Report from the Commission to the European Parliament and the Council Implementation of the Public Health Programme in 2005
Date: 2006-11-23
Institutions: European Commission
Subjects: EU programme, health policy, public health, report

COMMISSION OF THE EUROPEAN COMMUNITIES 

Brussels, 23.11.2006 
COM(2006) 711 final 

REPORT FROM THE COMMISSION TO THE EUROPEAN PARLIAMENT AND 
THE COUNCIL 

Implementation of the Public Health Programme in 2005 

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REPORT FROM THE COMMISSION TO THE EUROPEAN PARLIAMENT AND 
THE COUNCIL 

Implementation of the Public Health Programme in 2005 

(Text with EEA relevance) 

1. 

INTRODUCTION 

This  report  aims  to  inform  the  European  Parliament  and  the  Council  of  the 
implementation of the Public Health Programme in 20051. A report on the first two 
years of the Programme can be found on the Europa website2. 

2. 

POLICY CONTEXT 

2.1. 

Public health policy in 2005 

2.1.1.  Health and Consumer Protection Strategy 

A  joint  Health  and  Consumer  Protection  strategy  was  adopted  on  6  April  2005, 
setting  up  a  proposal  to  establish  a  joint  programme  for  Health  and  Consumer 
protection3.  The  strategy  and  programme  proposal  bring  together  and  extend  the 
current EU Public Health Programme and the current Consumer Policy Programme. 
The  proposal  not  only  sets  up  overall  common  objectives,  but  also  reinforces  the 
existing strands of the Public Health Programme and creates three additional strands 
for public health. 

The  programme  proposal  aims  to  exploit  synergies  between  health  and  consumer 
policies  in  order  to  reinforce  citizens’  concerns  in  EU  policy  making.  A  joint 
programme  would  bring  economies  of  scale,  increased  visibility  and  streamlined 
procedures.  The  proposal,  which  is  part  of  the  programmes  package  related  to  the 
financial perspectives 2007-2013 is now undergoing co-decision procedure.  

2.1.2.  Mid-term evaluation of the Public Health Programme 

An external mid-term evaluation of the Public Health Programme was launched, as 
foreseen  in  the  programme  Decision4  to  obtain  independent,  evidence  based 
information  on  the  implementation  and  achievement  of  the  programme  during  its 
first three years (2003 - 2005). 

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4 

In accordance with article 12(1) of Decision No 1786/2002/EC of 23.9.2002 Official Journal L 271 of 
9.10.2002, p. 1. 
http://europa.eu.int/comm/health/ph_programme/keydo_programme_2003_2008_en.htm  
COM(2005)115 final of 6.4.2005. 
Article 12 (3) of Decision No 1786/2002/EC of 23.9.2002 Official Journal L 271 of 9.10.2002, p. 1. 

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Main  objectives  of  the  evaluation  are  to  assess  the  programme’s  impact  on  health 
matters  in  the  EU,  the  efficiency  of  its  use  of  resources,  the  sustainability  of  its 
actions and complementarity with other Commission actions. 

Results  of  the  evaluation  will  be  used  to  provide  feedback  for  future  Commission 
initiatives in the field of Public Health.  

2.1.3. 

Stakeholder consultations 

To further involve civil society in health strategy, the second Open Forum took place 
in November to address Health challenges and future strategy. It provided a platform 
for  networking  and  exchange  of  ideas  for  some  380  participants  representing 
regional,  national  and  European  health  organisations  as  well  as  the  European 
Institutions.  They  included  the  main  partners  for  health  in  Europe,  e.g.  policy 
makers, service providers, industries, patients, health professionals and academia. 

The  High  Level  Group  on  health  services  and  medical  care  held  four  meetings.  It 
made  good  progress,  including  the  establishment  of  a  European  network  on  health 
technology  assessment;  development  of  recommendations  for  pilot  projects  on 
centres  of  reference  in  2006;  proposals  for  a  European  patient  safety  strategy; 
guidelines for cross-border healthcare purchasing contracts. An annual report to the 
Council provides a coherent view on the work carried out by the 6 working groups, 
and  proposes  recommendations  and  ways  forward  to  improve  cooperation  between 
Member states in the area of health care. 2005 was also the first year where European 
NGOs  representing  civil  society  interests  of  particular  relevance  were  involved  in 
some of the working groups. 

