Public health : improving health for all EU citizens.
Date: 2015-09-22
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  E U  w or ks  t o  p ro te ct   
and   im p rove  th e h e al th   
o f  al l   Eur o p eans   th ro ugho u t   
t heir   l ives.

CONTENTS 

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

 3

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

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

 6

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

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

THE EUROPEAN UNION 
EXPLAINED

This publication is 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 find the publications online:
http://europa.eu/pol/index_en.htm
http://europa.eu/!bY34KD

How the EU works
Ten priorities for Europe
The founding fathers of the EU

Agriculture
Banking and finance
Borders and security
Budget
Climate action
Competition
Consumers
Culture and audiovisual
Customs
Digital single market
Economic and monetary union and the euro
Education, training, youth and sport
Employment and social affairs
Energy
Enlargement
Environment
Food safety
Foreign affairs and security policy
Humanitarian aid and civil protection
Internal market
International cooperation and development
Justice, fundamental rights and equality
Maritime affairs and fisheries
Migration and asylum
Public health

Regional policy
Research and innovation
Taxation
Trade
Transport

The EU explained: Public health

European Commission 
Directorate-General for Communication 
Citizens' information 
1049 Brussels 
BELGIUM

Did you find this publication useful? Let us know: 
comm-publi-feedback@ec.europa.eu

Manuscript updated in September 2015

Cover and page 2 picture:  
© BananaStock/Jupiterimages 

16 pp. — 21 × 29.7 cm

PDF

Print

ISBN 978-92-79-50944-5
doi:10.2775/522015
NA-02-15-719-EN-N

ISBN 978-92-79-50955-1 
doi:10.2775/07916
NA-02-15-719-EN-C

Luxembourg: Publications Office of the European Union, 
2015

© European Union, 2015

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.

s
h
t
a
R

r
e
d
n
a
x
e
A

l

/
.
c
n
I

,

k
c
o
t
s
r
e
t
t
u
h
S
©

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 2014 Ebola outbreak that began in West 
Africa and led to several medical evacuations to 
Europe 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 2012. 

 — Drop in infant mortality: there was a 

cumulative reduction in infant mortality of over 
82 % between 1975 and 2012. 

 — 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 

8.5 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:

•  Europeans have shared health values;

•  health is the greatest wealth;

•  considerations about health must be included in all 

policies;

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’.

EU financial support

With its budget of nearly €450 million, the third health 
programme will support and add value to the policies of 
Member States that aim to improve people's health and 
reduce health inequalities. It will do so by promoting 
health, encouraging innovation in health, increasing the 
sustainability of health systems and protecting EU 
citizens from serious cross-border health threats. The 
programme builds on the achievements of the previous 
two health programmes and focuses on key issues 
where Europe can deliver added value. The EU's work 
will complement and support national efforts in four 
key areas:

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

·  disease prevention and health promotion measures;

global health;

It identified three key objectives:

•  fostering good health in an ageing Europe;

•  protecting citizens from health threats;

•  supporting dynamic health systems and new 

technologies.

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.

·  protecting citizens from cross-border health threats;

·  innovative and sustainable health systems;

·  better and safer healthcare for citizens. 

All 28 EU countries plus Iceland and Norway participate 
in the programme.

Since 2003, the EU health programme has provided 
funding for more than 750 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

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.

Separate legislation on cross-border healthcare gives 
you:

•  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;

Did you know?
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.

The EU is keeping an ever closer eye on emerging health 
threats — be they Ebola, a new strain of influenza such 
as bird flu or the more recent novel corona virus, a 
foodborne disease such as E.coli, or a slower spreading 
threat such as antimicrobial resistance. 

In 2013, the Commission adopted rules on serious 
cross-border health threats to protect EU citizens by 
means of a robust and coordinated risk and crisis 
response. Included in the new rules are:

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

•  an extension of the existing EU coordination 

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

mechanism for communicable diseases to include all 
health threats caused by biological, chemical or 
environmental factors;

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

A national contact point has been set up in each EU 
country to provide information to patients on their 
rights and on quality and safety issues.

/

s
i
b
r
o
C
a
p
e
/
z
e
m
ó
G
o
g
e
D
©

i

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

•  a reinforced mandate for the EU Health Security 

Committee to react in a crisis situation;

•  recognition of a European ‘health emergency 

situation’ which allows the activation of 
pharmaceutical legislation so that vaccines and 
medicines can be provided faster.

