Public health : improving health for all EU citizens.
Date: 2014-02-10
Institutions: Directorate-General for Communication
Subjects: AIDS, European Union, chronic illness, health care, health legislation, health policy, infectious disease, public awareness campaign, public health

T H E   E U R O P E A N  
U N I O N  
E X P L A I N E D

Public health

Improving 
health for all 
EU citizens

‘T he   EU   wo rk s  t o   pro t ec t   
an d  im p r ove t he   healt h   
o f  al l   Eu ro p eans   thr o ug ho ut   
t heir   l ives ’

CONTENTS 

Why we need  
a public health policy  .  .  .  .  .  .  .  .  .  .  .  . .

 3

How the EU goes about it .  .  .  .  .  .  .  .  . .  5

THE EUROPEAN UNION 
EXPLAINED

What the EU does  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . .

 6

Outlook  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . 15

Find out more  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . 16

This publication is a part of a series that explains  
what the EU does in different policy areas,  
why the EU is involved and what the results are.

You can see online which ones are available  
and download them at:
http://europa.eu/pol/index_en.htm

How the EU works
Europe 2020: Europe’s growth strategy
The founding fathers of the EU

Agriculture
Borders and security
Budget
Climate action
Competition
Consumers
Culture and audiovisual
Customs
Development and cooperation
Digital agenda
Economic and monetary union and the euro
Education, training, youth and sport
Employment and social affairs
Energy
Enlargement
Enterprise
Environment
Fight against fraud
Fisheries and maritime affairs 
Food safety
Foreign affairs and security policy
Humanitarian aid and civil protection
Internal market
Justice, citizenship, fundamental rights
Migration and asylum

Public health 

Regional policy
Research and innovation
Taxation
Trade
Transport

The EU explained: Public health

European Commission
Directorate-General for Communication
Publications
1049 Brussels
BELGIUM

Manuscript updated in February 2014

Cover and page 2 picture: © BananaStock/Jupiterimages

16 pp. — 21 × 29.7 cm
ISBN 978-92-79-35689-6 
doi:10.2775/15123

Luxembourg: Publications Office of the European Union, 
2014

© European Union, 2014
Reproduction is authorised. For any use or reproduction 
of individual photos, permission must be sought directly 
from the copyright holders.

Why we need a public health policy

3

Citizens’ health is a core EU priority. EU health policy 
complements national policies to ensure that everyone 
living in the EU has access to quality healthcare.

The main objectives of EU health policy are to:

•  prevent disease,

•  promote healthier lifestyles,

•  promote well-being,

•  protect people from serious cross-border threats to 

health,

•  improve access to healthcare,

•  promote health information and education,

•  improve patient safety,

•  support dynamic health systems and new 

technologies,

•  set high quality and safety standards for organs and 

other substances of human origin,

•  ensure high quality, safety and efficacy for medicinal 

products and devices for medical use.

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The EU seeks to improve the quality of healthcare for all its 
citizens.

While the organisation and delivery of healthcare is the 
responsibility of individual countries, the EU brings 
added value in helping countries achieve common 
objectives. EU health policy generates economies of 
scale by pooling resources, and helps countries to tackle 
the common challenges, including health threats such 
as pandemics, the risk factors associated with chronic 
diseases or the impact of increased life expectancy on 
healthcare systems.

Key challenges

To achieve a high level of human health and quality of 
healthcare across the EU, a significant number of 
challenges must be overcome, including those listed 
below.

•  Sustainability: Healthcare systems must adapt to 
demographic changes and a growing demand for 
care, and make the best use of innovative health 
technologies. Health system reforms must guarantee 
universal access to high-quality care and improve the 
efficiency and financial sustainability of the health 
systems.

•  An ageing population: EU citizens are living longer 
— often well beyond the retirement age — but the 
average age to which they enjoy good health remains 
the same. This places pressure on society and the 
economy, as well as healthcare systems. The 
incidence of certain diseases, for example Alzheimer’s 
and dementia, is also increasing as the population 
gets older. The EU seeks to increase the number of 
healthy life years by two by 2020 to help Europeans 
remain active and productive for as long as possible.

•  Reducing the incidence of preventable diseases: 
Cancer, heart disease, diabetes, respiratory, mental 
and other chronic diseases represent great suffering 
to citizens and come at a huge cost to society and the 
economy. It is estimated that they will cost the global 
economy around €22.5 trillion between 2012 and 
2030. In the EU, the cost of diseases linked to 
smoking alone totals over €100 billion. Chronic 
diseases are responsible for 87 % of all deaths in the 
EU. Many cases of chronic diseases are preventable 
and linked to four common risk factors — tobacco, 
harmful use of alcohol, nutrition and lack of physical 
activity.

