1. EPHA presentation to network of self-help groups European Public Health Alliance Health and the EU – a guide for NGOs Tamsin Rose, General Secretary, EPHA EPHA is a network of 90 non governmental and not-for- profit organisations across Europe working on health and health-related issues. Our mission is to improve the health of European citizens and to increase their participation in EU policy-making.

2. EPHA presentation to network of self-help groups What does the EU treaty state? The EU Treaty is the legal basis for the EU role on specific policy areas. Article 152 of the 1997 Amsterdam Treaty covers public health: “a high level of health protection shall be ensured in the definition and implementation of all Community policies and activities”  But the EU must respect Member State responsibilities for organisation and delivery of healthcare. (11 of the current 15 countries have de-centralised healthcare systems).  The key EU mechanism of legislation to harmonise Member States laws is not permitted except on the safety of blood and blood products (law finalised in autumn 2002) and human tissues and cells (law expected to be adopted in 2004).

3. EPHA presentation to network of self-help groups What EU rights to health exist? “Everyone has the right of access to preventative healthcare and the right to benefit from medical treatment under the conditions established by national law and practices” Article 35 of the Charter of Fundamental Rights of the EU, Adopted in Nice, 12/2000 In practical terms this means the right to be treated by a doctor. It does not cover issues such as ‘quality’ and ‘timeliness’. It is less ambitious than the WHO definition of health.

4. EPHA presentation to network of self-help groups How is responsibility for health issues covered at EU level?  DG Health and Consumer Protection (public health, food safety, animal health, monitoring of health, tobacco and alcohol policies)  DG Environment (chemicals, pesticides, soil, air and water pollution, bio-diversity, nature reserves)  DG Employment and Social Affairs (health and safety at work, combating discrimination and poverty, maternity and parental leave).  DG Internal Market (Recognition of professional qualifications)  DG Competition (approving mergers eg; Pharma companies)  DG Agriculture (Common Agriculture Policy)  DG Development (EU is the world largest source of overseas aid)  DG Education and Culture (sport, youth policies)

5. EPHA presentation to network of self-help groups How is responsibility for health issues covered at EU level? Part II  DG Trade (TRIPS, GATS, access to medicines)  DG Research (scientific research on genomics, food safety, causes of diseases, environmental health)  DG Information Society (e-health applications)  DG Transport and Energy (energy generation, rail transport, road safety)  DG Enterprise (pharmaceuticals and medical devices)  DG Tax and Customs (excise duties on tobacco/alcohol)  European Medicines Evaluation Agency (EMEA) authorisation of drugs, pharmacovigilance

6. EPHA presentation to network of self-help groups Health in the European Parliament Committees (2004-2009 Parliament)  Environment, Public Health and Food Safety  Internal Market and Consumer Protection  Industry  Civil Liberties, Justice and Home Affairs  Employment and Social Affairs Inter-group on health

7. EPHA presentation to network of self-help groups The New Public Health Programme 2003 - 2008 Replaces the earlier 8 separate programmes on AIDS, Cancer, Injuries, Rare diseases, Health Monitoring, Health Promotion, Drugs, Pollution-related diseases. First Call for Proposals in 2003. > 400 projects submitted, 1 in 8 selected. 2004 Call for Proposals closed on 26 May. Strand 1 :Improving health information and knowledge Strand 2: Responding rapidly to health threats Strand 3:Addressing health determinants

8. EPHA presentation to network of self-help groups What is the problem?  Citizens put health in the top 5 priority areas they want addressed by the EU. (see Eurobarometer survey results on CAP, Enlargement, sustainable development etc)  Health should be fully integrated in all EU policies (eg: implementation of Article 152). The Common Agriculture Policy (CAP) results in destruction of 1 million tonnes of fruit and vegetables annually and pays farmers to grow tobacco for consumption in the developing world!  Very limited resources allocated to public health at EU level (13.98 cents per person annually, 6.5 € spent on scientific research and >800 € subsidy per cow !)  Citizens are stakeholders in decision-making and setting policy priorities not just passive consumers of healthcare  Consultation and participation in health decision-making.

9. EPHA presentation to network of self-help groups The role of NGOs on health  Advocacy of health rights for all  Representation of citizen and public interest  Awareness raising on health and human rights issues  Monitoring of implementation of health rights  Challenging violations of health rights

10. EPHA presentation to network of self-help groups EPHA Recommendations  Convention and Treaty reform: critical political opportunity to adequately prioritise human health (currently the Commission has more powers to protect animals than humans)  Organisation of health at EU level: fragmented across many Directorates, lacks coherence and consistency  Inadequate resources: € and human  European policies: balancing economic priorities with social, environment and health aspects in internal and external policies

11. EPHA presentation to network of self-help groups Patients rights: an overview No standard approach across the EU.  Legislation in some countries eg; Finland, Holland, Israel, Lithuania, Iceland and Denmark  Patient charters or codes eg; France, Germany and UK  WHO and Council of Europe have created some consensus principles, strategies and mechanisms.

12. EPHA presentation to network of self-help groups Principles of patients rights WHO Consultation on patients rights, Amsterdam, 1994  Respect as a human being  Self-determination  Physical, mental integrity and security  Respect for privacy  Respect for ethical, cultural and religious values  Protection of health through disease prevention and healthcare

13. EPHA presentation to network of self-help groups European Public Health Alliance 39-41 Rue d'Arlon B-1000 Brussels Belgium Tel : +32-2 230 30 56 Fax : +32-2 233 38 80 epha@epha.org www.epha.org