With the new rules, joint purchasing of vaccines and 
medicines during a pandemic or emergency situation 
becomes a reality in the EU. By means of this 
mechanism, EU countries that have signed the Joint 
Procurement Agreement should obtain the necessary 
medicines quicker and at a better price than in the past.

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

THE EUROPEAN UNION EXPLAINED   
   
   
 
 
7

©
S
h
u
t
t
e
r
s
t
o
c
k

,

I
n
c
.
/
T
o
m
a
s
z
N
e
w
e
g
o
w
s
k
i

l

i

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 alert systems: If an EU country detects a threat 

•  European Centre for Disease Prevention and 

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.

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

•  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.

Case study: Preparing Europe for 
possible Ebola cases

The Ebola epidemic in West Africa is the largest 
outbreak on record. The risk of Ebola to the 
general public in the EU has been assessed as 
‘very low’ by the European Centre for Disease 
Prevention and Control (ECDC). Nevertheless, 
since the beginning of the outbreak, the 
Commission and Member States have been 
working on preparedness and coordination or risk 
management, in close cooperation with the ECDC 
and the World Health Organization.

The EU Health Security Committee (HSC) has met 
regularly to coordinate Ebola prevention and 
readiness. Its activities have included:

 — establishing lists of available Ebola assets 

which could be shared, including high security 
laboratories, hospital capacity and medical 
evacuation equipment; 

 — procedures for organising medical evacuation 
of international healthcare workers suffering 
from Ebola to have treatment in Europe; 

 — providing information in all EU languages for 

travellers and reviewing procedures for airports 
and health authorities on handling possible 
Ebola cases. 

In addition, the Commission has launched the Ebola 
communication platform for clinicians – an online 
platform enabling the rapid exchange of information 
on the treatment and prevention of the Ebola virus. 
The platform brings together EU hospitals and 
physicians recognised as reference points for the 
treatment of Ebola.

PUBLIC HEALTH 
 
 
8

A global one health approach to protect

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 in the EU and €1.5 billion in 
additional healthcare costs and productivity losses. 

Antimicrobial Resistance (AMR) is a complex and 
multi-faceted problem. It spreads through global 
tourism, transfer of patients between healthcare 
facilities within and from outside the EU, and through 
trade in food and animals. It is a serious economic and 
a societal challenge that cannot be tackled by individual 
countries alone. The problem needs to be tackled at 
global level, by means of a comprehensive one health 
approach. That implies a holistic, multi-sectorial 
approach, involving many different sectors (public 
health, food safety, bio-safety, environment, research 
and innovation, international cooperation, animal health 
and welfare as well as the non-therapeutic use of 
antimicrobial substances).

The EU monitors AMR on a continuous  basis with the 
support of the ECDC and EFSA. In 2011, the European 
Commission launched a five-year AMR action plan to 
help tackle the mounting 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.

The global one health approach to antimicrobial 
resistance will remain a priority in the EU beyond 2016. 

The Commission is currently carrying out an evaluation 
of the AMR action plan which will be the basis for any 
decision on future actions to fight AMR.

Did you know?
 — Around 35 % of Europeans used antibiotics in 

2013.

 — 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.

l

i
i
x
o
h
p
/
.
c
n
I

,

k
c
o
t
s
r
e
t
t
u
h
S
©

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. Since it came into force in September 2013, 
the new symbol appears 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. On 1 July 2015, a common logo defined by 
the EU to identify legally operating online pharmacies/
retailers of medicines became compulsory.

9

©
S
h
u
t
t
e
r
s
t
o
c
k

,

I
n
c
.
/

i

K
n
e
t
i
c

I

m
a
g
e
r
y

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 
 
 
10

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.

Tackling rare diseases

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.

Did you know?
 — The Orphanet database defines 5 958 rare 

diseases;

 — Between 6 and 8 % of EU citizens (around  
30 million) 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.

Helping to reduce tobacco smoking 

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.

To reduce tobacco consumption throughout the EU, the 
Commission implements a comprehensive tobacco 
control policy. This involves legislation and work with 
Member States in areas such as prevention, help to give 
up smoking and smoke-free environments.

A central pillar of tobacco control is EU legislation on 
tobacco products. Over the years this has led to the 

Towards a smoke-free life.

THE EUROPEAN UNION EXPLAINED 
 
introduction of compulsory warning labels on all 
tobacco products about what 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’. 

