ARCHIVES HISTORIQUES 
DE LA COMMISSION 
 
 
 
COLLECTION RELIEE DES 
DOCUMENTS "COM" 
 
 
 
 
COM ( 84) 502 
 
 
 
Vol. 1984/0202 
  
 
Disclaimer  
Conformém ent au règlement (CEE, Euratom) n° 354/83 du Conseil du 1er février 1983 
concernant l'ouverture au public des archives historiques de la Communauté économique 
européenne et de la Communauté européenne de l'énergie atomique (JO L 43 du 15.2.1983, 
p. 1), tel que modifié par le règlement (CE, Euratom) n° 1700/2003 du 22 septembre 2003 
(JO L 243 du 27.9.2003, p. 1), ce dossier est ouvert au public. Le cas échéant, les documents 
classifiés présents dans ce dossier ont été déclassifiés conformément à l'article 5 dudit 
règlem ent. 
In accordance with Council Regulation (EEC, Euratom) No 354/83 of 1 February 1983 
concerning the openi ng to the public of the historical archives of the European Econom ic 
Community and the European Atomic Energy Communit y (OJ L 43, 15.2.1983, p. 1), as 
amended by Regulation (EC, Euratom) No 1700/2003 of 22 September 2003 (OJ L 243, 
27.9.2003, p. 1), this f ile is open to the public. Where necessary, classified documents in this 
file have been declassified in conformity with Article 5 of the aforementioned regulation.  
In Übereinstimmung mit der Verordnung (EWG, Euratom) Nr. 354/83 des Rates vom  1. 
Februar 198 3 über die Freigabe der historischen Archive der Europäischen  
Wirtschaftsgemeinschaft und der Europäischen Atomgem einschaft (ABI. L 43 vom  15.2.1983,  
S. 1), geändert durch die Verordnung (EG, Euratom) Nr. 1700/2003 vom 22. Septem ber 2003  
(ABI. L 243 vom 27 .9.2003, S. 1), ist diese Datei der Öffentlichkeit zugänglich. Soweit  
erforderlich, wurden die Verschlusssachen in dieser Datei in Übereinstimmung mit Artikel 5  
der genannten Verordnung freigegeben.  
COMMISSION OF THE EUROPEAN COMMUNITIES
COM(84) 502 final
Brussels, 13 September 1984
COOPERATION AT COMMUNITY LEVEL ON 
HEALTH RELATED PROBLEMS
Communication from the Commission to the Council
CoM(84) 502 final

- 2 - C®H
When the Ministers of Health last met in 1978 they agreed that work in 
the two broad areas of disease prevention and health care costs should be 
started, the object of which would be to exchange experience and develop 
ideas for cooperation at Community level. A budget line was established and 
this work has progressed in the form of studies, expert meetings, symposia 
etc. (Annex I). A close working relationship has been established with the 
World Health Organisation, the Council of Europe, other international 
agencies and competent national authorities.
At the same time the European Parliament has repeatedly raised public 
health issues by way of resolutions, debates and questions. Specific 
matters have concerned drugs, tobacco, alcohol, organ transplantation, 
infectious diseases, dental health, health cards and health policy. The 
interest of the EP may be summarised as seeking better protection of the 
individual, both as a citizen and as a patient.
A further expression of concern for such matters was made at the 
Fontainebleau Summit when the European Council, in setting up an Ad hoc 
Committee, considered that it was essential that the Community should 
respond to the expectations of the people of Europe. That these include 
health was demonstrated most clearly in the results of the 1983 public 
opinion survey of the Community. Altogether 58% valued health in first 
place when questioned about their well-being and a total of 81% placed it in 
the first three of a range of items covering family, relationships, money 
and leisure.
At the Fontainebleau Summit the European Council also endorsed the 
work programme set out in the Community's Medium-Term Social Action Plan. 
In the area of social protection the Council agreed that Member States 
should examine the means employed to control health costs and arrangements 
for cooperation in the field of health. The purpose of this communication 
is to provide the basis for developing such cooperation.
The Commission considers that there are three examples of public 
health problems, namely drug addiction, smoking, and infectious diseases, 
for which cooperation between Member States and joint action at Community 
level would be practicable and should be a priority.

- 3 -
Addiction to Illicit drugs
Recent years have seen a marked increase in the use of illicit drugs 
and in all Member States there is evidence that the number of addicts to 
heroin in particular has increased. In some towns and cities there are 
reports of a problem with drug addiction that was not evident a few years 
ago; in some, the available data suggest a ten-fold increase over the past 
ten years. Heroin addiction is now being described in epidemic terms. In 
addition, increasing concern is being expressed about the misuse of 
pharmaceutical agents, solvent abuse and the availability and use of 
cocaine.
The epidemiological picture of heroin use has substantially changed. 
Previously young adults were most affected and generally there was 
progressive use of a variety of substances culminating in addiction to hard 
drugs. Now it is observed that heroin is being used by schoolchildren and 
young adolescents and that it may be among the first of many different 
substances to be tried. The immediate and long- range health and social 
consequences of drug usage by these young people are of the utmost concern. 
There is evidence to suggest that the younger a child is when he or she gets 
involved with drugs on a regular basis, the more likely he or she is to 
develop problems related to drug usage. These problems are serious and lead 
to death, chronic sickness and social dysfunction. Accidental deaths and 
deaths from related diseases are frequent and serious infectious diseases 
are common. The associations of drug addiction with crime, prostitution, 
social and economic deprivation are well recognised although caution is 
necessary in any generalisation about cause and effect.
A factor underlying the present epidemic of heroin addiction is the 
increased quantity of the drug on the market in recent years. Reports 
repeatedly underline a situation where heroin of a higher quality is much 
more easily available and cheaper than was the case 5 years ago. An 
indication of the increased amounts in circulation can be gained from 
official statistics of drug seizures. These have increased markedly but it 
has to be observed that amounts seized and destroyed form an unknown and 
possibly a diminishing proportion of the total.