PUBLIC HEALTH 
 
 
4

•  Health inequalities: Huge differences in health and 

healthcare exist between and within EU countries and 
regions. The level of disease and the age at which 
people die are strongly influenced by factors such as 
employment, income, education and ethnicity, as well 
as access to healthcare. For example, life expectancy 
at birth varies by 10 years between EU countries.

•  New and emerging health problems: New diseases, 
or strains of diseases, are being identified all the 
time. AIDS, for example, was first clinically observed 
in 1981, the corresponding virus, HIV, was identified 
in 1983; in 2009, a new type of pandemic influenza 
— H1N1 — was identified. Some bacteria have 
become resistant to the drugs used to treat them. 

This has made it harder to treat specific infections 
with certain antibiotics. Mental health problems are 
another disease group where the number of 
diagnoses has increased significantly.

•  Health security: serious cross-border health threats 
— including biological agents and infectious disease, 
chemical agents and environmental hazards — pose 
a great threat to health and international travel and 
trade. The 2011 E. coli outbreak and the 2009 global 
H1N1 flu pandemic are recent examples that 
demonstrate the importance of being able to tackle 
health threats at a multinational level.

EU health trends

Good news

 — Increased life expectancy: on average, 
life expectancy in the EU increased 
from 65 years in the 1950s, to 80 
years by 2010. 

 — Drop in infant mortality: there was a 

cumulative reduction in infant mortality 
of over 80 % between 1975 and 2010. 

 — Better treatment of life-threatening 
conditions such as heart attacks, 
strokes and cancer: mortality rates 
following hospital admission for a heart 
attack fell by 50 % between 2000 and 
2009. 

 — Increase in the survival rates for 

different types of cancer, including 
colorectal and breast, thanks to earlier 
detection and better treatment. 

 — Increase in the number of doctors per 
capita: from 2.9 per 1 000 population 
in 2000 to 3.4 in 2010.

Bad news:

 — Inequality: life expectancy still varies by 
around 9 years between EU countries. 

 — Increase in cancer deaths: since 1985, 
EU cancer deaths have increased by 
12 % for men and by 9 % for women. 

 — Increase in diabetes: according to the 
International Diabetes Federation, 35 
million adults were living with diabetes 
(both type 1 and type 2) in Europe in 
2011. This is expected to increase by 
23 %, to 43 million, in 2030. 

 — Increase in Alzheimer’s cases: the 
likelihood of developing dementia in 
people aged 65+ roughly doubles every 
5 years in Europe. 

 — The EU’s healthcare bill for chronic 
disease: €700 billion, or 70–80 % of 
healthcare costs.

Sources: Eurostat and Organisation for Economic Cooperation 
and Development.

THE EUROPEAN UNION EXPLAINED5

How the EU goes about it

The scope for EU action in health policy is set in Article 
168 of the Treaty on the Functioning of the European 
Union. The overriding principle is that human health is 
well protected and accounted for in the development of 
all EU policies and activities.

The Treaty also makes clear that the EU shall fully 
respect the responsibility of individual Member States 
to define their health policies and organise and deliver 
their health services and medical care, including any 
resources assigned to them.

The EU mostly complements and supports the work that 
goes on in individual EU countries on issues where 
coordination, cooperation and exchange of information, 
knowledge and best practice is the best way forward. It 
also uses legislative instruments to regulate certain 
areas.

In 2007, the EU adopted its ‘Health strategy’.

It is based on four key principles:

These principles and objectives support the goals of the 
Europe 2020 strategy for smart and sustainable 
growth: targeted investment in health boosts 
productivity and innovation, creates new skills, helps 
reduce inequalities and contributes to more sustainable 
health systems.

In February 2013, the European Commission adopted a 
package entitled ‘Social investments for growth and 
cohesion’. One part of this package is dedicated to 
investments in health. The main message is that health 
is a value in itself, and also a key to economic 
prosperity. The document emphasises that smart 
investments for sustainable health systems, investing in 
people’s health as human capital, and investing in 
reducing inequalities in health can contribute to 
economic growth. The EU will support reforms through 
the European semester process and through its funding 
instruments, i.e. ‘Structural Funds and health 
programme’.

•  Europeans have shared health values;

EU financial support

•  health is the greatest wealth;

•  considerations about health must be included in all 

policies;

•  the EU’s voice must be heard on all issues affecting 

global health;

The EU’s current health programme runs from 2008 to 
2013 (a third multiannual EU health programme will 
begin in 2014 and run to 2020). Its objectives are: to 
improve citizens’ health security, to promote health and 
to generate and disseminate health information and 
knowledge. All 28 EU countries plus Iceland, 
Liechtenstein and Norway participate in the programme.

It identified three key objectives:

•  fostering good health in an ageing Europe;

•  protecting citizens from health threats;

•  supporting dynamic health systems and new 

technologies.

The total budget of the 2008–13 programme is €321.5 
million, which so far has been used to fund more than 
120 different actions.

