EPHA President Andrew Hayes provides an assessment of the junction at which EPHA currently finds itself.
This issue of Update celebrates EPHA’s tenth anniversary: ten years of innovation, development and consolidation. Change is the one constant you can rely on in this world, and EPHA has seen plenty of change: ten years of non-stop change. So it is no surprise perhaps, that on our tenth birthday we can look back with $ÙÃ÷sfaction - so much has been achieved - but also forward with some trepidation towards alternative scenarios that range from "even greater" to "nothing at all". How come that we stand at such a critical crossroads, peering possibly into the terrifying black hole of science fiction - a vacuum leading nowhere?
EPHA, first and foremost, is a membership organisation. It exists to support the work of its members in their commitment to advocate healthy public policies in Europe. It does so through information exchange, networking, consultation, policy analysis and development, and capacity building. There are articles from several EPHA member organisations in this issue, which "tell it as it is" from a grassroots perspective. They clearly describe the added value of working alongside like-minded colleagues - each of whom have their own particular policy interests and advocacy goals, but who find that they share certain principles and approaches in pursuing their separate objectives.
Ties that bond
What is it that unites the EPHA family, what are the principles that we hold in common? First, we all come from a not-for-profit perspective. We represent the interests of the voluntary sector, of professional bodies, of academics and researchers, even of some statutory agencies. Taken together, these can jointly be described as "civil society". Second, therefore, we are concerned with the public good. EPHA members join in order to promote their own interest or perspective; but their activities, however specific, contribute towards a healthier community for all.
Third, this implies a commitment to solidarity. True, we should never underestimate the power of the committed individual. But several committed individuals, or organisations, working together, can move mountains (and there are plenty of unhealthy mountains around the new Europe that could do with a spot of movement). So EPHA members are there for one another. The fourth and final principle that concerns us all is equity: this relates to human rights and the right of EU citizens to expect equal access to care (including health protection), and standards of care that are equally effective wherever we happen to live or work in the Community.
Civil society, health for all, solidarity and equity: these are the building blocks of EPHA. Throughout the past ten years, EPHA members have practised these principles in support of the Community’s developing public health agenda; working both as partners - in delivering programmes such as cancer, AIDS and drugs etc - and as constructive critics of the various Community Institutions. As such, EPHA has benefited from a series of annual grants from the Commission, mainly from DG SANCO and its predecessor DG. For the reality is that whilst disease specific organisations have little difficulty raising money from the public (although they could always do with more), generic health organisations have no emotional appeal whatsoever. Imagine standing on the pavement with a collecting can, asking for support for "public health". It just doesn’t work. So organisations like EPHA find themselves dependant upon public monies (i.e., from governments or statutory agencies) and not on voluntary monies (i.e., from the public) for much of their income: most of the rest comes from membership fees, the sale of some services and subscriptions, and occasional project grants.
This makes us vulnerable to the changing priorities and fortunes of the funding agencies with whom we work. In the case of EPHA, we are talking about the EU’s public health programme - which has been renewed this year (until 2008) on an entirely different basis than previously. The budget has changed very little, whilst the potential demand has increased substantially. This is partly due to enlargement, partly due the increased awareness and interest of potential project partners, and partly due to changing political priorities in the world around us. Food safety scares, bio-terrorism and now SARS - all underline the wisdom of introducing a central plank to the new programme - namely an effective response mechanism to cross-border health threats. But this new activity has got to be funded from a budget line that is no bigger than previously. Inevitably, some EU-funded networks will be squeezed out. We are all at risk, and that includes EPHA.
Responding to citizens’ interests
There is an irony in this, of course. The present Commission, and now the European Convention, have played heavily on the mantra of "connecting to the citizen". To create greater legitimacy for the EU, in the hearts and minds of its citizens, why not listen to them and respond to their interests? A major interest, according to recent Eurobarometer surveys, is health protection. EU citizens expect EU policies to protect their health, not expose them to risk. Putting more resources into health presents a potential "win-win" situation: it helps to improve public health status and it conveys an image of the "EU with a human face" - i.e., doing things that are important for its citizens. Civil society organisations, with information networks operating in the Member States, are ideally placed to communicate both messages: this is the programme and this is what the EU is doing for you. The potential is there: the Community just has to agree which are the most effective networks, and to keep them alive.
Sure, this is special pleading for EPHA. We happen to believe that we are worth it. We have shown over the years that a small but dedicated secretariat, supported by the willing commitment of our broad membership base, have managed to create and sustain widespread understanding of the EU decision-making process, enthusiasm and capacity to help with policy analysis and development, and support for programme delivery mechanisms. EPHA can and will continue to function, funded by membership subscriptions, ad hoc project work and grants; but it would be a downsized EPHA, our level of activities severely diminished, without ongoing Community support.
We have not just survived, but grown steadily throughout our first ten years. We hope to continue to do so, throughout the next ten years - certainly throughout the life of the new public health programme. We thank all those who helped to create EPHA in the early 1990s; those who had faith in us and backed us from the start; those who have worked with us, in whatever capacity and for however long. We recognise that each and every person who has helped us along the way is responsible for making EPHA what it is today. For that we are grateful; and for your continuing support also.
A special thanks to all present and former colleagues - and consultants and interns too. You all helped to make EPHA what it is today!
Lesley Armitage
Paul Belcher
Ros Bragg
Nicola Cannarozzi
Carole Défossé
Lara Garrido Herrero
Nicole Fontaine
Nicoletta Forcheri
Giovanna Fragapane
Laura Fernandez
Lizzie Hocken
Génon Jensen
Nicholas Leavey
Danielle Limonier
Francesco Longu
Mary McPhail
Robert Nitsche
Inaki Otalora
Saila Pitkänen
Regina Sauto Arce
Thomas Wyaux
Andrew Hayes is EPHA President and EU Liaison Officer for the International Union against Cancer and the Association of European Cancer Leagues .
