20 January 2024

Enable healthier living

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The share of spending on prevention has increased to 6% of total health spending across the EU, thanks to the COVID-19 pandemic and the increased spending on immunisation programmes. Investments in public health, disease prevention and health systems should be a key priority and sustained also in the future. A lack of investments and action on preventable diseases causes avoidable mortality, morbidity, and financial costs.

There are many diverse preventable health problems, such as non-communicable diseases (NCDs), communicable diseases, environmental pollution, or mental health disorders. All these problems should be taken into consideration in policymaking.

As an example, NCDs such as cancer, diabetes, cardiovascular and chronic respiratory diseases, are responsible for 80% of the disease burden in the EU countries and the leading causes of avoidable premature deaths. There are ways to reduce the behavioural risk factors such as alcohol, tobacco, and nutritionally poor foods but also the environmental risk factors such as air pollution.

In the beginning of 2021, the current European Commission presented the Europe's Beating Cancer Plan, its main health priority. One of the plan’s key action areas is prevention, recognised as the most cost-efficient long-term cancer or disease control strategy. It was announced that the aim of the plan is to raise awareness of and address the above-mentioned key risk factors. More importantly, it was said that the actions would be supported by EU-level regulatory instruments.

Unfortunately, many promised proposals have been delayed. This means that the next Commission and the Parliament have a crucial role in finalising and adopting the leftover actions.

On alcohol, the main acts are the revision of the EU rules on taxation and cross-border purchases as well as the introduction of mandatory labelling rules of ingredients, nutritional values, and health warnings. All these initiatives are delayed. In addition, the new policymakers should monitor the implementation of the Audiovisual Media Service Directive provisions on commercial communications for alcoholic beverages to reduce the exposure of young people to alcohol marketing. Alcohol use in adolescence continues to be very common in Europe and alcohol related harm in general remains a major public health concern.

On tobacco, the revision of the EU’s Taxation Directive and the legal framework on cross-border purchases are yet to be concluded as part of the cancer plan. Moreover, the processes to review the Tobacco Products Directive and the Tobacco Advertising Directive should be started by the next Commission. There is an urgent need for these actions especially because of the emerging products, such as e-cigarettes, nicotine pouches, and heated tobacco products. One of the main concerns is their appeal to young people.

The European Ombudsman has recently found maladministration in the Commission’s failure to ensure transparency when it comes to meetings with tobacco lobbyists. Currently, excise duties on novel products are less than for conventional cigarettes, and the industry is keen to keep it that way. Fortunately, one of the cancer plan goals should be fulfilled in the end of January as the Commission will propose to update the Council Recommendation on Smoke-Free Environments, extending its coverage also to emerging products.

On food, the EU’s cancer plan has promised to propose a harmonised, mandatory front-of-pack nutrition labelling to empower people to make better and healthier food choices. The plan has also committed to evaluate the outdated EU Action Plan on Childhood Obesity. Moreover, linked to the Farm to Fork Strategy, the Commission has been expected to propose an EU Sustainable Food Systems Law. Also, all these initiatives are delayed. It is important that policymakers find solutions to make sustainable and healthy food more affordable and available.

In general, regulation is important. For example, alcohol and tobacco taxation is one of the most effective policies to reduce consumption but also to increase government revenues. Policies also help to reduce health inequalities.

Fortunately, there is also some progress in the field of prevention. As an example, the trilogue to revise the EU air quality directives is expected to be concluded by the end of the current Parliament’s mandate. Hopefully, we will see a full alignment of the EU standards with the WHO guidelines. Regarding vaccination, the EU has supported its member states to increase vaccination coverage and confidence. As a result, immunisation campaigns have reduced the incidence of vaccine-preventable diseases. The Commission will also propose a Council Recommendation on vaccine-preventable cancers in the end of January. Moreover, it has been supporting the Coalition for Vaccination, co-chaired by CPME, which brings together European associations of healthcare professionals.

Well-being of European citizens should be in the focus of the next EU policymakers. The challenge of people suffering from mental health issues worsened with the COVID-19 pandemic. A new EU-wide strategy is therefore needed to ensure that resources are allocated for mental health services. Key is to break stigma around mental health and to guarantee access especially to effective prevention, but also to mental healthcare and treatment.

The EU must make better use of its cross-sectoral regulatory tools to prevent disease and improve people’s physical and mental health and well-being. Health must be viewed as an investment.

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