The future of health in the European Union
Health challenge such as antimicrobial resistance that may cause more deaths than cancer by 2050, air pollution that is accountable for almost a half of million premature deaths annually, or mental health burden that reached 4% of EU’s GDP; are the unprecedented challenges that European Union is facing and which question the sustainability of Member States health systems progressively.
There is an ongoing need for more, for example for additional prevention, as more than a million Europeans die pre-maturely each year of diseases that could be avoided through better policymaking.
More complexity in dealing with Union’s health issues is brought in by the fact that, according to the Treaty, organizing the health system and providing healthcare continues to be a competence of the Member States.
On one hand this secures the authenticity of how Member States deal with their diverse nature of healthcare systems, but this privilege comes also with shortcomings that lead to significant discrepancies in the quality of treatments across the EU, interoperability issues between national health systems and considerable obstacles for patients accessing healthcare, particularly for the most vulnerable ones.
Despite the fact that more Europeans require more action in the field of Health from the Union level, it seemed that health was no longer a priority within the future Multi-annual Financial Framework. Take for example the health component and health budget from the original proposals from the Commission as regards Horizon Europe and the Health Strand within European Social Fund Plus (ESF+): reduced budget, no separate instrument for health. From my point of view, undermining our main health policy instrument will not solve many issues.
As regards to the Health Program, the European Commission indeed aimed to simplify fund programming and reduce unnecessary bureaucracy, but it also reduced the budget of the fourth EU Health Program (2021-2027) and merge it with four other programs, under the ESF+, measures that were not perceived positively by our citizens, who overwhelmingly demand more EU intervention in health.
What we need is to reinforce the EU Health Program and make it fit the purpose better, as it has already provided health policies of considerable added value with limited resources.
Major health challenges can be effectively and efficiently addressed only through enhanced collaboration at the EU level.
The Parliament has endorsed my efforts as ENVI committee’s rapporteur to preserve EU Health Program’s well-functioning through maintaining the same budgetary allocation as in the previous program. Merely a stable Health Program can deliver required policy support to Member States, especially in the transition from disease-centered to people- centered health systems, placing thus persons in the center of healthcare, rather than diseases. The program draws attention to mental health issues, which currently requires more political prioritization and pooling of resources, for the reason that mental problems are a resilient, widespread and considerable generator of discrimination, with severe socio-economic repercussions.
Finally, I consider it of vital importance to be successful in strengthening health systems by supporting the digital transformation of health and upholding national reforms to make health systems more effective, accessible and resilient.
The European Semester can play a crucial role in this matter, as it is now empowered to recommend Member States reforms towards improved accessibility and sustainability of health systems.
On the other hand, our society expects breakthrough innovation to deliver accelerated solutions to major challenges in health. In my capacity of ENVI committee’s rapporteur for Horizon Europe, the 9th research and innovation program, I advocated together with fellow rapporteurs from ITRE committee, to raise the budgetary line dedicated to research and innovation in health from 7,7 billion as proposed by European Commission to 9,12 Billion.
Only a robust research program can deal with the complexity of current health issues, which are interlinked and necessitate cross-sectorial, multidisciplinary and trans-national collaboration.
On these grounds, I emphasize the strong potential of the novel concept of missions. A few, simple, well-funded missions with a high societal impact will serve to bring all relevant actors in research, industry, and academia around a common purpose. Moreover I proposed in my report a first mission to be “the eradication of pediatric cancer by 2040” and this has been the trigger for the negotiating team to agree in March this year upon “tackling cancer” to be one of the 5 missions under Horizon Europe.
Innovative solutions in the field of pediatric oncology are crucial for Europe’s future generation considering that every year 35 000 new cases of cancer on young people are registered within the EU. Given that research and innovation are severely fragmented in this field and national actions alone have not been achieving sufficient results by themselves, this mission could bring a tremendous EU added value in the years ahead.
Research and innovation projects under Horizon Europe are designed to develop close connections between discovery, clinical, environmental, epidemiological, social and economic research, aiming to deliver new solutions and ensure the uptake of results in clinical practice as well as in health care systems. I stress that Horizon Europe’s health objectives are designed to contribute proportionally to EU’s policy objectives, such as the European One Health Action Plan against anti-microbial resistance (AMR), the EU Directive on cross-border healthcare, EU Pillar of Social Rights (which stands up for a universal right to timely access, affordable, preventive and curative health care) and EU Digital Single Market.
The program will also uphold the EU’s commitment to the Paris Agreement and the United Nation’s 2030 Agenda for Sustainable Development SDG 3, “Good health and well-being for people” and SDG13 – “Climate action,” underlining that 35% of Horizon Europe budget will contribute to climate objectives.
As a final point, health in the European Union is in urgent need to achieve improved cost-effectiveness. Health expenditure reaches already 10% of EU’s GDP, cumulated by the fact that in health the cost of non-action is dramatically higher than the cost of action. A feasible solution has been proposed through Health Technology Assessment (HTA), an evidence-based process aiming to determine the added therapeutic value of new health technologies in comparison with existing ones. As IMCO committee’s rapporteur on this file, I continue to highlight the necessity to reach consensus within the Council of ministers.
Our patients and specialists need to be sure if a new health technology delivers improvements or not, while at the same time, competent national authorities need to allocate budgetary resources for health based on precise evidence obtained jointly at the EU level.
If adopted, HTA will increase the level of human health protection drastically, but as well the performance of the single market.
To conclude, the future of health in the European Union should bring political will, breakthrough innovation and evidence-based implementation closely together, not excluding one another.