#EAPM – Member states must act together. And communicate better…

| May 2, 2019

It’s perhaps hardly surprising to find the European Commission talking about ‘strength in unity’, as it did in a communiqué this week in respect of the EU’s next strategic agenda (2019-2024), writes European Alliance for Personalised Medicine (EAPM) Executive Director Denis Horgan.  

We tackle that lower down, but the fact is that the knowledge gap about what the EU does is substantial, as has been proven by the whole Brexit fiasco, which has seen a lack of honest information coupled with some downright lies.

Right now, were seeing a far-too-late information overload (much, as it was pre-vote, contradictory) alongside a Brexit burnout among most people in the UK. The media hasn’t helped – the right-wing has talked and written a lot of easily provable nonsense and the centre, liberal and left-wing media hasn’t talked enough. And when it has, it has done so disjointedly.

In the end, the whole referendum palaver left too many voters doing the Monty Python’s Life of Brian type of thing and saying: “What have the Romans ever done for us?” For ‘Romans’, obviously read ‘the EU’, but it would be unfair to say that this has only been happening since Brexit. It hasn’t. It’s been going on for years (if not decades) and Brussels has been spectacularly bad about singing its own praises.

At least now it is singing its own praised, and not before time. Especially as more than seven-in-10 Europeans want the EU to do more in the realm of healthcare.

This, of course, brings about its own difficulties given that healthcare is a member-state competence, and we only have to look at the ongoing battle of the Commission’s plans for mandatory aspects in EU-wide HTA co-operation to see what a tough ‘ask’ that is.

Part of the EU executive’s plan on HTA is to bring about more transparency (coupled with improved efficiency as well as access), but such transparency is at least perceived to be in very short supply within the corridors of power.

The bottom line is that if the EU is going to move forward in its current shape-and-form we need the institutions themselves to actually be permitted to act for the benefit of citizens. And those same citizens need to be able to see, feel and understand the results. Again, we’re back to information and, more importantly, getting that information out there.

A core issue is to put health care front and centre, to allow and encourage citizens to live healthier lives. There is plenty of health innovation out there but it’s a struggle to embed it into the EU’s healthcare systems and allow citizens access to it, before they even become patients.

A ‘stab in the dark’?  

We’ll come back to transparency/access later, and let’s now focus briefly on information, or a lack thereof. Vaccines are a prime example. There’s a problem here, and nobody is denying it. In fact the only denial is from those who believe that vaccines don’t do a job, and are dangerous, which leads to not enough vaccination and too many avoidable deaths from diseases that the medical arena learned how to manage years ago.

Experts have even gone so far as to suggest that a lack of trust in institutions is part of the reason for an increase in the prevalence of infectious diseases across Europe. Ouch, that hurt.

You may be surprised to read that a very recent EU-wide survey suggests that almost 50% of the population believes falls claims about vaccination. Yes, almost half – an astonishing figure.   European Commission Vice President Jyrki Katainen called the trend “worrisome”, and it’s fair to say that such a word is under-playing things somewhat.

One problem is that there’s little coherence across Europe when tackling, for instance, the rise in measles across the EU and the alignment of vaccination schedules.

There’s also a need to tackle the serious amounts of misinformation and to improve vaccine availability. People have grasped the fact that vaccines are important, but this comes with a majority in more than 16 countries believing that vaccines are often linked to serious side effects.

On top of this, more than one-third of those asked think a vaccine can cause the disease against which it is designed to fight. Neither of the beliefs have any basis in fact and, if ever there were a case for the EU to take a lead, this has to be it, right?

This is surely especially the case with some politicians opposed to mandatory vaccinations, and sometimes scaring citizens about having injections.   France and Italy have seen recent successful results from their mandatory vaccine programmes. But, still, 60% of French citizens incorrectly believe vaccines often cause serious side effects. This puts the French the fourth-highest behind Cyprus, Croatia and Malta when it comes to such misconceptions.

