COUNCIL CONCLUSIONS of 26 November 1998 on the future framework for Community action in the field of public health (98/C 390/01)

On 27 May 1993, with a view to the entry into force of the Treaty on European Union, the Council and the Ministers for Health, meeting within the Council, adopted a resolution on future action in the field of public health (1), in which they called on the Commission to submit as soon as possible proposals for a programme of action in the field of public health, having regard to the guidelines given in the resolution for such action.

Following the entry into force of the Treaty on European Union, on 1 December 1993 the Commission submitted a communication on the framework for action in the field of public health, putting forward strategies, priority areas and measures on the basis of Article 3o and Article 129 of the Treaty establishing the European Community.

In its resolution of 2 June 1994 on the framework for Community action in the field of public health (2), the Council agreed that priority should be given to the following areas: cancer, drug dependence, AIDS and other communicable diseases, and health promotion, education and training, as well as disease surveillance and the collection of reliable and comparable health data.

Furthermore, the Council, in the same resolution, outlined more general considerations and guidelines in order to meet the objectives of Article 129 of the EC Treaty and invited the Commission to submit a global multiannual programme plan of existing and future Community actions.

The Commission then submitted to the Council and the European Parliament, in the main proposals for incentive measures in the areas assigned priority by the Council, as well as in the areas of rare diseases, pollution-related diseases and injury prevention.

It is now appropriate to examine how the existing framework for action can be developed in order both to give further consideration to the more general and long-term aspects indicated in the resolution of 2 June 1994 and to respond to a number of important developments such as new emerging health threats and increasing pressures on health systems as well as the enlargement of the Community and the new public health provisions in the Treaty of Amsterdam. Moreover, such an examination is particularly urgent as most of the existing programmes will be coming to an end in or about the year 2000 and proposals will have to be put forward in the near future.

With this in mind, the Commission, with its communication of 15 April 1998 on the development of public health policy in the European Community, launched a broad debate on the way ahead for Communtiy health policy.

The Council, at its meeting on 30 April 1998, expressly welcomed that communication as a good basis for further discussions and is taking the opportunity offered by it to make the following points, which the Commission should take into account in future proposals for specific measures to be submitted as soon as possible.

1. Following the coming into force of the Amsterdam Treaty, a high level of health protection has to be ensured in the definition and implementation of all Community policies and activities, and Community action in the field of public health has to be directed towards improving public health, preventing human illness and diseases and obviating sources of danger to human health.

2. In the framework of future activities in the field of public health, greater emphasis should be placed on Community measures designed to support cooperation between the Member States.

3. The Community should take action, in accordance with the principle of subsidiarity, only if activities pursuant to the aim of contributing to a high level of human health protection can better be undertaken at Community level rather than by Member States acting alone, and in full respect of the responsibilities of Member States for the organisation and delivery of health services and medical care.

4. Integration of health protection requirements into other Community policies, as required under the EC Treaty, forms part of the overall strategy and has to be taken into account at each stage of the implementation of the future public health strategy.

5. The greatest benefits for the health of citizens of the European Union are likely to be achieved by focusing Community action on the following areas:

- tackling major health scourges, including communicable, rare and pollution-related diseases,

- reducing mortality and morbidity related to general living conditions and lifestyles, with regard to both physical and mental aspects,

- fostering equality in health across the European Union.

The methodology for the selection of priorities for action in the aforementioned areas should in particular take into account the following criteria: health-related criteria (such as mortality, morbidity and risk factors, including socioeconomic differences in health), implemental criteria (such as availability of effective methods and measures of prevention, or potential for their development), Community-related criteria (such as added value) and criteria established by international organisations in the health field, in particular the WHO.

A combination of incentive measures, recommendations and binding instruments in those areas identified by the Amsterdam Treaty should be used with a view to enhancing efficiency of Community action in the abovementioned areas.

6. Actions at Community level should comprise three main strands:

- improving information for the development of public health by developing a structured and comprehensive Community system for collecting, analysing and disseminating information,

- reacting rapidly to threats to health, by the creation of a Community surveillance, early warning, and rapid reaction capability,

- tackling health determinants through health promotion and disease prevention, both through broad health promotion activities and by specific disease prevention actions, underpinned by intersectoral action and the use of instruments offered by the EC Treaty, not only in the health field but also in other sectors.

7. These future Community actions should be set out in one overall public health programme to be established by a Decision based on Article 129 of the EC Treaty.

8. The public health programme should allow for:

- the development of new ways of assessing the health impact of Community action,

- cooperation with international organisations in the health field, in particular with the WHO, and third countries,

- account to be taken in an appropriate way of the necessities arising from the enlargement process.

9. The public health programme should provide for the funding of all Community activities in the field of public health, including the necessary preparatory work for the development of legislative proposals for health-related Community action. Existing activities are included in the public health programme in appropriate form once the potential for their continuation has been assessed.

10. The public health programme should be established for a period of at least five years.

11. The decision establishing the public health programme should provide for regular reports on, and evaluation of, measures with a view to achieving its objective. Reports should be placed before the European Parliament, the Council, the Economic and Social Committee and the Committee of the Regions.

12. In implementing the public health programme, the Commission should be assisted by a committee composed of representatives designated by Member States.

(1) OJ C 174, 25.6.1993, p. 1.

(2) OJ C 165, 17.6.1994, p. 1.