Update Online Articles

Update 66, "Making Trade Work for Health" - now available online

EU Trade Commissioner, Pascal Lamy, will be in a position of awesome power when he attends the next World Trade Organization ministerial meeting in Cancun in September 2003. By then, with the accession agreements signed, he will represent the world’s number one economic power. At the Mexico meeting, he could ensure that Europe’s leadership is social as well as economic by charting a new path for a healthy, just and environmentally-friendly trade.
In this issue: Click on a title to (...)

Update 65, "The Eu Makes Plans for Health" - now available online

Change is in the air. In Luxembourg, the work plan for Europe’s new Public Health Programme (2003-2008) is being finalised ready for implementation. In Brussels, Health Commissioner David Byrne believes there is a need for a change in the European Union Treaty - and he is saying so. EPHA welcomes his position. The current legal basis in the Treaty for health protection is very weak. In the absence of political initiatives, it is the European Court of Justice that is making decisions on (...)

Update 64, "A European approach to child health" - now available online

Every parent embarks on the greatest experiment of all. Quite literally. As children grow they are exceptionally vulnerable to the physical, social and emotional environment around them. But are we, European citizens, doing enough to protect children and ensure their good health?
In this issue:
Click on the titles below to get to the corresponding article A European approach to child health
Identifying the threats to children’s health in Europe
Interview: Dr Roberto (...)

Update Online Articles

The Update Issues sub-section contains the tables of contents of the most recent issues of the Update magazine.
You can get to the online Update articles by clicking on their title on the TOC (where available) or by searching for the keyword Update Online Articles in our internal search engine.
Please find below a list of Update issues from 2000 to 2003. Do not hesitate to contact the EPHA Secretariat for more information.
Update Issues 2000
Update 49 (January - February), "Does trade (...)

The origins of EPHA

Dr Michael Joffe was chairman of EPHA when it was founded in 1993. Here, he explains why growing numbers of public health experts began to think it was important to work at European level, and describes some of the achievements of the first few years.
During the 1980s, the European Community, as it was then called*, became more active in legislating for its Member States. In particular, environmental protection seemed to be largely driven from Brussels, especially from the perspective of (...)

Ten years on: where next?

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 (...)

Nursing ambitions in Europe: why EPHA works for us!

Susan Williams, European Officer for the Royal College of Nursing in the UK, says EPHA helps a national organisation like her own to find its way more easily through the "Euro Village". The UK has traditionally kept itself on the fringes of European activity - like a reluctant bride not wanting to commit herself for good.
Strange perhaps that this attitude is not reflected in the voluntary and public sector. You only have to see the number of offices that UK organisations have opened in (...)

Who are our Public Health Heroes?

EPHA’s mission during the past ten years has been to promote and protect the health of all people living in Europe, and to advocate greater participation of citizens in health-related policy making at the European level. The EPHA staff aim to be public health campaigners though sometimes it is really hard to raise awareness on the issues.
It is difficult for several different reasons. First, the concept of public health is broader than the concept of personal well-being: it includes (...)

Holding up the health banner at the European Union

The European Heart Network joined EPHA eight years ago when the two organisations were sharing the same Brussels’ office at 1 Place du Luxembourg. Susanne Logstrup, EHN’s Director says her main reason for being part of EPHA is the same now as it was then.
The European Public Health Alliance (EPHA) and the European Heart Network (EHN) are about the same age. EHN celebrated its 10 years in 2002 and in many ways the two entities can be said to have grown up together. They were "childhood" (...)

What has been achieved?

The following are just some of EPHA’s achievements during the past ten years.
Management of the European Parliamentary discussion group
EPHA has provided the secretariat for the Health Intergroup of the European Parliament since June 1993. Intergroups are informal discussion groups, established by MEPs, which provide a forum for cross-party debate of important issues. Over the decade, the meetings have focused on many issues, including public health policy and programmes, the Common (...)

EPHA seminar: Where Next for EU at Health Level?

EPHA held a seminar on Monday 2 December 2002 aimed at discussing and developing a future policy path. Presentations focused on the right to health in Europe, the Peoples’ health charter and the "Open Method of Co-ordination". Participants agreed that the future health competence at the European level was a priority.
The Convention on the Future of Europe appears to be downgrading the importance of health. This is of concern because it could ultimately affect changes to the constitution (...)