- 4 -
World-wide control of supplies is pursued through UN agencies: within 
Europe a complementary organisation is the Cooperation Group to Combat Drug 
Abuse and Illicit Trafficking in Drugs (Pompidou Group). However, the 
increased availability of heroin throughout the Community is evidence that 
despite the efforts of customs and police services of Member States, 
containment of addiction to hard drugs through the control of supplies has 
not been sufficient. Such actions could be made more effective by increased 
cooperation between customs services within the structure of the customs 
union. The Commission already supports this cooperation, notably within the 
framework of the Convention of 7 September 1967 on Mutual Assistance. A 
further strengthening of the measures against illicit trafficking of drugs 
would be possible within the framework of the Customs Cooperation Council's 
International Convention on Mutual Assistance (Nairobi, 9 June 1977). These 
might be matters for the Ad hoc Committee to address in the framework of 
their remit to examine measures to combat drug abuse.
Regulatory and restrictive measures to control supply cannot however 
succeed in controlling drug abuse on their own and matching efforts to limit 
demand are necessary. Indeed current thinking is placing increased emphasis 
on primary prevention and on those activities concerned with the prevention 
of the onset and regularization of drug abuse by youth. Control of demand 
calls for a different form of cooperation which must be the responsibility 
of the health and education authorities. The objective is to develop 
prevention strategies based on educational programmes aimed at the 
professions, the public - especially parents of young children - and the 
children themselves. The broader aim is to create a climate of non-drug 
use. From an epidemiological perspective it can be theorized that the drug 
addict entices others to use drugs and hence contributes to the increase in 
drug usage. The terra "heroin epidemic" is frequently used and indicates an 
acceptance of this concept. Comparing heroin usage to the spread of an 
infectious epidemic identifies the spatial dimension of the problem, and the 
need for a common commitment to establishing a norm of non-drug use by chil­
dren and young adults based upon individual choice and responsibility. To 
this end various actions can be envisaged at the macro level - that is 
directed towards whole populations - and at the micro level dealing with 
defined sub-groups both of those at risk and of the caring professions.

- 5 -
At a macro Level there is a need for better coordination of 
information campaigns that not only communicate, in a straight forward 
manner, the adverse effects of drugs but also introduce what is known about 
the motivations for drug use and ways to counter these motivating factors. 
For this the concerted role of the media is of central importance both for 
the dissemination of information and to avoid covert pro-drug messages. The 
needs of the health and education professions for input during training and 
for current awareness of the continuing evolution of drug related problems 
must also be met.
At a micro level actions should address collaboration between parents 
and staff in schools and between parents, staff and young people in other 
community settings and agencies. The focus of such actions would be to 
create a climate in which children and young people are discouraged from 
drug taking by their peer group as well as from parents, schools and the 
community, reinforced by the media. At Community level action should serve 
to support and improve existing national programmes and could take the form 
of a series of pilot or demonstration projects, with interchange and compar­
ison between different settings in Member States.
Also at the micro level are the specific needs of health professionals 
engaged on the treatment of established drug addicts and the needs of the 
social workers engaged in the rehabilitation of the "social casualties", 
including those with criminal convictions. The present situation is one of 
immense diversity of practice, fragmentation and isolation leading to 
frequent expressions of hopelessness or therapeutic nihilism.
Whilst the treatment and management of the drug addict is one of the 
most difficult problems in both medical and social terms, it is made worse 
by incomplete knowledge and misunderstanding of the different approaches in 
Member States. Thus there needs to be greater opportunity for meeting and 
exchange of the personnel involved in particular for the appraisal of diffe­
rent treatment regimes and patient management policies. This would allow 
the caring professions to make a more informed contribution to policy making 
and community-based actions.
Finally at both macro and micro levels there is the need for better 
information. This is necessary to monitor trends in drug use, to evaluate 
the effectiveness of actions and to provide the basis for community

-  6 -
awareness. Various sources of data exist but these have, in general, not 
been satisfactorily developed or utilised. Actions at either level require
data for planning, conduct and evaluation which are not at present 
available.
Drug abuse is an old problem for which there is no solution, only a 
policy of containment and watchfulness. Actions aimed at reducing demand 
will have a latent period measured in years before any effect is apparent. 
Cooperation at Community level will need to be ongoing and responsive to the 
needs of Member States in order to achieve success.
Diseases due to smoking
The scientific evidence is that most cases of lung cancer and chronic 
bronchitis are caused by cigarette smoking and that cigarette smoking is 
associated with increased coronary heart disease and a number of other 
cancers. Furthermore there is some evidence that children of parents who 
smoke have more chest illnesses and that the risk of lung cancer is 
increased in the non-smoking wives of husbands who smoke.
The size of the problem has been quantified in various ways. One 
calculation published recently gives an estimated 11 fold increase in deaths 
from lung cancer in cigarette smoking men when compared to non-smokers and 
almost a doubling of the overall risk of death. In the European Community 
it is projected that in all Member States, with the exception of the UK, the 
lung cancer death rate will continue to increase over the next 10 years. In 
total more than one million deaths from lung cancer are to be expected 
before the year 2000.
Patterns of cigarette smoking have changed considerably in the last 10 
years and vary between Member States. In general the habit has decreased in 
males of professional or managerial status, is increasing in women, and 
remains high and unchanging in young adults. There has been a marked 
decline in total consumption in one Member State and similar declines in 
other countries, eg. Norway, Sweden and the US, providing good evidence for 
the effectiveness of anti-smoking measures. Studies of the mortality of 
doctors provide good evidence of the considerable benefits from giving up 
smoking in terms of reduced mortality.

