COMMISSION OF THE EUROPEAN COMMUNITIES 
Brussels, 27.01.1998 
COM(1998) 34 final 
Third Report from the Commission 
to the Council, the European Parliament, the Economic and Social 
Committee and the Committee of the Regions on the integration of health 
protection requirements in Community policies 
(1996) 

Third report on the integration of health protection 
requirements in Community policies 
1. Public health and the health dimension of Community policies are at the centre 
of the concerns of the Community and its citizens. This is recognised by the 
Treaty and the Community has taken steps to ensure that these concerns are 
met. The Community as a whole, and the Commission in particular, are 
committed to contribute with their policies, actions and activities to the 
attainment of a high level of health protection (Article 3 (o) of the Treaty). The 
Amsterdam Treaty strengthens further the role of the Community in the field of 
public health. 
2. This report sets out key developments in this respect in 1996 and gives an 
overview of Community activities with an impact on health. It shows how 
health protection requirements were taken into account in measures and 
activities undertaken, and discusses, health-related aspects of Community 
policies. It also looks at possibilities for further developing this work in the 
future. 
A detailed overview of Community activities with a health impact is provided 
a separate Commission services working document. in 
Background to Community work on health in other policies 
3. Article 129 of the Treaty states that health protection requirements shall form a 
constituent part of the Community's other policies. The Commission has put in 
place procedures to meet this obligation. 
4. First, it introduced measures to ensure that services in charge of public health 
are consulted on all health-related proposals and their comments are attached to 
the proposals before their adoption. This procedure is continuously monitored 
for its effectiveness and steps will be taken to strengthen it should it prove 
necessary. 
5. Second, a Interservice Group on Health was created which provides a forum to 
exchange information, discuss major health-related issues among the 
Commission's Directorate Generals and coordinate the position of services with 
respect to health-related matters which the Commission would consider 
subsequently. A number of ad hoc groups provide the opportunity for in-depth 
examination of specific issues. In addition, it provides for the designation of 
appropriate contact persons for health-related questions in all Commission 
Directorate Generals, whose role is to transmit requests and replies, check that 
all parties concerned have been involved and facilitate the resolution of 
outstanding questions and disputes. 
6. Third, the Commission has prepared annual reports on the integration of health 
requirements in Community policies with the intention to encourage the other 
Community institutions to look carefully into the health implications of other 
policies when considering measures and programmes as part of the Community 
decision-making process; and also to stimulate similar exercises in other 
Member States aiming at enlisting the help of other policies in implementing 
measures with beneficial health impact. Two reports have already been 
presented to Council, Parliament, the Economic and Social Committee and the 
Committee of the Regions 1. Both previous reports on the integration of health 
protection requirements proved of considerable interest not only to the 
Institutions but also to Member States and the public. Council has adopted a 
resolution on the second report in November 1996, calling upon the 
Commission to continue its efforts to integrate health protection requirements 
into Community policies^. Parliament is currently discussing the second report 
and has appointed a rapporteur. Finally, some Member States (e.g. Finland) 
have produced reports along the lines of those of the Commission, with 
important findings and consequences for policy in other areas. 
Major developments in 1996 
BSE/CJD 
7. 1996 was an important year for health at Community level, particularly 
regarding developments in food and agricultural policy. The issue of a possible 
link between Bovine Spongiform Encephalopathy (BSE) and a new variant of 
Creutzfeld-Jakob disease (CJD) has, in particular, caused major concern. 
Against this background, the Commission services working document has 
dedicated a specific chapter to a detailed description of measures taken in 
different policy areas to protect human and animal health and to efforts to 
acquire better knowledge on the link between BSE and the new CJD variant. 
8. From the public health point of view, a number of important measures have 
been taken, considering the limited Community powers in this area: 
•—first, a proposal was put forward for a network for the epidemiological 
surveillance and control of communicable diseases in March 1996^ before 
the announcement by the UK government of a possible link between BSE 
and CJD which precipitated the BSE crisis. The proposal provided for 
comprehensive surveillance and control measures for communicable 
1 COM (95) 196 final of 29.5.1995 and COM (96) 407 final of 4.9.1996 
2 Council Resolution of 12 November 1996 on the integration of health protection requirements 
into Community policies, OJ No. C 374 of 11.12.1996, p. 3. 