EPHA members’ priorities for action

Employ what works to avoid an AIDS disaster
"Medium term forecasts for HIV in Eastern Europe are catastrophic: the USA National Intelligence Council predicts that 6-11% of Russian adults will be HIV positive by the end of the decade. UNAIDS says about 1% of the adult population is already HIV positive in Ukraine, Russia and Estonia. Some applicant countries are facing exponential growth in infection rates.
This recent explosion of the HIV epidemic is related mostly to intravenous drug use (...)

EPHA’s vision for the year 2008

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 (...)

Highlights from EPHA’s 2002 seminar

Our annual seminar this year covered the new Public Health Programme, sustainable development, enlargement and partnerships. Taking place on 17-18 June in Brussels, it attracted representatives from more than 40 organisations. Participants heard from Fernand Sauer, Director of Public Health plus representatives of DG Environment and the World Health Organization. The meeting also provided the opportunity for EPHA to announce the findings of its survey on health and enlargement.
Dr Fernand (...)

Free movement of professionals: opening up opportunities or perpetuating problems?

The free movement of nurses and doctors within Europe provides new employment opportunities. But will it also perpetuate existing shortages? Glenn Gathercole provides the perspective of the Standing Committee of Nurses of the European Union.
The European Commission communication "New European Labour Markets, Open to All, with Access for All" (1) ensures that people are free to move throughout Europe to find work. The move promotes the single European market by liberating the movement of (...)

Water as a public health good

Experts at the European Centre for Environment and Health in Rome describe the importance of water to health in the European Region of the World Health Organization (WHO). They highlight the challenges that need to be overcome to improve the current situation and introduce the policy instruments that exist in this region to achieve health goals.
The right to water forms part of the right to public health, which was first reflected in the WHO constitution adopted in 1946 and then (...)

Cancer epidemic blamed on nuclear power

A major review of the risks of radiation links nuclear pollution with increased rates of breast cancer and child leukaemia. This new assessment appears at a time when environmental groups are urging a reform of Euratom, the European nuclear energy treaty.
The present cancer epidemic is a result of pollution from nuclear energy and of exposures to global atmospheric weapons fallout, which peaked in the period 1959-63, according to a report from the European Committee of Radiation Risk (...)

Resources on water and health

United Nations
A consortium of 23 UN agencies reported on the world water crisis on World Water Day, 22 March.
It is called "The World Water Development Report: Water for People, Water for Life". The report was released at the 16-23 March Third World Water Forum in Kyoto, Japan., a landmark event of the 2003 International Year of Freshwater.
The International Year of Freshwater 2003 was launched to galvanise action on the critical water problems the world faces.
Thanks to gains in the (...)

Civil society unites on water policy

Non-governmental water experts, health advocates, local authority leaders and trade unions put up a unified front at the third World Water Forum in Kyoto, Japan, 16-23 March 2003. They unanimously rejected a report from the development banks calling for dams and privatisation, and called for investment for the poorest of the poor with appropriate technology and public control of privately-funded water projects.
The World Water Forum in March 2003 aimed to promote action on the UN (...)

Privatisation arrives in Ukraine

Svetlana Slesarenok of a women’s organisation called MAMA-86 in the Ukraine has first-hand experience of the privatisation of the water utilities in the seaport city of Odessa. She describes how the take-over by a French multinational took place, says why she is against it and what she proposed to European Water Initiative improve public control over public-private partnerships.
Poverty is increasing in the Ukraine, and one of the reasons is the huge price increases charged for water. At (...)

Europe’s water law: stronghold against commercialisation

Governments wanting to achieve sustainable, safe water supplies should focus on implementing the Water Framework Directive and question the current pressures for water liberalisation, according to Stefan Scheuer of the European Environmental Bureau.
Europe’s water management is undergoing significant changes. Since December 2000, EU Member States have been obliged to implement one of Europe’s most complex and demanding laws - the EU Water Framework Directive (WFD). This requires (...)

How will water shape the 21st century?

Increasing demand
The demand for water has doubled in the last 50 years. (1)
How is it used?
Worldwide, irrigation currently accounts for 70% of all water withdrawals. (1) In Europe, water use is 40% agricultural, 40% industrial and 20% domestic. (2)
Who takes care of their water?
At the bottom of the global listing (1) of 122 countries is Belgium, where raw sewage pours untreated into rivers where it mixes with manure from intensive livestock farms. Water quality should improve once a new (...)

Update 67 Editorial - Water: preventing a crisis

Nothing is more important for health than a supply of pure water. Diarrhoea, caused by a lack of safe drinking water, is the biggest killer of children and a major cause of sickness in adults world-wide. At any one time, half the world’s hospital beds are occupied by patients suffering from water-borne diseases.
Approximately 40% of the world’s population do not have access to safe drinking water. The challenge of meeting this human right and basic need is not getting any easier. Water is (...)