- 7 -
Actions to promote non-smoking take a variety of forms. Clearly, as 
with drug abuse, personal health education to limit demand is essential. 
But to be most effective this must be supported by other kinds of measures. 
Again it is a task of creating a climate of non-smoking, rather than a 
climate of acceptance or tolerance which encourages young people to 
experiment and copy. The sort of measures that can be taken are shown in 
Annex II with an indication of those already introduced in Member States.
In the past few years all Member States have taken some action and 
some are now beginning to develop a series or programme of actions. The 
future aim should be to begin to coordinate these actions in order to avoid 
conflicting interests and confusion in the minds of young people, more and 
more of whom now travel extensively in the Community for study and 
vocational purposes. The objective should be to reduce current levels of 
smoking in adults and to discourage children and young people from taking up 
the habit.
Experience shows that this is not unrealistic. The level of smoking 
in male professional groups is now less than half of other groups. Where 
concerted programmes have been aimed at young people the rate of smoking has 
been reduced to the extent that future non-smoking generations can be 
envisaged. Furthermore such changes have been achieved by influencing 
personal choice and responsibility as opposed to restriction. Cooperation 
at Community level should support actions of Member States in the areas 
referred to in Annex II. Cooperation would need to recognise that Member 
States have not all reached the same stage of progress against smoking and 
will not, therefore, be able to advance at the same rate. Community 
cooperation would provide the impetus, and agreement on common objectives 
and policies would help overcome many of the difficulties.
Infectious disease control
Both drug abuse and smoking related disease are increasing problems. 
By contrast infectious disease is considered to have declined to a level of 
minor importance. As a broad generalisation this is true but only in an 
historical perspective. Recent years have seen a number of instances when 
public and professional concern has been voiced. While the past 10 years 
has seen the eradication of smallpox resulting from a coordinated world-wide

-  8 -
action, it has also seen continuing problems in Member States from 
tuberculosis, measles, rubella and pertussis for example, an increasing 
incidence of gastro-intestinal and sexually transmitted infections, newly 
identified problems such as Legionnaires' Disease and Acquired Immune 
Deficiency Syndrome, and potential problems arising from increased travel 
and tourism. There is current research interest in the possible role of 
transmissible agents in some neurological and neoplastic diseases and 
considerable research investment in the production of new vaccines.
Immunisation against the common diseases of childhood is a long 
established policy in all Member States and Annex III displays existing 
practices. There is considerable variation between what is required, 
recommended and available. Present policies are least well formulated and 
implemented for the newer programmes for rubella and measles. As a result 
uptake is variable and effectiveness diminished.
The importance of the prevention of both of these diseases is well 
recognised. Rubella in early pregnancy substantially increases the risk of 
congenital malformation. Measles is not always a minor ailment and data 
from one Member State show that 9% of cases develop ear infections, 7% 
respiratory complications and 0.3Z encephalitis. These complications 
frequently lead to hospital admission.
Recognising the importance of measles in both medical and economic 
terms, thé US established in 1978 the goal of eliminating indigenous 
transmission of the infection. Achieving and maintaining high levels of 
immunisation in schoolchildren was the primary component of the elimination 
strategy. This has been so successful that by autumn 1981, 97% of school 
entrants had proof of immunity. As a result by 1982 only some seventeen 
hundred cases of measles were reported, less than 3% of the 1977 total. 
Significantly, of 199 cases imported in 1982 only 19 Led to any secondary 
transmission. Following the US initiative Canada, Sweden and Finland have 
declared similar intentions. The position in the Community is that overall 
the incidence of measles remains relatively high while immunisation rates 
are low.
In 1982 a meeting of officials responsible for infectious diseases 
organised by the WHO Regional Office for Europe reported that there is 
little coordinated prevention policy among the countries in the Region owing

