EFA

Despite many positive concerns showed by the European Union on the matter of public health and patients’ safety, the biggest and most worrying news of December is that the National Emission Ceilings (NEC) Directive aimed to improve air quality in Europe has been withdrawn from the European Commission’s agenda for 2015.

A new Start for Europe: jobs and employment but not health

On the 16^th Of December, the European Commission presented its Work Programme for 2015 to focus on the priorities proposed by Juncker’s team. The Work Programme sets 23 new initiatives, leaving 80 existing proposals including Clean Air Package, either out of their planning or to be reviewed. The Commission proposed to review the NEC Directive again arguing that it has been a controversial legislation and it was hard to reach an agreement between the Member States. European Commission Vice-President announced that a new revision will be proposed to reassess the methods stated in the proposal without compromising the planned goals. Nevertheless, the European Parliament will vote on the proposed work plan early next year, when we expect to have more clarity and the reasons, timeline and objectives of a new revision for the NEC. At EFA, together with the European Academy of Allergy and Clinical Immunology (EAACI), we showed our concerns on this policy development and urged the EU to put air quality policy back on the 2015 agenda. The joint press release is available here. In 2015 the Commission committed to deliver:

1. An Investment Plan for Europe: the legislative follow-up to the Plan announced last month, unlocking public and private investments in the real economy of at least € 315 billion over the next three years.
2. An Ambitious Digital Single Market Package: creating the conditions for a vibrant digital economy and society by complementing the telecommunications regulatory environment, modernising copyright rules, simplifying rules for consumers making online and digital purchases, enhancing cyber-security and mainstreaming digitalisation.
3. The first steps towards a European Energy Union: to ensure energy supply security, further integrate national energy markets, reduce European energy demand and decarbonise the energy mix.
4. An Investment Plan for Europe: the legislative follow-up to the Plan announced last month, unlocking public and private investments in the real economy of at least € 315 billion over the next three years.
5. A Fairer Approach to Taxation: An Action Plan on efforts to combat tax evasion and tax fraud, including measures at EU level in order to move to a system on the basis of which the country where profits are generated is also the country of taxation; including automatic exchange of information on tax rulings and stabilising corporate tax bases.
6. A European Agenda on Migration: developing a new approach on legal migration to make the EU an attractive destination for talent and skills and improving the management of migration into the EU through greater cooperation with third countries, solidarity among our Member States and fighting human trafficking.
7. Deeper Economic and Monetary Union: Continued efforts to promote economic stability and attract investors to Europe.                                                                                                                                                                                                                                                                                                                                                                              Picture: EC Vice-President Frans Timmermans at the EC Workplan Announcement 
   

Outcomes of the COP20 Lima Conference on the Climate Change

 From the 1st-12th of December, 192 countries participated in the United Nations (UN) framework convention on climate change (COP 20) that took place in Lima (Peru). The purpose of the conference was to settle the principles that will underpin a UN agreement to limit global warming to below 2C, a much needed development to replace the 1997-2012 Kyoto Protocol on emission targets. After several strong statements from UN Secretary General Ban Ki Moon urging countries to come up with ‘meaningful commitments’, the outcomes of the conference include:

 (1) A pact to defeat climate change by adopting a format for national pledges to cut Earth-warming greenhouse gases;

 (2) A blueprint to guide next global negotiations on a climate change, which will take place in Paris in December 2015.

Envoys from the EU, small island states, least developed countries and a Latin American alliance all welcomed the conference updates outlining the types of carbon cutting and financial commitments countries should make before meeting next year in Paris. However, two main issues seem to be holding up the talks. The first is whether developed and developing countries should face different obligations under a 2015 deal. The second is what climate pledges for this agreement (known as intended nationally determined contributions) should contain and how they will be assessed. Decisions on those aspects have been postponed and will be further addressed in 2015. The European Union took the lead on the previous COP Convention in 2009 by adopting ambitious goals to reduce internal emissions, a package known as the "20-20-20" targets, where it set three key objectives for 2020: 1) a 20% reduction in EU greenhouse gas emissions from 1990 levels; 2) raising the share of EU energy consumption produced from renewable resources to 20%; 3) a 20% improvement in the EU's energy efficiency. However, the economic crisis and the new European Commission U-turn approach towards the clean air and waste package hamper the achievement of those goals. Climate change is closely linked to air quality and hazardous climate phenomena impacting human health. By implementing ambitious measures reverse climate change trends, air pollution and its negative effects to our health also will be tackled.

 Picture: UN Secretary General Ban Ki Moon speech at the UNFCC

The EU recalls measures on the healthcare and patient safety

On the 1^st of December 2014, the Council of the European Union adopted the conclusions on patient safety and quality of care, including the prevention and control of healthcare associated infections and antimicrobial resistance. The document provides an overview of the key European public health legislation and recalls both the European Commission and the Member States on the crucial actions aimed to improve patients’ safety and quality of healthcare in Europe. The Council of the European Union is the institution representing the Member States' governments. Also informally known as the EU Council, it is where national ministers from each EU country meet to adopt laws and coordinate policies. The Council is an essential EU decision-maker. It negotiates and adopts new EU legislation, adapts it when necessary, and coordinates policies.