One drag can start nicotine addiction

A new study shows that preventing smoking in young people is even more difficult than in adults. Not only are children more vulnerable to advertising by tobacco companies, they are also more prone to becoming addicted.
’’It was assumed kids did not become hooked until they were smoking every day, and at least half a pack a day," says McGill University epidemiologist Jennifer O’Loughlin, commenting to Globalink* readers on recent findings from a study by McGill University of Medicine in (...)

Child environmental health issues at a glance

The following are defined as the main areas of concern in Europe:
Asthma, allergies and respiratory infections
Asthma and atopic (asthma related, such as hay fever and eczema) disorders are the leading cause of chronic respiratory illness
Factors playing a role, particularly in early life, are: infectious/microbial burden, environmental tobacco smoke/maternal smoking in pregnancy, allergens, smog (particulate in the air)
Acute respiratory infections are the single largest cause of (...)

Kids on the move: making Europe’s roads healthier for children

Among the European Commission’s responses to concerns about the effects of environmental factors on children’s health is a lively publication, illustrated with children’s drawings, describing initiatives to improve child mobility and health. Claude Bichou, DG Environment, presented "Kids on the move" at the Green Week Conference held in Brussels earlier this year. His presentation formed part of a session moderated by MEP Dr Caroline Lucas on how children’s mobility enhances their mental (...)

Resources on health and sustainable development

The Rio to Johannesburg process
Agenda 21, adopted at the UNCED meeting held in Rio de Janeiro, Brazil, 3 to 14 June 1992, is available at http://www.un.org/esa/sustdev/agenda21.htm
United Nation’s site for the World Summit on Sustainable Development to be held in Johannesburg 26 August - 4 September 2002 is at http://www.johannesburgsummit.org/flat/riomajorgroups.htm
It includes:
the preparatory committee report on health and sustainable development prepared by WHO and a report of the (...)

The case for integrating health into Article 6 of the EC treaty

Gaudenz Silberschmidt of the International Society of Doctors for the Environment believes changes should be made to the European Community Treaty to ensure health has a higher profile in the achievement of sustainable development at the European level. He calls for "Health Integration" so that health considerations would be given the same status as environmental protection in all areas of EU policy making.
"Sustainable development" appears at the beginning of Article 2 of the Treaty (...)

European women champion health

Women in Europe for a Common Future (WECF) are responsible for European women’s input for the World Summit on Sustainable Development (WSSD). Here, Marie Kranendonk, Helen Lynn and Elizabeth Danielyan (WECF president, health working group co-ordinator for Western Europe, and health working group co-ordinator for Central and Eastern Europe respectively) describe their perspectives on health.
How can the crucial importance of health be strengthened in the debate in Johannesburg?
Helen (...)

What role for Europe?

With a home-grown commitment to "sustainable development", the wealthy countries of the European Union are in an ideal position to show leadership at the World Summit on Sustainable Development in Johannesburg later this year - and to ensure that real change takes place afterwards.
Jan Pronk, Minister of Housing, Spatial Planning and the Environment in the Netherlands, is playing an important role in the preparatory process for the Summit, including chairing the panel on poverty and (...)

WHO’s vision for Rio + 10

The World Summit on Sustainable Development (WSSD) provides an unprecedented opportunity to show the importance of health in the development process according to Dr Yasmin von Schirnding, Coordinator for WSSD, World Health Organization, Geneva.
Health is recognised as a key goal of sustainable development in the first principle of the Rio Declaration, which states that: "Human beings are at the centre of concerns for sustainable development. They are entitled to a healthy and productive (...)

On the brink of a healthier future?

This year just might produce a vision of a global system in which "development" is seen in terms of achievements in environmental and social justice as well as economic growth. The World Summit for Sustainable Development (WSSD) to be held in August in Johannesburg creates an opportunity for "a coalition for responsible prosperity", according to UN Secretary-General Kofi Annan. Many hope that Europe, as one of the two most powerful players at the event, will play a key role in that (...)

EU Greek Presidency: Interview with the Greek Minister for Health and Welfare, Professor Costas Stefanis

The European Public Health Alliance (EPHA) has been very concerned about signs that the Convention on the Future of Europe is proposing a downgrading of health from a "shared responsibility" to a "supporting responsibility" in the future EU treaty. We therefore welcome the fact that the Greek presidency is seeking a broadening of the EU health competence. Could you tell us more about the exact position the Greek presidency is taking on this issue?
Costas Stefanis: Health should be a (...)

