At last week’s European Health Forum Gastein (EHFG), the theme surrounded the United Nations Sustainable Development Goals (SDGs) for 2030. Out of the 17 SDGs, 12 are in some way connected to health and nutrition. In attendance were key stakeholders in European health including Martin Seychell, deputy director of health and nutrition at the European Commission (EC). In a press conference, he highlighted some of the worlds greatest future challenges in regards to major health issues and what the EC is doing to combat them.
What are the biggest challenges we are facing in health and what is the EC doing about them?
An Ageing Population
Obviously, we are increasingly facing problems with our ageing population and the challenges that arise from chronic and preventable diseases. We are ensuring that this is not just seen as a health priority but an overall priority. in the European semester process, the country specification recommendations (which is one of the main tools of the EU to ensure fiscal sustainability) we are looking at the root causes of the pressured on health care systems. This is why the importance of prevention and promotion and the importance of primary care are really central to this. We must understand the drivers of expenditure and ensure we can work more efficiently to support member states.
It is an embarrassing situation. Europe is the only region in the world where diseases like measles and rubella are becoming an issue again.
A major problem is antimicrobial resistance (AMR), something that I fear is very often underestimated. This is not just to say that some infections will become difficult to treat, that would be bad enough. The issue is that the fast growth of AMR — something that is happening even faster than climate change, would mean that a lot of medical procedures that are today essential such as chemo, surgery or even dental care, could become high-risk or almost impossible to perform if this problem gets out of hand.
Therefore we must take this very seriously. The EC has adopted a One Health Action Plan (now in the second phase) that focuses on the human health side, the use of antimicrobials in veterinary medicine and also antimicrobials in the environment. We are so far the only global region that has a comprehensive action plan based on this ‘One Health’ concept. We are also working with our international partners to convey the message and have taken legal measures that hopefully the council and parliament will adopt. We have proposed a package of new legislation on veterinary medicines to safeguard the food chain and to protect human and animal health. There will be measures to ban the use of antibiotics in animals that are also used by humans because this is one of the main drivers of resistance.
Then, other challenges, particularly in Europe is low rates of vaccination. This is of major, major concern. In many respects, it is an embarrassing situation. Europe is the only region in the world where diseases like measles and rubella are becoming an issue again. These diseases are practically eradicated in other regions. We are not only seeing an increase but we are also exporting them. This is something we should be ashamed of collectively. There are many reasons for this. Of course, vaccine hesitancy but also there are some real issues with shortages of some vaccines caused by the fragmentation that exists in Europe. We are working on that and have produced a series of recommendations and other political initiatives to address this problem.
Another thing not to be proud of — among all the regions in the WHO we have the highest rate of tobacco consumption. Compared to other countries we still have an excessive use of this major risk factor. 700,000 Europeans die because of tobacco every year and this is all avoidable.
We have made progress. Our legislation in this area is very comprehensive and covers all aspects from packaging to flavourings. We are now implementing new measures that are tackling illicit tobacco trade. There will be a system of tracking and tracing tobacco products from the very beginning to the retail end of the chain.
The aim is particularly to protect the young and vulnerable from tobacco consumption.
Opportunities for improvement
I don’t want to be just pessimistic. There are some exciting opportunities ahead. The digitalisation of health is a golden opportunity if we can identify the technologies that can help us address some of the major needs in ensuring the continuity of care and also being able to support patients in their own homes. We have been speaking for many years about moving away from hospital-based care to patient centred care. What could be better than providing as much treatment as possible in patients own homes and communities? Well, technology today makes that possible.
Of course, there is a lot of work to be done to ensure the right standards and interoperability so that data can be exchanged (in the interest of the patient) between various providers. Then there are security aspects and data protection aspects of course, but the potential is enormous.
A very practical example I can mention, and something that I am personally very proud of is the work that we have done in the EC on the European Reference Networks for patients with rare and complex diseases. We now have 24 networks and over 300 hospitals across Europe. These are now operational and we have input the IT backbone. These hospitals are allowing patients and specialists to work together on diagnoses and treatments across borders for those suffering from rare diseases. There are around 30, 000 000 people in Europe who suffer from some rare disease or other and this is often a very difficult ordeal for them as it takes, on average, 5 years to be diagnosed. We are putting in place these networks to help bring the knowledge to the patient and minimise the patients need to travel and provide them with support closer to home.
This is a very exciting time and a good time to talk about the future to ensure that we are not only in a position to achieve the Sustainable Development Goals but if possible to even do better.