2.2. 

Activities related to legislation 

Two  directives  were  adopted  to  implement  Directive  2002/98/EC5,  ensuring  a  high 
level  of  human  health  protection  regarding  blood  and  blood  components  through 
standards  of  quality  and  safety  for  the  collection  and  testing  of  human  blood  and 
blood  components,  as  well  as  for  their  processing,  storage  and  distribution  when 
intended for transfusion. 

Directive  2005/61/EC  laid  down  traceability  requirements,  verification  procedures, 
and  notification  of  serious  adverse  reactions  and  events  of  human  blood  and  blood 
components6.  To  complete  this  Directive,  Directive  2005/62/EC  was  adopted  for 
for  blood 
Community  standards  and  specifications  on  a  quality  system 
establishments7. 

2.3. 

Co-operation with international organisations 

To  strengthen  cooperation  with  international  organisations,  direct  grant  agreements 
were  negotiated  for  the  first  time  with  the  World  Health  Organisation8  and  the 
Organisation for Economic Cooperation and Development9.  

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Directive 2002/98/EC of 27 January 2003. Official Journal L 33, of 8.2.2003 p. 30. 
Commission Directive 2005/61/EC of 30 September 2005, Official Journal L 256 of 1.10. 2005, p. 32. 
Commission Directive 2005/62/EC of 30 September 2005 Official Journal L 256 of 1.10.2005, p. 41. 
Commission Decision C(2006)197-1. 

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With  the  WHO,  prioritised  were  mental  health,  pandemic  influenza,  mobility  and 
health  services,  environment  and  health,  and  obesity  for  a  total  co-funding  by  the 
Public Health Programme of €2.5 million.  

Direct grant agreements with the OECD amounted to a total co-funding of €800,000 
for health accounts, indicators on quality of health care, improving the efficiency of 
delivery of health services, and economics of prevention. 

2.4. 

Structural support 

2.4.1.  Executive Agency for the Public Health Programme 

In January 2005, the Commission created an Executive Agency for the Public Health 
Programme10.  The  Agency  aims  to  provide  technical,  scientific  and  administrative 
assistance necessary for efficient implementation of the programme’s objectives. 

The  Agency  will  manage  all  the  phases  in  the  lifetime  of  specific  projects,  in  the 
context  of  implementing  the  programme  on  public  health,  on  the  basis  of  Decision 
No 1786/2002/EC and of the work plan provided for in that Decision and adopted by 
the Commission, and the necessary checks to that end, taking the relevant decisions 
where  the  Commission  has  empowered  it  to  do  so.  The  Agency  will  provide 
logistical,  scientific  and  technical  support  for  non-political  working  groups  and 
events. 

Recruitment of the Director and first staff began in 2005, but the Agency is expected 
to  become  fully  operational  only  in  2006.  A  steering  committee,  comprising  five 
high level Commission staff, oversees the work of the Agency. It was appointed in 
the first quarter of 2005. 

2.4.2.  European Centre for Disease Prevention and Control (ECDC) 

The  Communicable  Diseases  Network,  managed  by  the  Commission  since  1999, 
required  substantial  reinforcement  to  control  communicable  diseases  effectively.  In 
April 2004, the Council and European Parliament created the legislative framework11 
for a European Centre for Disease Prevention and Control which gradually became 
operational  in  2005,  after  the  nomination  of  Zsuzsanna  Jakab  as  Director  in 
December 2004. Two handover notes were prepared by the Commission to ensure a 
smooth transition of activities12. 

The  ECDC  provides  a  structured  and  systematic  approach  to  the  control  of 
communicable diseases and other serious health threats which affect European Union 
citizens. The ECDC also mobilises and significantly reinforces the synergies between 
the existing national centres for disease control. 

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Commission Decision C(2005)4651-1. 
C(2004)4839 of 15.12.2004. Official Journal L 369 of 16/12/2004, pp. 73–75. 
Regulation (EC) No 851/2004 of 21.4. 
The handover notes can be found on 
http://europa.eu.int/comm/health/ph_overview/strategy/ecdc/ecdc_en.htm 

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3. 

