By imagining the thoughts of a creature from outer space, EPHA’s President Andrew Hayes has come up with what could be achieved over the next six years by the new Public Health Programme.
There is very little legislation that does not impact, directly or indirectly, on health. The Man from Mars, preparing to land in Europe in 2008 to review the success of the Public Health Programme, is unlikely to be impressed by a spot of EU added value to health promotion initiatives that are, in any case, best designed for local communities. He would, however, be mightily impressed to see that the EU has long since stopped paying lip service to the notion of "health in other policies"; and, instead, has started doing something meaningful to place positive health outcomes at the centre of the entire decision-making process. He will recognise that the generic, three stand approach has been used as a spring board to catapult health to the forefront of concerns shared not only by EU citizens but also by the body politic in Europe: indeed, that the building of the new Europe has become the pathway towards a healthy Europe. So what does he see?
Health impact assessments (HIA), routinely undertaken by every DG to accompany any new policy proposal or programme evaluation. From 2005 onwards, the Council and Parliament refuse to consider any Commission proposal that has not been subject to HIA, or has been found to have a potentially negative health effect. Information from this database is also available to, and well understood by EU citizens; because the Community Institutions have engaged in constant dialogue and partnership with representative NGO networks, who have relayed data backwards and forwards amongst their member organisations.
The second strand of the programme (rapid reaction to health threats) recognises that health, both good and bad, knows no boundaries; and that the European public is well aware that national governments are powerless to take meaningful action on their own. EU-level action is far more likely to be effective in protecting the health of EU citizens. So the programme has established a surveillance network to monitor and assess health risks (such as communicable and non-communicable diseases, environmental pollution, pesticide residues, antibiotic resistance, bio-terrorism etc.); created a well-publicised reporting mechanism for potentially adverse risks (including immunity from prosecution for employees who divulge information about hazardous products or manufacturing processes); and developed and shared models of good practice. The surveillance network links scientists and policy-makers: emerging health threats are subject to rigorous and impartial assessment, with practical recommendations fed directly into the decision-making process. The network is designed to cope with emergency situations; but it has another, equally important, day-to-day role: namely to inspire the routine application of the precautionary principle in all EU policy-making.
The third strand of the programme (health determinants) has become the think-tank for the future development of EU health policy. In particular, based on lessons learnt from the application of the precautionary principle and the introduction of health impact assessments, it has constructed a coherent and well-argued philosophical paradigm underlying the EU’s role in health. It has funded a limited number of innovative projects designed to tackle the "major burdens of disease" from a policy outcome perspective - i.e. to explore and recommend potential legislative and/or policy initiatives. It has taken the lead, across the Community Institutions, in promoting positive health as the cornerstone for policy design and implementation. It has built effective partnerships for change, consulting widely with a broad range of key stakeholders, and building awareness and support amongst the voluntary sector and civil society interests - those that have the most direct role in "connecting with the citizen".