A decade of achievement: Interview with David Byrne, European Commissioner for Health and Consumer Protection

Interview with David Byrne, European Commissioner for Health and Consumer Protection
Do you believe that the existing Treaty commitment, to ensure "a high level of human health protection" has been fully exploited? Could more have been done? Could you give positive and negative examples?
Byrne: The Treaty of Amsterdam, with its commitment that the EU should ensure a high level of health protection, entered into force on 1 May 1999 - just a few months before I started my mandate as (...)

Milestones in European public health

Protection of public health
1992: Maastricht Treaty ratified Article 129 gave the European Community its first responsibilities in health protection.
For the first time, health was recognised as being within the scope of the European Community activity, though certain limits were set as to the form the action could take. The task of the Community, acting together with Member States, was to contribute to "a high level of human health protection", particularly through preventative (...)

Editorial: Celebrating 10 years of public health in Europe

EPHA exploded onto the Brussels scene in 1993, just as the European Union first acquired a health competence - Art 129 of the Maastricht Treaty (subsequently Art 152 of the Amsterdam Treaty). This issue of the European Public Health Update celebrates EPHA’s 10th anniversary. We look back over the past ten years to highlight the successes, learn lessons and evaluate how the political context has changed.
Looking forward, there has never been a more exciting time to work on health issues in (...)

Greek health minister backs "shared competence"

Greek presidency: 1 January - 20 June 2003
Mr Costas Stefanis, Greek Minister of Health and Welfare has emphasised his government’s support regarding the position of Public Health in the European Union Treaties. On Monday 27 January 2003 on the occasion of the exchange of views between Mr Stefanis and the members of the European Parliament’s Committee on the Environment, Public Health and Consumer Policy in the European Parliament he expressed his commitment to pushing for health as a (...)

Danes finalise, Greeks prioritise

Danish presidency: 1 July 2002 - 31 December 2002
Danes finalise enlargement process The European Council met in Copenhagen on 12 and 13 December 2002. The accession negotiations with Cyprus, the Czech Republic, Estonia, Hungary, Latvia, Lithuania, Malta, Poland, the Slovak Republic and Slovenia were signed and completed. The Presidency Conclusions state: "Today marks an unprecedented and historic milestone in completing this process […] The Union now looks forward to welcoming these (...)

How the Commission Collaborates on International Public Health

The following notes outline the structure of the relationship of co-operation between the European Commission and the World Health Organization. It is based on a contribution from the Public Health Directorate’s Unit for Policy Analysis and Development headed by Bernard Merkel.
Exchange of letters
Co-operation between the European Commission and the World Health Organization (WHO) is based on three exchanges of letters (1972, 1982 and 2000).
Memorandum of Agreement
The third "Exchange (...)

Interview with Danish Minister of Interior and Health Lars Lokke Rasmussen

The Public Health Programme was agreed by the EU Health Council on 26 June 2002. What can it achieve in terms of improvements in the health status of all EU citizens?
Lars Løkke Rasmussen: I see the new public health programme as an important supplement to the national activities to improve public health. In September, the Danish government launched a new programme for public health and health promotion for the period 2002-2010. It focuses action on the eight most common diseases including (...)

Treaty changes for a "Europe of health"

The following text is from a speech by David Byrne, European Commissioner for Health and Consumer Protection entitled "EU health policy on a world stage". It defines the questions that need to be addressed in relation to a change in the Treaty Article on public health. The speech was given on 29 October 2002 at the European Policy Centre in Brussels.
David Byrne:
Early next year, I intend to publish a Communication on how Community health policy should develop to meet the challenges we (...)

Where we are and where we are going

Director of Public Health at DG Health and Consumer Affairs (Sanco), Fernand Sauer describes the new programme for Community action in the field of public health (2003-2008). In May 2000 the Commission put forward its proposal (1) for a new public health programme to replace the existing set of eight programmes and to unite these in a single, integrated horizontal scheme.
The proposal went through a lengthy co-decision procedure that ended successfully on 8 May 2002 with the agreement (...)

A stronger role for the EU in public health policy?

Interview with Martin McKee, Professor of European Public Health and Research Director, European Observatory on Health Care Systems, London School of Hygiene and Tropical Medicine, London.
EPHA would like to see a stronger role for the European Union in public health and a clearly defined EU public health policy. Do you agree with this position?
McKee: There are many arguments for strengthening the role of the EU in public health, simply because so many threats to health act at a (...)

