Europe on treatment table as Byrne fights health threats

Date: 07/11/02

By Karen Carstens

'LETHARGY is the forerunner of death to the public liberty.' These words once uttered by that ever-so-quotable early 19th-century US President, Thomas Jefferson, surely apply now more than ever to legions of increasingly stressed-out yet less physically active people on both sides of the Atlantic.

Obesity, which was once smugly dismissed by most EU citizens as a phenomenon limited to the plus-sized country that brought the world McDonald's and the 'All-You-Can-Eat' dining experience, has now become one of the biggest health concerns in Europe.

The most dramatic increase has been in the UK, where the rate of obesity has more than doubled since 1980 (see report, Page 20), according to the International Obesity TaskForce.

But at least this is a health issue every single afflicted person can strive to address on their own: what about health problems that transcend borders, such as patients' needs for special treatments or procedures in other member states, or spooky health safety threats, such as communicable diseases, environmental threats or even bioterrorism?

Speaking last week during a debate in Brussels hosted by the European Policy Centre, Health and Consumer Affairs

Commissioner David Byrne said: 'As BSE taught us, we need to be proactive rather than reactive when it comes to our citizens' health.'

Recognised for the first time under the 'services' heading in EU law in 2001, health is one policy area in which EU competencies are widening.

'Following the Court's [European Court of Justice] definition of health services as services under the Treaties, a competence gap risks emerging where neither member states nor the Commission health sectors are in a position to fully manage the situation,' Byrne said.

'We will quickly need to find new ways of managing these issues.'

Nevertheless, EU governments are still in charge of their own national health care systems.

'Article 152 of the treaty strikes fear in the hearts of member states that the Commission wants to run the hospitals of Europe,' Byrne told an audience of business and health care professionals at the EPC talk on 29 October.

'I want to assure you I have no such ambition.'

But Byrne does want to press on with his vision for a 'Europe of Health', and has launched a six-year programme that becomes operational in January to do so. 'This programme signals a clear -reorientation of our approach by moving from being a project-driven to a policy-oriented programme,' he said.

But Diana Smith, a spokeswoman for the Brussels-based European Public Health Alliance, said that with a budget of about €312 million, this programme is grossly underfunded.

'It's a tiny, tiny amount of money,' she lamented, especially when compared to the vast sums funnelled into EU agricultural and structural assistance programmes.

'You can get such huge dividends for spending just a little more on health policy. We feel there ought to be more resources and more monitoring,' she added.

Even though the subsidiarity principle, which assumes decisions should be taken as close as possible to the people, applies to health policy, the EU could take more concrete action, she said.

Byrne is trying to do just that when it comes to protecting citizens against health threats, including the possibility of bioterrorism.

'We already have in place a Community network of communicable diseases,' he said. 'But I am concerned that we are not fully prepared for epidemics of major communicable diseases, and other serious health threats, which require a rapid and coordinated reaction.'

To address this current lack of 'fully effective and coordinated surveillance and response capacities' in the EU, Byrne said the Commission is committed to creating a European Centre for Disease Control by 2005.

'This will act as a reference and coordination point both in routine and in crisis situations,' he said.

Moreover, he said, a health security committee of high-level ministers has been established that will work with an expert task force that draws its members from both the Commission and the member states.

In addition, the Commission is also working with the G8 countries, Mexico and the World Health Organization (WHO) in the context of the Global Health Security Action Plan, he added.

Byrne also pursues one of his most noble pet projects - fighting the scourge of smoking, an addiction that afflicts about five times more Europeans than North Americans and has often been cited as 'the biggest public health threat in Europe' - via the WHO Framework Convention on Tobacco Control.

His latest manoeuvre on this battlefield is the second phase of an anti-smoking TV advertising campaign geared towards children that will be launched tomorrow, 8 November.

Another 'hot' issue is the free movement of doctors and nurses as well as patients in an enlarged EU of 25 members. 'The organisation and delivery of health care remains in the hands of member states,' Byrne said.

'But the courts are clarifying now how this competence interfaces with the provision of cross-border services.'

To keep citizens better informed on the latest developments on the health policy front, Byrne said the Commission is also planning to set up a new 'Community health portal' on the internet.

'I want to see this up and running by 2004,' he said.

'By providing easy access to timely, accurate and reliable information, we want to avoid partial, biased or misleading information.'

Feature on health care issues in the European Union.