2012 was a busy one for EPHA and its members as we worked on identifying the health impacts of the economic crisis, which are very visible but yet not fully understood. EPHA’s Annual Conference 2012 was ’Health system reform in times of austerity’. Speakers included Former Health Commissioner John Dalli, Zsuzsanna Jakab, Director for the WHO Europe, Sanjeev Gupta, from the International Monetary Fund and Pervenche Beres, chair of the Employment and Social Committee in the European Parliament. Following the conference, 9 MEPs, 65 leading trade unions, civil society organisations, health organisations, and industry associations united in an open letter calling on European leaders to stop cutting essential health and welfare systems.

EPHA will make every effort to bring forward the debate and in the spirit of solidarity look towards the future of public health. With this goal in mind, the theme of EPHA’s 2013 Annual Conference will be inclusive growth and the response to the economic crisis. The conference is part of EPHA’s work on the impact of economic governance on health and health systems. EPHA hopes to facilitate a dialogue on how to tackle injustice and inequalities, the added value of innovation in the future of health systems, and how to create efficient societies and health systems.

The mobilisation of the health community continued into 2013, with European doctors sending an open letter to European leaders on the effects of austerity on the health of people. The letter reminded EU leaders the obligation that all policies should consider health impacts, and encouraged them to look for alternatives to reverse the current situation. Despite the fact that several countries are in the midst of a deep economic crisis, a grouping of health professionals and leading academics for the first time criticised the response to the economic crisis. The Lancet, a well-known medical journal published a series on the health effects of the economic crisis, which contributes to the evidence base for future policy making. Professor Martin McKee, one of the study authors, argued that "we do contrast the willingness of the governments and of the European Central Bank to bail out the banks, but not to protect health care for ordinary people."

EPHA member Medecins du Monde(MdM) launched a new report that documents the effects of the economic crisis and rising xenophobia on undocumented migrants and other vulnerable groups at risk of exclusion from healthcare systems. Results show that the consequences of austerity impacts are particularly strong in Southern Europe for many undocumented migrants for administrative reasons and European citizens experience healthcare access problems due to loss of employment.

As Commissioner Borg recently stated “too often health is perceived as a cost, and not an asset for the future.” To correct this misconception, the Commission adopted a paper on ‘Investing in health’ which forms part of an overall package on "Social Investment". EPHA applauds this initiative to tackle the social impact of the crisis and believes it has potential to strengthen prospects of recovery by enabling individuals to bounce back. February ended with a landmark move, as for the first time the Employment, Social Policy, Health and Consumer Affair Council approved guidance that reiterate the importance of “sustainable universal health and long-term care, delivering improved outcomes and services with a strong focus on health promotion, disease prevention, quality and patient safety.

As the Commission’s Annual Growth Survey 2013 focuses on economic growth and fiscal consolidation, without a meaningful emphasis on promoting better health, healthy ageing and improving the quality of healthcare EPHA encourages the health community to engage in this pertinent policy debate. In order to facilitate this, EPHA has developed a briefing on health in Europe 2020 that outlines the mechanisms and impact, as well as highlight the importance of the health sector in reaching Europe 2020 goals. The briefing examines the health impacts of EU economic governance, what changes to healthcare systems intervened and highlights recommendations from civil society and the European Parliament on health in the annual growth survey. Finally, EPHA has launched its Health, civil society and the reform of economic governance: A call to action to encourage civil society to get involved in the reform of economic governance and the decisions taken under new frameworks such as the European Semester that affect population health and health outcomes.

EPHA advocates for better spending. It can be achieved through solidarity and equity in structural reforms for sustainable health systems and by focusing on constraining healthcare budgets risks but not by undermining access and quality of care. EPHA has developed a position on health system reform to recall the values and purposes of these systems explore the room for healthcare reform and highlight that health promotion and disease prevention are value for money as they reduce long-term treatment costs.

Besides the drastic reduction in public health spending, countries affected by the crisis have been facing shortages in medicine supplies. In Greece the situation is worsening, as medicines are exported to other European countries where prices are much higher and pharmaceutical companies are accused of halting supplies to the country. The situation has reached such a drastic state that an American NGO “Essential Inventions” encouraged the Greek government to adopt a compulsory licence law that would allow Greece to import generics from other countries. As similar situations have been noted in several countries, EPHA has drafted a briefing on access to medicines that provides case studies on countries experiencing medicine shortages, changes in coverage, the use health technology assessment, and evaluates the role of competition and innovation in meeting unmet needs and creating new affordable medicines. This culminated with an event that EPHA organised on 16 May that gathered patients, health professionals, civil society actors, and academics from Greece, Lithuania, Spain, Portugal, Belgium, the UK, and international organisations to debate solutions to medicines’ shortages.

Well thought-through investments in health that will make public care sustainable is the current imperative for health actors. Business-as-usual in economic decision making will not deliver on the needs and expectations of people affected by the crisis. With the conviction that leadership from decision makers can change the status quo, EPHA Secretary General Monika Kosinska participated to the WHO Ministerial conference the 17-18 April Health systems in times of global economic crisis: an update of the situation in the WHO European Region. The event concluded health specialists should be a part of negotiations on macroeconomic policies, social policy-making process and austerity measures. Many health reforms have been introduced in times of crisis in order to increase efficiency of health systems. Key areas of those reforms were:

  • disease prevention and health promotion
  • strengthening primary health care
  • updating pharmaceutical policies - increase the use of generic medicines
  • streamlining benefit packages.

EPHA resources on economic governance and the financial crisis

- EPHA briefing on health in Europe 2020
- Health, civil society and the reform of economic governance: A call to action
- EPHA position on health system reform
- EPHA drafted a briefing on access to medicines

For more information please contact Leonardo Palumbo at leonardo@epha.org.

Photo source: © Associated Press Images

Related EPHA articles
- [EPHA Open Letter] to EPSCO Council - Boosting investment in health and sustainable development
- Council conclusions on the Annual Growth Survey 2013
- [Press Release] Economic policies must address the real impact of crisis on people living in Europe
- European doctors send open letter on the effects of austerity on the health of people
- New WHO study on Policy responses to the Financial Crisis
-  Towards an effective implementation and delivery of the Health 2020 strategy in times of austerity
- European Health Forum Gastein - 2012 Edition Highlights Austerity Impacts on Health
- EPHA Press Release: MEPs lead urgent plea from health community to prevent health crisis in Europe
- New evidence on access to healthcare: austerity marginalises Europe’s weakest
- The economic crisis & EPHA fact & figures on the impact of the financial crisis on health
- EPHA Press Release: MEPs lead urgent plea from health community to prevent health crisis in Europe

Last modified on May 24 2013.