Opinion of the European Economic and Social Committee on the ‘Proposal for a Decision of the European Parliament and of the Council on serious cross-border threats to health’ COM(2011) 866 final — 2011/0421 (COD)
Date: 2012-03-28
Institutions: European Economic and Social Committee
Subjects: cross-border cooperation, disease prevention, epidemiology, health control, health risk, infectious disease








C_2012181EN.01016001.xml










21.6.2012   


EN


Official Journal of the European Union


C 181/160





Opinion of the European Economic and Social Committee on the ‘Proposal for a Decision of the European Parliament and of the Council on serious cross-border threats to health’
COM(2011) 866 final — 2011/0421 (COD)
2012/C 181/28
Rapporteur (no study group): Ms OUIN

The Council and the European Parliament decided, on 19 and 17 January 2012 respectively, to consult the European Economic and Social Committee under Article 304 of the Treaty on the Functioning of the European Union, on the

Proposal for a Decision of the European Parliament and of the Council on serious cross-border threats to health

COM(2011) 866 final — 2011/0421 (COD).
The Section for Employment, Social Affairs and Citizenship, which was responsible for preparing the Committee’s work on the subject, adopted its opinion on 29 February 2012.
At its 479th plenary session, held on 28 and 29 March 2012 (meeting of 28 March), the European Economic and Social Committee adopted the following opinion by 149 votes to 2 with 4 abstentions.
1.   Conclusions and recommendations

1.1   The European Economic and Social Committee supports the proposal for a decision on serious cross-border threats to health.
1.2   It welcomes the approach adopted, which takes the successful system for communicable diseases (1) and an analysis of recent crises as a basis for remedying the shortcomings of the current mechanism, as allowed for by the Lisbon treaty.
1.3   Europe-wide coordination that cuts across sectoral boundaries will be needed in order to more effectively counter risks that do not stop at borders.
1.4   Nonetheless, the Committee stresses that all elements of civil society must be involved both in planning to ensure preparedness for crisis situations, and in communication should a crisis occur. An approach that limits coordination to healthcare professionals and civil protection experts is no longer in keeping with the way society now operates, with the media having a significant role in disseminating information to the public.
2.   The background

2.1   The great plague, cholera and flu epidemics of previous centuries have remained in the collective memory as scourges that seemed able to decimate the population within a matter of weeks.
2.2   20th century Europeans thought they had seen the last of these risks with the arrival of modern medicine: states set up public health systems (compulsory vaccinations, health monitoring) to protect the public, and Europe developed effective legislation and networks to combat communicable diseases. The system works well with respect to known viruses that were identified a long time ago, but has proved less effective against new diseases such as AIDS or SARS (2).
2.3   Other threats have emerged that could also put the populations of entire regions at risk. The widespread mobility of people, food, products etc. has produced new weaknesses: viruses that were previously restricted to local areas can now travel very quickly, and may be dangerous in regions where they are unknown.
2.4   The discovery and mass production of new chemical products have made it possible to treat diseases, improve agricultural yields, facilitate construction and travel, make better-quality products available, and speed up and expand all forms of communication, but they also have a downside: people now live in a ‘chemical soup’ of pollutants of all kinds in the air, in water and in food.
2.5   Rivers, rain, wind and viruses know no borders. If there is any domain that absolutely must be organised at European level, it is public health protection.
2.6   The consequences of industrial mass production include global warming and its myriad repercussions, but they also include industrial accidents, new viruses, etc. Health protection can no longer focus solely on communicable diseases or on public health monitoring.
2.7   In an interdependent society, health risks may come from anywhere: health crises may start with industrial pollution, a veterinary epidemic or a natural disaster. It is therefore not only geographical boundaries that need to be removed, but also sectoral ones.
2.8   There is already an effective global instrument for dealing with communicable diseases, run by the World Health Organization (3).
2.9   The EU is not starting from scratch: it, too, has a well-established, effective system for communicable diseases. The H1N1 flu pandemic, however, revealed shortcomings with regard to the purchase of vaccines that could not be developed until the new virus had emerged. Industrial production of the vaccine and negotiations on the price thereof led to differences in European countries’ attitudes to vaccination, which could have had serious consequences in terms of propagation of the virus, had it been more virulent.
2.10   In the wake of the attacks on 11 September 2001, and the delivery in the United States of letters and parcels containing anthrax spores, a Health Security Committee (4) was set up at EU level. It covers risks other than communicable diseases, but has not been placed on an institutional footing and therefore cannot take policy decisions should the need arise.
3.   Improving the existing system

