Calling on EU to put people's health and well-being back on top of its priorities

EPHA Conference

On 4 and 5 September 2013, and in an official event of the Lithuanian Presidency of the Council of the European Union, the European Public Health Alliance (EPHA) celebrated 20 years helping shape Europe's public health. The European Child Safety Alliance participated in this two-day conference entitled "Brave New World: Inclusive Growth and Well-Being or Vested Interests and Lost Generations?" which brought together more than 30 speakers from all across Europe's health professions, experts and civil society along with several institutional actors and an audience of more than 200 people. The Conference addressed the current failure amongst European decision-makers to ensure that ordinary people, their health and well-being are sufficiently protected and promoted.

The event's speakers (which included Health Commissioner Tonio Borg, who opened the Conference with a video message) agreed that social inequalities are dangerously high across Europe, and while public health systems deal with the outcomes of these disparities both in terms of the unnecessary disease burden and the associated costs, our leaders must address the root causes that bring about these inequalities through political commitment, good governance and inclusive growth. This includes injury prevention, an area in which health inequities are particularly conspicuous.

One of the biggest factors that perpetuates the cycle of social and health injustice (3) is the poor understanding of public health. The protection of people's well-being and their right to healthcare cannot be swept aside in any circumstances, let alone in times of crisis. As Vytenis Povilas Andriukaitis, Lithuania Minister of Health, said during his speech (4), "healthy people are more creative and productive. Their well-being sets the foundations that move societies forwards. Health in all policies should be at the driving seat of our efforts to cut inequalities as it lays the groundwork for social justice and economic sustainability".

"Health is at the centre of the lives and concerns of almost everybody. To rebuild the trust of European populations, European leaders must take steps to ensure they do no more harm and have the courage to take action that will improve the lives and well-being of those they are responsible for and in whose name they act," said Monika Kosińska, Secretary General of the European Public health Alliance (EPHA).

On the one hand, shrinking public health budgets have accentuated the need to address the flaws of Europe's health care systems. As Paola Testori Coggi, European Commission's Director-General for Health and Consumers pointed out in her speech, "in its Annual Growth Survey and the Country Specific Recommendations (5), the European Commission encourages EU member states to make sure that their health systems are more cost effective and sustainable, while ensuring the access to quality health care. To go beyond mere efficient gains like lower pharmaceutical prices and lower wages and initiate genuine structural reforms for patient centred health systems, they have a broad range of tools at their disposal, like health technology assessments, e-health, and innovation. This is part of an 'Investing in Health' approach, as established by the Commission in a paper of February this year, which furthermore includes investing in effective health promotion and prevention, and fighting inequalities in health as they are a waste human potential and an economic loss at the same time."

On the other hand, the current squeeze in public finances has brought to a renewed light neglected public health principles. "Health promotion and disease prevention not only produce results in the long run - they also do so in the short term. There is a solid body of evidence about the ample economic advantages of preventive policies and that social welfare spending is associated to mortality reduction more than GDP increase," said in her intervention (6) Zsuzsanna Jakab, World Health Organisation (WHO) Regional Director for Europe. It is time to recognise the economic weight of the health sector as an engine for wealth, job creation, investment and growth.

Cutting public health care as a means to balance the books has not only proven ill-thought but remarkably counterproductive (7). In his speech, Yves Leterme, Deputy Secretary General of the Organisation of Economic Cooperation and Development (OECD), indicated that "virtually every country that has cut health spending has also increased co-payments. But it is a false saving: there is very little evidence that increased co-payments reduce public spending on health, particularly over the longer term. On the other hand, there is considerable evidence that co-payments discourage people from seeking the help they need and increase health inequalities. As some countries have demonstrated, there are ways to deliver value for money on medicines, devices and hospital services like the extension in the use of generics and the reduction of waste."

In his intervention, Dr Raed Arafat, Romanian Secretary of State for Health, pointed to the vast shortage of doctors caused by austerity measures in his country. "After a cut of up to 28% on their salaries, many highly-skilled and experienced physicians have left Romania in what is a de facto dreadful brain drain in our health system," said Dr Arafat.

As good health and high quality accessible healthcare are essential for economic and social development, the current economic situation should be an opportunity for action, not inaction. Yet our political leaders are not heeding the warning signs. Improving health requires bold leadership and addressing structural issues within European political governance. Health is more than an engine of growth. Growth and economic prosperity are supposed to deliver good health and positive social outcomes. In our prioritisation and choice of tools, if we fail to retain this overall objective high on our priority list, it is no wonder we are failing on our priorities to improve the lives of people living in Europe.

For more information on the conference, visit www.epha.org.

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