Since 2003, the EU health programme has provided 
funding for a total of 673 individual projects and 
operating grants, supporting a range of initiatives.
Other sources of EU financial support, e.g. Structural 
Funds and the research framework programmes, also 
contribute to health priorities.

PUBLIC HEALTH6

What the EU does

Access to healthcare in all EU countries

Did you know?

If you fall ill unexpectedly during a trip to another EU 
country and need to visit a doctor, there’s no need to 
cut short your visit to return home for treatment. Take 
your European Health Insurance Card with you to a local 
doctor.

The European Health Insurance Card makes it easier 
for you to claim this right to healthcare in other EU 
countries and Iceland, Liechtenstein, Norway and 
Switzerland. It is issued free of charge by your national 
health insurance provider and gives you access to 
unplanned medically necessary, state-provided 
healthcare during a temporary stay in any of the 
partner countries. The card can either feature on the 
reverse of a national health card or be entirely 
separate.

20 million Europeans received medical 
treatment in another EU country in 2010.

Fighting serious cross-border threats to 
health

As the world becomes increasingly interconnected, 
biological, chemical or environmental health threats 
pose a greater risk than ever to health and international 
travel and trade. Various cross-border health 
emergencies, including the 2009 H1N1 pandemic, the 
volcanic ash cloud in 2010 and the E. coli outbreak in 
2011, have highlighted the importance of a coordinated 
EU response.

Separate legislation on cross-border healthcare gives 
you:

EU action is largely linked to improving cooperation and 
coordination between national governments. This is 
achieved through:

•  access to information on your right to receive 

healthcare anywhere in the EU, and on the quality 
and safety of the care you will receive;

•  the right to be reimbursed some or all costs for any 

treatment you receive in another EU country to which 
you would have been entitled at home;

•  the possibility to process your prescriptions abroad so 
that you can obtain abroad the medication you need.

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The European Health Insurance Card gives you access to 
medical treatment and care across Europe.

•  EU alert systems: If an EU country detects a threat 

to citizens’ health and safety, it notifies the European 
Commission through one of the EU’s rapid alert 
systems. These ensure that information is transmitted 
EU-wide, quickly and that there is a rapid response. 
The Early Warning and Response System (EWRS) and 
the Rapid Alert System for Food and Feed (RASFF), for 
example, were triggered in 2011 in response to the 
E. coli outbreak in Germany and the Fukushima 
nuclear disaster in Japan.

•  EU Health Security Committee (HSC): This 

committee coordinates health security measures, 
preparation and planning and the response to an 
emergency. It is made up of representatives from all 
EU countries.

•  European Centre for Disease Prevention and 

Control (ECDC): The centre aims to strengthen the 
EU’s defences against infectious diseases such as 
influenza, tuberculosis and HIV/AIDS. It works with 
national health authorities across the EU to identify, 
assess and communicate current and emerging 
health threats.

THE EUROPEAN UNION EXPLAINED 
 
 
7

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The E. coli bacterium: an 
outbreak in 2011 triggered 
the EU’s Rapid Alert System 
which helped authorities in 
other EU countries to combat 
the risk efficiently.

•  EU-wide research networks: Specific projects linked 
to serious cross-border threats to health have also 
been awarded EU funding. These include an Alerting 
System for Chemical Health Threats (ASHT II) which 

  has brought together poison centres in different EU 

countries to improve the response to potential 
cross-border chemical threats to health.

What happens in an EU health crisis?  
The case of E. coli …

Between May and July 2011, an outbreak 
of illness caused by a harmful strain of 
E. coli — a common and normally non-
harmful bacterium found in the digestive 
systems of humans and animals — left 55 
people dead, 850 seriously ill and a further 
3 000 unwell in the EU. This is how the EU 
responded.

▼

German authorities notified the European 
Commission of the outbreak.

▼

EU-wide alert systems and response 
networks were activated.

▼

Scientists quickly identified the strain of 
E. coli responsible for the outbreak.

▼

The European Commission held daily 
meetings with national public health and 
food safety authorities to monitor the 
outbreak and coordinate responses, and 
posted daily updates on its website to keep 
citizens informed.

▼

Having identified the source of the 
outbreak — fenugreek seeds used for 
sprouting imported from Egypt — the EU 
ordered the destruction of all fenugreek 
seeds imported from one exporter and a 
temporary ban on imports of other risky 
products.

▼

The EU started work with national 
authorities, the European Food Safety 
Authority (EFSA) and the European Centre 
for Disease Prevention and Control (ECDC) 
to identify areas for further cooperation, 
improvement and preventative action.

PUBLIC HEALTH 
 
 
Protecting you from resistant bacteria

Did you know?

8

 — Around 40 % of Europeans used 

antibiotics in 2009.

 — One in two patients wrongly believes 
that antibiotics are effective against 
viruses.

 — Every year, about 4.1 million people in 
the EU acquire an infection whilst 
receiving healthcare, often caused by 
resistant bacteria.

