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Time for treaty changes and a joined-up approach on EU health




1440081238665Opinion by European Alliance for Personalised Medicine Executive Director Denis Horgan

Whether or not you agree with German Chancellor Angela Merkel’s on-the-record assertion that multi-culturalism “has failed, utterly failed,” there have certainly been mixed reactions across EU member states regarding the intake of refugees.

A couple of weeks ago European Union ministers approved a plan to split the burden of relocating up to 120,000 migrants awaiting placement from Greece and Italy, with each member state taking in numbers based on its economic strength, population, unemployment and the asylum applications it has passed since 2010.

The quotas were approved after overruling the votes of the Czech Republic, Hungary, Romania and Slovakia.

At the time, Luxembourg’s Foreign Minister Jean Asselborn said: “We would have preferred to have adoption by consensus, but we did not manage to achieve that.”

Overall, this deal – and the fact that it had to be forced through – represents a fragmented EU approach to the refugee crisis. One that is mirrored in the various health services across the 28-member bloc.

Refugees aside, when it comes to the health time bomb of an ageing population of 500 million citizens, who will all be ill at some stage, the lack of a joined-up health plan across the EU, inadequate cross-border co-operation (even cross-regional in many countries), differing medicine prices and reimbursement systems, as well as huge inequalities in access for patients to the best treatments possible, it is clear that individual health systems are failing to provide for their own already-resident citizens, let alone anyone else.


Of course, the EU does not have competency for Europe-wide health – it is a member state responsibility under the subsidiarity principle and locked into the legally binding treaties – although certain regulations have had their impact: health and safety rules, clinical trials regulations and laws governing in vitro diagnostics, for example. Officially, the EU has ‘supporting competences’ in the health arena but what these add to cohesion across Europe is debatable.


Now Europe’s commissioner for health, Vytenis Andriukaitis, has gone on record talking about broadening the role of the EU executive when it comes to health policy.

At a conference in Riga he said: “I believe it will be nice to discuss the possibility to change the European Union treaties in the future,” with the treaties covering wider ideas. Andriukaitis added that: “I think it will be very timely to raise questions” with the European Parliament and the EU Council.

“Believe me, I can’t imagine a more economically effective possibility than to manage health issues at EU level,” the commissioner said.


This could represent a major shift in top-level thinking, although individual Member States would take some persuading.

One of many organisations that would need no convincing, however, is the Brussels-based European Alliance for Personalised Medicine (EAPM) which has been calling for greater collaboration and cooperation in health since its foundation several years ago and whose multi-stakeholder membership has been championing a potentially greater EU role in health-related matters.


Personalised medicine (or ‘precision medicine’, as US president Barack Obama refers to it) uses the explosion in genetics-based science and other advances in order to give ‘the right treatment to the right patient at the right time’.

EAPM’s current Taking Stock initiatives – to culminate in its Spring 2016 conference – are looking at how far personalised medicine has come and, crucially, where it needs to go next to improve treatments, modernise clinical trials, encourage research and level the playing field when it come to access for patients.


For example, the Alliance believes that it is crystal clear that resources such as Big Data – crucial for ongoing research – should be collected, stored and shared in a manner that, yes, adequately protects the privacy of patients, yet is not so over-regulated that it stymies the swapping of information between Member States (and within them).

Meanwhile, it maintains that quality standards and the concept of ‘value’ (for pricing and reimbursement) need to be agreed and apply across all of the EU’s 28 countries and that the cross-border health directive needs to be properly implemented.

A European Union in which every nation does things differently in their health systems is no longer feasible and will become less so with every passing year. Genuine unification is difficult but EAPM believes it is something that must be worked towards.

At the end of the day Angela Merkel may truly believe that multi-culturalism doesn’t work, but a multi-national, EU-led health structure is a must. Fortunately, Europe is at least trying to work together to solve the refugee crisis, despite the dissenting voices, and it must now start to do so in the vast and vital arena of health.

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