REPORT FROM THE COMMISSION TO THE EUROPEAN PARLIAMENT, THE COUNCIL, THE EUROPEAN ECONOMIC AND SOCIAL COMMITTEE AND THE COMMITTEE OF THE REGIONS Ex-post evaluation of the 2nd Health programme 2008-2013 under Decision No 1350/2007/EC establishing a second programme of Community action in the field of health (2008-2013)
Date: 2016-05-10
Institutions: Directorate-General for Health and Food Safety, European Commission
Subjects: EU Member State, EU financing, EU programme, disease prevention, health care, health care system, project evaluation, public awareness campaign, public health

EN 

   EN 

   EUROPEAN COMMISSION  Brussels, 10.5.2016  COM(2016) 243 final   REPORT FROM THE COMMISSION TO THE EUROPEAN PARLIAMENT, THE COUNCIL, THE EUROPEAN ECONOMIC AND SOCIAL COMMITTEE AND THE COMMITTEE OF THE REGIONS Ex-post evaluation of the 2nd Health programme 2008-2013  under Decision No 1350/2007/EC establishing a second programme  of Community action in the field of health (2008-2013) {SWD(2016) 148 final} {SWD(2016) 149 final}  
 
 
1.  Introduction 

The Commission is required under Article 13(3)(c) of Decision No 1350/2007/EC1 to transmit 
to the European Parliament, the Council, the European Economic and Social Committee and 
the Committee  of the Regions  an external and independent  ex  post evaluation2 covering the 
implementation and results of the 2nd Health Programme. 

This  report  briefly  presents  the  Programme  and  summarises  the  main  conclusions  from  the 
mid-term  and  ex-post  evaluations.  It  also  outlines  three  areas,  where  implementation  of  the 
current 3rd Health Programme can be improved. 

2.  The 2nd Health Programme (2008-2013) 

The 2nd Health Programme was the main instrument to support health policy coordination to 
implement the EU’s 2008-2013 health strategy Together for health3 in line with the priorities 
of the Europe 2020 strategy.4 

2.1.  The objectives of the Programme 

The  overall  aim  of  the  Programme  was  to  complement,  support  and  add  value  to 
Member  States’  policies  and  contribute  to  increased  solidarity  and  prosperity  in  the 
European Union by protecting and promoting human health and safety and improving 
public health. 

The Programme financed action geared to achieving three main objectives: 

i. 

improving  citizens’  health  security  and  protecting  them  from  health  threats  and 
emergencies, such as pandemics or natural disasters; 

ii.  promoting health and reducing health inequalities across Europe, whether relating to 
lifestyle, such as access to opportunities for physical activity, or to health care, such as 
access to the necessary medical intervention; and 

iii.  generating  health  information  and  health  knowledge  and  disseminating  them  to 
relevant parties, from the general public to policymakers and health professionals. 

2.2.  Implementation of the Programme through priority actions and financial mechanisms 

Under Article 168 TFEU, the Union shall encourage cooperation between the Member States, 
and support their action, including through the establishment of guidelines and indicators, the 
organisation of exchange of best practice and support for monitoring and evaluation. Member 
States’  responsibilities  for  the  definition  of  their  health  policy  and  for  the  organisation  and 
delivery of health services and medical care should be respected. 

Action  under  the  Programme  was  in  line  with  the  EU’s  role  in  health  policy  as  set  out  in 
Article  168  of  the  Treaty  and  within  its  limits.  Actions  were  designed  to  follow  a  strategic 
approach with a focus on those specific initiatives that maximise EU added value. As a result, 
implementation  concentrated on priorities key to economic development and growth. These 

1   Decision No 1350/2007/EC of the European Parliament and of the Council of 23 October 2007 establishing a 
second programme of Community action in the field of health (2008-13) (OJ L 301, 20.11.2007, p. 3–13). 

2   The external evaluation report is annexed, with executive summaries in English and French. 
3   COM(2007) 630 final, 23.10.2007. 
4   COM(2010) 2020 final, 3.3.2010. 

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priority  actions  contribute  to  a  healthier  population,  well-functioning  healthcare  systems,  , 
and technological and scientific development.  

