Health security is as vital as havens from terrorism

By European Alliance for Personalised Medicine (EAPM) Executive Director Denis Horgan 

Everyone wants to feel secure, and the Brussels ‘lockdown’ over the weekend and the past few days has thrown that into sharp relief.  Closed schools, closed metros, closed shops and almost-empty bars have been in stark contrast a heavy army and police presence alongside more news crews than tourists in the city’s Grand’Place. 

But security amidst the very real threat of terrorism isn’t the only arena in which it saves lives - health security is also vital in a Europe of 500 million potential patients across 28 member states. The European Commission’s Health Security Committee (HSC), which collects data on threats and risks from EU agencies, lists among its priority issues ‘detection and communication’, stating that ‘preparedness requires timely detection and rapid distribution of information to relevant stakeholders’.

It adds that scientific advice is key, too, as ‘responding to a public health crisis requires rapid mobilization of experts’.  The HSC recently discussed the risk of communicable diseases in refugee camps across EU Member States and, further back, met to appraise the possible impact, health wise, of the 2010 volcanic ash cloud as well as the H1N1 pandemic of the year before.  Clearly it is of paramount importance to maintain security and public safety but, to do this requires a fine balance between over-reacting and under-reacting - protocols were not properly in place for the Ebola scare, for example - and the science also has to be ready to roll out at a moment’s notice.  A disease or environmental disaster are obviously not exactly the same as a group of terrorists, but in each case the technology and science has to exist to locate them, contain them and/or eradicate them.

We have heard all week that the nine police forces in Brussels sometimes fail to communicate and coordinate, and this is also true of security forces across borders who still, in this day and age, fiercely guard their own intelligence. Had such intelligence been shared between Belgium and France there is a solid argument that the attacks would have been thwarted.  Collaboration is clearly vital and this is also the case with health security.  The Brussels-Based European Alliance for Personalised Medicine (EAPM) takes the view that, for example, investing in ‘Big Data’ systems - a cornerstone of this new and fast-growing method of prevention, diagnosis and treatment - is vital if we are to be able to access EU-wide information and data sets that could secure and improve the well-being of EU citizens - by giving the right patient the right treatment at the right time.

And this also involves the patients, who are at the heart of personalised medicine. There needs to be a higher degree of health literacy among the public and, in this area, front-line healthcare professionals have a big part to play.

The latter need to be up-to-date on modern methods, be aware of relevant clinical trials and be able to communicate properly with the patient in front of them, empowering him or her and engaging in co-decision about their treatment options.  Training is key here, obviously, and needs to be ongoing to keep up with the science that is outstripping Moore’s Law and moving at a blistering and often bewildering pace.  But it is not only that. Best practices have to be established in many health arenas and, crucially, need to implemented properly.

We need smarter legislation to aid this but, however, smart it may be, it amounts to nothing if it is not adhered to and makes a mockery of initiatives such as, for example, cross-border health care.  Where are the electronic health records, theoretically easily accessible from any EU country? ‘Difficult to spot’, is the answer. The fact is that hospitals within a country (or even a region) struggle to access records and struggle even more to share them. And woe-betide the patient who asks for a copy…he or she will be met with reluctance and best and downright obstruction at the worst.  None of this helps to create a Europe that can react quickly to a healthcare threat until, in some cases, it is to late. Just like Paris.

Nobody says it is easy. Stopping coordinated attacks, such as those that left 130 dead and many more injured, is difficult. Stopping a highly communicable disease in its tracks is equally problematic.  At the European Health Forum Gastein early this year, Health and Food Safety Commissioner Vytenis Andriukaitis (part of whose dossier is ensuring that the Commission is ready in supporting the EU’s capacity to deal with crisis situations in food safety or pandemics) spoke about: “the rising of risk factors provoking chronic diseases which afflict our societies and threatens the sustainability of our health systems. This causes major expenditures in our health systems”.

He added: “I will never tire of stressing that we need a major shift in the way we finance, organize and operate our health systems.We need more public health. We need more prevention. And for this we certainly need a greater understanding that people's health - our health resource - is our most precious economic resource to which all ministers must contribute.  “To keep people in good health and prevent diseases, we need literacy; we need education; we need affordable healthy food; we need appropriate houses; public spaces where people can exercise; we need healthy working and living conditions; decent living standards. In turn, this fosters good health, which translates into a productive workforce.”  Scientists are agreed that health security is a global necessity, and also that Europe (with the US) should lead the way in expanding surveillance networks in rural and urban communities.

One expert - David Perlin, executive director of the Public Health Research Institute and the Rutgers Regional Biocontainment Laboratory in New Jersey - wrote in the New York Times: “Diagnosing an infection without the ability to treat and manage patients effectively renders diagnostics useless. It is time for a comprehensive investment plan that addresses total global health needs.”  EAPM could not agree more, yet a great deal of work clearly remains to be done.  With this in mind, the Alliance is undertaking a process of ‘taking stock’, to see where we are in personalised medicine, big data application, research budgets, and more, as well as where we need to be and where we need to go to secure better health for our citizenry.

This process will culminate in EAPM’s fourth annual conference, to be held in conjunction with the Dutch presidency of the EU in Brussels next April. The conference acts as a multi-stakeholder platform bringing together patients, scientists, academics, industry, legislators and more.  Fighting terrorism and fighting illness are clearly not exactly the same. But both terrorism and ill health have a profound and negative affect on the state of the Union and must be tackled in a smart, confident and coordinated manner. For all our sakes.

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