Public health in Europe


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Public health
in Europe
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Employment Sc social affairs
European Commission Cover photo: © Isopress Public health in Europe
Employment & social affairs
Public health
European Commission
Directorate-General for Employment, Industrial Relations
and Social Affairs
Directorate F
Manuscript completed in 1997 Notice to readers
The information contained in this publication does not necessarily reflect the opinion or the position of the European
Luxembourg: Office for Official Publications of the European Communities, 1997
ISBN 92-828-0390-2
© European Communities, 1997
Reproduction is authorized, except for commercial purposes, provided the source is acknowledged
Printed in Germany Contents
Preface — P. Flynn 5
I — Public health policy in the European Union 7
Public health in today's European Community 8
Integration of health requirements in Community policies 11
Report on the state of health in the European Community5
Public health framework programme — Article 1298
A new Community actione on health monitoring 2
A safe and secure blood supply 24
II — Cancer 27
The 'Europe against cancer' programme and its third action plan (1996-2000) 2
European cancer prevention weeks 31
Smoking and tobacco6
EPIC — European prospective investigation into cancer and nutrition 39
European initiative on breast cancer screening 42
European network of cancer registers5
Training activities within the Europe against cancer programme7
III —Drugs 50
Priority attached to drug prevention in the Treaty on European Union 51
A programme of Community action 53
The Community's priorities for the next five years (1996-2001)6
Review of Community activities since 19937
IV — AIDS and other communicable diseases 6
The European Community and the AIDS epidemic1
The 'flying condom' a visual code for communication8
Prevention of HIV/AIDS in prisons: establishment of a European network 70 n networks in the field of prostitution 72
Combating discrimination5
Psychosocial support to HIV/AIDS sufferers7
V — Health promotion ~9
Health promotion: central to the Community's objectives and policies 80
The European network of health-promoting schools (ENHPS)
European network for workplace health promotion 92
Annex 99 Preface
his issue of the 'Employment and soci­
al affairs' series focuses on public T health and the work we are doing to
give effect to the new competence in this area
that the Treaty on European Union gave to the
Almost immediately after the Treaty came into
force in November 1993, the Commission
took the first step towards implementing its
public health provisions by adopting my
proposal for a series of priority programmes
within an overall framework for action in the
field of public health.' A large part of that
framework has now been put into place.
The health problems facing the Community Member States individually. Viewed from that
perspective, our work to date is an important are too urgent and too large in scale to allow
first step. complacency. Every year in Europe millions die
prematurely or suffer ill health from serious
conditions that could have been prevented. Indeed, it is now time to begin thinking about
At the same time health systems throughout what the future will hold. So, in close contact
the Community are coming under increasing with the Member States, we are now begin­
strain as a result of the mounting demands ning discussions in order to determine the
being made upon them and the difficult fi­ strategy to be followed in the first years of the
nancial situation that Member States are fac­ new millennium.
ing. The pressures of having to cope with rap­
idly changing medical technology, with an I hope that this issue of the series devoted to
ageing population with ever-growing needs public health will help bring to the fore both
for health care and social support and with what has already been achieved and the main
people's constantly rising expectations about problems that remain to be resolved. In this
health services are therefore forcing Member way it can help inform public discussion and
States to take sweeping measures to reform debate on public health and show how the is­
their health systems and to control costs. sues to be faced and the actions we are taking
are not only of the greatest importance in
Against this backdrop, Community policies their own right, but are also vital elements of
must be geared to supporting Member States the Community's social policy as a whole.
in their efforts to make their health systems as
effective as possible so that the health of the
population is protected and improved. We
Pádraig Flynn
must also ensure that our actions have prac­
Member of the European Commission
tical value for individual citizens by, for exam­
with responsibility for employment and
ple, working to secure the continuity of ser­
social affairs
vices across internal borders. To make a real
impact on this situation implies a continuing
and growing long-term effort and commit­
ment both by the Community and by the COMÍ93) 559 final of 24 November 1993. I
Public health policy in
the European Union Public health in today's European Community
Pressure on health services t is one of the great paradoxes of public health in the
European Community today that while the population
What are the causes of this pressure? The first I has never been healthier, the demand on Member States '
of these is that of ageing populations. The
health systems, and thus the tendency towards increased
falling birth rate and lengthening life expec­
expenditure, is ever-growing and expenditure on health is
tancy means that progressively there will be
being constantly forced upwards. The Community's public
larger numbers of elderly people who are dis­
health strategy has been developed against this background
proportionate users of health services. Not
and is designed to reflect and respond to the problems which
only do elderly people need more medical
are putting pressure on Member States ' health services; treatment services than younger people, but
pressure which is likely to become even greater in the future. they also make more demands on social and
health-care services. Moreover, the effect of
the ageing population is made more acute be­
cause it also means that the burden of paying
for these services will fall increasingly on a
relatively smaller working population.
Second, the development of powerful new
technologies for diagnosis and treatment, in­
cluding new and costly pharmaceutical prod­
ucts, has a considerable impact on health­
care expenditure. The use of new technology
does not always involve greater costs per pa­
tient or course of treatment. Indeed with, for
example, increased use of day surgery and
out-patient care, these costs may well drop.
However, the technology is also leading to a
much larger number of patients being treat­
ed for a much wider range of conditions, with
the result that it is adding to the overall costs
of health care.
Third, and linked to the improvements in ther­
apy, there are rising expectations among the
public about what health services can provide,
and rising demands about what they should
provide. One factor behind this is the grow­
ing knowledge of and interest in health of the
ordinary citizen resulting notably from im­
proved health education and information ac­
tivities. Another is the increasing awareness of
differences in levels and standards of provi­
sion within and between Member States re­
sulting from increasing travel and mobility.