3 COM (96) 78 final of 7.3.1996 
diseases and covered CJD. It is still being discussed by the European 
Parliament and Council. 
• the Commission has also prepared a proposal for a programme of 
Community action on rare diseases'* which may serve for actions on CJD. 
9. With regard to CJD and other Transmissible Spongiform Encephalopathies, the 
Commission services have prepared working documents which have served as a 
basis of discussions at the Health Councils under the Italian, Irish and Netherlands 
Presidencies. These documents contained epidemiological data from the Member 
States on CJD and analysis of trends, and a survey of measures taken by the 
Member States and the Community. Similar documents will be prepared in the 
future. 
10. The impact of and the Community response to the BSE crisis from a public health 
point of view showed clearly the need for a coherent approach to the consideration 
and integration of health requirements across the board of Community policies. 
President Santer underlined this when he said, in his speech to the European 
Parliament on the report of the BSE committee of enquiry, that 'the time has come 
to put health to the fore in Europe'. The series of measures taken since, especially 
the application of the precautionary principle and the separation of the 
responsibilities on advice, legislation and control, as well as the reinforcement of 
scientific committees and relevant binding instruments, bear witness to the 
determination of the Commission to live up to this commitment. 
11. The Commission has decided on a number of important changes to policy and 
administrative responsibility within its services to reflect the growing public 
awareness and its growing responsibility to protect the health of consumers and of 
the public at large. The Commission services in charge of public health are involved 
in these restructuring activities, and take part in the new co-ordinating bodies set 
up. Its responsibilities to implement a 'health watch' function over the other policies 
will come out strengthened by these reforms. Progress will be duly reported in the 
fourth report on the integration of health requirements, covering activities and 
policy in 1997. 
Other major developments 
12. The BSE crisis and its possible implications for human health is one of a 
number of important policy areas with a strong health dimension. The 
Commission services working document provides a full picture of these policy 
areas. 
13. Activities in the field of food law have direct consequences for human health. 
Legislation in 1996 on food additives, on labelling and on foods for infants and 
small children reflect the need for adaptation and progress in Community policy 
4 COM (97) 225 final of 26.5.1997 
in this field. The regulation on novel foods and food ingredients, adopted in 
early 19975, introduces a framework for premarket safety assessment and 
authorisation of novel foods, including all foods and food ingredients produced 
from genetically modified organisms. In addition, it establishes a framework for 
labelling of novel foods and food ingredients. 
In order to prepare the reorientation of Community food law, the Commission 
has published, in 1997, a Green Paper on the general principles of food law in 
the European Union^. Coming as it does at a time when public concerns about 
food and health have never been higher, this Green Paper provides an 
opportunity to debate new approaches to these issues, both within general food 
policy and specific legislation. 
14. Equally, important health-related decisions are being prepared in the field of 
research. During 1996, the Commission prepared a set of proposals for the 
future of Community research programmes, disseminated widely during 1997. 
This report shows that a considerable amount of research programmes support 
projects with a health dimension, be it in medical research, research on health 
systems, biotechnology, telematics, agriculture or environmental research. 
15. Environmental protection, the provision of a clean environment, the protection 
against radiation, and civil protection also have important repercussions for the 
health of the public. Cooperation between the health and environment sides has 
therefore been close, and will be further strengthened in the future. 
16. The interaction and interdependence of social and health policies may be self-
evident; however, maximising the beneficial impact of one on the other requires 
special attention and effort. Significant strides have been made in this direction 
during 1996, especially in the area of social protection. Further steps will be 
taken to enhance the place of health in social policy development, e.g. in 
respect of inequalities and poverty. 
17. Many public health concerns span across a number of Community policy areas. 
Drugs, for example, are being dealt with - among others - in the context of 
public health activities, of justice and home affairs, and external relations. 
Specific attention is focused on tobacco in the context of preventive activities 
in public health (Europe against cancer), but agriculture deals with tobacco 
growing and research policy with the development of less harmful tobacco 
varieties. The indirect taxation of tobacco - an area of concern for taxation 
policy - influences the price of tobacco products. This is reflected in the report. 
18. The Commission services working document covers under particular headings 
the policy areas which are of particular relevance to health. This takes into 
5 Regulation (EC) 258/97 of the European Parliament and of the Council of 27.01.1997 concerning 
novel foods and food ingredients, OJ L43, 14.02.1997, p. 1. 