The EU’s activities in health at a glance

1951 - Health and safety at work
Activities in the field of safety and health at work begin at the same time as the European Coal and Steel Community is established.
1987 - Early programmes
"Europe Against Cancer" begins. It represents the first European action programme aimed specifically at improving public health throughout the Union. An initiative to deal with "the scourge of drugs misuse" starts later the same year followed by the "Europe Against AIDS" programme four years later.
1992 (...)

Landmark Thinking on European Public Health

Looking beyond health protection and health promotion
Padraig Flynn, the first European Commissioner with responsibility for health, speaking in 1995:
"EU’s health role is not confined to health protection and positive health promotion, as is commonly assumed. Our work is much broader. To name but a few matters, it includes environmental issues, food safety, development and emergency aid, research and development, the recognition of medical qualifications and health and safety at work." (...)

Spanish presidency: interview with Celia Villalobos Talero, Spanish Health Minister

Which priorities has the Spanish Presidency chosen in the field of Public Health and why?
Celia Villalobos Talero: I would like to begin by making a clarification. In English, public health refers to the health of populations and to health services. In Spain, salaud publica refers only to tobacco and alcohol and the other factors relating to health status but it never includes health care services. I understand in answering your question that I include public health plus health (...)

Spanish presidency: three top priorities

The Spanish Minister of Health and Consumer Affairs, Celia Villalobos Talero, presented the Presidency’s priorities on Health and Consumer Protection on 4 February 2002. The public health programme, the blood directive and a common understanding on tobacco are urgent issues.
Minister Villalobos began her speech to the European Parliament’s Environment Committee in February by highlighting the fact that the Spanish Presidency "places special importance on all those matters concerning the (...)

Mixed outcome on the health framework plenary

The EU’s health plan should be finally agreed during the first half of 2002. Originally intended to cover 2001-2006, the Second Reading took place in December 2001 and more delays are likely since the legislative process now looks set to go to conciliation. However, health NGOs working at the European level have welcomed the likelihood that the health budget will rise and will continue to lobby to achieve a more secure financial base.
"Health is a major concern of Europe’s citizens": so (...)

Making CAP healthier

Developments in reforming the Community’s farming policy are heating up across Europe. EPHA is ensuring that health is on the agenda says Policy Director, Genon Jensen.
Everyone knows that CAP (Common Agricultural Policy) isn’t working, but most have difficulty in agreeing on what the policy instruments for change should be.
The Commission’s July Mid-Term Proposal for reform set out its vision, and is now being discussed in the European Parliament and EU Council. Civil society is holding (...)

"Fat tax" proposed to fight food poverty

Social policy experts in the UK are proposing a tax on the advertising of highly processed and fatty foods.
City centre supermarkets target cash-rich, time-poor shoppers who are prepared to pay a premium for pre-prepared healthy food, according to a new report entitled "Inconvenience food: the struggle to eat well on a low income". The targeting of these consumers by major supermarket chains which control a large proportion of the food retail market effectively excludes people on low (...)

Towards a healthy farming and food policy

How well do the proposals of the Common Agricultural Policy review fit with EPHA’s goals for changes in farming and food policy?
Three years ago, the European Public Health Alliance produced a consultative document on food, health and the Common Agricultural Policy (CAP). (1) It was signed by 50 groups and individuals concerned with health, nutrition, environment and social justice in Europe. Its purpose was to outline demands for policy change, and to provide a focus for joint action by (...)

How to win some hearts

Fruit and vegetable consumption reduces the risks of heart disease. Europeans therefore need to be encouraged to eat more fresh fruit and green vegetables. Yet, in most European countries, supplies of this vital source of nutrients and fibre are insufficient to meet the WHO-recommended dietary intake. Should European policy encourage the production of more local produce?
Cardiovascular diseases - including coronary heart disease and stroke - are the main cause of death in Europe. They are (...)

Making healthy food a factor in CAP reform

Tim Lang, Professor of Food Policy at Thames Valley University, UK, believes that those involved in health must stop talking about outcomes of ill-health and concentrate on altering the determinants - such as the nutritional impact of the food supply chain, starting at the farm. He believes that changing the Common Agricultural Policy (CAP) is a symbol of whether there is real political will to act.
European Union food policy is witnessing remarkable change. (1) Although the new Fischler (...)

