action, which shall complement national policies, shall be directed towards improving public health, preventing physical and mental illness and diseases, and

obviating sources of danger to physical and mental health.

Such action shall cover the fight against the major health scourges, by promoting research into their causes, their transmission and their prevention, as well as health information and education, and monitoring, early warning of and combating serious

cross-border threats to health.

The Union shall complement the Member States' action in reducing drugs-related health damage, including information and prevention.

EU action on health determinants

- Tobacco- Nutrition and physical activity- Alcohol and drugs- Mental health- Environment and health- Social determinants and health inequalities

Disease Group Specific Actions

• Cancer: Guidelines on screening, European Partnership for Action Against Cancer

• CVD: support to European Heart Health Charter

• Mental health: Actions on depression and suicide

• European initiative on Alzheimer’s disease and other dementias

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(

- Not a funding instrument but a stakeholder-led, cross sectorial, collaboration instrument for research, innovation & intervention.

- Launched 2012 as part of Europe 2020 Strategy.

- Reach a critical mass for action by pooling EU resources/ expertise & recognising innovation/ excellence.

Reference Sites

ActionGroups

TWO STREAMS FOR ACTION

Sustainable & efficient care

systems growth & expansion of EU industry

health & quality of

life of European citizens

The EIP on Active and Healthy Ageing approach

+2 Healthy Life Years by 2020Triple win for Europe

SIX AREAS OF INTERVENTION A1. Adherence to treatmentA2. Preventing fallsA3. Frailty & cognitive declineB3. Integrated care C2. Independent LivingD4. Age-friendly environments

Improving health system performance Towards effective, accessible and resilient health systems (Commission communication 2014)

•Health system performance assessment

•Quality of care, patient safety

•Integration of care

•Health workforce

•Cost effective use of medicines

•Implementation of cross border Directive

•Health Technology Asesssment

•Health information e-health

EU ACTION ON CHRONIC DISEASES

Health systems cooperation

Disease specific actions

Risk factors and health deteminants

"(…)Union action, which shall complement national policies, shall be directed towards improving public health, preventing physical and mental illness and diseases, and obviating

sources of danger to physical and mental health.(…)" (Art. 168, TFEU)

PROMOTE PREVENT PROTECT

Legislation

Exchange of good practices

The Cancer Example: an integrated approach from health promotion to control

EU added value in the field of cancer

Aim: Integrated cancer plans in all Member States to contribute to reducing the cancer burden in the EU – Target: 15% incidence reduction by 2020. 25 of the 28 Member States had a plan or strategy by 2014.

EPAAC Cancer joint action (2010-2013)

• Health Promotion and cancer prevention, including screening,

• Identification of best practice in cancer-related healthcare,

• The collection and analysis of comparable data and information,

• A coordinated approach to cancer research.

European Partnership for Action Against Cancer

CanCon Joint Action - Workpackages1. Coordination

2. Dissemination

3. Evaluation

4. Guide

5. MS Platform

6. Integrated Cancer Control

7. Community level cancer care

8. Survivorship

9. Screening

www.cancercode.eu

The health promotion challengeRedefining the boundaries:

•promotion/prevention,

•primary/secondary,

•screening/early diagnosis

•Chronicity/Multimorbidity

•Rehabiltation/treatment/survivorship

•Target vulnerability

The EU contribution

Help Member States develop strategic approachesReview our instruments, using them to address chronic diseasesPilot and scale up good practiceCreate transparency: improve monitoring and evaluation

Implementing WHO goals, objectives and targets

• Collection, validation and dissemination of good practises to address chronic conditions

EIP-AHA networking, chronic disease community

• Health promotion and prevention focus on behavioural risk factors, social determinants and inequalities in health

streamlining

• Diabetes: a case study on barriers to prevention, screening and treatment of diabetes and improvement of cooperation among Member States to act on diabetes

Country analysis, policyadvice

• Work on multi-morbidity with focus on multi-disciplinary & integrated care, patient safety and professional training

• Development of common guidance and methodologies for care pathways for multi -morbid patients

Health outcomes, quality of care

How does CHRODIS contribute to reduce the burden of chronic diseases in Europe?

Thank you!