6 COM (97) 176 final of 30.4.1997 
account, in this respect, the list of priorities suggested by the Council in its 
resolution on the first report^, with the addition of a specific chapter on 
BSE/CJD: 
- Social policy 
- Agriculture, food and fisheries, 
- BSE and CJD, 
- Internal market, 
- Research and development, 
- Environment and energy, 
- Transport, and 
- International cooperation. 
Strengthening the integration of health requirements 
19. The Commission services working document shows the wide range of health-
related activities in almost all major areas of Community policy. It is a joint 
responsibility of the Community's institutions to ensure that health 
requirements are integrated in policy and actions. In addition to Article 129, 
they have to take into account a range of other Treaty provisions designed to 
protect public health. 
20. The importance of integrating health requirements in other policies in order to 
ensure a high level of human health has been confirmed by the Court of Justice 
in its ruling** on the UK's request for interim relief regarding the export ban for 
cattle and related products in the context of BSE. Within the Commission, 
implementing the obligation in Article 129 starts with the work of the services 
which have lead responsibility in a particular policy area. In addition, the 'health 
watch' kept on Commission proposals provides an additional instrument to 
ensure that proposals are checked for possible health consequences before 
adoption. 
21. One important consideration in this context is to determine the respective 
Member States' and Community contribution to improving health and ensuring 
a high level of health protection, and to use the results as a launching pad for 
corrective measures or adjustments in policies and actions both in the Member 
States and at the Community level. Satisfactory results have already been 
obtained in individual instances, such as in the transport sector, 
pharmaceuticals, tobacco subsidies, alcohol-related competition rulings, risks 
from telecommunication fields and power transmission, and nutritional 
requirements. 
22. Implementing the relevant obligation in Article 129 is fraught with uncertainties 
as to what constitutes a high level of health protection, and what is the best 
7 Council resolution of 20 December 1995 on the integration of health protection requirements in 
Community policies, OJ C 350, 30.12.1995, p. 2 
8 C-180/96 R, United Kingdom v Commission of the European Communities, ECR 1996,1-3903 
methodology to arrive at reliable conclusions as to the respect or achievement 
of this objective by the measures or actions concerned. The Commission has 
launched a number of studies on these issues and obtained advice. The recently 
adopted programme of Community action on health monitoring^ should 
provide opportunities to make progress in this area. 
A more pro-active approach has already begun on social and employment 
policy, and health is increasingly being taken into account at an early stage in 
the development of these policies. 
23. Above all, to make real and sustained progress in this field will depend on three 
key factors: 
• a political commitment to make health-related measures and actions a joint 
responsibility, at all steps of Community decision-making, of those in charge 
of health and those in charge of the other policy areas; 
• the provision of sufficient and expert resources in the public health area to 
shadow key policy sectors effectively; 
• the monitoring of the implementation of the measures and actions 
concerned. 
24. The Commission will give consideration to instruments to give effect to these 
commitments, and will return to these issues in the fourth report. It will also 
address the question of lessons and experiences gained in mainstreaming health 
in other areas of policy. 
Revision of Article 129 
25. In 1997, the Treaty of Amsterdam has introduced important changes to Article 
129 with a view to strengthen the scope of potential action by underlining that 
a high level of human health protection shall be ensured both in the definition 
and implementation of all Community policies and activities. 
Conclusion 
26. The Commission considers the Treaty provision that health protection 
requirements shall form a constituent part of the Community's other policies as 
a central element of the Community's powers in public health and is committed 
to strengthen its relevance and application. The attached report is in support of 
these efforts, but also shows the wide range of activities involved. A 'health 
watch' over policies and measures would have to be stringent and 
comprehensive, and for this additional resources and increased efforts are 
necessary. The Commission will take the necessary steps to strengthen this 
process and will report on progress in future communications. 
9 OJL 193/1 of 22.7.1997 
27. The Commission hopes that this report and the working document will also 
stimulate and enrich the ongoing discussion on the future orientations of 
Community policy in the field of health. It invites comments on how to ensure 
progress in this area and will take them into account in future policy 
development. 
ISSN 0254-1475 
COM(98) 34 final 
DOCUMENTS 
EN 05 15 01 
Catalogue number : CB-CO-98-034-EN-C 
ISBN 92-78-30336-4 
Office for Official Publications of the European Communities 
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