- 9 -
to wide differences in the legislative and infection control measures used, 
and to the fact that no attempt has been made so far to assess the 
importance of the various control measures. They endorsed an earlier 
meeting in 1981 which highlighted the overall importance, and most 
importantly, the economic cost of infections.
Cooperation at Community level should seek to implement and augment 
WHO initiatives which would assist the Regional Office to encourage develop­
ment in other European Countries. There is a need in the Community for a 
network of national and regional centres with rapid exchange of information, 
commonly agreed definitions and reporting procedures, standardisation of 
materials and testing, and joint training and research projects. 
Surveillance of long-term trends would be valuable to identify areas requii 
ing special attention and research. Immunisation will continue to be the 
central focus of infectious diseases control and a common approach to child­
hood infections as well as widespread epidemics and rare diseases of special 
significance should be the aim.
Towards cooperation
Three priority areas for cooperation at Community level have been 
identified. The premise is that such cooperation would lead to greater
effectiveness and that this benefit could be achieved at a lower cost. Dup­
lication and conflict might be avoided; acceptability might be improved. 
Moreover many other areas of common interest could be identified turning
what might initially appear as a series of specific problems into a more 
general concern about public health in the Community. This implies that any 
mechanism of cooperation should be flexible enough to be able to address 
other issues as appropriate within a general frame of reference and
priorities.
At the last meeting of Ministers of Health in 1978 a proposal for an 
Advisory Committee on Public Health was discussed and it was agreed to place 
this matter on the agenda of a subsequent meeting. The Commission was
invited to consider to what extent such a Committee was necessary and
whether existing committees might not serve the purpose.

-  10 -
Numerous committees have a health related Interest although no 
committee is concerned with health per se, The Committee of Senior 
Officials on Public Health exists to oversee the application of Directives 
on the mutual recognition of medical and allied diplomas, There are 
advisory committees on the training of the health professions. There is an 
advisory committee on health and safety at work. Expert committees on food, 
cosmetology, pesticides and toxicology consider various matters which may 
affect health. Technical progress committees and programme management 
committees exist for defined tasks arising from Community instruments. Out­
side of the Community institutions various groupings are to be found. A 
Hospitals Committee of the EEC exists in a semi official capacity drawing 
financial support from hospital organisations in Member States. The Chief 
Medical Officers meet to exchange views. Professional interests are 
represented in a variety of ways.
The Council, in adopting the Second Programme of Action on Safety and 
Health at Work in February 1984, requested the Commission to prepare 
annually, after consulting Member States, a forward outline of the work it 
intends to carry out for its implementation. This has led to the formation 
of a group of Senior Officials of Member States with responsibilities in the 
field who meet with Commission officials to determine priorities and actions 
to be undertaken. An implementation plan of work is established and this 
document is made available to all interested parties. For instance, a 
different procedure for cooperation exists in the field of education where a 
Committee of representatives of Member States has the task, with the 
Commission, of coordinating the implementation of the various action 
programmes. This Committee is also charged with the preparation of matters 
for meetings of Ministers including future developments in the field.
The Commission considers that a similar form of mechanism has now 
become necessary to further cooperation in the field of public health and to 
give substance to the recent conclusions of the Social Affairs Council and 
the Fountainbleau Summit.

-  11 -
Conclusions
Public health is not specifically referred to in the Treaties with the 
exception of Chapter 3 of the Euratom Treaty which makes reference to the 
protection of the health of the general public from the dangers of ionising 
radiation. Public health has in the past found no expression in Community 
policies and actions unless subsumed under other names. In a debate in 1983 
on a question to the CounciU1), it was asked if the time was not now ripe 
to develop and launch a European health policy in accordance with the wishes 
expressed by the Parliament. The Council reply indicated awareness of the 
resolutions of the Parliament, the importance of public health questions and 
a willingness to consider every initiative or proposal from the Commission.
Following this debate and in answer to the point that no proposals had 
been made which would justify a further meeting of Health Ministers, 
proposals for a Directive relating to the protection of dialysis patients by 
minimising the exposure to aluminium(2) (June 1983), a Recommendation 
concerning the adoption of a European Health Card(3) (December 1983) and a 
Resolution on a programme of action on toxicology for health protection^) 
(May 1984) have been presented to the Council.
In the selection of these topics, and in the identification of the 
three problem areas discussed in this Communication, particular weight was 
attached to the priorities identified by the Parliament. To the extent that 
these reflect the priorities common to the responsible authorities in Member 
States this is justified. In any event, there is a need to arrange for a 
continuing dialogue between Member States and the Commission to establish 
new priorities and areas for cooperation in health matters which would 
complement other areas of social policy and give expression to the concept 
of a People's Europe.
To this end Council is asked to continue its examination of the three 
proposals for Community instruments referred to above, to consider what 
actions should be mounted on the three topics discussed in this 
Communication, to identify any other priorities for cooperation at Community 
level and to decide on the ways and means for effecting this cooperation.
(l] OJ, Annex 1-303 (Session EP 12-16.9.1983)  
(2·) OJ No. C 202, 29.7.1983, p. 5  
(3■) OJ No. C 21, 28.1.1984, p. 7  
^4") OJ No. C 156, 16.6.1984, p. 6

