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)
Date: 1998-01-27
Institutions: European Commission
Subjects: EU policy, EU situation, activity report, health policy, public health

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. 

2. 

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. 

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. 

4. 

5. 

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. 

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. 

information,  discuss  major  health-related 

Second, a Interservice Group on Health was created which provides a forum to 
exchange 
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 

9. 

10. 

11. 

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. 

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. 

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. 

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. 

13. 

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. 

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. 

15. 

16. 

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. 

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. 

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. 

20. 

21. 

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 
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. 

institutions  to  ensure 

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. 

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 
sector, 
pharmaceuticals,  tobacco  subsidies,  alcohol-related  competition  rulings, risks 
from  telecommunication  fields  and  power  transmission,  and  nutritional 
requirements. 

individual 

instances, 

such  as 

transport 

the 

in 

in 

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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