In each of the countries the letter has been signed by doctors in leading positions including the presidents of national and regional medical associations. Its primary recipients are the president of the European Commission, José Manuel Durao Barroso, the President of the Council of the European Union, Herman Van Rompuy, the president of the European Union, Martin Schulz, the Commissioner for Health and Consumer Policy , Tonio Borg, among others.

In the letter they reiterated that “formally adopted European policy principles require that all public policies take into account their health impact and that alternative options, minimizing negative health effects, are explored and seriously considered”. They denunciate that this is not the case in Greece, Spain, Portugal nor Ireland. Furthermore, they draw attention to the fact that since 2008 the financial, economic and social crisis is producing “more serious consequences for the most vulnerable countries, as a consequence of both their immediate and structural shortcomings” while emphasizing that “a large sector of these countries communities has not contributed to this crisis or benefited from its precursors in any way but is suffering the full burden of its consequences.”

EPHA has also been drawing attention to the deterioration of Public health aspects in these countries and how austerity measures are exacerbating health inequalities. For example, we have drawn attention to the situation in Portugal where for instance, the number of abortions is increasing among unemployed women and “factory and agricultural workers” which marks a clear shift from previous years where students and non-skilled workers were the groups where most of these procedures occurred.”

In Greece, pharmaceutical company Merck halted the supply of some cancer drugs to Greek hospitals following the non-payment of bills. At the same time pharmacists, afraid that the government might not reimburse them, are asking for cash payments, even from those with insurance. Moreover health coverage has been restricted leaving those unemployed for more than a year without. Increasing waiting times for cancer surgeries have been reported to happen.

Doctors have pointed out cases in which, breast cancer patients often have to wait three months now to have tumours removed. These new arrangements are creating a system in which those who can afford have differential access to diagnosis and treatment.

The signatories warn that “public services are being deprived from the funding necessary to perform adequately while community health needs are increasing”. For example in Spain, the recession has significantly increased the frequency of mental health disorders and alcohol abuse among primary care attendees in Spain, particularly among families experiencing unemployment and mortgage payment difficulties. The same is happening in Portugal where, since January 2011 the use of mental health services – both first visits and admissions - at the two main psychiatric hospitals of Lisbon and Oporto have increased.

Finally, the group warns that “the deterioration of health systems as well as the migration of the most qualifies amongst the young, long lasting unemployment and depressed fertility rates” will have consequences that will affect future generations. They label the current situation of “most unfortunate” and deplore the lack of adequate “monitoring systems for these ill effects of the socioeconomic crisis and of an effective timely response at the international, national and local levels”.

EPHA echoes the group’s position and remains committed to push for the uptake of health in all policies as well as the implementation of monitoring mechanisms that will allow for halting of readjustments of policies that are failing to protect the health of the public.

- Open letter to European political leaders and health authorities.


EPHA related articles


- European Health Forum Gastein - 2012 Edition Highlights Austerity Impacts on Health
- Towards an effective implementation and delivery of the Health 2020 strategy in times of austerity.
- EPHA Press Release: MEPs lead urgent plea from health community to prevent health crisis in Europe.
- Time to Act: WHO Global Code of Practice on International Recruitment of Health Personnel.

Last modified on February 6 2013.