The European Public Health Alliance (EPHA) is playing a key role in challenging the health inequalities that exist in Europe. It represents member organisations which run activities in local communities aimed at reducing these injustices and it relays their views to the European Institutions. At the same time, EPHA pushes for greater attention to be given to health in European social and environmental movements. UPDATE editor Diana Smith reports.
The need to reduce inequalities in health plays a key role in EPHA’s underlying philosophy. Many of the 90 non-governmental and other not-for-profit organisations which EPHA represents are working specifically to improve the health of vulnerable communities. Examples include Mental Health Europe, European Forum on HIV/AIDS Children and Families, Greek Network of Health Promoting Schools Association, and Women in Europe for a Common Future.
Part of EPHA’s role is to provide opportunities for these NGOs to voice their specific concerns in the European Institutions and at the European level more generally. They themselves provide information on current health problems and injustices from local communities and often propose solutions as well. Many member organisations were set up specifically to address a health problem that might otherwise have been marginalised or ignored.
A common voice
But as well as creating the opportunities for members to express their views, EPHA also creates a common voice for the non-governmental health sector community. Over a period of many months, and in a process involving several stages and including seminars, meetings and e-mail consultation, EPHA and its members defined priorities in European health policy. The process revealed the importance attached to issues of solidarity and equity in health.
First, EPHA members want regular and real opportunities to express their views and concerns within the European policy making process. Working close to health problems in local communities, including both poor and rich, these groups offer a knowledge base which is different from government or commercial organisations, or even professional associations. They feel that the need to contribute this information would be paramount.
Second, members want priority to be given to the "health determinants" strand in European health policy and funding. Health determinants are the factors behind Europe’s top causes of ill-health and premature death. For example, obesity and smoking are key factors behind heart disease and cancer, two of the major causes of premature death in Europe.
EPHA members are keenly aware that disadvantaged groups are more vulnerable to "food poverty" (living far from retail sales of low cost, high quality fruit and vegetables) and to the temptations of tobacco and alcohol. They are also aware that the only way they can really address the issues is to take an intersectoral approach. For example, the International Union against Cancer works on tobacco control. This requires not only raising awareness of the risks associated with smoking but also lobbying against EU agricultural subsidies to tobacco farmers. Pesticides Action Network raises public awareness of the toxicity of chemical fertilisers but it also lobbies for more stringent environmental regulation.
The specific priorities for reducing health inequalities form part of EPHA’s 12 recommendations to the European Commission on the proposed Public Health Community Action Plan (2001-2006). The common position provides a vital component in EPHA’s strategy in challenging health inequalities.
Social and environmental networks
Another component in EPHA’s approach to challenging health inequalities is through collaboration with environmental groups and through membership of the Platform of European Social NGOs. EPHA is a member of both the Steering Group and the College of the Platform, and as such is able to bring health issues to the attention of major groupings of European women, youth, disabled, homeless and so on. At the recent World Trade Organisation meeting in Doha, EPHA represented the Social Platform and was a member of the Solidar delegation, a grouping of social NGOs and trade unions. As part of a major non-governmental presence at the talks, EPHA was able to ensure that statements and press releases covered public health as well as social and labour issues.
Key role
Like many public health experts, EPHA believes that addressing social inequalities is more important to improvements in health in Europe than increasing access to quality health care provision. Reducing these inequalities can only be done by integrating health into other policy areas. EPHA is playing a key role not only in representing and influencing key NGOs active in the field but also by putting forward proposals on how to promote health in EU agriculture, trade and environment policy.
