REPORT FROM THE COMMISSION TO THE EUROPEAN PARLIAMENT AND THE COUNCIL Implementation of the third Programme of Community action in the field of health in 2014
Date: 2017-04-03
Institutions: Directorate-General for Health and Food Safety, European Commission
Subjects: EU programme, chronic illness, cross-border cooperation, financing method, health care system, implementation of the budget, joint action, programme budgeting, public contract, public health

EN 

   EN 

   EUROPEAN COMMISSION  Brussels, 3.4.2017  COM(2017) 149 final   REPORT FROM THE COMMISSION TO THE EUROPEAN PARLIAMENT AND THE COUNCIL Implementation of the third Programme of Community action in the field of health in 2014 {SWD(2017) 119 final}  
 
 
Table of contents 

Introduction ................................................................................................................................ 3 

Action of the year — thematic focus of 2014: chronic diseases ................................................ 5 

PATHWAYS Project — Participation to healthy workplaces and inclusive strategies 
1.1 
in the work sector ................................................................................................................... 5 

Initiatives that directly contribute to implementing EU law ...................................................... 6 

1.2  Request for service — implementation of the Cross-border Healthcare 
Directive 2011/24/EU ............................................................................................................. 6 

Budget implementation .............................................................................................................. 7 

1.3  Budget .......................................................................................................................... 7 

1.4 

1.5 

Priorities for 2014 and financing mechanisms ............................................................ 8 

Implementation of the operational budget by financing mechanism .......................... 8 

1.6  Direct grant agreements with international organisations ......................................... 13 

1.7 

Procurements (service contracts) ............................................................................... 13 

1.8  Other actions .............................................................................................................. 14 

1.9  Budget consumption in 2014 ..................................................................................... 15 

1.10  Type of beneficiaries ................................................................................................. 15 

Conclusion ................................................................................................................................ 16 

2 

 
 
 
 
 
 
 
 
 
 
 
 
 
INTRODUCTION 

This  report  presents  the  implementation  of  the  Third  Health  Programme  in  2014.  This  was  the  first 
year  of  the  implementation  of  the  Third  Health  Programme  established  by  Regulation  (EU) 
No 282/2014  of  the  European  Parliament  and  of  the  Council  of  11  March  2014.1  This  Regulation 
applies  from  1  January  2014  for  a  Programme  lasting  seven  years  until  31  December  2020.  Under 
Article 13 of the Regulation, the Commission must report to the Health Programme Committee on the 
implementation of all actions funded through the Programme, and keep the European Parliament and 
the Council informed. This report meets that requirement. It provides detailed information on the 2014 
budget and how it was spent. 

The accompanying Staff Working Document in Annex 1 presents a set of examples of the key multi-
annual  actions  co-funded  under  the  Second  Health  Programme2  for  which  final  results  became 
available  in  2014.  It  also  describes  examples  of  action  funded  under  the  2014  work  programme  in 
ancillary  fields  such  as  evaluation  and  dissemination.  Overview  tables  detailing  all  activities  co-
funded and contracts provided can be found in Annexes 2-10. 

The Third Health Programme has a total budget of EUR 449 400 000. It has four specific objectives: 

1.  to promote health, prevent diseases and foster supportive environments for healthy 

lifestyles taking into account the ‘health in all policies’ principle; 
2.  to protect Union citizens from serious cross-border health threats; 
3.  to contribute to innovative, efficient and sustainable health systems; 
4.  to facilitate access to better and safer healthcare for Union citizens. 

The  Programme  defines  progress  indicators  for  each  objective.  To  reach  these  objectives,  the 
Programme can be implemented using a wide range of funding instruments. These are: 

action co-financed with Member State authorities (‘joint actions’); 

 
  projects  and  operating  grants  to  specifically  support  non-governmental  organisations  and 

networks; 

  direct agreements with international organisations, public procurement; and 
  other actions. 

In  line  with  the  multi-annual  plan  drawn  up  in  2013,  the  2014  annual  work  programme  focused  on 
chronic  diseases.  Hence,  several  actions  to  tackle  chronic  diseases  were  co-funded  in  2014;  one  is 
highlighted in this report. The Programme also co-funds initiatives that help implement EU law. This 
report provides two examples of how the Programme was successful in this area in 2014. 

