COMMISSION OF THE EUROPEAN COMMUNITIES 
Brussels, 18.04.1995 
COM(95) 138 final 
94/0130 (COD) 
Amended proposal for a 
EUROPEAN PARLIAMENT AND COUNCIL DECISION 
adopting a programme of Community action on 
health promotion, information, education and training 
within the framework for action 
in the field of public health 
(presented by the Commission pursuant to Article 189 a (2) 
of the EC-Treaty) 
EXPLANATORY MEMORANDUM 
Amended proposal for a European Parliament and Council Decision adopting a 
programme of Community action on health promotion, information, education and 
training within the framework for action in the field of public health. 
The Commission's initial proposal for a European Parliament and Council Decision 
adopting a programme of Community action on health promotion, information, education 
and training within the framework for action in the field of public health was adopted by 
the Commission on 1 June 1994. 
The Commission's initial proposal was accorded a favourable opinion by the Committee 
of the Regions1 and the Economic and Social Committee2. 
Following the opinion of the European Parliament adopted at first reading on 15 March 
1995 the Commission is presenting, pursuant to Article 189a of the EEC Treaty, an 
amended proposal for a decision. Two types of amendment are mainly involved, viz: 
- a set of amendments adding useful detail and clarifications with respect to the initial 
proposal; 
- another set of amendments slightly strengthening the content of the actions involved 
in the programme as regards specific aspects of health promotion. 
The Commission's amended proposal retains the same structure and aims as the initial 
proposal, but some provisions and programme actions have been clarified or elaborated 
on. 
Of the 43 European Parliament amendments, 18 have been accepted either as they are (4, 
9, 28, 30, 31, 37, 39, 47 and 48) or in substance but with amended wording (2, 6, 8, 14, 
16, 18, 19, 21 and 25). 
As for the three amendments (10, 12 and 13) concerning committee arrangements and 
determination of the appropriations available for each year, the Commission will adopt 
the provisions later agreed at inter-institutional level. 
For amendments 11, 34, 35, 36 and 38, which include both acceptable and unacceptable 
elements, the Commission proposes changes in their wording. 
The Commission has not accepted four amendments (1, 5, 23 and 41) dealing with fields 
of activity (health and safety at work, medical treatment and care, specific diseases) 
outside the scope of the programme or of Article 129. 
1 Plenary session of 15-16 November 1994 
2 Plenary session of 25-26 January 1995 
The Commission was unable to retain amendments 7, 15, 17, 20, 24, 26 and 44. These 
refer to general accepted principles or commitments entered into by the Commission but 
explicit mention of which is not justified or appropriate in the specific context in which 
they are proposed. 
Finally, six amendments (22, 27, 29, 33, 40 and 43) were not accepted by the 
Commission because they refer to population groups (the elderly, disadvantaged groups) 
or activities (information on medicines) already explicitly covered by actions under the 
programme. 
0^0 
Initial proposal 
(COM)94 202 final Amended proposal 
THE EUROPEAN PARLIAMENT AND THE 
COUNCIL OF THE EUROPEAN UNION, 
Having regard to the treaty establishing the European 
Community, and in particular Article 129 thereof, 
Having regard to the proposal from the Commission, 
Having regard to the opinion of the Economic and 
Social Committee, 
Having regard to the opinion of the Committee of the 
Regions, 
1. Whereas, with reference to point (o) of Article 3 of 
the Treaty, Community action must include a 
contribution of the Community towards the 
achievement of a high level of health protection; 
Article 129 expressly provides Community 
competence in this field by encouraging the 
cooperation between Member States and, if 
necessary, lending support to their action; 
2. Whereas the Commission communication of 
24 November 1993 on public health, states that 
experience acquired by the Commission until now 
from actions in public health, justifies a programme 
of Community actions in the four priority areas of 
health promotion, information, education and 
training; 
3. Whereas the resolution of the Council and of the 
Ministers of Education meeting within the Council, 
of 23 November 1988, concerning health education 
in schools, emphasized that certain eating habits, 
the uncontrolled use of some chemical substances 
and medicines, drug abuse, smoking and 
environmental pollution have a harmful effect on 
health, bearing in mind the related problems of 
safety and accident prevention; 
I I su~ 
Initial proposal 
(COM)94 202 final Amended proposal 
4. Whereas, the resolution of the Council and of the 
Representatives of the Governments of the Member 
States, meeting within the Council, of 3 December 
1990, concerning an action plan on nutrition and 
health has underlined that the promotion of a 
healthy lifestyle related to nutrition is vitally 
important to enable people to make the necessary 
choices for ensuring appropriate nutrition in 
keeping with individual needs; 
5. Whereas the conclusions of the Council and the 
Ministers for Health of the Member States, meeting 
within the Council, of 13 November 1992, 
concerning health education based on the 
Commission communication to the Council of 
11 May 1992 on school health education, identified 
the school as a vital setting for systematically 
developing a healthy lifestyle that will enable 