The overall design of the Programme was similar to that of the 1st Public Health Programme, 
but the scope was extended beyond ‘classical’ public health issues, such as the promotion of 
health and protection from communicable diseases, extending it also to new approaches such 
as  e-health  and  health  technology  assessment,  and  to  medicinal  products.  Within  the  broad 
range  of  issues  to  be  covered,  programme  priorities  were  streamlined  from  2010  to  focus 
more  on  the  Europe  2020  strategy,  taking  as  a  starting  point  the  notion  that  health  is  a 
prerequisite for economic recovery and ‘inclusive growth’, and the fact that the health sector 
attracts interest for innovation and ‘smart’ investment.   

On  the  basis  of  Decision  No  1350/2007/EC,  the  Commission  established  priorities  in  the 
annual work programmes, in close consultation with Member States health authorities serving 
on  the  Programme  Committee.  Implementation  of  the  Programme  was  entrusted  to  the 
Consumers,  Health,  Agriculture  and  Food  Executive  Agency  (CHAFEA),  which  organised 
the calls and supervised the evaluation procedures leading to the award of co-funding to the 
best  actions.  CHAFEA  continues  to  manage  the  still  on-going  grants  and  contracts  and 
disseminates the outputs of Programme actions and results. 

An informal network of national focal points was established to help CHAFEA promote the 
Programme  and  disseminate  results.  With  their  support,  national  information  days  were 
organised, dissemination conferences held and informative printed material translated. 

In addition to grants for projects and tenders, new funding mechanisms were introduced from 
the  beginning  of  the  Programme  in  the  form  of  joint  actions,  operating  grants,  conferences 
and direct grants to international organisations. 

Projects are used to explore a wide range of subject areas and delivery mechanisms, and to 
take health policy initiatives forward in an innovative way, almost as ‘pilots’. They represent 
the  biggest  share  of  the  available  Programme  budget.  However,  in  the  course  of  the 
Programme, the proportion of the budget dedicated to projects was reduced in favour of joint 
actions and tenders. This was also the result of an effort to concentrate the Programme on a 
few major actions involving as many partners as possible, ideally from all Member States, to 
generate momentum for wider impact. 

Tenders are used to procure specific studies, evaluations and surveys that are needed for the 
development and implementation of EU health policy and legislation, e.g. rules governing the 
production,  distribution  and  use  of  medicinal  products.  They  are  also  used  for 
Commission-driven actions with very concrete scope and objectives, such as the design and 
delivery of training courses and exercises with Member States geared to developing capacity 
to deal with extreme emergency situations.   

Joint  actions  are  a  type  of  financial  mechanism,  introduced  for  the  first  time  with  the  2nd 
Health Programme, to support Member States’ cooperation in areas of high policy relevance. 
The  selected  joint  actions  made  a  particular  contribution  to  the  Europe  2020  objectives  of 
‘smart  and  inclusive  growth’.  Joint  actions  are  often  the  result  of  long  cooperation  among 
authorities  and  relevant  stakeholders  and  aim  to  secure  Member  State  authorities’  political 
commitment  and  endorsement  of  outcomes  and  optimise  policy  coordination.  Joint  actions 
typically  develop,  share  and  test  tools,  methods  and  approaches  for  specific  issues  or 
activities, and involve capacity-building. The gain for the Member States involved in terms of 

3 

 
 
knowledge and experience exchanged is intended to be substantial and in some cases lead to 
tangible cost savings. For this reason, the Programme seeks the widest possible participation 
from all Member States. 

Operating grants were used for the first time in the 2nd Health Programme to support the 
functioning costs of pan-European non-governmental organisations and specific networks. 

Conference grants, also introduced with the Programme, were used to support central health 
conferences under each EU presidency and to co-finance, through an annual competitive call, 
pan-EU conferences on important health issues. 

Finally,  direct  grants  to  international  organisations  were  used  to  support  international 
cooperation on major health issues (mainly collection and analysis of health data). 