Against this backdrop, the European Commission is working to develop an online vaccine information portal with the European Medicines Agency and the European Centre for Disease Prevention and Control to monitor online vaccination information. At the same time Commissioner Katainen has admitted that there is “no magic wand”. Or, presumably, ‘magic needle’.

Back to access… 

The Center for Global Development (CGD) has some advice for the World Health Organization on transparency and access in respect of HTA. After taking a look at the WHO’s technical report on cancer-drug pricing, the CGD reckons the United Nation’shealth body should focus on HTAto improve access to cancer treatments, as opposed to throwing all its efforts into increasing transparency. The expert-led paper, entitled ‘It’s the demand side, stupid!’, says increasing cost transparency could actually reduce access to much-needed cancer drugs.

It puts forward six priorities for the WHO, and these include helping low and middle-income countries build up their HTA and expand value-based pricing, supporting efforts to improve evidence generation to inform HTA, focusing on “effective procurement” and market competition.

In its conclusion, the paper states: “Effective management of the demand side is a far more effective way to get R&D that meets patient and health system needs than seeking to restructure R&D.”

Sing-a-Long-an-EU  

Let’s return to that EU communiqué that we mentioned up top… In advance of a meeting of EU27 leaders in Sibiu, Romania (9 May), the European Commission has set out a number of policy recommendations for how Europe can shape its future in what it calls an increasingly multipolar and uncertain world. Flagging up the European Parliament elections on 23-26 May, and the change of political leadership of the EU institutions that will follow, the Commission says “the time has come for new policy orientations and new priorities.

As both the priorities we set and the way we explain and engage with Europeans will be decisive in strengthening our Union, the Commission is also making suggestions on how to better communicate our collective decisions. Together, these form the Commission’s contribution to the next strategic agenda for 2019-2024”.

For his part, the Commission’s President Jean-Claude Juncker said this week: “The duty of every generation is to change the destinies of Europeans, present and future, for the better. To make good on our enduring promise of peace, progress and prosperity. The challenges we Europeans collectively face are multiplying by the day. “For Europe to thrive, the EU’s Member States must act together.”

The outgoing Commission chief added: “I remain convinced that it is only in unity that we will find the strength needed to preserve our European way of life, sustain our planet, and reinforce our global influence.”

The EU’s next strategic agenda   The Commission believes thatthe EU’s strategic agenda for 2019-2024 is the right moment to address the challenges and opportunities Europe faces today.

It is looking at five areas for future action: building an effective and genuine European Security Union while moving towards a genuine European Defence Union; upgrading, modernizing and fully implementing the single market in all its aspects; continuing to deliver on the European Pillar of Social Rights, while working with member states to achieve social inclusion and equality, including by addressing regional disparities, minorities’ needs, gender issues and the challenge of an ageing population; modernizing the economy to embrace sustainable consumption and production patterns, and; leading the world through consistent and strong support for a multilateral, rules-based global order, with the UN at its core.

“The EU should also make it a priority to develop strong relations with close neighbours, based on a clear balance of rights and obligations. A strengthened international role of the euro would also increase Europe’s economic and monetary sovereignty,” the Commission says.

Crucially, it added: “The priorities we set and the way we explain and engage with Europeans will be decisive in making our Union more united, stronger and more democratic”.

Yes. Exactly. It’s just a pity we needed Brexit to help work that one out. In this context, EAPM would like to add that a priority should be encouraging the uptake of personalised health care across the EU’s member states.

An example could be screening programmes and agreed guidelines on, for example, lung cancer but what is key is visible co-operation. This will allow EU citizens to have more confidence in the institutions, with a knock-on effect that the institutions themselves (as well as healthcare actors) can focus on the added value that such co-operation can bring. Members and stakeholders can rest assured that the Alliance will continue to push for enhancement in this area, via its multi-stakeholder approach.

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Category: A Frontpage, EU, European Alliance for Personalised Medicine, Health, Health care, Personalised medicine

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