Opinion of the Economic and Social Committee on the 'Proposal for a European Parliament and Council Decision adopting a programme of Community action from 1999 to 2003 on injury prevention in the context of the framework for action in the field of public health'
Date: 1997-10-29
Institutions: European Economic and Social Committee
Subjects: EU programme, disease prevention, exchange of information, health policy, public health

21. 1. 98

EN

Official Journal of the European Communities

C 19/1

II

(Preparatory Acts)

ECONOMIC AND SOCIAL COMMITTEE

Opinion of the Economic and Social Committee on the ‘Proposal for a European Parliament
and Council Decision adopting a programme of Community action from 1999 to 2003 on
injury prevention in the context of the framework for action in the field of public health’ (1)

(98/C 19/01)

On 6 June 1997 the Council decided to consult the Economic and Social Committee, under
Article 129 (4) of the Treaty establishing the European Community, on the above-mentioned
proposal.

The Section for Protection of the Environment, Public Health and Consumer Affairs, which
was responsible for preparing the Committee’s work on the subject, adopted its opinion on
7 October 1997. The rapporteur was Miss Maddocks (Co-rapporteurs: Mr Linssen and
Mrs Wahrolin).

At its 349th plenary session (meeting of 29 October 1997), the Economic and Social Committee
adopted the following opinion by 75 votes to three with one abstention.

1.

Introduction

1.1.
The Commission Communication on the frame-
work for action in the field of public health (2) set out
criteria on which to determine priority areas for future
Community action programmes. It also identified and
announced several such areas, including injury preven-
tion, pollution-related diseases and rare diseases. The
Commission has just adopted relevant programmes in
these three fields.

1.1.1.
The present proposal for an action programme
on injury prevention (1999-2003) is based on Article 129
of the Treaty and comes under the principle of shared
competence between the Community and the Member
States.

1.1.2.
The programme responds to the specific call
made by both the European Parliament and the
Council (3), and it seeks to promote public health by
contributing to actions which reduce the incidence of
injury, by promoting the more effective dissemination
and application of prevention techniques whose worth
is widely accepted by experts, and by helping to
strengthen the general capacity of public health bodies
to mount effective injury prevention activities.

Injury is a broad concept which in principle
1.2.
covers all kinds of ill-health resulting from external
causes (as opposed to disease processes) and, in the EC,
is the leading cause of death at all ages between 1 and 34,
and also the over 75s.

(1) OJ C 202, 2. 7. 1997, p. 20.
(2) COM(93) 559 final, 24. 11. 1993, ESC Opinion: OJ C 388,

31. 12. 1994.

(3) EP: Resolution of 19 November 1993, OJ C 329, 6. 12. 1993
— Council: Resolution of 27 May 1993, OJ C 174,
25. 6. 1993.

C 19/2

EN

Official Journal of the European Communities

21. 1. 98

1.3.
The present Commission proposal targets a small
number of key areas within the broad field covered by
the concept of injury, selected on the basis that they:

will incorporate information on Community financing
in the various fields of action as well as the results of
evaluations.

— are an important cause of avoidable injury and

death;

— are not already addressed by action at Community

level;

— present opportunities for cost-effective intervention;

— would deliver Community added value by bringing
together and complementing work done at national
and sub-national level.

1.7.
The financial framework for the implementation
of the programme for the year 1999 shall be ECU
1,3 million in keeping with the current financial perspec-
tives. The cost for the remaining four years (2000-2003)
shall be determined after the establishment of the future
Community financial perspectives.

1.3.1.

These target areas are:

2. General comments

— home and leisure accidents to children, young adults

and elderly people;

— accidents to children while at school;

— suicide and lesser forms of deliberate self-harm

(sometimes called parasuicide);

— injury prevention capacity.

The incentive measures proposed are of two

1.4.
kinds:

— support for the sharing — and shared development —
of expertise, particularly in the selection of inter-
ventions and the epidemiology of injury;

— encouraging improvement in the quality of data
about injuries, which are vital to determine what
situations, products, behaviours and places are
dangerous.

The means which will be appropriate for achiev-

1.5.
ing the above at a Community level are:

— encouraging and supporting the creation of net-

works;

— dissemination of information about prevention cam-

paigns;

— work on improving the quality of data;

— supporting surveys and technical investigations of

injury risk factors;

— helping Member States to coordinate policies and

programmes;

— adding public health value to other Community

programmes.