3.1   The proposal in question therefore remedies the current shortcomings on the basis of the Lisbon treaty (5), which establishes new competences in this field, and based on an analysis of the problems encountered during recent health crises.
3.2   There have been many such crises, including mad cow disease, the H1N1 pandemic, E. coli/STEC O104 bacteria, chlorine attacks in Iraq, melamine contamination, toxic red mud, oil spills and ash clouds. Each crisis reveals the weaknesses in the current system and suggests improvements. The proposed decision aims to create a consistent framework, based on the existing system, and to improve national and sectoral cooperation.
3.3   The proposal does not deal with the issue of radiological and nuclear risks, which are already covered by other European legislation.
3.4   Current EU legislation relates only to threats connected with communicable diseases (6). The network for the epidemiological surveillance and control of communicable diseases, which issues warnings and coordinates responses at European level, does not meet current standards or needs. The intention is therefore for it to be replaced by the provisions set out in the proposed decision.
3.5   Strengthening the existing system by expanding it to cover other risks will make it more effective without entailing significant additional costs.
3.6   The Committee supports the objectives of the proposal:






—


in the area of preparedness planning, coordinating the efforts of the Member States in terms of improved preparedness and capacity building. ‘To this end, the Commission will ensure coordination between national planning and between key sectors such as transport, energy and civil protection, and will support Member States in setting up a joint procurement mechanism for medical countermeasures.’










—


an ad hoc network will be set up in situations where a Member State has raised an alert on a serious threat other than a communicable disease, in order to provide the relevant information and data for risk assessment and monitoring of emerging threats. Communicable diseases will continue to be monitored as they are today.










—


the use of the existing Early Warning and Response System will be expanded to cover all serious threats to health, and not only communicable diseases.










—


coordinated development of national or European public health risk assessments for threats of biological, chemical, environmental or unknown origin in a crisis situation.










—


finally, the Decision sets up a coherent framework for the EU response to a public health crisis. In concrete terms, by formalising the existing Health Security Committee, the EU will be in a better position to coordinate national crisis responses in a public health emergency.




3.7   The stated aims of this proposal are to improve coordination and effectiveness, allow for European-level procurement to negotiate prices with pharmaceutical laboratories, thus providing protection for all Europeans, establish a warning system at European rather than just international (WHO) level, and expand existing instruments to cover chemical, bacteriological, environmental risks etc. The Committee is, of course, completely in favour of this.
3.8   Measures that will help make the existing system work better without adding new mechanisms that might make it cumbersome include: assessing risks with a European network of specialists; agreeing on the severity of a threat in order to determine the appropriate response and decide jointly on the messages to issue; exchanging sensitive information in compliance with the rules (in particular those relating to the processing of personal data), both with comparable data between Member States and with neighbouring countries; and drafting joint travel advisories.
4.   Taking account of current developments

4.1   The EESC would nonetheless draw the attention of European and national public authorities to the course of events during recent crises.
4.2   In the case of both the H1N1 flu pandemic and the E. coli/STEC O104 bacteria outbreak, it was clear that the public authorities were not the only ones disseminating information and that some of the public put more trust in unverified information circulating on the Internet. This information overload could complicate matters for handling a crisis and have a serious impact both on public health and on entire economic sectors, for example if some doctors were to be critical of vaccines or if incorrect information were to be spread regarding the origin of the bacteria.
4.3   Poor dissemination of information may lead to huge waste and may reduce the effectiveness of the mechanisms in place. As much importance must be attached to educational aspects as to economic considerations.
4.4   The Committee therefore recommends that all elements of civil society be involved in crisis mechanisms, as conduits for information. It also recommends that awareness-raising campaigns be carried out in schools and workplaces, at a time when no crisis is actually occurring, to explain to the European public how they are being protected, how the monitoring and alert systems work, and whom to believe in the event of a crisis, i.e. who is qualified to provide reliable information.
4.5   Communication has become a major challenge during public health crises, and is just as important as having adequate supplies of vaccines: there is no point having a good vaccine if the public do not believe that they need to be vaccinated.
4.6   Calling on people to take responsibility will only be worthwhile if they actually have the means to exercise that responsibility. They therefore need to be informed and educated in advance about existing systems and the role that each individual can play. The public can make a contribution to and be real players in common protection, but they can also make matters worse if they are not properly informed and made aware of their responsibilities. The public authorities must, in the general interest, ensure that all organisations concerned with public welfare are involved in protecting everyone, by promoting appropriate information sharing.

Brussels, 28 March 2012.


The President of the European Economic and Social Committee

Staffan NILSSON




(1)  Decision No 2119/98/EC of the European Parliament and of the Council of 24 September 1998 setting up a network for the epidemiological surveillance and control of communicable diseases in the Community (OJ L 268, 3.10.1998, p. 1).

(2)  Severe Acute Respiratory Syndrome.

(3)  International Health Regulations (IHR): http://www.who.int/ihr/en/

(4)  See the Presidency conclusions of 15 November 2001 on bioterrorism (13826/01) and the Council conclusions of 22 February 2007 temporarily prolonging and extending the mandate of the Health Security Committee (6226/07).

(5)  Article 6(a) and Article 168(1) of the Treaty on the Functioning of the European Union.

(6)  Decision No 2119/98/EC of the European Parliament and of the Council of 24 September 1998 setting up a network for the epidemiological surveillance and control of communicable diseases in the Community (OJ L 268, 3.10.1998, p. 1).