Strengthening the quality, safety and 
efficacy of medicines

The EU has clear rules in place for the authorisation and 
distribution of medicinal products. Before medicines can 
be sold, they must either be authorised by the individual 
EU Member State or be available for sale throughout 
the EU. The latter is ensured by the European Medicines 
Agency, based in London, and the European 
Commission. This ensures patients are treated with 
medicines that are in compliance with strict standards 
on quality, safety and efficacy. These rules contributed 
to ensuring a high level of patient safety while giving 
them access to medicines of their choice, including 
innovative medicinal products, and products for rare 
conditions (‘orphan medicinal products’) and for 
paediatric use.

Antimicrobial agents — such as antibiotics — are 
substances that kill or reduce the growth of micro-
organisms including bacteria, fungi and parasites. They 
are an essential tool in modern medicine and have 
dramatically reduced the number of deaths from 
infectious diseases since they were introduced 70 years 
ago. These drugs have been used so widely and 
inappropriately, however, that some of the organisms 
they target have become resistant to them. It is 
estimated that this resistance results in 25 000 deaths 
per year and €1.5 billion in additional healthcare costs 
and productivity loss.

Since this problem was first recognised in the 1990s, 
the EU’s health programme has supported various 
projects and research into antimicrobial resistance 
(AMR). For example, a study launched in 2009 focused 
on antimicrobial resistance and the prescription of 
antibiotics in children. The EU also monitors AMR on an 
ongoing basis with the support of the ECDC and EFSA.

In 2011, the European Commission launched an action 
plan to help tackle the rising threats from antimicrobial 
resistance. It identifies seven areas for future action:

•  the appropriate use of antimicrobials in humans and 

animals;

•  prevention of microbial infections and their spread;

•  development of new, effective antimicrobials or 

alternatives for treatment;

•  international cooperation to contain the risks of 

resistance;

•  better monitoring and surveillance of antimicrobial 

use;

•  research and innovation;

•  better communication, education and training.

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EU rules ensure that patients are treated with medicines that 
comply with strict standards on quality, safety and efficacy.

THE EUROPEAN UNION EXPLAINED 
 
 
Once a medicinal product has been authorised in the 
Union and placed on the market, its safety is monitored 
during its entire lifespan to ensure that in case of 
adverse reactions the appropriate action is taken 
swiftly, including additional warnings, restrictions of use 
or even withdrawal of the product. In order to further 
improve this control, the EU introduced a new symbol in 
the form of a black inverted triangle to identify 
medicines for which additional monitoring is considered 
necessary. As of September 2013, the new symbol will 
be printed on the package leaflet and the summary of 
product characteristics of the medicines concerned, 
along with information on how to report suspected side 
effects. This is particularly important as patients now 
have the right to report suspected side effects directly 
to their national authorities.

A cornerstone of the legislation is the supervision of all 
steps in the medicines distribution system, from 
manufacturing to distribution including specific rules for 
the sale of medicines over the Internet.

To protect patients from the risks associated with 
unauthorised ‘fake’ or ‘falsified’ medicines, the EU has 
introduced strict rules which became applicable at the 
beginning of 2013. These include:

•  rules for imports of active substances from third 

countries, controls and inspections;

•  rules for record-keeping by wholesale distributors;

•  rules on inspections; and

•  the obligation for manufacturers and distributors to 

report any suspicion of falsified medicines.

The sale of falsified medicines over the Internet is also 
addressed. By the end of 2013 the EU plans to define a 
common logo that will help to identify legally operating 
online pharmacies/retailers of medicines. This logo will 
become obligatory by the end of 2014.

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As more people turn to the Internet to buy medicine, the EU is 
helping to identify online pharmacies operating within the law.

Ensuring the safety and quality of 
donated blood, tissue, cells and organs

Donated blood, tissues, cells and organs are essential in 
the treatment of a number of serious and life-
threatening medical conditions including cancer and 
heart problems. In 2011 alone, there were 30 000 
organ transplants in the EU, many of them carried out 
in a different EU country to the organ’s origin.

To guarantee quality and patient safety, the EU has 
developed common rules and procedures that apply 
across the EU to ensure that all donated human 
material is of high quality and carefully screened to 
prevent the transmission of disease, for example HIV or 
hepatitis. This ensures that patients in all EU countries 
have the same high level of protection and guarantees 
cooperation between countries in case of shortages.

There are also strict EU rules regarding the donation, 
procurement and traceability procedures of donated 
human substances. Donation must be voluntary and 
unpaid and donated organs must be traceable. EU rules 
also require national authorities to exchange and store 
information on cross-border organ exchanges and to 
provide a 24/7 service in case of serious or adverse 
reactions or events.