BASIS FOR 2005 ACTIVITIES 

3.1. 

Appropriations 

Of  the  programme’s  global  budget  for  2003-2008  of  €354  million,  the  total 
appropriation  of  operational  and  administrative  credits  for  2005  amounted  to  €61.5 
million.  €50  million  was  allocated  to  financing  projects  under  the  2005  call  for 
proposals. A further €1.9 million was committed to calls for tender and €3.6 million 
to direct grant agreements. 

3.2. 

Call for proposals 

A single call for proposals, covering all the activities of the 2005 work plan13, was 
launched  in  January  on  the  Public  Health  Programme’s  Europa  website.  The  call 
remained open for three months. An information day was held in February, gathering 
stakeholders and public health professionals interested in submitting proposals to the 
Public health programme.  

The  242  submitted  proposals  were  evaluated  both  by  independent  external  experts 
and Commission officials. Evaluators endeavoured to use a consistent approach and 
common  evaluation  standards.  An  Evaluation  Committee  was  set  up  in  conformity 
with  the  financial  rules.  55  projects  were  considered  suitable  for  funding  and  18 
projects were placed on a reserve list. The remaining 169 projects were rejected. An 
internal  Commission  consultation  was  held  to  ensure  that  projects  selected  for  co-
financing would not duplicate or overlap with ongoing projects in other DGs. 

In July, the Programme Committee gave a unanimous favourable opinion to finance 
the  proposals  selected  by  the  evaluation  procedure.  The  same  list  of  projects  was 
then  endorsed  by  the  Authorising  Officer,  allowing  contract  negotiations  to  start. 
Although  the  first  grant  agreements  were  signed  end  2005,  most  grant  agreements 
remained to be concluded in 2006.  

3.3. 

Calls for tender 

Four  contracts  were  signed  for  Eurobarometer  surveys  in  the  fields  of  attitudes 
towards  tobacco,  medical  errors,  aids  prevention,  and  health  and  food14.  The  polls 
among the general European public sought to assess public opinion in general and to 
help  with  appraising,  validating  and  defining  work  carried  out  in  these  areas.  The 
contracts  covered  standard  Eurobarometer  face-to-face  surveys  in  33  countries  and 
areas.  

A  call  was  launched15  and  a  service  contract  was  successfully  concluded  after 
negotiation, for setting up quality assurance schemes for diagnosis of very high threat 
and  high  threat  pathogens.  The  purpose  of  the  contract  is  to  organize,  prepare  and 
perform  an  outcome  orientated  external  quality  assurance  exercise  for  four  high 
threat bacterial pathogens. Participants were laboratories in all 25 Member States and 

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Commission Decision C(2005)29 of 14 .1.2005. 
Contract notice 2004/S 1-000083 of 02.01.2004. 
Contract notice 2004/S 178-152217 of 11.09.2004. 

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EEA countries, designated by their authorities for primary confirmatory tests of the 
bacterial pathogens. 

4. 

MAIN ACTIVITIES IN 2005 

4.1. 

Health information 

As  a  follow-up  to  the  WHO  European  Ministerial  Conference  on  Mental  health  in 
January, a Green paper16 was published. The paper stressed the relevance of mental 
health  for  the  EU’s  strategic  policy  objectives  on  public  health.  It  proposed 
developing a strategy on mental health at EU-level in order to address the increasing 
level  of  diagnosed  mental  disorders  in  the  EU-population  and  their  economic  and 
social implications.  

Work  continued  on  the  establishment  of  a  comprehensive  European  health  and 
environment  information  system,  constituting  an  important  contribution  to  the 
European Environment and Health Action Plan 2004-201017 and a mid-term review 
foreseen  in  2007  on  the  implementation  of  the  conclusions  of  the  2004  Budapest 
Ministerial Conference on Environment and Health. 

Public  health  monitoring  needs  and  public  concern  was  addressed  in  the  area  of 
electromagnetic fields. Research was carried out on the potential effects of Universal 
Mobile Telephone System (UMTS) mobile phones (third generation mobile phones), 
particularly on development of cancer in the human ear canal. 