sickness and accidents to be reduced, considered 
that there were a variety of other settings such as 
homes, local communities, workplaces, hospitals, 
etc. in which health promotion and health education 
had a central role, and invited the Commission to 
strengthen cooperation between Member States in 
implementing effective health promotion and health 
education actions in the various settings; 
6. Whereas these actions need to be undertaken within 
the framework for action in the field of public 
health set out by the Commission and take into 
account, as the Council requested in its resolution 
of 27 May 1993, other actions undertaken by the 
Community in the field of public health or which 
have an impact on public health; 
7. Whereas in its Resolution concerning public health, 
health promotion and health education the 
European Parliament formulated a series of 
proposals for Community action in the field of 
accident prevention and prevention of 
cardiovascular diseases which are not the subject of 
existing Community programmes; 5. Whereas the conclusions of the Council and the 
Ministers for Health of the Member States meeting 
within the Council, of 13 November 1992, 
concerning health education based on the 
Commission communication to the Council of 
11 May 1992 on school health education, identified 
the school as a vital setting for systematically 
developing a healthy lifestyle that will enable 
sickness and accidents to be reduced, considered 
that there were a variety of other settings, such as 
homes, local communities, workplaces, hospitals, in 
which health promotion and health education had a 
central role, and invited the Commission to 
strengthen cooperation between Member States in 
implementing effective health promotion and health 
education actions in the various settings; 
7a. Whereas it is desirable to make provision for health 
promotion and health education measures for older 
people: 
Initial proposal 
(COM)94 202 final Amended proposal 
Whereas the results of the integrated approach as 
demonstrated in the joint World Health 
Organization - Council of Europe - European 
Community Project 'The European network of 
health promoting schools' are encouraging with 
respect to the different ways of implementing 
health promotion in particular settings; 
Whereas it is recognized that socio-economic 
conditions such as housing, unemployment, 
urbanization, and social exclusion should be taken 
into consideration in the promotion of health, 
particularly for those living in deprived areas; 
9a. Whereas some social policv objectives coincide 
with public health objectives, as a feeling of well-
being at work is a factor in each human being's 
personal development and psychological balance; 
10. Whereas health education and information are 
expressly mentioned in the provisions of the Treaty 
dealing with public health, and constitute a priority 
for Community action in public health; 
11. Whereas, in accordance with the principle of 
subsidiarity, action on matters not under the 
exclusive competence of the Community, such as 
those on health promotion, must be undertaken by 
the Community solely where, by reason of their 
scale or effects, the objectives can better be 
achieved at Community level; 
Initial proposal 
(COM)94 202 final Amended proposal 
12. Whereas cooperation with the competent 
international organizations and with non-member 
countries should be strengthened; 
13. Whereas a multiannual programme should be 
launched with clear objectives for Community 
action, and priority action selected to promote the 
health of all the citizens of the Community as well 
as appropriate mechanisms for the evaluation of 
such action; 
13a. Whereas, although maintenance of health 
throughout people's lives is universally desirable, 
the tendency of women to live longer than men 
requires particular attention; 
14. Whereas the programme has to contribute to the 
enhancement of awareness of health determinants 
and risk factors, early detection of adverse effects, 
counselling and advice, and health and social 
support; 
15. Whereas, from the operational point of view, the 
investment made in the past both in terms of the 
establishment of Community networks of non­
governmental organizations and of the mobilization 
of all those involved in health promotion and 
education has to be safeguarded and developed; 
16. Whereas, however, possible duplication of effort 
has to be avoided by the promotion of the 
exchange of experience and by the joint 
development of basic information modules for the 
public, for health education and for training 
members of the health professions; 
16a. Whereas it is desirable for the various past or 
current actions implemented in Member States to 
be taken into account, by either the relevant 
authorities or other bodies involved in health 
policv; 
Initial proposal 
(COM)94 202 final Amended proposal 
17. Whereas this programme must be of five-year 
duration in order to allow sufficient time for 
actions to be implemented to achieve the 
objectives set, 
HAVE DECIDED AS FOLLOWS: 
Article 1 
A Community action programme on health promotion, 
information, education and training is adopted for a 
five-year period, from 1 January 1995 to 31 December 
1999. 
Article 2 
The Commission shall ensure implementation of the 
actions set out in the Annex in accordance with 
Article 5 and in close cooperation with the Member 
States and the institutions and organizations active in 
health promotion. 
Article 3 
The budgetary authority shall determine the 
appropriations available for each financial year. 
