1. The European Public Health Alliance: Health at the heart of EU policy
Daniela Negri
“European Networking Conference”
Prishtina, April 2008

2. Who we are
The European Public Health Alliance (EPHA) is the largest European Platform on health, representing approximately 100 NGOs and not-for-profit members working in the field of health.
Our membership is unique in its diversity.

3. EPHA members Health advocates Disease specific patient groups
Local Councils
Academic researchers
Health professionals
Consumer groups
Environment organisations
Development organisations

4. Our mission
EPHA aims to promote and protect the health interests of all people living in Europe and to strengthen the dialogue between the EU institutions, citizens and NGOs in support of healthy public policies.

5. Why is health important?
The common causes of the ill health that affect populations are environmental.
“ This explains why some European countries have improved their health while others have not and why health differences between social groups have widened or narrowed as social and economic conditions have changed¹ ”.
¹World Health Organisation
People further down the social ladder run at least twice the risk of serious illness and premature death as those near the top.

6. Environmental aspects
The social ladder
Social and psychological circumstances
Early life
Social exclusion
Working conditions/Unemployment
Transport/Urban mobility
-People further down the social ladder run at least twice the risk of serious illness and premature death as those near the top.
e.g. having few family assets, having poorer education, having insecure employment, living in poor housing.
-Social and psychological circumstances can cause long-term stress. Psychological risks accumulate during life increase the chances of poor mental health and premature death. The lower people are in the social hierarchy of industrialised countries, the more common these problems become.
-Health effects: Anxiety, insecurity, low self-esteem, social isolation have a direct impact on health in raising the heart rate, diverting blood to muscles and increasing alertness.
cardiovascular and immune systems are affected.
-If people feel tense too often, they become more vulnerable to a wide range of conditions including infections, diabetes, high blood pressure, heart attack, stroke, depression and agression.
-The health impact of early development and education lasts a lifetime. Slow or retarted physical growth in infancy is associated with reduced cardiovascular, respiratory, pancreatic and kidney development and function, which increases the risk of illness in adulthood.
-Excluded groups are exposed premature death.
Stress at work plays an important role in broadening the social status differences in health, sickness absence and premature death.
- Importance to reduce the burden of musculosketal disorders and improve the early detection of mental health. IMPORTANE of job quality.

7. How to address environmental factors
Government
Environmental
aspects
Communities
Workplaces
Public and Private
institutions

8. Environmental aspects
Policy entry
Environmental aspects
Individual Behaviour
Behaviour is shaped by environment: hence, environmental changes would lead to healthier behaviour.
Policies should be addressed to the environmental factors to enable full participation in society.

9. Why policies should address environmental aspects
Reduction of
educational failure
Reduction of
social insecurity
Better health
Employment
Removal of barriers
to healthcare
Improving housing and
social services

10. Health legislation at EU level
Art 152 of the Amsterdam Treaty (1997)‏
“a high level of health promotion shall be ensured in the definition and implementation of all Community policies and activities”.
Reform Treaty: Charter of Fundamental Rights and amended art.152
It emphasises:
physical and mental health protection
monitoring measures to tackle serious cross-border threats to health
cross-border cooperation
enhancing standards of quality and safety for medicinal products and devices for medical use
protection of public health in relation to tobacco and abuse of alcohol.
EU Member States decide on healthcare; EU legislates on blood safety and human tissue. However, the EU must respect Member States’ responsibilities for organisation, financing and delivery of healthcare. New focus is given to “measures designed to protect and improve human health and in particular to combat the major cross-border health scourges, measures concerning monitoring, early warning of and combating serious cross-border threats to health, and measures which have as their direct objective the protection of public health regarding tobacco and the abuse of alcohol, excluding any harmonisation of the laws and regulations of the Member States”.

11. Why should civil society be involved at the EU level?
The majority of all new legislation comes from Brussels

12. The EU Works on: Agriculture, fisheries and food
Business (internal market and entreprise)‏
Culture, education and youth
Economy, finance and tax
Employment and social rights
Energy and natural resources
Environment, consumers and health
External relations and foreign affairs
Justice and citizens' rights
Regions and local development
Science and technology
Transport and travel

13. Brussels-based actors
Court of Justice
Court of Auditors
European Commission
European Council
European Parliament
CoR
EcoSoc
Professional
associations
Industry
Platforms
NGOs
Trade
Unions
Public
bodies

14. EPHA works by: Information provision Capacity building
Tracking policy issues
Information exchange
Representation of public health on EU fora
Facilitating horizontal information (between membership)‏
Capacity building
Providing expertise (workshops, conferences, training sessions)‏
Web-Based tools
Face-to-face membership enabling best-practice exchange
Coordinated actions
Advocacy
Networking
Awareness raising
Representing members’ interests
Advocate to promote EU health policies at the highest common denominator rather than lowest. Networking and Partnerships are the means to make our voices heard.
Who to lobby: 1) EU institutions,2) ECB, Court of Auditors, 3) Advisory bodies such as the European Economic and Social Committee, Committee of Regions.

15. EPHA works on: Health Determinants Health systems EU Affairs
The Second Programme on Community Action in the field of health (2018) adopted in October objectives:
Improving citizens’ health security
Promoting health by focusing on health inequalities
Health information and knowledge
At the same time the EC adopted a new Health Strategy: ‘Together for Health: A strategic approach for the EU ’.
The Strategy aims to set clear objectives to guide future work on health at EU level, and to put in place an implementation mechanism to achieve these objectives, working in partnerships with Member States.
4 principles and 3 strategic themes:
Principles: 1)values-driven approach, 2) links between health and economic prosperity, 3) integrating health in all policies, 4) strengthening the EU voice in global health.
Strategic themes: 1) fostering good health in an ageing Europe, 2) protecting citizens from health threats, 3) dynamic health systems and new technologies.
Budget: 321,5 million for five years.
EPHA advocates for:
Health in all policies
Stating clear goals
Pragmatic approach to meet limited resources
Implementation of regulatory framework
Commitment from MSs
Strengthening role of NGOs.

16. Health determinants CAP: subsidy for the production of raw tobacco
How European policies affect lifestyles:
CAP: subsidy for the production of raw tobacco
CAP, labelling and advertising influence eating and drinking habits
Employment legislation has an impact on mental health

17. Health systems Healthcare legislation Movement of professionals
Movement of patients
Pharmaceutical and medical device regulation

18. EU Affairs Reform Treaty Parliamentary Elections
Budget allocation for health
Open Method of Coordination
Health in all policies

19. EPHA’s participation at European and international level
Membership at various EU regulatory agencies’ stakeholder boards such as EFSA and EMEA
Secretariat of the EU Parliament’s Health and Consumer Intergroup
Secretariat of the Health Policy Forum
High level Group participation in ‘Competitiveness of Agro-Business’
Participation at the Alcohol Policy Forum and EU Platform on Diet, Physical Activity and Health
Cooperation with WHO

20. EPHA: the voice of public health in Europe

21. European Public Health Alliance
49-51 rue de Trèves
B-1040 Brussels
Belgium
Tel :
Fax :