Looking ahead… 
In  this  first  year  of  the  Third  Health  Programme  a  number  of  important  initiatives,  including  eight 
joint actions, were supported and started thanks to Programme co-funding. In line with the conclusions 
from  the  ex  post  evaluation  of  the  Second  Health  Programme,  the  Commission  ensures  that  the 
implementation  of  the  Third  Health  Programme  is  closely  monitored  and  that  results  are  publicised 
more  widely.  The  Commission  further  continues  to  encourage  and  foster  the  participation  of  all 

1 OJ L 86, 21.3.2014, p. 1. 

2 OJ L 301, 20.11.2007, p. 3. 

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Member  States  and  countries  participating  in  the  Programme  and  seek  synergies  with  other  EU 
funding programmes. 

4 

 
 
 
 
ACTION OF THE YEAR — THEMATIC FOCUS OF 2014: CHRONIC DISEASES 

The priority health topic for the 2014 annual work programme was chronic diseases. Overall, 
three  calls  for  proposals  for  projects  on  different  aspects  of  chronic  disease  prevention  and 
management were launched, resulting in  five co-funded projects. A joint action on nutrition 
and physical activity and another one on dementia were concluded, as were six projects in the 
area  of  active  and  healthy  ageing.  The  PATHWAYS  project  described  below  is  a  good 
example. It addresses the important issue of the participation of chronic disease patients in the 
work force. This is fully in line with the Commission’s agenda on jobs and growth. 

1.1  PATHWAYS  Project  —  Participation  to  healthy  workplaces  and  inclusive 

strategies in the work sector 

1.1.1  Background 

PATHWAYS  —  Participation  to  healthy  workplaces  and  inclusive  strategies  in  the  work 
sector  was  one  of  the  projects  co-funded  in  2014  as  part  of  the  focus  that  year  on  chronic 
diseases. PATHWAYS started in summer 2015, will run for 36 months and will receive up to 
EUR 969 379.00 in co-funding. It involves 12 partners from 10 different European countries 
(Austria,  Belgium,  the  Czech  Republic,  Germany,  Greece,  Italy,  Norway,  Poland,  Slovenia 
and Spain), all of whom have vast expertise in the area of chronic and mental conditions and 
employment. 

1.1.2  Brief description 

People  with  chronic  diseases  and  mental  disorders  often  experience  work-related  problems, 
such  as  unemployment,  absenteeism,  reduced  productivity  and  stigmatisation  in  the 
workplace.  The  rising  prevalence  of  chronic  diseases  and  mental  disorders  against  budget 
austerity requires innovative strategies to help these people participate in the labour market. 

However,  we  lack  knowledge  about  available  strategies  and  whether  they  are  effective.  We 
must  also  clarify  the  employment-related  needs  of  people  with  chronic  diseases  and  mental 
disorders.  Hence,  in  response,  PATHWAYS  will  identify  integration  and  reintegration 
strategies  that  are  available  in  Europe  and  beyond  and  determine  their  effectiveness.  It  will 
further  assess  the  specific  employment-related  needs  of  people  with  chronic  diseases  and 
mental disorders. Lastly, it will develop guidelines to support the implementation of effective 
professional  integration  and  reintegration  strategies.  Stakeholder  consultations  will  be  one 
method used. 

1.1.3  Expected results 

PATHWAYS will provide a series of reports, including: 

  one comparing the available strategies based on the five categories of social welfare 

and healthcare models in Europe; and 

  one  on  unmet  employment  needs  in  people  with  chronic  diseases,  including 

recommendations on how to tackle them. 

5 

 
 
A  database  will  compile  the  available  evidence  on  the  effectiveness  of  existing  integration 
and  reintegration  into  work  strategies  for  people  with  chronic  conditions,  and  the  evidence 
will be described in a scoping paper. 

Lastly,  PATHWAYS  will  conclude  with  policy  recommendations  to  implement  inclusive 
strategies towards a more inclusive labour market in which people with chronic diseases and 
mental disorders can participate meaningfully. 

INITIATIVES THAT DIRECTLY CONTRIBUTE TO IMPLEMENTING EU LAW 

The Health Programme funds services provided by external contractors that support the 
Commission in implementing decisions and directives in the field of health. Below one 
example of such services that were carried out in 2014. 