Article 4 
The Commission shall ensure that there is consistency 
and complementarity between the Community actions 
to be implemented under this programme and the other 
relevant Community programmes and initiatives. A Community action programme on health promotion, 
information, education and training is adopted for a 
five-year period, from 1 January 1996 to 31 December 
2000. 
The Commission shall ensure implementation of the 
actions set out in the Annex in accordance with 
Article 5 of this decision and in close cooperation with 
the Member States. It shall also act in cooperation with 
the institutions and organizations active in health 
promotion. 
The Commission shall ensure that there is consistency 
and complementarity between the Community actions 
to be implemented under this programme and the other 
Community actions affecting health, especially in the 
areas of education and training, and of health and 
safety at work. 
Initial proposal 
(COM)94 202 final Amended proposal 
Article 5 
1. For the implementation of this programme the 
Commission shall be assisted by a committee of an 
advisory nature, hereinafter referred to as 'the 
Committee', composed of two representatives from 
each Member State and chaired by the 
representative of the Commission. 
2. The representative of the Commission shall submit 
to the Committee a draft of the measures to be 
taken. The Committee shall deliver its opinion on 
the draft, within a time limit which the chairman 
may lay down according to the urgency of the 
matter, if necessary by taking a vote. 
The opinion shall be recorded in the minutes, in 
addition, each Member State shall have the right to 
ask to have its position recorded in the minutes. 
The Commission shall take the utmost account of 
the opinion delivered by the Committee. It shall 
inform the Committee of the manner in which its 
opinion has been taken into account. 
Article 6 
1. The Community shall encourage cooperation with 
non-member countries and with international public 
health organizations, including the World Health 
Organization. 
2. The EFTA countries, in the framework of the 
Agreement on the European Economic Area and the 
countries from central and eastern Europe with 
whom the Community has concluded association 
agreements may be associated with the activities 
described in the Annex. The Community shall encourage cooperation with 
non-member countries and with international public 
health organizations, including the World Health 
Organization. 
The programme shall provide support for proposals 
submitted by Member States and for initiatives by 
organizations and agencies active in the health 
promotion field. 
Initial proposal 
(COM)94 202 final Amended proposal 
Article 7 
1. The Commission shall regularly publish information 
on the actions undertaken and the possibilities for 
Community support in the various fields of action. 
2. The Commission shall submit to the European 
Parliament, the Council, the Economic and Social 
Committee and the Committee of the Regions a 
mid-term report on the actions undertaken, as well 
as an overall report at the end of the programme. 
Annex 
Community action programme 
on health promotion (1995 to 1999) 
A. Health information 
1. Efforts to contribute to a better knowledge of the 
psycho-sociological mechanisms involved and of 
health information methods and techniques, as 
well as fostering the assessment of results. 
Surveys of public opinion on various aspects of 
health promotion (Eurobarometer survey) and 
support for the preparation and assessment of 
specific information campaigns including those 
coordinated at Community level or in several 
Member States. 
3. Support for a European infrastructure for 
information and documentation on public health 
and health promotion for use by professionals, 
administrators and decision-makers in the field of 
public health, and dissemination to interested 
parties of information on the Community's 
activities in this field. Community action programme 
on health promotion (1996 to 2000) 
1. Support and coordination of the work carried out in 
the Member States with a view to a better 
knowledge of the psycho-sociological mechanisms 
involved and of health information methods and 
techniques. 
Fostering the assessment and dissemination of 
results. 
2a. Support for work to become better acquainted with 
socio-economic and cultural differences in relation 
to health promotion and health education. 
3. Support for development of a European 
infrastructure, particularly in the form of 
transnational networks, reference centres for 
information and documentation on public health 
and health promotion for use by professionals, 
administrators and decision-makers in the field of 
public health, and dissemination to interested 
parties of information on the Community's 
activities in this field. 
Initial proposal 
(COM)94 202 final Amended proposal 
B. Health education 
4. Promotion, by consultation between the Member 
States, of the inclusion of health education in 
school curricula, and support for the development 
and distribution of appropriate health education 
programmes, teaching materials and modules. 
Support for demonstration projects and innovative 
measures with the aim of promoting healthy 
lifestyles and behaviour, including support for the 
European network of health promoting schools in 
cooperation with WHO and the Council of Europe. 
5. Support for health education measures in the 
workplace, particularly in relation to prevention of 
alcohol abuse and tobacco consumption, and 
nutrition. 
6. Support for health education projects among young 
persons and adolescents who have left the school 
system in settings such as sport and leisure 
activities and socio-cultural activity centres, 
including innovative means of providing continuing 
structured health education. Promotion, in consultation with the Member States, 
of greater integration of health education in school 
curricula, and development of exchanges of 
experience, teaching materials and training staff in 
particular by means of pilot projects, in order to 
promote healthy lifestyles and behaviour. 