Table 1:   2nd Health Programme spending by funding mechanism 

Funding mechanism  

Total  

Projects  

Tenders  

Joint actions 

Operating grants 

Direct grant agreements 

Grants for conferences 

5

Other

Total 

2.3.  Programme outcomes 

 €106 293 671.24  

 €72 053 873.45  

 €63 962 704.38  

 €20 825 185.85  

 €13 805 987.00  

 €5 268 308.14  

€11 693 227.81 

% 

36 % 

25 % 

22 % 

7 % 

5 % 

2 % 

4 % 

€293 902 957.87 

100 % 

The  Programme  generated  useful  knowledge  and  evidence  to  serve  as  a  basis  for  informed 
policymaking  and  further  research.  This  took  the  form  of  best  practice,  tools  and 
methodologies  that  help  to  secure  benefits  for  both  the  public-health  communities  and 
citizens directly (e.g. with regard to improving diagnostic tests, supporting Member States in 
developing  national  actions  plans  on  cancer,  improving  patient  care,  etc.).  It  supported 
awareness and sustained networking activities (e.g. by co-funding pan-European conferences 
and  networks  such  as  those  in  the  field  of  public  health  and  health  promotion).  Also,  it 
supported the collection of comparable data across the Union, covering many Member States 
and  providing  information  for  policymaking  purposes,  e.g.  European  core  health  indicators 
(ECHIs)  and  the  ORPHANET  database  on  rare  diseases,  and  produced  training/educational 
materials  (e.g.  to  train  health  professionals  on  migrant  and  ethnic  minority  health)  and 
guidance.  Finally,  it  supported  public-health  capacity-building  at  various  levels  (e.g.  by 
fostering Member States’ preparedness in the event of health emergencies) through training 
and  exchange  of  knowledge  between  healthcare  institutions  in  the  Member  States. 

5   ‘Other’ includes actions signed and committed to by DG SANTE and CHAFEA, such as special indemnities 
to experts for their participation in and work for EU scientific committees, an administrative agreement with 
the  Joint  Research  Centre,  publications  and  various  communication  initiatives  to  promote  the  2nd  Health 
Programme, sub-delegations to Eurostat, etc. 

4 

 
 
 
 
 
 
                                                 
3.  Programme evaluation 

External  independent  evaluations  were  conducted  at  mid-term  (in  2010-2011)  and  ex-post 
(2014-2015).  Both  gave  a  positive  assessment  of  the  Programme  with  limitations.  They 
confirmed  the  relevance  of  the  actions  funded,  although  underlining  the  weaknesses  in  the 
Programme design (large scope and non-explicit specific objectives). They concluded that the 
Programme  demonstrated  EU  added  value  mainly  regarding  identification  of  best  practices, 
benchmarking for better decision making and networking but to a lesser extent on innovation, 
EU health legislation and economics of scale, while the actions covering cross-border health 
threats  and  free  movement  of  persons  were  under-represented.  They  concluded  that  every 
relevant need cannot lead to an impactful action; only actions that have an EU added value 
have  the potential to impact  on Member States’ health policies.  The impact  depends on the 
uptake and implementation of the results by the Member States. Therefore the dissemination 
to  the  relevant  stakeholders,  in  particular  to  national  health  authorities,  that  set  out  and 
implement  national  health  policies,  is  important.  In  relation  to  outreach  to  relevant 
stakeholders the actions of the Programme were successful to varying degrees. Another factor 
that  is  influencing  the  uptake  by  Member  States  is  their  buy-in  on  the  actions  which  was 
increased through a stronger focus in the second half on Joint Actions. 

3.1.  Overall assessment 

The  2nd  Health  Programme  reflects  the  development  of  EU  health  policy,  with  more 
emphasis — in addition to the classical public-health approach (promotion and prevention of 
diseases, fight against communicable diseases and other cross-border health threats, safety of 
patients) — on other health issues emerging from the need to innovate and modernise health 
systems  while  keeping  health  expenditure  under  control,  and  to  optimise  actions    in  areas 
such as health technology assessment (HTA), e-health and the cross-border directive6 for the 
health  and  rights  of  EU  citizens.  The  Programme  mobilised  relevant  stakeholders  in  all  28 
Member States (with more of them being from EU 15 than EU 12 Member States) and three 
EEA  EFTA  countries  (Norway,  Iceland  and  Lichtenstein).  It  covered  a  series  of  common 
health  concerns  (i.e  concerning  major  chronic  diseases,  the  health  of  an  ageing  population, 
the development of capacity to respond to cross-border health threats), provided a wide range 
of useful tools (i.e the EU information database for rare diseases)7 and best practices (i.e. for 
preventing the spread of HIV/AIDS8, addressing obesity9 or applying cancer screening)  for 
use  at  national  and  regional  levels,  and  promoted  cooperation  and  coordination  between 
Member States’ health authorities to keep health issues such as health inequalities10, mental 
health11, ageing, etc. high on their agenda. 