1.2  Request  for  service  —  implementation  of  the  Cross-border  Healthcare 

Directive 2011/24/EU 

1.2.1  Background description 

This study considered the effects of the Cross-border Healthcare Directive 2011/24/EU3. Its 
overall  objective  was  to  report  on  Member  States'  implementation  of  the  Directive,  as 
required  under  Article 20(1),  and  identify  gaps  and  potential  for  improvement.  The  study 
drew on the situation on the ground and other valuable external sources. These services were 
provided  through  a  service  contract  with  KPMG  Advisory  N.V.,  Technopolis  Group  and 
Empirica GmbH, under the framework contract SANCO/2012/02/011 — Lot 1. The contract 
ran from 21 July 2014 to 21 March 2015 at a cost of EUR 179 026. 

1.2.2  Brief description 

In addition to desk research and a literature review, a detailed website review and widely used 
participatory  research  methods  were  used.  Building  on  previous  research  efforts,  all  the 
websites of the 32 national contact points for cross-border healthcare (NCPs) were analysed 
(32 countries or territories as Scotland, Wales, England, Northern Ireland and Gibraltar were 
included separately for the UK). 

The ‘pseudo-patient’ research method was used to take account of the ‘end-user’ perspective. 
The evaluators approached NCPs in 12 Member States (Austria, Belgium, France, Germany, 
Hungary, Italy, Lithuania, Malta, the Netherlands, Slovenia, Spain and Sweden) by both email 
and telephone using three different pre-designed scenarios.  

Subjective,  opinion-based  data  were  also  collected  in  the  focus  countries  and  at  European 
level via 59 stakeholder interviews and an online survey addressed to the NCPs in the focus 

3 OJ L 88, 4.4.2011, p.45 

6 

 
 
 
 
                                                            
countries. Some 50 % of stakeholders contacted agreed to be interviewed over the four-week 
period. They represented a range of health insurance providers, healthcare providers, patient 
ombudsmen, national and regional authorities, patient groups, audit bodies, trade unions and 
frontline healthcare prescriber organisations. All NCPs completed at least a part of the online 
survey.  A  Strength-Weakness-Opportunities-Threats  (SWOT)  analysis  focusing  on  the 
services provided to the patients complements the conclusions of the study. 

1.3.3 Specific results 

This study is part of ongoing work to build a zero baseline as a starting point for measuring 
and assessing cross-border healthcare in the Union. As a general finding, all the stakeholders 
involved  confirmed  that  the  number  of  patients  having  made  use  of  cross-border  healthcare 
under the Directive is low. 

This  study  delivers  a  meaningful,  albeit  qualitative  contribution  to  the  baseline  assessment 
and to future evaluation efforts, in line with the ‘evaluate first’ principle. The study findings 
were  published in  May 2015 on the  European Commission’s  website and  were  presented at 
the NCPs’ meeting organised by the European Commission on 2 December 2015, where they 
were met with great interest. It is hoped that the methodological avenues of the study will be 
explored further by interested stakeholders and by the wider research community. 

This study is, however, not a formal evaluation. Complaints, infringements and transposition 
measures were not part of its remit. Given the recent adoption of the Directive and the scarcity 
of readily available data on patient mobility, a formal evaluation of the Directive would have 
been premature. 

BUDGET IMPLEMENTATION 

1.3  Budget 

The budget for the Third Health Programme 2014-2020 is EUR 449.4 million. This includes 
EUR 33.48  million  for  the  functioning  of  the  Consumer,  Health,  Food  and  Agriculture 
Executive  Agency  (Chafea)  which  the  Commission  has  asked  to  manage  the  Health 
Programme 2014-2020. Chafea has been providing the Commission with technical, scientific 
and administrative assistance in implementing the Health Programme since 2005.4 It organises 
annual  calls  for  proposals,  coordinates  the  evaluation  of  submissions,  and  negotiates,  signs 
and  manages  related  grant  agreements.  It  is  also  responsible  for  many  procurement 
procedures. 

The budget set out in the work plan for 20145 was EUR 58 579 000, broken down as follows: 

4 Decision 2004/858/EC of 15 December 2004 (OJ L 369, 16.12.2004, p. 73) amended by Decision 2008/544/EC 
of 20 June 2008 (OJ L 173, 3.7.2008, p. 27). 

5 Commission Decision C(2014) 3383 of 26.5.2014, 
http://ec.europa.eu/health/programme/events/adoption_workplan_2014_en.htm. 