The Common Agricultural Policy at a glance

We publish more information about the common agricultural policy and its impact on health.
Origins of CAP
Born in post World War ll reconstruction. The 1957 Treaty of Rome article 39 stated CAP should:
"increase production by promoting technical progress..
"ensure a fair standard of living for the agricultural community..
"stabilise markets...
"assure availability of supplies...
"ensure that supplies reach consumers at reasonable prices..."
Stresa Conference
In July 1958, (...)

Health NGOs maintain the pressure

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 (...)

Resources on children’s health in Europe

World Health Organization
The child and adolescent health and development programme of the World Health Organization Regional Office for Europe assists European member states to take appropriate measures to pursue the full implementation of the health-related articles of the United Nations Convention on the Rights of the Child.
(www.who.dk/eprise/main/WHO/Progs/CHD/Home)
The Children’s health and environment programme is based in Rome.
http://www.who.dk/eprise/main/WHO/Progs/CHE/Home
The (...)

Do children have a right to health?

One of the principal stated objectives of the European Union is to establish European citizenship, including fundamental rights. Yet the existing competence of EU does not take children’s rights into account. European NGOs are campaigning to achieve a legal base for children in the Treaty. The current legal status of the child in the EU Treaty is unclear, according to the European Children’s Network (Euronet), a network of NGOs campaigning for the rights of children within the European (...)

Young people provide visions on inequalities

European adolescents are being interviewed about inequality and health in preparation for a conference in Copenhagen in December 2002.
Young people in several European countries are being asked their thoughts about social inequalities in health. The opinions expressed will be represented in a video to be shown at the Danish presidency conference on "Social inequalities in health among children and young people" taking place in Copenhagen, 9-10 December 2002.
Preliminary results of the (...)

EPHA in action for children’s health

Thanks to the commitment of WHO and the European Commission, much is now being done to achieve improvements in children’s environmental health in Europe. EPHA hopes that as the process goes on stronger emphasis will be given to inequalities in children’s health and to acknowledging their rights.
Millions of European children have poor health because of the poverty in which they live. According to UNICEF, the number of children living in households that do not include a working adult has (...)

Young people brainstorm on alcohol

During a conference on "Education and Health" which took place in the Netherlands in September 2002, the results of the Young Minds project were presented. Students from secondary schools in twelve European countries highlighted young people’s opinions on the links between youth, culture and health. Here is how students in Spain propose to deal with the attitudes of young people towards alcohol and drugs.
Student report: It was hard to start off. At first we didn’t have a very clear idea (...)

Identifying the threats to children’s health in Europe

Europe’s children face health problems that are different from other regions of the world. Dr Roberto Bertollini of the World Health Organization’s European regional office identifies the main threats and defines WHO’s approach to tackling the problems.
What are the main threats to children’s health? How do they differ from those facing adults?
Bertollini: The answer depends on which part of the world we are talking about. In developing countries, although much progress has been made in (...)

Free movement of patients: is it in the interests of patients and citizens’?

More people are crossing borders for medical treatment. But is cross-border health care a good thing? Willy Palm of Association Internationale de la Mutualité (AIM) addresses this question and describes the recent European Court of Justice cases that have made so-called "health tourism" more accessible.
Cross-border mobility of patients has become a very topical issue. Successive rulings of the European Court of Justice in the cases Kohll and Decker, and more recently in Smits-Peerbooms, (...)

Resources on tackling health inequalities

The role of health promotion in tackling inequalities in health is the European Commission-funded study featured on page 7. It includes a Report and Executive Summary on the development of policies and strategies by the European Network for Health Promotion Agencies (September 2001). It is available from the Flemish Institute for Health Promotion (VIG) Gustave Schildknechtstraat 9, B-1020, Brussels, Belgium. And via the website: http://www.vig.be/doc/kansarmen/Social_inequalities.doc; a (...)

Nurses take a community approach

Tackling health inequalities has become a key focus for health policy and practice across Europe. In the UK, there is increasing awareness of the capacity of community development approaches to improve health. Jane Naish, policy advisor with the Royal College of Nursing, UK, describes one successful project.
Jenny Gough is an experienced public health nurse and health visitor who has worked in a socially deprived area of the UK’s West Midlands for several years. She quickly recognised the (...)

Approaching health inequalities on the Island of Ireland

The Institute of Public Health in Ireland has been instrumental in encouraging the two Irish governments to address disparities in health related to socio-economic factors. Owen Metcalfe, Associate Director, describes the process, the emphasis on partnership between government departments and disciplines, and the hopes for the future.
The focus on health inequalities has sharpened on the island of Ireland recently. At a policy level this is demonstrated in Northern Ireland where the (...)