1
A N N E X E  I
1) L IS T E  D ES E T U D E S  E N  SA N TE P U B L IQ U E  ^
T i t r e D a te
f in a leR é s u it a t
D RO G U E
M é th o d o lo g ie  c o m m u n e  à a p p liq u e r d a n s la  
r e c h e r c h e  d e s  m o tiv a tio n s  et d e s  c o m p o r te ­
m e n ts  d a n s  la  c o n s o m m a tio n  a b u s iv e  d e s  m é d i­
c a m e n ts ; d e s c r ip tio n  e t é v a lu a tio n  d e s  p r o g r a m ­
m e s  d 'é d u c a tio n  p o u r la  s a n té  s u r  le s  m é d ic a ­
m e n tsd é c e m b r e
1981r a p p o r t
fin a l
A n a ly s e  c r itiq u e  de la  d o c u m e n ta tio n  s p é c ia ­
l i s é e  ( r é s u l t a t s  d 'é tu d e s , de r e c h e r c h e , 
d 'e n q u ê te s , e t c .)  c o n c e rn a n t l'é v o lu tio n  d e la  
c o n s o m m a tio n  de d ro g u e s  d a n s le s  p a y s  de la  
C o m m u n a u té  (B , F , N L , L , D) et le s  m e s u r e s  
p r é v e n tiv e s  e t th é r a p e u tiq u e s  p r i s e s  (v o ir a u s s i 
R é s o lu tio n  du P a r le m e n t e u ro p é e n  du 14 m a i 82 
s u r  la  lu tte  c o n tr e  la  d ro g u e ). (3 c o n tr a ts )f é v r i e r  1981 
d é c e m b r e  1981 
ja n v ie r  1984r a p p o r t
f in a l
A n a ly s e  c r itiq u e  d e la  s itu a tio n  a c tu e lle  de la  
to x ic o m a n ie  - c o n s o m m a tio n  e t a b u s  d e s 
d ro g ù e s  l i c i t e s  e t i l l i c i t e s  - d a n s  le s  p a y s  de 
la  C o m m u n a u té  e u ro p é e n n eo c to b r e
1982r a p p o r t
f in a l
A n a ly s e  c o m p a r a tiv e  d e s  p o litiq u e s  de lu tte  
c o n tr e  la  to x ic o m a n ie  d a n s le s  p a y s  m e m b r e s  
du p o in t de v u e  de l'a r t i c u l a t i o n  de b d if f é r e n ­
t e s  m o d a lité s  d 'in te r v e n tio n  e t de l e u r s  
s u p p o r ts  l é g is la t if s  (1 è re  tr a n c h e )o c to b r e
1982r a p p o r t
A n a ly s e  c o m p a r a tiv e  d e s  p o litiq u e s  de lu tte  
c o n tr e  la  to x ic o m a n ie  d a n s  le s  p a y s  m e m b r e s  
du p o in t de v u e de l 'a r t i c u l a t i o n  d e s  d if f é r e n ­
t e s  m o d a lité s  d 'in te r v e n tio n  et de l e u r s  
s u p p o r ts  l é g is la t if s  (2 è m e  tr a n c h e )o c to b r e
1984r a p p o r t 
è n  c o u r s
T A B A G IS M E
A n a ly s e  d e s  s t r a t é g i e s  a c tu e lle s  ou e n v is a ­
g e a b le s  de la  lu tte  a n tita b a g iq u e  d a n s  le s  
p a y s  de la  C o m m u n a u té  e u ro p é e n n e  
( 1 è r e  tr a n c h e )s e p te m b r e
1980
F  P u b lic a tio n  
De u r  8 0 3 i f r
A n a ly s e  d e s  s t r a t é g i e s  a c tu e lle s  ou e n v is a ­
g e a b le s  de la  lu tte  a n tita b a g iq u e  d a n s  le s  
p a y s  de la  C o m m u n a u té  e u ro p é e n n e  
(2 è m e  tr a n c h e )o c to b r e
1981
1

2 ANNEXE I
T itr eD ate
finaleR ésu ltat
TABAGISM E (suite)\
D onnées et in fo rm a tio n s de b a se  s u r le ta b a g ism e  
dans le s E ta ts  m e m b re s  de la C om m unauté 
eu ro p éen n e p o u r la p é rio d e  c o m p ris e  e n tre  
I960 et 1980 (1 ère tra n c h e )o cto b re
1980P u b licatio n  
>  EU R 7907 DE
D onnées et in fo rm a tio n s de b a se  s u r le ta b a g ism e  
dans le s E ta ts  m e m b re s  de la  C om m unauté 
eu ro p éen n e p o u r la p é rio d e  c o m p ris e  e n tre  
I960 et 1980 (2èm e tra n c h e )o cto b re
1982
S tatistiq u es re la tiv e s  à la co n so m m atio n  de tab ac 
dans la  C om m unauté éco n o m iq u e eu ro p éen n e - 
A n aly se et ex am en  c ritiq u ese p te m b re
1984ra p p o rt 
en c o u r s -
VACCINATION
E tude c o m p a ra tiv e  des a s p e c ts  m é d ic o -lé g au x  
d es c o m p lic a tio n s p o s t-v a c c in a le s  dans le s 
E ta ts  m e m b re s  de la C om m unauté eu ro p éen n es e p te m b re
1979P u b licatio n  
EU R 7019 FR
NUTRITIO N
L 'é d u c a tio n  n u tritio n n e lle  à l'é c o le  dans le s 
p ay s de la C om m unauté eu ro p éen n eo c to b re
1980P u b lica tio n  
EU R  7331 F R
M ise au point d 'u n  m odèle de fo rm a tio n  
d estin é à l'é d u c a tio n  n u tritio n n e lleo c to b re
1981ra p p o rt
fin al
D éfinition d 'u n e m éthodologie de l'é v a lu a tio n  
appliquée à l'é d u c a tio n  s a n ita ireo c to b re
1981ra p p o rt
fin al
E nquête su r la re s ta u r a tio n  s c o la ire  dans le s  
E ta ts  m e m b re s  de la C o m m u n au té eu ro p éen n eaoût 1983 ra p p o rt
final
P r in c ip e s  et b a s e s  d 'in itia tiv e s  c o m m u n a u ­
t a i r e s  en éd u catio n  s a n ita ire  d an s le dom aine 
de la n u tritio nse p te m b re
1984ra p p o rt 
en c o u rs
A LCO O L
A n aly se c ritiq u e  d es f a c te u r s  d é te rm in a n ts  en 
m a tiè r e  de c o n so m m atio n  de b o isso n s a lc o o lisé e s, 
ten an t p a rtic u liè re m e n t co m p te d es a s p e c ts  
re la tifs  à l'é d u c a tio n  p o u r la santé et à la p u b li­
citéju ille t
1983ra p p o rt
final
R ED U C TIO N  COUT DE SANTE
P r é p a r a tio n  d 'in s tru m e n ts  s ta n d a rd is é s  de 
d é cisio n s et d 'év a lu a tio n  en santé publique 
et dans le dom aine m é d ic o -s o d ia l (1 ère tra n c h e)o cto b re
1983ra p p o rt