The  eEurope  Action  Plan18  set  the  objective  for  Europe  to  have  “modern,  online 
public  services”  by  2005.  One  of  the  proposed  actions  was  to  promote  eHealth 
services. Specific plans included electronic health cards, health information networks 
and online health services. As part of this initiative, extensive work was carried out 
to develop the European Union Public Health Portal19, funded by the Interchange of 
Data  between  Administrations  programme.  A  project  was  supported  with  the 
European Broadcasting Union to develop radio and TV documentaries on issues of 
relevance to public health. 

A  first  joint  meeting  between  the  eHealth  Working  Group20  of  the  Information 
Society  and  Media  DG  and  the  Health  Systems  Working  Party  of  the  Health  and 
Consumer  Protection  DG  was  held.  It  was  instrumental  in  increasing  synergies 
between the two groups21 and Commission services, thereby contributing to a better 

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COM (2005) 484 of 14 October 2005, 
http://ec.europa.eu/health/ph_determinants/life_style/mental/green_paper/mental_gp_en.pdf 
SEC(2004) 729 of 9.6.2004, http://ec.europa.eu/environment/health/pdf/com2004416.pdf  
COM/2002/0263 final of 28.5.2002, http://eur-
lex.europa.eu/LexUriServ/site/en/com/2002/com2002_0263en01.pdf 
http://ec.europa.eu/health-eu/index_en.htm  
As from April 2006, the eHealth Working Group is referred to as the i2010 sub-group on eHealth. 
The Health Systems Working Party of Health and Consumer Protection DG consists of Project leaders 
from  projects  in  the  field  of  health  systems  under  the  Public  health  Programme  and  the  previous  8 
public  health  programmes.  The  Working  Group  on  eHealth  (now  i2010  sub-group  on  eHealth)  of 
Information  Society  and  Media  DG  consists  of  representatives  of  Member  States  responsible  for 
eHealth at national level in both Ministries of Health and Ministries of Industry and/or Innovation. 

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implementation and management of the Public Health Programme and of the eHealth 
Action Plan.  

As  for  rare  diseases,  a  European  Conference  was  organized  in  Luxembourg  to 
reinforce  partnerships,  share  experiences  and  discuss  existing  bottlenecks  and 
possible solutions. Another highlight was the start of the Task Force on chronic and 
major diseases.  

Continued  progress  was  made  in  developing  health  indicators  for  comparable  data 
collection  among  EU  Member  States.  A  short  list  of  health  indicators  is  now 
available on-line and a long-list is in development. 

4.2. 

Health threats 

4.2.1.  Generic Preparedness Planning 

The Communication on EU generic preparedness planning for public health threats22 
presents  a  foundation  on  which  Member  States  can  build  their  own  generic  or 
specific plans, laying down the main elements that need to be addressed in planning 
for both disease-specific and general public health emergencies.  

The strategy aims to provide the backbone for developing core elements addressing 
generically different types of health threats. It should also lead to the establishment 
and improvement of the inter-operability of national plans, mainly by the creation of 
co-ordination  mechanisms  and  analysis  and  communication  tools  that  enhance  co-
operation between key Member States and Commission players.  

A number of issues are of particular importance. Firstly, Member States should share 
and  compare  national  plans  to  ensure  their  effectiveness  and  interoperability. 
Secondly, national plans need to take into account EU legislation in different sectors, 
as well as EU-level mechanisms for public health crisis. Finally, generic health threat 
preparedness  must  extend  beyond  the  health  sector  to  include  e.g.  civil  protection, 
transport,  communications,  emergency  services,  investment  in  laboratories,  and 
international relations. 

4.2.2. 

Influenza pandemic preparedness 

The Communication on influenza pandemic preparedness planning23 takes account of 
recommendations issued by the WHO and the establishment of the European Centre 
for Disease Prevention and Control (ECDC). 

towards 

important  step 

An 
this  Community  pandemic 
implementation  of 
preparedness plan has been taken by the constitution of a Public Health Preparedness 
and Response Planning Group to advise the Public health programme on actions to 
be taken in the event of an imminent pandemic threat.  

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COM(2005)  605  final  of  28.11.2005,  http://eur-lex.europa.eu/LexUriServ/site/en/com/2005/com2005 
_0605en01.pdf; 
COM(2005)  607  final  of  28.11.2005,  http://eur-lex.europa.eu/LexUriServ/site/en/com/2005/com2005 
_0607en01.pdf. 