However,  both  evaluations  pointed  out  that  the  lack  of  explicit  objectives  and  progress 
indicators  in  the  Programme's  design  was  conducive  to  the  proliferation  of  priorities  and 
made it difficult to define the overall results in a meaningful way. 

6   Directive 2011/24/EU of the European Parliament and of the Council of 9 March 2011 on the application of 

patients’ rights in cross-border healthcare (OJ L 88, 4.4.2011, p. 45-65). 

7   http://www.orpha.net/consor/cgi-bin/index.php 
8   http://ec.europa.eu/chafea/documents/health/hiv-infopack_en.pdf 
9   http://ec.europa.eu/chafea/documents/health/nutrition-physical-activity-2014_en.pdf 
10   http://ec.europa.eu/chafea/documents/health/health-inequality-brochure_en.pdf 
11   http://ec.europa.eu/chafea/documents/health/mental-health_en.pdf 

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3.2.  Mid-term evaluation12 

The mid-term evaluation included a number of recommendations to improve the prioritisation 
of  needs,  fix  more  targeted  and  focused  objectives,  co-fund  fewer  actions,  monitor  on  the 
basis of SMART indicators and better disseminate outcomes. 

The  pertinent  recommendation  for  streamlining  the  annual  priorities,  providing  better 
guidance  to  applicants  and  ensuring  better  dissemination  of  actions  and  their  results,  were 
implemented immediately in the 2011–2013 annual work programmes. This resulted in more 
focus (limiting the health topics covered) and better alignment with the Europe 2020 strategy. 
The CHAFEA improved the guide for applicants and the help-desk services for the calls and 
concentrated more on the dissemination of results.  

The lessons learnt from the evaluation were applied in the impact assessment accompanying 
the Commission’s proposal for the 3rd Health Programme and guided the design of the new 
Programme. As a result, Regulation (EU) No 282/2014:13 

  provides for explicit specific objectives and indicators (Article 3); 

  establishes a restricted number of clear thematic priorities (Annex I); 

 

includes  specific  criteria  for  gauging  EU  added  value  (recital  6)  concerning  the 
prioritisation of needs (Annex II) and the awarding of funding; 

  formally recognises the role of national focal points (Article 15); and  

  underlines  the  need  for  better  dissemination  of  the  results  of  actions  and  overall 
corporate communication on the Union’s political priorities (Articles 13(4) and 9). 

The mid-term evaluation of the 3rd Health Programme, will assess whether and to what extent 
the above changes contribute effectively to improved implementation and the achievement of 
Programme objectives. 

3.3.  Ex post evaluation14 

The  ex  post  evaluation  reviewed  key  aspects  of  Programme  implementation,  including 
follow-up  of  the  mid-term  review  recommendations.  It  focused  on  the  management  of  the 
Programme,  the  dissemination  of  its  results,  the  Programme's  effectiveness,  and  synergies 
with other EU programmes. This meant that it was possible to concentrate on issues that could 
not  yet  have  been  sufficiently  explored  in  the  mid-term  evaluation  and  avoid  duplicating 
previous evaluation work. Given the fact that in health it usually takes a long time for results 
and  impacts  to  manifest,  and  that  in  any  case  the  impact  of  the  Programme  depends  on  the 
uptake  of  actions'  outcomes  by  Member  States,  which  is  out  of  the  Programme's  control, 
evaluators  approached  the  issue  with  a  view  to  the  next  programming  period  and  sought  to 
elicit  elements  for  a  better  understanding  of  how  the  Programme  could  impact  on  health 
policies in the Member States. The conclusions identified both success factors and factors that 

12   The findings  and  conclusions of  the  mid-term  evaluation were  transmitted  to  the  European  Parliament,  the 
Council,  the  European  Economic  and  Social  Committee  and  the  Committee  of  Regions,  as  required  by 
Decision No 1350/2007/EC, with staff working document SWD(2012) 83 final of 29 March 2012. 

13   Regulation  (EU)  No  282/2014  of  the  European  Parliament  and  of  the  Council  of  11  March  2014  on  the 
establishment of a third Programme for the Union’s action in the field of health (2014-2020) and repealing 
Decision No 1350/2007/EC (OJ L 86, 21.3.2014, p. 1–13). 