PUBLIC HEALTH 
 
 
As demand for these treatments increases, the EU is 
taking steps to encourage voluntary organ donation. 
Around half of the EU Member States report regular 
shortages and there are currently around 50 000 
patients in the EU on an organ transplant waiting list, 
12 of whom will die, each day, while waiting for an 
organ. An important element of the EU’s action plan on 
organ donation and transplantation is the appointment 
of hospital transplant donor coordinators to develop 
proactive donor detection programmes. Studies have 
shown this is one effective way of facilitating the organ 
donation process.

The EU also funds projects linked to blood, cell, tissue 
and organ donation. Recent examples include the 
setting-up of ‘Efretos’, a new pan-European registry of 
the evaluation of organ transplants.

Did you know?

37 % of the Europeans participating in a 
Eurobarometer survey of 2010 had given 
blood at least once in their life.

10

Did you know?

 — The Orphanet database defines 5 958 

rare diseases;

 — Between 6 and 8 % (27–36 million 

citizens) of the (EU-27) population in all 
the EU countries are, or will be, affected 
by a rare disease during their lifetime.

Tackling the risk factors of chronic 
disease

The onset and development of many chronic diseases 
are influenced by common risk factors such as smoking, 
harmful alcohol consumption, an unhealthy diet and a 
lack of exercise. They can often be prevented by making 
certain lifestyle changes. The EU is tackling this problem 
from multiple angles, for example via public information 
campaigns, encouraging action by relevant industries 
and NGOs, supporting individual country initiatives and 
through specific, targeted support, for example to help 
people give up smoking.

Tackling rare diseases

Helping to reduce tobacco smoking 

Rare diseases are life-threatening or chronically 
debilitating diseases which affect fewer than 1 in  
2 000 people. While the number of people suffering 
from an individual disease may be small, overall, 
between 27 million and 36 million Europeans suffer 
from a rare disease. The impact of such diseases on 
sufferers, their families and carers is substantial and 
patients often go undiagnosed due to a lack of scientific 
and medical knowledge or to difficult access to medical 
expertise.

The EU supports research into rare diseases to help 
improve rates of diagnosis. It also offers a number of 
incentives to pharmaceutical companies (10-year 
market exclusivity, for example) to encourage research, 
development and marketing of new ‘orphan’ drugs 
which could be used to diagnose, prevent or treat rare 
diseases. Without such incentives, the costs of 
developing these drugs would not be covered by sales.

The EU also supports the distribution of information on 
rare diseases, including through Orphanet — a database 
of rare diseases — and the alliance of patients’ 
organisations, Eurordis, (European Organisation for Rare 
Diseases) which brings together over 350 rare disease 
organisations from across the EU.

Smoking is the single largest cause of avoidable death 
in the EU and accounts for around 700 000 deaths each 
year. Despite this, one third of EU citizens smoke 
regularly.

Over the years, the EU has adopted various rules to 
help reduce the number of smokers in the EU and the 
costs associated with smoking. They include compulsory 
warning labels on all tobacco products about what 
tobacco smoking does to people’s health: for example 
‘Smoking kills’, ‘Smoking causes fatal lung cancer’, 
‘Smoking causes heart attacks and strokes’ and 
‘Smoking when pregnant harms your baby’. 

Towards a smoke-free life.

THE EUROPEAN UNION EXPLAINED 
 
The EU also promotes the use of graphic images and 
photographs on cigarette packages to reinforce the 
message that smoking can seriously damage your 
health.

In addition, EU law prohibits tobacco advertising in all 
print media, radio and Internet in the EU. Tobacco 
sponsorship at international events and sports activities 
is also banned.

In 2005, the EU launched ‘HELP — for a life without 
tobacco’, a multimedia campaign targeted at 15- to 
25-year-olds to raise awareness about the risks 
associated with smoking. The campaign was screened 
on almost 100 TV channels.

In 2011, the EU’s ‘Ex-smokers are unstoppable’ 
campaign was launched to promote the benefits of 
giving up smoking. FC Barcelona and the European 
Commission designed a free quit smoking programme 
that guides smokers step-by-step towards a  
smoke-free life.

At the centre of the campaign is iCoach, an innovative 
digital health platform. iCoach supports and motivates 
users to quit smoking and charts their progress through 
a personalised programme. Users have access to an 
extensive support network via social media sites such 
as Facebook and Twitter. 

By the end of 2012, almost 300 000 EU citizens had 
signed up to iCoach. The campaign also received the 
EURO EFFIE awards in 2012 for excellence in marketing 
communication.

Fighting obesity

It is estimated that over 200 million adults are 
overweight or obese in the EU — over half the adult 
population. One in four children are also overweight or 
obese. Obesity leads to serious physical and mental 
health problems including heart disease, diabetes, 
cancer and psychological disorders. It accounts for up to 
8 % of the EU’s healthcare costs. Since obesity is a 
complex problem, it is vital to pool a wide range of 
expertise at local, national and international level. 
Coordination at EU level is essential.