What role for health promotion? Models of good practice

POLICY DEVELOPMENT
1. National health inequality targets
United Kingdom: National inequalities target, inequalities in health national consultation
Sweden: The national strategy for public health set 18 goals including high employment, education and green recreation areas, and family friendly policies
2. Integrating health determinants into other policy areas
Austria: Health Promotion Act 1998
Germany: Eastern Brandenburg employment and health promotion services joint working programme (...)

Danish showcase: Copenhagen addresses inequality

The Copenhagen City Council has just approved its public health targets for the next five years. One is that efforts to reduce social inequality should be integrated into all policies in the City. The following are three examples of initiatives run by the Copenhagen Health Administration. Health Care Services - The Family Clinic
Two hospitals in Copenhagen are offering family clinics which have a special service for pregnant women and mothers with problems with alcohol and drug abuse. (...)

Belgian presidency: can the EU bring about change?

The Belgian presidency of the European Union, which ended in December 2001, made a considerable contribution to raising the issue of inequalities in health. But health minister, Magda Aelvoet ended her term of office expressing a sense of frustration over how little could be achieved.
Sitting around the table at a Ministerial meeting in December 2001, participants were reminded that ten years ago a discussion about how to tackle inequalities in health would not have been possible. The (...)

The evidence and the options

How serious are inequalities in health in Europe and what can be done to reduce them? UPDATE Editor Diana Smith investigates.
As Europe opens up to the East, Western Europeans are becoming increasingly aware that people living in the less wealthy countries of central and eastern Europe have poorer health and shorter life expectancy that those in western Europe. Male life expectancy in the Russian Federation is 62.7 years compared with 73.7 years in Germany.
What is less well known is that (...)

Tackling health inequalities: what can health promotion do?

A recent European Commission-funded report provides recommendations for a policy approach to reduce inequalities in health through health promotion. These recommendations were presented to a Health Council meeting on 15 November 2001 and to a ministerial round table on 5 December 2001. The following article is based on the report and suggests key roles for health NGOs. It is written by John Middleton of Sandwell Health Authority, an EPHA member involved in projects aimed at reducing (...)

European pharmaceutical association makes its case to EPHA

The European Federation of Pharmaceutical Industries and Associations (EFPIA) has responded to an article in EPHA’s "Update" magazine.
Brian Ager, Director General, European Federation of Pharmaceutical Industries and Associations (EFPIA), requested an opportunity to respond to the article by Greg Perry of the European Generics Association published in EPHA Update Magazine (March/April 2003).
Please find his statement attached to this (...)

Affordable medicines threatened in Europe

To date the focus on access to medicines has understandably concentrated on the critical need to provide affordable medicines to developing and least developed countries. However, new EU pharmaceutical legislation presents a threat in the accession countries, which are highly dependent on non-brand name medicines at low cost, according to Greg Perry of the European Generic Medicines Association.
While the much-discussed TRIPS Agreement threatens access to medicines in the world’s poorest (...)

Interview: Robert Madelin, DG Trade

Interview with Robert Madelin who coordinates the European Commission’s trade dialogue with civil society.
EPHA question: EPHA believes that the views and resources of transnational corporations carry too much weight in World Trade Organization talks as compared with those of UN specialised agencies, such as the World Health Organization, and civil society. How can a greater balance be achieved?
Robert Madelin: All players in the process have an opportunity to influence the talks only (...)

Resources on Trade and Health

Health
WTO Agreements and Public Health, a joint WHO/WTO report, 2002.
Revision of the International Health Regulations, Public Health and Trade, Comparing the role of three international organisations, WHO Wkly Epidem. Rec., No. 25, 1999, pp. 193-201.
"Global trade and health: key linkages and future challenges" by D. Bettcher et al, Bulletin of the World Health Organization, 78 (4), 2000.
"World Trade Organization: World Trade and Population Health" by Ron Labonte, IUHPE, and "The (...)

Harnessing Trade to Reduce Social Inequalities

Trade should be the means and poverty reduction the end, writes Genevra Forwood of Solidar, an international NGO involved in building "Citizens’ Europe" by involving people in building a social Europe. She provides some visions of how the World Trade Organization (WTO) could be reformed.
The European Union was built on the pursuit of peace, but also the pursuit of prosperity and equity - a similar challenge to the one confronting us today on a global level. European integration was always (...)

