Dublin, 1 November 2012 Challenges and Opportunities in Europe Monika Kosinska Secretary General European Public Health Alliance

Dublin, 1 November Introduction Brief overview of the EU Brief overview of the EU Alcohol in the EU Alcohol in the EU Challenges for health policy Challenges for health policy Opportunities for health advocates Opportunities for health advocates Conclusions Conclusions 2

Dublin, 1 November European Public Health Alliance Coalition from across the EU Coalition from across the EU o Public health non-governmental organisations o Health professionals’ associations o Patient groups o Academic organisations o Population or disease-specific groups o Others 3

Dublin, 1 November Understanding the EU Main goals of the European Union Main goals of the European Union o Peace and security o Economic recovery and development …via economic integration and dismantling interwar protectionist measures 4

Dublin, 1 November Understanding Brussels ‘Pristine’ policy environment (detached from ‘real’ citizens) ‘Pristine’ policy environment (detached from ‘real’ citizens) Economic vs socia/environment/health Economic vs socia/environment/health Lobbying Lobbying Legal & technocratic vs political & democratic Legal & technocratic vs political & democratic Dominance of Think Tanks, lawyers, compared to size of civil service Dominance of Think Tanks, lawyers, compared to size of civil service 5

Dublin, 1 November Understanding EU alcohol policy Alcohol is key EU commodity Alcohol is key EU commodity o Agricultural subsidies o Promotional funds for wine o Internal market excise law o International trade agreements and export good o Marketing across borders o Alcohol harm strategies… 6

Dublin, 1 November Complex policy context 20 years of economic thinking in question 20 years of economic thinking in question Europe in decline vs other regions Europe in decline vs other regions Technology developing quicker than policy Technology developing quicker than policy Budgets and public spending crisis Budgets and public spending crisis Financial -> Economic -> Political crisis Financial -> Economic -> Political crisis Political confidence in private sector low Political confidence in private sector low 7

Dublin, 1 November Challenges Legal: Legal: o Litigious sector + confidence from tobacco wins o MUP is public health tipping point… o Economic o Tension between two sets of rights o Political o ‘Jobs and growth’ o Strong lobbying from ‘key’ sector 8

Dublin, 1 November Opportunities Evidence has caught up – need to watch the Think Tanks Evidence has caught up – need to watch the Think Tanks North Europe / South Europe gap is closing North Europe / South Europe gap is closing Growing confidence from other regions – pushing back Growing confidence from other regions – pushing back Appetite for intervention – stretching regulatory muscle (taxes, MUP…) Appetite for intervention – stretching regulatory muscle (taxes, MUP…) Cracks in the economic-dominant hegemony Cracks in the economic-dominant hegemony 9

Dublin, 1 November Conclusions MUP is the most important public health case in 30 years MUP is the most important public health case in 30 years EU trend is in favour of health BUT need to be ready to capitalise on this EU trend is in favour of health BUT need to be ready to capitalise on this 2013 / 2014 very important for alcohol – (MUP, alcohol strategy, audio-visual media directive) 2013 / 2014 very important for alcohol – (MUP, alcohol strategy, audio-visual media directive) 2013 / 2014 will set the stage until / 2014 will set the stage until

Dublin, 1 November We need to keep an eye on the goal 11 Identifying the problem Framing the policy issues Policy decision Implementing decision Evaluating decision