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The EU is working with organisations across Europe to tackle 
the problems associated with poor diet and obesity.

The EU Platform for Action on Diet, Physical Activity 
and Health, set up in 2005, brings together a wide 
range of European organisations committed to tackling 
poor nutrition and physical inactivity. To date, it has 
triggered 300 actions by key EU actors in industry and 
civil society, including a ban on advertising sugary 
drinks to children, better nutritional information in 
restaurants, the redesign of recipes to lower salt, sugar 
and fat levels, and the promotion of sport in schools.

In 2007, the EU established a High-Level Group on 
Nutrition and Physical Activity, which has brought 
together government representatives from all EU 
countries, Norway and Switzerland to work towards 
solutions for obesity-related health issues.

Other efforts include the introduction of EU-wide rules 
for food labelling . These mean that consumers in all 
EU countries can rely on food labels to give them 
accurate information on health and nutritional values. 
For example, if a food claims to be ‘good for your heart’, 
this must have been scientifically proven. Nutrition 
labels must also include clear details on the level of 
energy, fat, saturates, carbohydrates, salt and sugar.

Finally, a number of projects are supported by the EU’s 
health programme and the research framework 
programme to reduce and prevent obesity. Between 
2007 and 2011, the EU helped to fund 27 projects 
related to diabetes and obesity at a total cost of €123 
million.

PUBLIC HEALTH 
 
 
12

Reducing the harm caused by alcohol

Harmful alcohol consumption is the third main cause of 
early death and illness in the EU, after tobacco and high 
blood pressure. It is responsible for an estimated 
195 000 deaths each year in the EU.

The EU works with national authorities (which are 
primarily responsible for national policies on alcohol), 
industry and other relevant parties to address harmful 
drinking and irresponsible marketing of alcoholic drinks.

Since 2006, the EU has promoted responsible drinking 
through the European strategy to reduce alcohol-
related harm . The strategy has five priorities:

•  protecting young people and children,

key stakeholders such as alcohol producers, advertisers 
and retailers, as well as health professionals, youth 
representatives and health NGOs. To date, the forum 
has generated 246 commitments by these members. In 
parallel, there is a Committee on National Alcohol Policy 
and Action, which enables EU countries to share 
information and promote best practice.

Tackling cancer

Cancer is a key health concern and puts a major burden 
on society. Around 2.5 million people are diagnosed with 
cancer in the EU each year. By working together with 
national authorities, the EU is able to share knowledge, 
capacity and expertise and tackle cancer in Europe more 
effectively.

•  preventing drink-driving,

The EU’s policies include:

•  reducing alcohol-related harm amongst adults,

•  Helping to prevent cancer by addressing its risk 

factors, in particular tobacco smoking.  

•  raising awareness of the impact of harmful and 

hazardous alcohol consumption on health,

•  Partnership: The European Partnership for Action 

•  collecting reliable data on alcohol consumption and 

the impact of policy measures.

It also encourages cooperation and coordination 
between EU countries to promote education and 
consumer information. The strategy includes actions 
across EU policies. For example, the EU’s action  
plan on road safety supports initiatives to tackle 
drink-driving.

In 2007, the EU set up an Alcohol and Health Forum, 
which aims to mobilise actors across society to commit 
to take action in support of the EU strategy. It includes 

Against Cancer (EPAAC) was launched in 2009 and 
brings together key players from across Europe. It has 
received over €3 million of EU funding and has a wide 
range of goals including health promotion, screening 
and early diagnosis, identification of best practice in 
cancer-related healthcare, and collection and analysis 
of cancer data. Its aim is to reduce the incidence of 
cancer by 15 % by 2020.

•  Screening: EU health ministers agreed on the 

principles of best practice for cancer screening and 
early cancer detection in 2003. Since then, the EU has 
also published guidelines on breast, cervical and 
colorectal cancer screening.

Regular screening for cancer 
is just one of the ways in 
which this disease can be 
tackled more effectively.

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THE EUROPEAN UNION EXPLAINED 
 
 
 
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•  Research: EU funding for cancer research since 2003 

Promoting healthy and active ageing

amounts to over €1.1 billion, contributing to 183 
projects.

•  The European Code Against Cancer: This is a list of 

recommendations, based on scientific evidence, which 
advises citizens on how to prevent cancer. It was first 
produced in 1987 and is currently being updated: a 
new version will be available at the end 2014.

Preventing AIDS and supporting those 
living with it

Over 50 000 people in the EU and its neighbouring 
countries are diagnosed with HIV/AIDS each year. While 
current treatments can slow down the development of 
AIDS and allow sufferers to live long and fulfilling lives, 
there is still no cure or vaccine.

Europeans are living longer, but the number of years 
they live in good health remains unchanged. On 
average, EU citizens spend 20 % of their lives in poor 
health which affects their quality of life and places 
significant pressures on national healthcare systems.