Anti-tobacco policies should tackle health inequalities

Although the numbers of smokers is decreasing, almost 1/3 of the EU citizens smoke. Tobacco smoking and secondhand smoke are linked to many health risks including widely spread asthma and chronic obstructive pulmonary disease (COPD). Moreover, smoking remains the largest avoidable health risk in Europe. But did you know that smoking is also one of the main sources of health inequalities in the EU? The new study published by the European Commission described the impact of tobacco control policies on socio-demographic groups in Europe. Many health risks, such as poor living and working conditions and unhealthy behaviours are more common among socially disadvantaged groups. According to the latest estimates, in Europe more than 700,000 deaths annually can be attributed to health inequalities. In this sense, smoking is highly prevalent among disadvantaged groups with lower education, socio-economic status and income. For example, the link between smoking and education level has been confirmed by several European studies: when comparing 25-44 years old groups, smoking prevalence is twice higher among people with only primary or lower secondary education. The same evidence of higher smoking rates were found among people with lower socio-economic status and from minority ethnic groups. Whereas tobacco control interventions are effective in reducing smoking prevalence, until recently, tobacco control measures have not been specifically targeted at disadvantaged groups. The European Commission has commanded a study to address this issue which it recommends to include specific interventions aimed to tackle health inequalities in disadvantaged groups in tobacco control policies, as a means to contribute both to reducing smoking rates and health-related inequalities.

New food labelling rules applicable since 13 December 2014

As of 13 December 2014, the new EU food labelling rules adopted by the European Parliament and the Council in 2011 will ensure that consumers receive clearer, more comprehensive and accurate information on food content, and help them make informed choices about what they eat. The key changes that will take place in the upcoming years are outlined below:

1. Improved legibility of information (minimum font size for mandatory information);
2. Clearer and harmonised presentation of allergens (e.g. soy, nuts, gluten, lactose) for prepacked foods (emphasis by font, style or background colour) in the list of ingredients;
3. Mandatory allergen information for non-prepacked food, including in restaurants and cafes;
4. Requirement of certain nutrition information for majority of prepacked processed foods;
5. Mandatory origin information for fresh meat from pigs, sheep, goats and poultry;
6. Same labelling requirements for online, distance-selling or buying in a shop;
7. List of engineered nanomaterials in the ingredients.
8. Specific information on the vegetable origin of refined oils and fats;
9. Strengthened rules to prevent misleading practices;
10. Indication of substitute ingredient for 'Imitation' foods;
11. Clear indication of "formed meat" or "formed fish";
12. Clear indication of defrosted products.

Food business operators have been given three years to ensure a smooth transition towards the new labelling regime for prepacked and non-prepacked foods. The Commission has been working together with businesses to ensure that the new rules will be properly implemented. Work is also underway on developing an EU database to facilitate the identification of all EU and national mandatory labelling rules in a simple way. The work for the creation of the database should be carried out during 2015.

Patient Solidarity Day 2014 focused on Universal Health Coverage

On the 6^th December the world celebrated the Patients’ Solidarity Day, which this year aims to raise awareness on Universal Health Coverage (UHC). According to the International Alliance of Patients’ Organisations (IAPO), the core principles of UHC include:

(1) Patient-centred: all stakeholders need to work together to ensure that health systems prioritise and meet the needs of patients, their families and carers;

(2) Accessibility: universal health coverage must ensure that all patients can access health services they require;

(3) Equity: all people, regardless of age, gender, race, disease or condition, and economic circumstances must have equitable access to healthcare;

(4) Quality: care must be of high quality at all levels and stages of healthcare;

(5) Empowerment: patients must be actively involved in all levels of healthcare decision-making;

(6) Collaboration: improved access to healthcare for all is only possible with the collaboration of all stakeholders, including patients;

(7) Value of healthcare: it is essential to place priority on the value, not the cost of providing access to high quality, equitable and affordable healthcare for all;

(8) Accountability: health systems must be accountable to the patients they serve, as accountability and transparency are vital to ensuring safe, effective healthcare.

In Europe and worldwide, there is a lot of room for improvement in terms of universal health coverage. At EFA we believe that this progress can be better achieved when patients are involved in the decisions affecting their health. Therefore, as patient representatives and members of the European patient movement we will continue fostering universal health coverage principles in Europe.

European Commission report: Health at a glance

The new report Health at a glance issued by the European Commission and the Organisation for Economic Co-operation and Development (OECD) presents the most recent data on health status, risk factors to health, access to high-quality care in all 28 EU Member States. The key messages of the report are presented below:

(1) The economic crisis has had a mixed impact on population health and mortality. For example, the exposure of the population to air pollution fell following the crisis, although some air pollutants seem to have risen since then.

(2) Between 2009 and 2012, expenditure on health was reduced in half of the EU countries and significantly slowed in the rest. While health expenditure has grown at a modest rate in 2012 in several countries (including Austria, Germany and Poland), it has continued to fall in Greece, Italy, Portugal, Spain, Czech Republic and Hungary.

(3) Most EU countries have maintained universal coverage for a core set of health services, with the exception of Bulgaria, Greece and Cyprus where a significant proportion of the population is uninsured.

(4) Overall quality of care has improved in most countries, but disparities persist. Furthermore, aging population will continue to increase demands on health and long-term care systems. Thus, for the upcoming years the challenge will be to preserve access to high-quality care for the whole population at an affordable cost.