14   The findings and conclusions of the final evaluation are discussed in detail in the Commission staff working 

document annexed to this report.  

6 

 
 
                                                 
negatively influence the potential impact of actions funded under the 2nd Health Programme. 
Those  lessons  learnt  will  be  used  for  improving  the  implementation  of  the  3rd  Health 
Programme and will feed into the three following main areas of action below.  

(a)  Improved monitoring, reporting and dissemination efforts 

The management of the Programme was substantially improved. Programme priorities 
were streamlined in the second half of the period around the Europe 2020 initiatives 
and  its  objectives  for  smart,  sustainable  and  inclusive  growth.  Monitoring  data  were 
(and  continue  to  be)  collected  and  a  more  systematic  approach  for  their  collection, 
analysis and regular use will provide an improved evidence basis for setting of annual 
priorities, for reporting15 on outputs and results, and for better targeting dissemination 
to relevant stakeholders. 

The success of the Programme depends to a large extent on the willingness of Member 
States and other participating countries to take up the results and integrate them into 
national initiatives and policies (i.e. the guide for cancer screening now adopted by all 
Member  States;  the  preparedness  plans  of  Member  States  for  responding  to  health 
threats and emergencies). It is therefore important that the actions and their results are 
well  known  to  the  relevant  key  stakeholders.  This  is  key  for  the  Programme’s 
visibility, accountability as regards the use of its resources and above all its usefulness. 

The  Commission  has  intensified  dissemination  activities  in  the  past  two  years.  The 
main  dissemination  tools  have  been  CHAFEA’s  project  database,16  brochures17 
presenting  the  co-funded  actions  by  policy  theme  (e.g.  health  inequalities,  rare 
diseases, etc.), the regular organisation of ‘cluster meetings’18 with journalists (e.g. on 
organ  transplantation19  and  HIV/AIDS)20  and  a  high-level  conference  on  the 
Programme  in  2012.21  Since  2014,  the  Programme  has  supported  Member  State 
authorities  in  the  organisation  of  conferences  and  other  events22  promoting  the 
dissemination  to  key  audiences  of  Programme  results  on  specific  health  topics.  This 
intensified support for the dissemination efforts of individual actions has shown to be 
useful  and  to  help  extend  the  reach  of  relevant  results.  However,  in  light  of  the 
diversity  and  breadth  of  action,  they  cannot  make  up  for  the  fact  that  some  projects 
have  not  promoted  their  results  to  the  specific  audiences  they  are  most  relevant  for. 
Therefore,  in  the  3rd  Health  Programme  an  effective  dissemination  strategy  must  be 
defined early on for all actions. 

(b)  Encouraged participation of all Member States and other participating countries 

The  Programme  is  an  instrument  to  support  policy  development,  coordination  and 
implementation in the area of health. While competence in this area lies largely with 
Member  States,  the  Programme  helped  them  to  develop  initiatives  at  EU  level  for 
more effective and efficient solutions to common health concerns, e.g. the ‘European 

15   The Commission reports annually to the European Parliament and to the Council on the implementation of 

the Health Programme (see http://ec.europa.eu/health/programme/policy/index_en.htm). 

16   http://ec.europa.eu/chafea/projects/database.html. 
17   http://ec.europa.eu/chafea/publications/publications_for_health_programme.html. 
18   Meetings organised in cooperation with competent Member State authorities to provide journalists and other 
interested audiences with an opportunity to learn about EU health policy and a portfolio of relevant Health 
Programme actions in a given topic area. 

19   http://ec.europa.eu/chafea/health/EAHC_conference_2013_-_Transplantation_Blood_Transfusion.html. 
20   http://ec.europa.eu/chafea/health/hiv-athens-2014-presentations_en.html. 
21   http://ec.europa.eu/health/programme/events/ev_20120503_en.htm. 
22   http://ec.europa.eu/chafea/health/events_en.html. 

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Guide  for  Quality  National  Cancer  Control  Programmes’,  which  provides  an  outline 
for policy-makers on the basic tenets of cancer control policy; better knowledge of the 
quality  and  effectiveness  of  the  systems  for  organ  donation  and  transplantation  in 
participating  countries;  diagnostic  tools  and  a  laboratory  network  to  boost  Member 
States’  preparedness  and  cooperation  in  the  event  of  health  threats;  or  the  rights  of 
patients living and working in a Member State other than their own. 