In 2011, the EU launched the European Innovation 
Partnership on Active and Healthy Ageing. It brings 
together researchers, health authorities, health 
professionals, businesses, regulators and patient 
organisations to examine new ways of reducing the 
pressure on healthcare and contributing to sustainable 
growth. The overall goal of the partnership is to 
increase healthy life by 2 years by 2020, enabling more 
people to enjoy life for longer.

Other EU initiatives include:

The EU’s policy, as set out in its 2009 communication 
‘Combating HIV/AIDS in the EU and neighbouring 
countries’, focuses on disease prevention and support 
for people living with HIV by improving access to 
prevention, treatment, care and social services. 
Particular efforts are aimed at high-risk groups and 
migrants from countries with a high prevalence of HIV.

•  The European initiative on Alzheimer’s disease and 
other dementias (2009), which provides EU support 
for national efforts in four key areas: prevention of 
dementia, early diagnosis, better coordination of 
research efforts across Europe, and ethical questions 
linked to the rights, autonomy and dignity of people 
with dementia.

In order to understand, improve and share data and 
evidence on HIV/AIDS, the EU works closely with the 
ECDC. 

The EU has also funded projects on HIV/AIDS through 
the health programme and the research framework 
programme. The EU funded €900 000, for example, 
towards the Correlation II project. This project provides 
help and information to sex workers, people who use 
drugs and migrants without papers who need access to 
health services that offer treatment for blood infections, 
particularly hepatitis C and HIV.

  This initiative was implemented through the Alcove 
joint action, which brought together 19 EU countries 
to exchange good practices and formulate policy 
recommendations; and through the joint programme 
‘Neurodegenerative disorders’, the largest global 
research initiative aimed at tackling the challenge of 
such diseases.

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The EU is working to prevent 
HIV/AIDS and improve 
treatment for sufferers.

PUBLIC HEALTH 
 
 
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As Europeans live longer, the problems associated with 
dementia are increasing.

•  The European Pact for Mental Health and Well-

Being (2008) . Mental disorders have become one of 
the most prevalent disease groups in the EU. Mental 
disorders are a leading cause of work absence, 
disability and early retirement and are often 
associated with stigmatisation and social exclusion.

  The pact provides an EU-wide framework for EU 
countries, non-governmental organisations and 
stakeholders to exchange information on the 
challenges linked to mental health. Best practices are 
collected in the online database ‘European compass 
for action on mental health and well-being’.

Assessing scientific risks

The European Commission’s scientific committees 
provide high-quality, independent scientific advice on 
consumer safety, health and environmental risks and 
emerging and newly identified health risks. In 2012, the 
scientific committees assessed 45 health issues 
including silicone breast implants, security scanners for 
passenger screening, cadmium in fertilisers and 
cosmetic ingredients such as hair dye chemicals.

The work of the EFSA and the WHO also feeds into the 
EU’s scientific risk assessment.

14

Increasing access to health information

Increasing access to information is a vital part of the 
EU’s efforts to promote good health and tackle health 
inequalities.

The ‘Public health’ website of the European Commission 
highlights the work of the European Commission in the 
area of public health. On this website you can find press 
material, legal documents, videos, information on 
events, statistics and news on health in Europe.

The EU also holds an annual EU Health Prize for 
Journalists, to reward high-quality journalism on issues 
linked to healthcare and patients’ rights. (See the ‘Find 
out more’ section on page 16 for links to the above 
mentioned websites.)

Research and health expertise

The EU coordinates and supports European research in 
a number of areas. Health is one of them. Since 2007, 
the EU has spent €6 billion on health research, with an 
emphasis on:

•  translating basic discoveries into clinical applications;

•  developing and validating new therapies;

•  health promotion and prevention strategies;

•  better diagnostic tools and medical technologies;

•  sustainable and efficient healthcare systems.

European reference networks have also been introduced 
for a wide range of health issues from air pollution to 
maternal health. They help national authorities and 
health professionals to exchange best practice and 
expertise. EU funding for recent projects linked to this 
has included initiatives to support electronic health 
records and a European health and life expectancy 
information system.

THE EUROPEAN UNION EXPLAINED 
 
 
15

Outlook

Securing health for future generations

•  better coordination of cross-border treatment;

The EU’s efforts will consolidate existing activities in the 
field of health and healthcare with a particular focus on 
improving the sustainability of healthcare systems.

Multiannual programme of action for 
health 2014–20

At the end of 2011, the European Commission proposed 
a public health programme for 2014–20. It emphasises 
the role of good health in promoting productivity at 
work, economic competitiveness and living a better 
quality of life for longer. The EU’s work will complement 
and support national efforts in four key areas:

•  health promotion and disease prevention;

•  protecting citizens from cross-border health threats;

•  innovative and sustainable health systems;

•  better and safer healthcare for citizens.