1.6.
An evaluation of the actions implemented under
the programme will be provided in two reports, one
during the third year (evaluation) and a final report on
the implementation of the programme. These reports

2.1.
The Economic and Social Committee congratu-
lates the Commission for the latest proposals for action
programmes in the context of the Communication on
the framework for action in the field of public health.
These programmes show a will towards a more horizon-
tal approach in public health policy, according to which
health promotion should deal with all aspects of the
living environment. Such approach was advocated by
the Committee in its opinion on the above-mentioned
communication (1).

2.2.
The Committee welcomes the Commission pro-
posal aiming at health promotion through injury preven-
tion. It also notices with satisfaction that the new
Article 129(1) of the Treaty makes a more specific
reference to this type of action, as it states that
‘Community action ... shall be directed towards ...
obviating sources of danger to human health’.

2.3.
The Committee is particularly pleased that the
Commission is carrying out a more in-depth analysis of
the health circumstances of specific age groups (i.e.
children, young and elderly people) and environments
(i.e. home and schools) as reflected in the current
proposal. Such analysis is in line with the ‘New
Approach’ on public health policy suggested by the
Committee in the context of the Communication in the
field of public health (2).

2.4.
The present proposal aims at facilitating the
sharing of existing expertise, both technical and non-
technical, on injury prevention at both Member State
and Community level. This aim reflects the principles
of the Committee’s opinion on the aforementioned
communication (2), which stressed the need to involve
all interested parties, to assure a more solid scien-
tific/technical basis and to prevent duplication of efforts

(1) Cf. p. 6 of the Opinion, OJ C 388, 31. 12. 1994.
(2) Cf. p. 7 of the Opinion, OJ C 388, 31. 12. 1994.

21. 1. 98

EN

Official Journal of the European Communities

C 19/3

with regards to health policy. Such involvement should
be guaranteed at the earliest possible stage.

2.4.1.
The Committee stresses the importance of the
role to be played by voluntary organizations which have
recognized and valuable experience to offer in this field.

3.2.1.3.
It is also vital, in the view of the Committee
and as stated in its opinions on the subject (4), to improve
the system which has also been outlined in the present
Commission proposal. In this context, the Committee
feels that the Commission should issue guidelines on the
methodologies to be followed for data collection in
order to achieve comparability of information between
Member States.

3. Specific comments

3.1.
Article 3: Budget. On one hand, the Committee
understands the reasons behind the relatively modest
budget — 1,3 MECU — for the implementation of the
action programme. On the other hand, the Commission
presents very strong evidence on the cost-effectiveness
of the proposed measures (1). Therefore, and given that
funds are only allocated up to 1999, the Committee
considers it critical that, from the onset, the continuity
of the programme is guaranteed until the year 2003,
which is the end of the proposed period of action.

Article 4: Consistency and complementarity. The
3.2.
Committee considers it essential that consistency and
complementarity with other relevant Community pro-
grammes and actions are guaranteed especially with
regards to:

3.2.1.
The EHLASS system — Data on home and
leisure accidents have been collected since 1986 under
the EHLASS system (2). This information has been used,
inter alia, in prevention campaigns, negotiations with
industry to modify products, and the introduction of
standards and regulations.

The Committee is aware that the relevant
3.2.1.1.
Commission services have just completed a final report
on the implementation and effectiveness of the EHLASS
system on the basis of which the system might be
extended beyond its current expiry date of end of
1997 (3).

3.2.1.2.
The Committee feels that the action pro-
gramme on injury prevention cannot function without
the EHLASS system and calls for it to be extended.

(1) Cf. p. 4, point I(4), COM(97) 178 final, Communication
from the Commission concerning a Community action
programme on injury prevention in the context of the
framework for action in the field of public health.

(2) Council Decision 86/138/EEC, OJ L 109, 26. 4. 1986.
Council Decision 93/683/EEC, OJ L 319, 21. 12. 1993
— Opinion ESC: OJ C 201, 26. 7. 1993. Decision No
30922/94/EC of the European Parliament and of the
Council, OJ L 331, 21. 12. 1994 — Opinion ESC: OJ C 195,
18. 7. 1994.

(3) Decision No 30922/94/EC of the European Parliament and
of the Council OJ L 331 21. 12. 1994 — Opinion ESC: OJ
C 195, 18. 7. 1994.

3.2.1.4.
In this way, EHLASS could further improve
its cost-effectiveness and give the necessary added value
at Community level for the provision of information on
home and leisure accidents. Once good quality/reliable
information is available, it will then be possible to
develop quantitative targets for injury reduction which,
in the view of the Committee, are fundamental for
achieving the objectives of the proposed action pro-
gramme.