- 3 -ANNEXE I
T itre D ate
finaleRé sultat
RED U CTIO N  COUT DE SANTE (suite)
P ré p a ra tio n  d 'in s tru m e n ts  sta n d a rd isé s de 
d ecisio n s et d 'év alu atio n  en santé publique 
et dans le dom aine m é d ic o -so c ia l (2èm e tra n c h e)o cto b re
1984ra p p o rt 
en c o u rs
P ro b lè m e s  lié s  à l'év o lu tio n  de la dém ographie 
m éd icale dans le s an n ées à v en ir dans le s pays 
de la C om m unauté européenneo cto b re
1984ra p p o rt 
en c o u rs
Statut du p e rs o n n e l p a ra m é d ic a l dans les E ta ts  
m e m b re s  de la C om m unauté européenneo cto b re
1984ra p p o rt 
en c o u rs
L 'o rg a n is a tio n , le financem ent et le coût des 
soins de santé dans la C om m unauté européenne 1979S érie politique 
so ciale - 
1979 n r. 36
C o n so m m atio n  p h a rm a c e u tiq u e -te n d a n c e s des 
d épense s -p rin c ip a le s  m e s u r e s  p r is e s  et o b je c ­
tifs so u s-jacV n ts des in terv en tio n s''publiques 
dans ce dom aine1978S érie politique 
so ciale - 
1978 n r, 38
A pproche m ic ro -é c o n o m iq u e  des p ro b lè m e s  
re la tifs  aux co û ts de l'h o sp ita lisa tio n
«1979 S é rie  politique 
so ciale - 
1979 n r. 39
L es soins de san té p r im a ir e  dans le s  E ta ts  
m e m b re s  de la C om m unauté européenne1980 D oc. V /4 7 6 /8 0
E volution de* d ép en ses pour le s  soins de 
santé pendant la  p ério d e  4970-1976- ra p p o rt
T echnologie m é d ic ale  de pointe, u tilisa n t des 
éq u ip em en ts coûteux dans le s E ta ts m e m b re s  
de la C om m unauté européenne, lég islatio n , 
politique et coût b-1982 D oc. V /943/82
R ap p o rt co n cern an t la deuxièm e p h ase de l'é tu d e  
de la téchnologiè m éd icale1984 D oc. V /4 8 2 /8 4
L 'e x p é rie n c e  de douze pays eu ro p éen s en 
m a tiè re  de co n trô le du coût d es soins de 
santé (1977-1983)1983 D oc. V /1 9 3 4 /8 3
DIVERS
E ducation s a n ita ire  en hygiène d e n ta ire  et 
p a ra d e n ta ired é c e m b re
1984ra p p o rt 
en cour*
R ôle et développem ent des d is p e n s a ire s  
de g é ria tried é c e m b re
1984ra p p o rt 
en c o u rs
P e rs o n n e s  âg ée s et co n so m m atio n  de m é d ic a ­
m en ts - Situation dans les E ta ts m e m b re sd é c e m b re
1984ra p p o rt 
en co u rs
-- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

