Print version ISSN 0042-9686
Bull World Health Organ vol.79 n.6 Genebra Jan. 2001
Heated debate likely on plan for EU-wide health coordination
In a vote on 4 April, the European Parliament called for the creation of a European Health Coordination and Monitoring Centre (HCMC) the cornerstone of a proposed new programme that would coordinate and streamline health policies across the 15 member states of the European Union (EU). At the same session, the Parliament also called for an almost 30% increase in funding from € (euros) 300 million (US$ 256 million) to € 380 million (US$ 336 million) for the programme, which would run from 2001 to 2006.
Officially termed programme of community action in the field of public health, the new programme was first proposed last May by the European Commission, the EUs executive body. The Parliament is currently calling for a number of revisions.
The proposed programme would replace eight existing programmes, which each addresses a single public health topic, such as cancer, AIDS and other sexually transmitted diseases, rare diseases, pollution-related diseases, epidemiological surveillance, health education, injuries and accidents, as well as drug abuse.
The Commissions public health proposal, explains Member of Parliament Antonios Trakatellis, is the first integrated EU venture in this sector. To date, important health topics have been dealt with in a piecemeal fashion, with different problems tackled mainly in isolation from each other. The main goal of the new programme, Trakatellis says, would be to collect and evaluate medical and epidemiological data across the EU, bookmark health-determining factors, including lifestyle, socioeconomic or environmental factors, and elaborate mechanisms by which one could respond rapidly and efficiently to health threats like, say, emerging infectious diseases.
The coordinating centre, the HCMC, that Parliament is calling for would be a clearing house for all types of public health data compiled from across the EU. It would gather data through national health agencies, monitor epidemiological trends and health inequalities, and come up with a catalogue of best health care practices to be provided to all EU citizens. In order to collect and manage data, you need a functioning coordination centre, which simply wasnt there [in the initial proposal], Trakatellis says.
In their vote, members of Parliament also included a wish-list of urgent issues the new programme should focus on: they include cardiovascular diseases, mental disorders, age-related neurodegenerative diseases, cancer, respiratory diseases, and AIDS and other sexually transmitted diseases. The Parliament also called for safeguards against exposure to electromagnetic fields and expressed the hope that research under the current WHO programme on magnetic fields would be supported.
The Parliaments revisions, says Trakatellis, would help ensure that this is a sound programme for the entire EU. Ideally, it would cover just about everything related to public health. I consider it the beginning of a long journey toward the convergence of health policies and services among the member states.
Dr Marc Danzon, the director of the WHO Regional Office for Europe in Copenhagen, welcomes the EU proposal.
The new programme, he says, would be a signal that the Commission is getting more involved in the sector of public health and that is good for the work of WHO. Once up and running, WHO is planning to collaborate closely with the EU networks, among other things in order to avoid any duplication of effort, Danzon says. Its neither in their interest, nor in ours. But the risk really is minor. In the field of epidemiology and public health, there are far too few people and too much data. In fact, there is work for 1000 organizations. The [Commissions] intention is good, the plans are good; now lets implement them together.
But Trakatelliss and the Parliaments vision has still a long way to go. The Council of the EU, composed of the responsible ministers of the member states, has its say on the proposal. Then the Commission, the Parliament and the Council have to settle on a compromise.
The Commission is not ruling out anything for the future but the first priority right now is to get the new programme up and running which, given its scope, is a massive effort, a Commission spokeswoman, who requested anonymity, told the Bulletin. Discussions are under way with other health agencies, including WHO, she added, on a broad range of topics, including what has to be done to make sure that there is no duplication of effort when the new programme goes into effect.
The Parliaments April vote is thus likely to mark the beginning of some heated debate.
Michael Hagmann, Zurich, Switzerland