In 2014, rules on tobacco products were revised and 
updated with a view to making smoking less attractive. 
Key elements include:

•  a ban on tobacco products with strong flavourings 

that mask the taste of tobacco, for example, vanilla 
or chocolate;

•  large mandatory pictorial health warnings placed at 
the top edge of both sides of the pack of cigarettes 
and roll-your-own tobacco, to serve as effective 
reminders of the severe health consequences of 
smoking;

•  a continued ban on the oral tobacco — snus — 

outside of Sweden; 

•  safety and quality provisions for nicotine-containing 

electronic cigarettes;

•  a regulation on cross-border distance sales of 

tobacco products;

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

against the illegal trade in tobacco products.

These measures will come into effect in 2016. 
Collectively, they aim to reduce the number of smokers 
in the EU by 2 % by 2020. The updated rules respond to 
international developments such as the WHO’s 
Framework Convention on Tobacco Control, which 
entered into force in 2005. 

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.

The EU has also — between 2005 and 2013 — run a 
series of pan-European awareness-raising campaigns 
aimed at reducing smoking. The first — `HELP — for a 
life without tobacco' — targeted 15 to 25-year-olds by 
means of a multimedia campaign. This was followed by 
the `Ex-smokers are unstoppable' campaign which 
focuses on smokers in the 25 to 34 age range. This 
campaign urges people to quit smoking by promoting 
the benefits to be gained by doing so, and provides 
practical help with quitting via iCoach, an innovative 
digital health platform.

11

©
S
h
u
t
t
e
r
s
t
o
c
k

,

I
n
c
.
/

G
a
n
g

i

L
u

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

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.

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 voluntary restriction of the 
marketing of soft drinks to children under 12 years old, 
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.

PUBLIC HEALTH   
 
 
 
12

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.

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:

Alcohol Policy and Action (CNAPA). This 2-year plan will 
contribute to achieving the objectives of the EU strategy 
to support Member States in reducing alcohol-related 
harm.

In 2007, the EU set up an Alcohol and Health Forum, a 
stakeholder platform that aims to mobilise actors 
across society to commit to take action in support of 
the EU strategy. To date, the forum has generated 246 
commitments by its 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.

•  protecting young people and children,

The EU’s policies include:

•  preventing drink-driving,

•  reducing alcohol-related harm amongst adults,

•  raising awareness of the impact of harmful and 

hazardous alcohol consumption on health,

•  collecting reliable data on alcohol consumption and 

the impact of policy measures.

In September 2014 an action plan on youth drinking 
and on heavy episodic drinking (binge drinking) was 
endorsed by the Commission’s Committee on National 

•  Helping to prevent cancer by addressing its risk 

factors, in particular tobacco smoking.  

•  Partnership: The 3-year Comprehensive Cancer 

Control Joint Action (CanCon) launched in 2014 builds 
on the success of the European Partnership for Action 
Against Cancer (EPAAC), which brought together key 
players from across Europe and led to improvements 
in health promotion, cancer screening and early 
diagnosis, identification of best practice in cancer-
related healthcare, and collection and analysis of 
cancer data. CanCon aims to deliver a European Guide 
on Quality Improvement in Comprehensive Cancer 

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

©
S
h
u
t
t
e
r
s
t
o
c
k

,

I
n
c
.
/

M
o
n
k
e
y

B
u
s
i
n
e
s
s

I

m
a
g
e
s

THE EUROPEAN UNION EXPLAINED 
 
 
 
Control. By presenting evidence-based 
recommendations for survivorship, such a guide 
should reduce inequalities in cancer survival between 
EU countries.

To achieve these objectives, the Communication is 
complemented by an operational action plan, originally 
running from 2009 to 2013 and now extended to 2016.

13

•  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.

•  Research: the EU is an important cancer research 
funder. From 2007 to 2014, the EU invested more 
than €1.4 billion in international collaborative 
research, frontier research, mobility programmes, 
public–private partnerships and coordination of 
national cancer research efforts.

•  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 the latest (fourth) edition was 
launched in October 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.

The Commission’s ‘Communication on combating HIV/
AIDS in the EU and neighbouring countries 2009–13’, 
provides an EU-level policy instrument to complement 
Member States’ policies on HIV/AIDS. It aims to 
contribute to the reduction of HIV infections across the 
EU, improve access to prevention, treatment, care and 
support, and improve the quality of life of people living 
with HIV/AIDS in the EU and neighbouring countries. 

y
h
p
a
r
g
o
t
o
h
P

x
x
i
N

/
.
c
n
I

,

k
c
o
t
s
r
e
t
t
u
h
S
©

The Commission works jointly with civil society and 
Member States through the HIV/AIDS Civil Society 
Forum and the Think Tank on HIV/AIDS to facilitate the 
planning and implementation of the response to HIV/
AIDS.