2) SEM INAIRES ET REUNIONS ORGANISES DANS L E  CADRE
DES DECISIONS DES M INISTRES DE LA  SANTE
S é m in a ire s D ates et L ieux
S é m in a ire  su r le s  ris q u e sm é d ic o -s o c ia u x  dans 
la co n so m m atio n  d 'alc o o in o v em b re 1977 
L uxem bourg
Sym posium  su r la n u tritio n , la technologie des 
p ro d u its a lim e n ta ire s  et l'in fo rm a tio n  n u tr i­
tio n n e lle  (S ession "E d u catio n  N u tritio n n elle 
en c o lla b o ra tio n  avec la DG III - B ru x elles)m a r s  1980 
L o n d res
S é m in a ire  "L e rô le  du m é d e cin  en éducation 
p o u r la san té"ju illet 1980 
L uxem bourg
S é m in a ire  In te rn a tio n a l d 'E d u catio n  p o u r la 
Santé "E la b o ra tio n  d 'u n e  politique p o u r la santé : 
p ro c e s s u s  et s tr u c tu r e s "
(en c o lla b o ra tio n 'a v e c  la Bunde s z e n tra le  fü r 
g esu n d h eitlich e A u fk läru n g - Cologne)ju in  1981
B erg n eu stad t
(A llem agne)
1er S ym posium  s u r le c a n c e r du poum on en 
E u ro p e -S e s s io n  c o n s a c ré e  à l'é d u c a tio n  s a n i­
ta ir e  s u r le th è m e  : "C o m m en t ré d u ire  l'u s a g e  
du ta b a c "  (en c o lla b o ra tio n  avec la Société 
E u ro p éen n e de P n eum ologie)s e p te m b re  1982
Knokke
(B elgique)
S é m in a ire  " L e s  p ro b lè m e s  lié s  à la  co n so m m atio n  
d 'alc o o l d an s la  C o m m u n au té e u ro p é en n e "m a r s  1983 
L uxem b o u rg
Sym posium , in te rn a tio n a l "T ab ac et C a n c e r"
(en c o lla b o ra tio n  avec "T he E u ro p e a n  O rg a n isatio n  
f o r  C o o p eratio n  in C a n c e r P ré v e n tio n  - B ru x e lle s)m a r i  1983 
B ru x e lle s
S é m in a ire  s u r la p ré v e n tio n  et le tra ite m e n t de 
la p h a rm a c o d é p e n d a n c e  (en c o lla b o ra tio n  avec 
l'O . M. S .)s e p te m b re  1983 
B ru x e lle s
S é m in a ire s  e u ro p é en s s u r le s  p o litiq u es de santé
1er S é m in a ire  : A llo catio n  de r e s s o u r c e s  et soins 
de san té aux p e rs o n n e s  â g ée sd é c e m b re  1978 
L uxem b o u rg
2 èm e S é m in a ire  : L a san té publique et le s  p r e m iè r e s  
a n n ée s de la vie (en c o lla b o ra tio n  avec l 'INSERM  - 
Le V ésinet)o c to b re  1979 
Is p ra  (Italie)
3èm e S é m in a ire  : E v a lu a tio n  et p olitique de santé 
m e n ta lem a r s  1980 
L uxem b o u rg
4èm e S é m in a ire  :  E v alu atio n  de m o d è le s de s e rv ic e s  
de santé eu ro p é en s, en p a r tic u lie r  le s  m o d èles 
Scandinave sd é c e m b re  1981 
L u x em b o u rg

- 5 -ANNEXE I
S é m in a ire s D ates et L ieux
S é m in a ire s eu ro p éen s su r le s politiques de santé
(suite) *
5èm e S é m in a ire  : E valuation des s e rv ic e s  de 
m éd ecin e du tra v a il p a r des m éthodes ép id ém io ­
logiques
6èm e S é m in a ire  : L e co n trô le du c a n c e rd é ce m b re  1983 
L uxem bourg
d é c e m b re  1983 
L uxem bourg
S ém in aire E thique du s e c re t m éd ical et d o s s ie rs  
s a n ita ire sd é ce m b re  1980 
L uxem bourg
G roupe de tr a v a il su r la c ré a tio n  de c e n tre s  
a n tic a n c é re u x  et su r l'é la b o ra tio n  de p ro g ra m m e s  
de lutte a n tic a n c é re u s e  dans la co llectiv ité en 
E u ro p e (en c o llab o ratio n  avec l'OMS)o cto b re 1981 
L uxem bourg
O rie n ta tio n s dans le s dom aines de la santé 
et du bien ê tr e  so cial des p e rso n n e s âg éeso cto b re 1982 
L uxem bourg
G roupe de T ra v a il de M édecine Sociale et 
d 'E p id ém io lo g ie d es C om m unautés eu ro p éen n esplusieurs réunions 
de 1974 à 1984 
à Bruxelles

-  6 -ANNEXE I
R éunions d 'e x p e rtsD ates
L ieu : L uxem bourg
DROGUE
L e s p ro b lè m e s  de la drogue dans la C om m unauté 
eu ro p éen n e
L utte c o n tre  la to x ico m an ie* n o v em b re 1981
ju in  1982
TABAGISM E - NUTRITION
E d u catio n  s a n ita ire  : ta b a g is m e  - n u tritio n
M otivation et co m p o rte m e n t
(im p o rtan ce d es m otivation, c o m p o rte m e n t des 
fu m e u rs  et h ab itu d es a lim e n ta ire s )
M ethodologie com m une p e rm e tta n t de c o m p a re r 
le s  ré s u lta ts  et d 'a p p r é c ie r l'e ffic a c ité  des 
cam p ag n e s d 'éd u c a tio n  s a n ita ire
L 'é d u c a tio n  n u tritio n n e lle  à l'é c o le  dans le s  
E tats' m e m b re s  de la  C om m unauté eu ro p éen n em ai 1979 
se p te m b re  1979 
o c to b re  1980
ju ille t 1979
se p te m b re  1979 
n o v e m b re  1979
o c to b re  1981 
o c to b re  1982 
s e p te m b re  1983
VACCINATIONS
L u tte c o n tre  le s  m a la d ie s  tr a n s m is s ib le s  
(p ro b lèm e  d e s v accin atio n s)
S en sib ilité d es enfants à la tu b e rc u lin em ai 1978
s e p te m b re  1982 
f é v r ie r  198 3
ASSISTANCE SANITAIRE
A s s is ta n c e  s a n ita ire  ré c ip ro q u e  en c a s  de c a ta s ­
tro p h e , d 'a c c id e n ts  m a je u rs  et de m a la d ie s 
ex cep tio n n ellem en t g ra v e sd é c e m b re  1979 
m a i 1980 
n o v em b re 1980 
f é v r ie r  1981 
ju illet 1981
CA RTE SANITAIRE
C a rte  s a n ita ire  d 'u rg e n c e  p o u r p e rs o n n e s  
à ris q u eju illet 1979

