Transcript EU Policy on Health Promotion and Chronic Diseases

EU Policy on Health
Promotion and
Chronic Disease
Vilnius, 24 November 2015
Michael Hübel, Head of Unit
Programme Management and
Diseases
DG 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
Health systems
Environment
Cancer
Mental diseases
Lack of
physical
activity
Musculo-skeletal
diseases
Neurodegenerative
diseases
Genetic
Background
Obesity
Diabetes
Over nutrition
Tobacco
Alcohol
Cardiovascular
diseases
Respiratory diseases
Communicable diseases
Social factors
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,
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spent on chronic diseases in the EU
Yearly cost of disease related absenteeism
estimated at 2.5% of GDP
Early retirement: Chronic diseases (Musculoskeletal, 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
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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 Treaty
A 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 drugsrelated 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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The EIP on Active and Healthy Ageing approach
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Not a funding instrument but a
stakeholder-led, cross sectorial,
collaboration instrument for research,
innovation & intervention.
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Launched 2012 as part of Europe
2020 Strategy.
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Reach a critical mass for action by
pooling EU resources/ expertise &
recognising innovation/ excellence.
+2 Healthy Life Years by 2020
Triple win for Europe
health &
quality of
life of
European
citizens
Sustainable &
efficient care
systems
growth &
expansion
of EU
industry
(
SIX AREAS OF INTERVENTION
A1. Adherence to treatment
A2. Preventing falls
A3. Frailty & cognitive decline
B3. Integrated care
C2. Independent Living
D4. Age-friendly environments
TWO STREAMS FOR ACTION
Action
Groups
Reference
Sites
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
"(…)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)
EU ACTION ON
CHRONIC
DISEASES
PROMOTE
PREVENT
PROTECT
Exchange of
good practices
Risk factors
and health
deteminants
Disease specific
actions
Health systems
cooperation
EU
programmes
ESIF
Legislation
The Cancer Example: an integrated
approach from health promotion to
control
EU added value in the field of cancer
Support to Member States
Prevention of Cancer - Primary Prevention (including work on health
determinants)
Secondary Prevention/Screening (Guidelines, European Initiative on Breast
Cancer)
Cancer Data and Information
Research
European Partnership for Action Against 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.
CanCon Joint Action - Workpackages
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2.
3.
4.
5.
6.
Coordination
Dissemination
Evaluation
Guide
MS Platform
Integrated
Cancer Control
7. Community
level cancer
care
8. Survivorship
9. Screening
www.cancercode.eu
The health promotion challenge
Redefining the boundaries:
• promotion/prevention,
• primary/secondary,
• screening/early diagnosis
• Chronicity/Multimorbidity
• Rehabiltation/treatment/survivorship
• Target vulnerability
The EU contribution
Help Member States develop strategic approaches
Review our instruments, using them to address
chronic diseases
Pilot and scale up good practice
Create transparency: improve monitoring and
evaluation
Implementing WHO goals, objectives and targets
How does CHRODIS contribute to reduce the
burden of chronic diseases in Europe?
• 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
Thank you!