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The  Programme  is  closely  collaborating  with  the  WHO  and  the  ECDC  to  improve 
influenza  pandemic  preparedness  at  EU  level.  Several  joint  meetings  with  WHO 
have been held to discuss national preparedness plans for influenza pandemics and to 
determine  the  stage  of  pandemic  planning  in  Europe,  exchange  best  practice  and 
discuss the main components of national planning. National Pandemic Preparedness 
Plans  have  been  established  and  are  already  in  place  in  all  Member  States.  The 
Commission  also  worked  with  the  Health  Security  Committee  and  the  European 
Vaccine Manufacturers to ensure sufficient supply of influenza vaccines in the EU in 
the shortest possible time in case of a pandemic. 

4.2.3.  Preparedness and response exercises 

Two  preparedness  and  response  exercises  were  organized  to  test  and  assess  the 
reaction capacity of the EU and Member States in the cases of a bio-terrorist attack 
and  an  influenza  pandemic.  The  specific  reports  issued  from  the  assessment  of  the 
communication  mechanisms  and  the  national  measures  have  been  published24  and 
constitute the basis for further improvements.  

4.3. 

Health determinants 

The  main  aims  in  2005  were  to  promote  and  stimulate  countries’  efforts;  and  to 
provide input into the assessment and preparation of Community policies, strategies 
and  measures.  The  work  plan  therefore  prioritised  actions  linked  to  nutrition  and 
alcohol,  tobacco  and  drugs,  AIDS;  health  inequalities  and  wider  socio-economic 
determinants;  as  well  as  in  areas  not  fully  covered  previously  such  as  genetic 
determinants and physical activity. Approaches to integrate a number environmental 
and socio-economic considerations and to target specific groups, in particular young 
people, were also prioritised. 

Council presidency initiatives were supported through two conferences. The Summit 
“Health Inequalities, Governing for Health” which took place in October as part of 
the  United  Kingdom  Presidency  and  a  conference  on  the  prevention  of  type  2 
Diabetes to take place during the Austrian Presidency in 2006. Two state of the art 
reports  on  health  inequalities  which  were  produced  for  the  UK  summit  have  been 
published on Europa25. 

Nutrition  and  physical  activity  actions  included  a  European  weight  disorder 
initiative,  a  campaign  for  the  improvement  of  lifestyle  related  workplace  health 
promotion,  support  for  a  network  on  physical  activity  and  ageing,  and  a  European 
schools network addressing childhood obesity. 

Important  new  activities  on  alcohol  were  supported  in  view  of  the  development  of 
the forthcoming Commission Communication on alcohol and health. These included 
activities  covering  drink  driving  in  young  people  focussing  on  the  role  of  peer 
education  and  covering  actions  such  as  health  warnings  and  labelling  of  alcoholic 

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Bio-terrorism (New Watchman exercise) 
http://ec.europa.eu/comm/health/ph_threats/com/watchman.pdf ;  
Influenza (Common Ground exercise) http://ec.europa.eu/comm/health/ph_threats/com/common.pdf;  
http://ec.europa.eu/health/ph_determinants/socio_economics/keydo_socioeco_en.htm  

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drinks  and  server  training.  Another  alcohol  related  project  is  supporting  the 
dissemination of good practice on the use of brief interventions in primary care. 

The European Network of Quitlines is developing additional good practice regarding 
tobacco cessation, including use of the internet. 

A secretariat for the European Commission Mental Health Working Party has been 
established  to  assist  work  taking  forward  the  Green  paper  on  Mental  Health. 
Community  action  programmes  on  depression,  and  child  and  adolescent  mental 
health  are  also  being  set  up.  Several  actions  addressed  drug  prevention,  harm 
reduction and access to drug treatment. European Partners in Action on AIDS aims 
to strengthen European non-governmental organisations and increase their capacities 
for concerted actions in the fight against HIV.  

Work  on  public  health  genetics  is  being  taken  forward  through  networking  and 
information exchange. An inventory of public health genetic issues is being created. 
A review is being carried out of current national practices in applying genetic testing. 

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