Support for the European network of health 
promoting schools in cooperation with WHO and 
the Council of Europe. 
6. Support, coordination and assessment of health 
education projects among young persons and 
adolescents who have left the school system, drawn 
up and implemented by either official bodies or 
private associations and non-governmental 
organizations in settings such as sport and leisure 
activities and socio-cultural activity centres, 
including innovative means of providing continuing 
structured health education. 
6a. Support for innovative pilot projects with regard to 
continuing structured health education for adults. 
Initial proposal 
(COM)94 202 final Amended proposal 
C. Vocational training in public health and health 
promotion 
7. Review and assessment of existing structures and 
training schemes in public health and health 
promotion and compilation of a European directory. 
Support for cooperation involving schools of public 
health, universities and bodies providing training in 
this area with a view to the development of 
common training courses and exchanges of students 
and teaching staff. 
8. Promotion of cooperation between the Member 
States on the content of training courses and 
training activities in the fields of public health and 
health promotion for professionals, administrators, 
managers and decision-makers, emphasizing 
interdisciplinary approaches. 
9. Support for training activities concerning health 
education in schools aimed at teachers, instructors 
and other staff concerned including development of 
modules, teaching aids and materials. Support for 
training for health professionals in the prevention 
of diseases, early detection of alcoholism and 
information for the public on the use of medicines 
and self-medication. Promotion of exchanges of training modules and 
training experiences in the fields of public health 
and health promotion for professionals, 
administrators, managers and decision-makers, 
emphasizing interdisciplinary approaches. 
Support for training activities concerning health 
education in schools aimed at teachers, instructors, 
and other staff concerned, including development 
of modules, teaching aids and materials. 
9a. Support for training and further training for health 
professionals in health promotion, the prevention 
and early detection of diseases and information for 
the public on the rational use of medicines, in 
particular generic medicines and self-medication. 
Initial proposal 
(COM)94 202 final 
D. Specific prevention and health promotion 
measures 
10. Support for integrated health promotion activities 
and projects relating to disadvantaged or vulnerable 
groups and particular territorial areas, and 
incorporating the intersectoral dimension of health 
promotion. 
11. Examination of the role of balanced nutrition as a 
health protection measure and of nutrition in the 
etiology of diseases, particularly cardiovascular 
diseases. Promotion of analysis, evaluation and 
exchange of experience in respect of innovative 
measures for the prevention of cardiovascular and 
related diseases. 
12. Support for activities on medication, including self-
medication, in cooperation with general 
practitioners and pharmacists, as well as efforts to 
monitor the development of practices and assess 
their implications. 10. Support for integrated health promotion activities 
and projects relating more particularly to groups 
disadvantaged due to their vulnerability or social 
exclusion (such as the elderly), to socio-cultural 
differences (migrants) or to their living in 
disadvantageous areas or situations, incorporating 
the intersectoral dimension of health promotion. 
11. Examination of the role of nutrition and other 
lifestyle factors in the etiology of diseases, and 
information for the public with a view to better 
understanding the basic principles of nutrition and 
new techniques and methods of presentation and 
preparation of foodstuffs. 
11a. Promotion of exchanges of experience and 
information and support for activities aimed at 
the prevention of cardiovascular and related 
diseases. 
lib. Promotion of exchanges of experience and 
information and support for actions concerning 
alcohol consumption and its medical and social 
consequences. 
lie. Support for actions to promote regular exercise 
and the adoption of proper physical and mental 
health practices. 
lid. Support for studies into the ageing populations of 
the European Union, promotion of exchanges of 
experience and information 
age-related diseases, in coordination with the 
other specific programmes. 
12. Support for activities on rational use of 
medicines, in particular generic medicines and 
self-medication, as well as actions to monitor the 
development thereof and the implications, in 
cooperation with general practitioners and 
pharmacists. 
10 
23/03/95 
Initial proposal Amended proposal 
(COM)94 202 final 
E. Health promotion strategies and structures 
13. Surveys and comparative analyses of health 
promotion structures and strategies and 
assessment of these policies, as well as activities 
to encourage and support cooperation between 
Member States on various strategic aspects of 
public health and health promotion. 
14. Support for networks of national or regional 
health promotion bodies, adopting an integrated 
approach (i.e. an approach covering the various 
determinants, contexts and population groups) and 
promotion of joint activities and projects. 
11 
ISSN 0254-1475 
COM(95) 138 final 
DOCUMENTS 
EN 05 
Catalogue number : CB-CO-95-150-EN-C 
ISBN 92-77-87758-8 
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