The budget proposed by the European Commission is 
€446 million. It is expected to enter into force on 
1 January 2014.

Increasing the use of e-health and 
telemedicine

E-health — using digital technology to improve access 
to care, quality of care and make the healthcare sector 
more efficient — will become an increasingly essential 
element of EU health policy in the future. Examples of 
EU efforts in this area include the establishment of a 
voluntary e-health network in 2011 to promote the use 
of electronic health systems and new, innovative 
solutions for healthcare.

E-health allows:

•  the possibility to be treated and monitored remotely;

•  doctors and patients to access electronic medical 

records;

•  data, e.g. test results or prescriptions, to be delivered 

rapidly;

•  better collaboration between health service providers;

•  patients to take more control of their own care.

Future objectives for e-health include the creation of a 
comprehensive and standardised electronic health 
records system, and new health information networks 
to link points of care. Another aim is to coordinate 
reactions to health threats, and the further 
development of teleconsultation, e-prescribing, 
e-referral and e-reimbursement capabilities.

Tighter rules for medical devices

There are around 500 000 different medical devices  
on the EU market ranging from a simple, everyday 
plaster, to replacement joints and kidney dialysis 
machines. They include any instrument, apparatus, 
implant or similar device used in the diagnosis, 
treatment, cure or prevention of disease or other 
conditions. In vitro medical devices include diagnostic 
tests, such as home pregnancy tests or blood tests for 
cholesterol and HIV.

In September 2012, the EU proposed new rules to  
boost safety, efficiency and innovation in the medical 
device sector. They are designed to improve traceability 
and coordination between national surveillance 
authorities, give clear rights and responsibilities to 
manufacturers, importers and distributors, set stricter 
requirements for clinical evidence and support a 
comprehensive, public database on medical devices 
available on the EU market. The new requirements are 
expected to come into force in 2015.

Strengthening health security

In recent years, the EU has been challenged by a 
number of pan-European health threats including the 
flu pandemic in 2009, the volcanic ash cloud in 2010 
and the outbreak of E. coli in 2011. It has learned 
important lessons from these events which are 
reflected in its proposals for new rules to protect EU 
citizens from a wide range of serious cross-border 
health threats, e.g. flu, food and waterborne diseases 
such as salmonellosis, chemical incidents or the result 
of extreme weather conditions. 

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The new rules are designed to fight or minimise the 
effect of these threats on the health of citizens by:

people — target manufacture, presentation and trade in 
tobacco products. 

•  extending the existing EU coordination mechanism for 
communicable diseases to include all health threats 
caused by biological, chemical or environmental 
factors;

•  strengthening the existing rules on preparing for and 

managing health emergencies;

•  reinforcing the mandate of the EU’s Health Security 

Committee (composed of national representatives) to 
react in a crisis situation;

Key elements include:

•  a prohibition of tobacco products with strong 

flavourings, e.g. vanilla or chocolate, that mask the 
taste of tobacco;

•  mandatory, pictorial health warnings covering at least 
75 % of the front and back of cigarette packages and 
roll-your-own tobacco, with further health warnings 
on the side;

•  a continued ban on the oral tobacco — snus — 

•  providing the means to recognise a European ‘health 

outside of Sweden;

emergency situation’;

•  allowing EU Member States to purchase vaccines and 
medical countermeasures jointly during a pandemic 
or during an emergency situation.

•  authorisation under pharmaceutical legislation of 

products containing nicotine, e.g. e-cigarettes, above a 
certain limit of nicotine;

•  regulation for cross-border distance sales of tobacco 

The new rules are due to be adopted in 2013.

products;

Revision of the tobacco products 
directive

The  European  Commission  proposed  new  rules  for 
tobacco  products  in  December  2012  following  a  public 
consultation which generated an unprecedented 85 000 
responses from all levels of society.

•  a new EU-wide tracing and tracking system to protect 

against illegal trade in tobacco products.

The  proposed  measures  are  expected  to  help  reduce 
smoking by 2 % in 5 years and respond to international 
developments such as the WHO’s Framework Convention 
on Tobacco Control, which entered into force in 2005.

The proposals — which aim to bring tobacco legislation 
up to date and make smoking less attractive to younger 

The proposals are now under discussion in the European 
Parliament and Council. It is hoped they will come into 
force in 2015–16.

Find out more

 X Public health: http://ec.europa.eu/health/index_en.htm
 X The European Commission’s Directorate-General for Health and Consumers:  

http://ec.europa.eu/dgs/health_consumer/index_en.htm

 X ‘Ex-smokers are Unstoppable’: celebrating the achievements of ex-smokers across Europe:  

http://www.exsmokers.eu

 X Questions about the European Union? Europe Direct can help: 00 800 6 7 8 9 10 11  

http://europedirect.europa.eu

ISBN 978-92-79-35689-6 
doi:10.2775/15123

THE EUROPEAN UNION EXPLAINED