All  Member  States,  the  three  EEA  EFTA  countries  (Iceland,  Liechtenstein  and 
Norway)  and  Croatia  participated  in  the  Programme  to  varying  degrees.  Despite  the 
fact that EU 15 Member States have participated more than the EU 12 Member States 
in  the programme in  general, and as coordinators of actions in  particular, the Health 
Programme  involved  Member  States  with  low  GDP/GNI  more  than  the  FP7.  The 
participation  of  as  many  countries  as  possible  creates  the  necessary  networking 
environment  to  identify  common  health  concerns,  raise  awareness  of  key  emerging 
health problems and transfer knowledge in order to improve health status and address 
inequalities.  Health  can  be  a  smart  incentive  for  investment23  in  the  economy  and 
plays a key role in European cohesion and inclusion. 

Difficult economic circumstances are stated  as among the reasons  for some  Member 
States' low participation. To address this the Commission has included the principle of 
‘exceptional utility’ in the current 3rd Health Programme24 as a financial incentive to 
involve  all  Member  States.  Information  days  to  promote  the  Programme  should 
continue  to  be  organised  in  all  Member  States  and  participating  countries,  the  aim 
being  that  at  least  half  of  these  events  will  take  place  in  Member  States 
underrepresented  in  the  previous  Programme  period.  More  information  material 
should be available in all EU languages. 

The  Programme  is  also  open  on  a  cost  basis  to  acceding,  candidate  and  potential 
candidate countries, where it functions as a mechanism that can help countries adapt to 
the acquis communautaire in the health area through their cooperation with Member 
States in projects and joint actions. 

(c)  Implementation of the Programme in synergy with other European programmes 

and Commission priorities 

The  uptake  of  Programme  outcomes  and  their  integration  into  national  policies 
remains the determining factor whether or not the Programme is a success. Given the 
limited budget and the tremendous health needs and challenges, developing synergies 
with other programmes to spread its outcomes further, promote their use and build on 
them has already been more extensively pursued with the Union research Programmes 
(FP7  and  Horizon  2020)  and  to  a  lesser  degree  with  the  European  Structural  and 
Investments Funds (ESIFs).  

Breaking down ‘silos’ and working more closely with other Union programmes is part 
of the Commission’s vision for delivering on its 10 major priorities25 in a coordinated 

23   Investing in health (staff working document SWD(2013) 43 final, 22.2.2013) 

http://ec.europa.eu/health/strategy/docs/swd_investing_in_health.pdf. 

24    The  Commission  provides  up  to  80 %  co-funding  as  a  financial  incentive  for  joint  actions  that  involve  at 
least 14 participating countries, of which at least four are Member States with a GNI per inhabitant below 
90 % of the Union average, and for which 30 % of the budget is spent on involving such countries (Article 
7(3) of Regulation (EU) No 282/2014). 

25   See at http://ec.europa.eu/priorities/index_en.htm 

8 

 
 
                                                 
 
 
 
way. The 3rd Health Programme offers possibilities for such cooperation in supporting 
health  in  areas  such  as  migration,  dealing  with  emerging  diseases  relating  to 
environmental  factors  such  as  climate  change,  innovation  in  health,  health-sector 
reform  and  global  health.  Finally,  the  Programme  involves  assessments  of  health 
systems  and  generates  country-specific  and  cross-country  knowledge  to  inform 
policies at national and European level. 

4.  Conclusion 

In  the  coming  years,  the  Commission  will  make  a  particular  effort  to  improve  monitoring, 
reporting  and  dissemination,  support  the  participation  of  less  active  Member  States  in  the 
Programme  and  develop  synergies  with  other  EU  programmes.  The  results  and  ideas 
emanating  from  the  Programme  could  be  communicated  more  actively  through  existing 
networks  of  contacts  in  health  ministries  and  via  coherent  and  comprehensive  coordination 
with actors in Union programmes that cover, but do not deal exclusively with, health.  

After 18 years of EU Health Programmes, at the end of the 3rd Health Programme in 2020, the 
Commission  will  assess  the  extent  to  which  the  first  three  Programmes  have  produced 
positive  impacts  on  Member  States  health  policies  in  an  effective,  efficient,  coherent  and 
relevant  way  ensuring  EU  added  value.  The  monitoring  arrangements  for  the  3rd  Health 
Programme will be used to support this broader assessment.  

9