Europe Mulls Rival Approaches to Tackling Disease

October offered a striking spectacle of contrasts in Europe’s ponderous attempts to construct a comprehensive policy on health.

On the one hand, the month opened with calls from a cross-party group of members of European Parliament (MEPs) seeking action from the European Commission in support of orphan drugs and rare-disease patients. “What measures has the Commission taken so far to ensure accurate and timely diagnosis of rare diseases,” ask the MEPs. In addition, they pointed out, patient access to medicines for rare diseases varies widely across Europe-so what is the Commission doing to promote the availability of affordable medicines to treat rare diseases, they demanded.

Throughout the month, groups as diverse as the European Alliance for Personalized Medicine and the Multistakeholder Pediatric Strategy Forum have been urging vigorous

action to promote targeted treatments, close collaboration on dialogue between regulators and drug developers, and early scientific advice-with much of the discussion centered on the emerging plan for coordinated European-level health technology assessment (HTA).

Conversely, the month was also marked by a crescendo of concern that health policymakers may be looking through the wrong end of the telescope with their traditional focus on treatment. Right at the start of October, one of Europe’s biggest annual health policy gatherings, the Gastein forum, named for the mountain resort in Austria where it takes place, heard plenty of calls for a bigger and better European health policy-but with an emphasis on wider access and greater equality, and with a focus on prevention rather than treatment.

A series of prominent healthcare policymakers, from World Health Organization (WHO) Regional Director for Europe Zsuzsanna Jakab, to Director of the European Center for Disease Prevention and Control Andrea Ammon, underlined what they saw as the need for a multisectoral, societal, and integrated response to health. There were repeated invocations of the United Nations’ Sustainable Development Goals (SDGs), and calls for Europe to lead by example in the program’s global ambitions to tackle poverty, inequality, climate, environmental degradation, and injustice.

EU’s Commissioner for Health Vytenis Andriukaitis has taken as his theme “the importance of our health-in-all-policies approach.” He told a WHO meeting in Kazakhstan: “We

need a much stronger focus on health promotion, protection, and disease prevention.” And Andriukaitis has developed the theme throughout the month, with speeches endorsing

the merits of a broader approach. The mantra is that the health sector cannot succeed alone. “We must address all the risk factors in a more holistic way: obesity and unhealthy nutrition, lack of exercise, tobacco, alcohol abuse, and also wider factors such as working conditions, unhealthy housing, and environment pollution” he said.

Andriukaitis followed a similar line at the G20 Health Ministerial Meeting in Argentina where childhood nutrition was on the agenda, and at the recent UN high-level meetings on non-communicable diseases and tuberculosis.

It is more than just a straw in the wind that the EU has set up a new steering group on health promotion and prevention of non-communicable diseases that is tasked with identifying priority areas for action and promoting exchanges of policies and practices between countries. Nor is it entirely a coincidence that it has chosen nutrition and physical activity as one of the areas for priority implementation.

Peter O'Donnell is a freelance journalist who specializes in European health affairs and is based in Brussels, Belgium