The problems with Trade for Health

The European Public Health Alliance and many other non-governmental organisations are concerned that the benefits of trade are not directed towards the objectives of health and development, and that some aspects of the current trading arrangements are adverse to the promotion of international public health. Diana Smith, "Update" Editor, describes some of the key areas of concern.
An unfair distribution of the benefits of trade Trade is a powerful instrument but much of its potential to (...)

Protecting Health in a Globalising World

Over the past three years, the World Health Organization has devoted considerable attention to the effects of trade on health and sustainable development. Here, Robert Beaglehole of the Department of Health and Development identifies what WHO sees as the main risks and opportunities of globalisation for public health. In brief, WHO recommends and assists governments to develop strong national health policies.
The World Health Organisation is the main intergovernmental agency responsible (...)

Why Trade isn’t Working for Health

The implications of increasing global trade and new trade agreements are having a major impact on health. Francesco Longu, EPHA’s Policy Assistant specialising in trade issues, describes the background to health and trade and suggests what is going wrong.
Trade statistics show that in the last 50 years international trade has been constantly growing. The creation of an International Trade Organization, which was to have addressed serious problems for developing countries such as the (...)

Trade and Health at a Glance

1851: First International Sanitary Conference aims at balancing the interests of trade with disease control.
1945/6: The International Monetary Fund (IMF) and the International Bank for Reconstruction and Development (IBRD or World Bank) set up as UN specialised agencies to strengthen and add stability to the western economic model. Since then, Structural Adjustment Programmes have been used as conditions for loans pushing developing countries towards greater market liberalisation and (...)

Making Trade Work for Health - editorial

EU Trade Commissioner, Pascal Lamy will be in a position of awesome power when he attends the next World Trade Organization ministerial meeting in Cancun in September 2003. By then, with the accession agreements signed, he will represent the world’s number one economic power. At the Mexico meeting, he could ensure that Europe’s leadership is social as well as economic by charting a new path for a healthy, just and environmentally-friendly trade.
Until now, the US trade delegation has (...)

WTO Agreements and public health - briefing of a joint study

The linkage between public health and international trade is increasingly recognised as an area of great significance for health. Here, we outline the areas covered, and issues involved, in a study that has been undertaken by the secretariats of two international organisations most involved.
The World Health Organization (WHO) and the World Trade Organization Secretariat (WTO) have published a joint study of the relationship between trade rules and public health. The 171-page study (...)

Complementary health care: is there a role for the EU?

The following is a message to UPDATE readers from MEP Nuala Ahern (Greens/EFA, Ireland), Chair of European Parliamentary Working Group on Complementary and Natural Medicine. She is planning a seminar in November 2002 on how complementary medicine can be integrated into the main health care structures.
Nuala Ahern writes: I am both a consumer and legislator at European level with regard to complementary medicine and natural health. I can say there has been an explosion of consumer interest (...)

Public interest group on medicines launched

The Medicines in Europe Forum, which was created in March 2002 in Paris, aims to ensure that European pharmaceutical policy serves the public interest. Christophe Kopp of International Society of Drug Bulletins describes why the Forum was created and introduces three principles that need to be reinforced in the proposed Pharmaceutical Directive and Regulation of the European Commission
In an unprecedented move, French and Belgium mutual insurance systems (1), consumer organisations, (...)

Integrated health care in Europe

Europeans want non-conventional medical therapies integrated into mainstream medicine, according to Stephen Gordon of European Council for Classical Homeopathy.
Across Europe a significant and growing proportion of the public, and increasing numbers of health care professionals, are actively choosing to integrate various forms of traditional, alternative, complementary or non-conventional medicine into their health care provision and practice. Interventions such as acupuncture, (...)

Free movement of pharmaceuticals: what defines the prices?

The forces at work to define the prices of pharmaceuticals are extremely complex. Patents on new drugs, EU regulation, and monopolistic buying by governments to supply national health services all play important roles, as Leigh Hancher of the University of Tilburg explains.
Prices for medicines, especially prescription medicines, continue to diverge dramatically across the Member States of the European Union - with some market leaders costing up to 50% more in the high price Northern (...)

Direct-To-Consumer Advertising - for or against?

The European Parliament has begun to consider proposals from the Commission to allow industry to disseminate information on prescription drugs directly to the consumer. This move could risk leading to Direct-to-Consumer Advertising in Europe. In response, Health Action international-Europe (HAI Europe) and EPHA organised a seminar in Brussels on January 10 to discuss the question of: "Providing Prescription Medicine Information to Consumers: Is there a role for Direct-to-Consumer (...)