Background - Chronic disease as Europe’s no.1. ’silent killer’

Lifestyles patterns in Europe, coupled with the political, economic and social structures of our societies have led to a situation whereby one in four people are obese, one in two are overweight and a further large proportion of people living in Europe suffer from other poor diet-related diseases. Tobacco is the leading cause of preventable and premature deaths and alcohol the third cause of disease. Such patterns have resulted in a situation whereby chronic non-communicable diseases like cancer, [1] cardio-vascular disease  [2], respiratory diseases such as Chronic Obstructive Pulmonary Disease (COPD) [3] , diabetes [4], mental disorders and others ) are increasingly widespread, accounting for 86% of deaths in the WHO European Region and 77% of the disease burden.

"Smarter investments can manage and prevent chronic diseases"

Throughout the Summit, all speakers agreed that chronic diseases had a significant economic impact. Ricardo Baptista Leite, Member of the Portuguese Parliament highlighted that it was essential to shift away from the vision of health as being an expenditure and to think of it more in terms of an investment

Beatrice Lorenzin, Minister of Health of Italy fully shared his vision arguing that investing in health was incredibly valuable. She added that authorities wanted everyone to have access to the best treatments available but at the same time were concerned with containing costs.

In addition, James Reilly, the Irish Minister of Health pointed out that having a healthy workforce was the key element to create a healthy economy.

Hans Martens (Chairman of the Coalition for Health, Ethics and Society) emphasised the link between health and spending and asked: "Do we get better health if we spend more?" He stressed that joint actions, learning from each other, and sharing best practices were key elements that we need to put into practise.

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"We have to get patients out of hospitals." - the necessity of patients’ involvement

The necessity of involving and empowering patients in the healthcare process was highlighted many times. Patient based policies must be established and implemented.

Zoran Stančič (Deputy Director-General, DG Communications Networks, Content and Technology) mentioned that ICTs could be a great way to empower patients.

In addition, Stanimir Hasurdjiev (Board Member of the European Patients Forum) emphasised that patients should not be seen as part of the problem - they could be part of the solution as well. For meaningful patient empowerment, however, proper resources should be made available.

"We need a healthy population which is fit for work" - the importance of Primary Care

The Slovenian Minister of Health, Mojca Gobec, highlighted the importance of primary care.

Yves Leterme (Deputy Secretary General at the Organisation of Economic Cooperation and Development (OECD)) asked for a strong leadership and investment in primary care, as well as a strong primary care system.

"We need to bring together relevant sectors, citizens, bodies to discuss prevention"

During the Summit the discussion revolved around the need to share best practices across Member States, but also across sectors.

The Director Eva Jané-Llopis, who is Head of Health Programmes at the World Economic Forum, focused on the Health for Growth Programme, which she thought was a positive example of how different actors have worked together. In her view, the finance ministers worked well together with the health ministers to unpack the value of health. Through joint actions, European policies could make a better impact on citizens. Health in All policies (HIAP) is an important approach that integrates this vision.

Antonius Helou, the Head of Division for Non-Communicable Diseases in the Federal Ministry of Health in Germany, stated that cooperation between the Member States is important as well as international and national strategies to control the burden of chronic diseases.

- Commission Communication on effective, accessible and resilient health systems which noted the importance of access and cost efficient use of medicines

To find out more:

- [EPHA Briefing] Access to Medicines in Europe in Times of Austerity

- [EPHA position paper] Reforming Health Sy­stems in Times of Austerity

- article 5192

"Health in all policies is a win-win situation"

Prevention was at the centre of discussions during the whole Summit.

EPHA’s president, Peggy McGuire, claimed that we were far from making progress towards reducing the number of people living with and dying prematurely from chronic diseases. This situation was unacceptable as we know that the biggest majority of these diseases and deaths were avoidable and preventable by reasonable and cost-effective mean.

Mojca Gobec, Director General of the Ministry of Health in Slovenia, pointed out that we need to upgrade preventive services in Europe.

Moreover, Witold A. Zatonski, who is a Professor at Curie-Sklodowska National Cancer Center in Warsaw, emphasised the need for effective primary prevention through well established vaccination programmes.

Additionally, Ricardo Baptista Leite, Member of Parliament in Portugal presented a clear idea of what concrete action should look like in the future. He said if a disease was preventable, we should prevent it and if it was curable, we should cure it.

Main messages of the speech of Peggy Maguire, EPHA president

Removing the burden of chronic disease is a Commission priority.

Health Commissioner Tonio Borg summarised in his final remarks that a strong political leadership was necessary to prevent increasing rates of chronic diseases in the European Union.

Inaction is not an option - Policy Recommendations emerging from the Summit

A. Strengthen political leadership to address chronic diseases - (including consistent and coordinated approaches and integration of the health in all policies approach, the broad involvement of civil society, prevention by strengthening effective action on the key major risk factors such as tobacco, alcohol, nutrition and physical activity)

B. Target key societal challenges - (ageing, addressing the health, social and equity dimension of chronic diseases, concentrating on chronic diseases with the highest burden and impact on health and social systems)

C. More efficient use of available resources - prevention, behaviour and lifestyle change, effective funding, integration of health objectives into other policies and fully exploit e-health, m-health and other IT solutions.

D. Strengthen the role and the involvement of citizens, patients and the health and social sector in policy development and implementation - (citizen and patient empowerment, mechanisms for citizen empowerment (in particular targeting the young generation), help and support patients, promote the participation of patients, the role of health and social professions, taking into account equity issues, as well as the social and gender dimension.

E. Strengthen evidence and information - strengthen efforts into research and development, use of new technologies to enable the collection of better and comparable data on the medical, economic and social dimension of major chronic diseases, stimulate the evaluation and dissemination of information, develop a comprehensive strategy responding to demographic change and population ageing and scaling up of innovative practices.

To find out more:

- The full text of the final recommendations is available here

- The Workshop RECOMMENDATIONS by rapporteurs are available here

- All PRESENTATIONS are available on the Commission website.

- Explore the latest updates on TWITTER by using the #EU4Health hashtag].

Related EPHA articles


[1] After circulatory diseases, cancer was the second most common cause of death in 2006, accounting for two out of ten deaths in women and three out of ten deaths in men - equating to approximately 3.2 million EU citizens diagnosed with cancer each year.

[2] Each year cardiovascular disease (CVD) causes over 4 million deaths in Europe and over 1.9 million deaths in the European Union (EU). CVD causes 47% of all deaths in Europe and 40% in the EU.

[3] The primary cause of COPD is tobacco smoke (through tobacco use or second-hand smoke). In Europe 4-10% of adults have COPD. Total COPD related expenses for outpatient care (= not in hospital) in the EU is approximately €4,7 billion per year, while for inpatient care (=in hospital) these expenses cost around €2,9 billion, with an additional €2,7 billion per year spent on pharmaceutical expenses.

[4] Rising obesity and population ageing are pushing up the numbers of people with type 2 diabetes, and there is an as yet unexplained increase in type 1 diabetes, notably in children. Direct healthcare costs alone already stand at 1109bn per year in Europe, and these are likely to rise in future.

Last modified on April 19 2014.