3.2.2.
Product safety — The Committee also feels, in
line again with comments made on the EHLASS system,
that there should be a strong cross-link established
between injury prevention and Directive 92/59/EEC on
general product safety (5). In this connection, it endorses
those proposed measures (i.e. under the injury prevention
capacity area) directed to add public health value to
other Community policies for injury prevention such as
the above-mentioned directive.

3.2.3.
Indeed, the Committee welcomes those changes
to Article 129 of the Treaty directed to ensuring a high
level of human health protection in the definition and
implementation of all Community policies and activities.

3.2.4. Health monitoring — ‘Accidents at home’ is
one of the domains in which health indicators may be
established under a future Community action pro-
gramme on health monitoring (6). It is therefore vital, in
the view of the Committee, to avoid any duplication or
overlap of work between that programme and the
proposed one, in order to achieve efficient interaction
between them.

3.3.
Article 5: Comitology. The Committee feels that
the views of the various socio-economic partners and
interests involved in injury prevention should be con-
sidered by Member States when making nominations
for the Advisory Committee that is to assist the Com-

(4) OJ C 201, 26. 7. 1993; OJ C 195, 18. 7. 1994.
(5) OJ L 228, 11. 8. 1992 — ESC Opinion: OJ C 75, 26. 3. 1990.
(6) OJ C 338, 16. 12. 1995 — ESC Opinion: OJ C 174,

17. 6. 1996.

C 19/4

EN

Official Journal of the European Communities

21. 1. 98

mission on both the criteria and procedures for selecting
and financing projects under the programme, and the
evaluation procedure.

3.4.
Article 7: Monitoring and evaluation. The Com-
mittee is pleased to note that it will receive copies of the
evaluation and implementation reports.

Brussels, 29 October 1997.

The President

of the Economic and Social Committee

Tom JENKINS

Opinion of the Economic and Social Committee on the ‘Proposal for a European Parliament
and Council Decision adopting a programme of Community action 1999-2003 on rare diseases
in the context of the framework for action in the field of public health’ (1)

(98/C 19/02)

On 27 June 1997 the Council decided to consult the Economic and Social Committee, under
Article 129 of the Treaty establishing the European Community, on the above-mentioned
proposal.

The Section for Protection of the Environment, Public Health and Consumer Affairs, which
was responsible for preparing the Committee’s work on the subject, adopted its opinion on
7 October 1997. The rapporteur was Mr Fuchs; co-rapporteurs were Mr Lemmetty and
Mr Linssen.

At its 349th plenary session (meeting of 29 October 1997), the Economic and Social Committee
adopted the following opinion by 101 votes to three, with one abstention.

1.

Introduction

1.1.
The proposed five-year action programme (1999-
2003), which is based on Article 129 of the Treaty and
which is accompanied by a explanatory communication,
seeks to address the problem of rare diseases in the
Community by complementing ongoing work on this
subject in the Member States. The problem of rare
diseases, which, in contrast to the United States, has not
been dealt with systematically in most of the Member
States to date, was identified as one of the eight priority
areas for Community action in the 1993 Commission
communication on the framework for action in the field
of public health (2).

1.2.
In response to this communication both the
Economic and Social Committee (3) and the European

Parliament (4) supported the idea of an action programme
on rare diseases. Furthermore, the Council invited the
Commission to take stock of existing knowledge and
experience regarding rare diseases and to examine the
situation of orphan drugs in the Community (5).

1.3.
To address the problem of rare diseases the
Commission proposes a number of specific actions
i) actions to provide better
under three headings:
information on the different aspects of rare diseases (e.g.
the establishment of a European rare diseases database);
ii) actions in support of patient and family support
groups (e.g. the establishment of such groups and their
collaboration); and iii) actions on handling rare diseases
clusters (e.g. the monitoring of rare diseases and the
creation of rare diseases cluster response teams).

(1) OJ C 203, 3. 7. 1997, p. 6.
(2) COM(93) 559 final.
(3) See its opinion of 6 July 1994 — OJ C 388, 31. 12. 1994.

(4) See its Resolution A4-0311/95 on the Medium-Term Social
Action Programme 1995-1997 — OJ C 32, 5. 2. 1996.
(5) See its Resolution of 20 December 1995 — OJ C 350,

30. 12. 1995.