ANNEXE li
EEC COUNTRIES
C ountry !  A d v ertisin g!
!  P ackage 
!  in form ation 
1!  L ev els of !  
!  h arm fu l !  
!  su b stan ces !  
!  !Sales
to
adult s!  Smoking in 
!  public 
!  p laces 
!!
!
!
!Sm oking
by
m in o rs!  M andatory 
!  health 
!  education 
|
B elgium !  OW" i---------- -----------
!  
WNTCr............................. T
!  ! 0 !
 © !
J
!!»
D enm ark i  (©) ]  (NT)!  !  
!  ! i °;  o
F ran ee !  © !  WNT !  ! !  ©1
!
!® !  ©
G erm any, F ed. Rep. ;  €(WNT) 1  (WNT)!  j  
1  1!
! !
G reece ! !  !  
!  !  
I  !!  O ! !  O
Ireland !  ©w!  WJ
! ! !
Italy • ! !  ! !  © ! ® ;
L uxem bourg1;  o ;  w!  !  
!  ! i ° 1O
N etherlands !  O !  WNT !  ! ! ! 1
United Kingdom ;  (©WT) ;  (WT)!  < ® >  !J
! ! !
€
Osee c rite r ia  belowKey to sym bols
=  total (or effectively total) ban 
=  " strin g e n t" control m e a s u re s  
=  "m o d e ra te" co n tro l m e a s u re s  )
=  o th er control m e a s u re s  (s trin g e n t/m o d e ra te  d istinction not applicable) 
W =  health w arning re q u ire d  
N =  indication of nicotine level re q u ire d  
T =  indication of ta r  level re q u ire d  
C =  indication of carb o n  m onoxide level re q u ire d
(  )  =  p ro v isio n s laid down by voluntary a g reem en t, not by leg islatio n  
E x am p les :
OW =  stringent co n tro ls; health w arning re q u ire d
W(©)= w arning re q u ire d  by law; also  stringent co n tro ls under te r m s  of 
voluntary ag re em e n tAdvertising
Smoking in public pi SCSi 
Smoking in workplscos
Msndslory  health tducotionCRITERIA FOR ASSIGNMENT OF SYMBOLS
I  = a to u t lor effectively total) bon on advertising of tobacco product* (in t o m  cases 
included in t  bon on odvortMng of oH  commodities)
O  ~ extensive rootriction* In oovorel media
O  = minor rootriction*. or ma)or rootriction* in on* medium only
C  = 0 wide range of restriction» clearly dictotod by hoolth conildaratlon*
0  = 0 limited rang* of "tradltlon»r restriction*, or on undefined ban in public places
O  t a ronae of »pacific measure* to protect workers health
O  = measures which effect workers' health only incidentelly. or which concern only a 
limited category of workers
C  - a broad health education policy (especially il funds srs expressly allocatedi 
Q  - health education directed at one or mo»* target group* (e.g. pregnant woman)

T ab leau  c o m p a ratif des situ atio n s nationales situation fin 198 3
Belgique D anem ark A llem agne G rèce F ra n c e Irlande Italie 1 Luxem bourg P a y s -B a s Royaum e-Uni
V ariole S A A - S - A S - -
R ougeole R D R O R D R R P R
Rubéole R D R R R R R R P R
D ip h térie R R -P R - -P O O R-P O R - -P R - -P R
T étanos R R -P R - -P O O R -P O R - - P R - -P R
C oqueluche R R -P R O R R -P - R - - P R - -P R
P o lio m y élite O R -P R - - P O O R - P O R - -P R - -P P
T. A. B. OGR - - D OGR R OGR - R R ;
B. C . G.R
OGRR -P R O OGR R OGR R R R
G rippe R R R D R R R R R R
O reillo n s R R R - -P R ’ - D - - - -
R age R D R R R D R R R R
H épatite B R - - D R - R - - -
C h o léra - - - D - - - - - -AN.l
F i
è v re  jaune - - - D - - - - - -Œ X
Le
pto sp iro  se - - - - R - - - - -M
H - »
r * ì
B ru cello se - - - - R - - - - -

In d e x  d e s  S y m b o le s
S = s u sp e n d u e  
A = a b o lie
O = o b lig a to ir e  Bauf c o n tr e  in d ic a tio n s  m é d ic a le s  p r é v u e s  p a r  le s  a u to r ité s  n a tio n a le s  de la  s a n té  
D = d is p o n ib le  s u r  d e m a n d e  d a n s le s  c o n d itio n s  p r é v u e s  p a r  le s  r è g le m e n ts  n a tio n a u x  en  v ig u e u r 
R  = » reco m m an d ée d a n s le s  c o n d itio n s  p r é c i s é e s  p a r  d e s  d is p o s itio n s  n a tio n a le s  p a r t i c u l i è r e s  
P  = p r o g r a m m e s  de v a c c in a tio n  d is p o n ib le s
OGR= o b lig a to ir e  p o u r c e r ta i n s  g ro u p e s  à r is q u e s  s a u f c o n tr e  in d ic a tio n s  m é d ic a le s  p a r t i c u l i è r e s