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.

Promoting healthy and active ageing

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 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.

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

PUBLIC HEALTH  
   
 
 
 
14

©
S
h
u
t
t
e
r
s
t
o
c
k

,

I
n
c
.
/

l

A
e
x
a
n
d
e
r

R
a
t
h
s

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.

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

Research and health expertise

  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.

The EU coordinates and supports European research in 
a number of areas. Health is one of them. Between 
2007 and 2013 the EU spent around €6 billion on 
health research. Under Horizon 2020 (2014-2020) the 
EU continues to invest in health, demographic change 
and wellbeing. Some €1 200 million are earmarked for 
this challenge during the first 2 years of Horizon 2020, 
with an emphasis on:

•  The European Pact for Mental Health and Well-

•  improving our understanding of the causes and 

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.

mechanisms underlying health, healthy ageing and 
disease;

•  improving our ability to monitor health and to prevent, 

detect, treat and manage disease;

•  supporting older people in remaining active and 

healthy; and

•  testing and demonstrating new models and tools for 

health and care delivery.

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 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. Since their 
new term began in April 2013, the committees have 
assessed 76 health issues including electromagnetic 
fields, tobacco additives, synthetic biology, surgical 
meshes, dental amalgam and cosmetic ingredients such 
as silica in nanoform.

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

THE EUROPEAN UNION EXPLAINED 
 
 
15

Outlook

Sustainable, cost-effective health 
systems

E-health allows:

Going forward, the EU’s efforts will consolidate existing 
activities in the field of health and healthcare with a 
particular focus on helping Member States to improve 
the sustainability of their healthcare systems.

With all EU countries being faced with an increased call 
for health services and more complex technological 
choices — during a time of intense pressure on public 
finances — the EU will:

•  continue to develop expertise on performance 

•  patients to take more control of their own care;

•  patients to be treated and monitored remotely 

without visiting a healthcare centre;

•  doctors and patients to access electronic medical 

records;

•  test results or prescriptions to be delivered rapidly;

•  better coordination of treatment;

assessments of health systems;

•  better collaboration between health service providers.

•  build up country-specific and cross-country knowledge 
on, for example, quality and productivity of the EU 
health workforce and quality and effectiveness of 
public expenditure on health.

The purpose of this knowledge and expertise is to 
inform policies at national and European levels, and the 
work of the European semester of economic policy 
coordination.

Increasing the use of e-health and 
telemedicine

E-health — using digital technologies to improve access 
to care, quality of care, and make the healthcare sector 
more efficient — is becoming an increasingly essential 
element of EU health policy. Examples of EU efforts in 
this area include the work of the e-health network 
made up of high-ranking officials from all EU countries 
to promote the use of electronic health systems and 
new, innovative solutions for healthcare. The network 
has already adopted guidelines on cross-border 
exchange of patient summaries and e-prescriptions.

Future objectives for e-health include the creation of 
comprehensive and standardised electronic health 
record systems and new health information networks to 
link points of care. Another aim is to better coordinate 
cross-border treatment and common reactions to health 
threats, and develop 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 Regulations are 
expected to be adopted by the co-legislator in 2016.

PUBLIC HEALTH  
  
 
 
16

Reinforcing the fight against 
antimicrobial resistance (AMR)

In September 2014, the Commission proposed a 
modernisation of rules on veterinary medicines and 
medicated feed, taking the opportunity to include 
tackling AMR in their scope. 

N
A
-
0
2
-
1
5
-
7
1
9
-
E
N
-
N

The proposal on veterinary medicines aims to keep 
antibiotics effective in animals and people by 
introducing the possibility of restricting the 
authorisation and use in animals of certain 
antimicrobials that are reserved to treat human 
infections. The medicated feed proposal will tackle AMR 
through measures such as a ban on medicated feed 
being used preventively or as growth promoters.

These new rules are expected to enter into effect in 1 or 
2 years.

Find out more

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

http://ec.europa.eu/dgs/health_food-safety/index_en.htm 

 X The European Commission’s Directorate-General for Internal Market, Industry, Entrepreneurship and SMEs: 

http://ec.europa.eu/growth/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

THE EUROPEAN UNION EXPLAINED