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  operational  expenditure:  EUR  52 870 000,  corresponding  to  budget  line  17 03 01 
Encouraging  innovation  in  healthcare  and  increasing  the  sustainability  of  health 
systems,  improving  the health  of  the  Union  citizens  and  protecting  them  from  cross-
border health threats; 

  administrative expenditure: EUR 1 500 000 — corresponding to budget line 
17 01 04 02 — support expenditure for Health for Growth programme.6 

The total operational budget – including in addition EFTA/EEA credits and recovery credits 
from previous budget years - was EUR 54 856 308.05 and the total administrative budget was 
EUR 1 547 747.69.  

In 2014, Chafea managed EUR 44 541 244.83 of this budget, while the Commission managed 
EUR 9 409 832.88 covering procurement, direct grants and other measures. 

1.4  Priorities for 2014 and financing mechanisms 

The priorities for 2014 were set out in Commission Implementing Decision C (2014) 3383 of 
26 May 2014 concerning the adoption of the 2014 work programme and related criteria.7 

Several  financing  mechanisms  were  used  to  implement  the  work  plan  for  2014.  These  are 
described in detail below. 

Competitive  selection  and  award  procedures  were  used  to  select  initiatives  for  funding. 
Competitive  selection  and  award  procedures  are  not  used  for  joint  actions,  direct  grant 
agreements  and  conferences  organised  by  Council  presidencies  because  in  those  cases 
competitive  procedures  are  either  not  allowed  under  the  specific  rules  or  are  not  used  in 
practice, for example due to a monopoly situation. 

Administrative credits covered expenditure such as studies, meetings of experts, information 
and publication costs, and technical and administrative assistance for IT systems. 

1.5 

Implementation of the operational budget by financing mechanism 

Type of financing mechanism 

Calls for proposals 
Project grants 

Implementation 
(EUR) 

Share of mechanism 
in total executed 
budget  

17 393 292.88 
12 677 193.08 

31.7 % 
23.1 % 

6 The name originally proposed for the Third Health Programme was ‘Health for Growth’ Programme: hence, 
the name of the budget line. As this name was not retained, the budget line has been re-named for the work 
programme 2016. 

7  

http://ec.europa.eu/health/programme/events/adoption_workplan_2014_en.htm. 

8 

 
 
 
 
                                                            
8.5 % 
33.7 % 

0.2 % 

7 % 

23.3 % 

9.7 % 
13.6 % 

2.3 % 

Operating grants 
Grants for joint actions 

Conference grants to the Member States 
holding the presidency of the EU  
Direct grant agreements 

Managed by CHAFEA 

4 716 099.80 
18 506 972.39 

157 901.00 

3 849 825.96 
2 700 000.00 

Managed by DG SANTE 

1 149 825.96 

Procurement (service contracts) 

12 769 292.44 

Other actions  

Managed by CHAFEA 

Managed by DG SANTE 

Managed by CHAFEA 

Managed by DG SANTE 

Budget spent in 2014 

Total available budget 
Credits not used8  

Budget spent 

by CHAFEA 

 by DG SANTE 

5 283 078.56 
7 486 213.88 

1 273 793.04 

500 000.00 

773 793.04 

53 951 077.71 

54 856 307.05 

711 310.68 

193 918.66  

98.3 % 

By way of comparison, the table below shows the percentage of the available budget spent per 
financial mechanism on average in the Second Health Programme and in 2014. While a lower 
proportion was spent on projects in 2014, more was spent on joint actions.  The percentages 
are similar for other financial tools. 

Type of financing mechanism 

Share  of  mechanism 
in 
executed 
total 
budget in 2014 

total 

Share  of  mechanism 
executed 
in 
budget 
Second 
Health Programme 

in 

Project grants 

23.1 % 

36 % 

8 Pre-accession credits not yet used, differences between amounts in the award decision and amounts actually 
contracted. 

9 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
                                                            
Operating grants 
Grants for joint actions 

Direct grant agreements 
Procurement (service contracts) 

Other actions  

Calls for proposals 

8.5 % 
33.7 % 

4.9 % 
23.0 % 

2.3 % 

7 % 
22 % 

7 % 
25 % 

4 % 

Calls  for  proposals  —  for  projects  and  operating  grants  actions  —were  launched  on 
6 June 2014  on  the  Participant  Portal  of  the  Horizon 2020  Programme,9  the  public  health 
website on EUROPA10 and on Chafea’s website.11 Most applications were received from main 
partners in EU-15 Member States, who accounted for 86 % of project applications, 100 % of 
operating grant applications, and 100 % of joint action applications. 41 % of all partners in the 
joint actions are from EU-13 countries, as are 16 % of the project partners. 

Chafea organised a joint action workshop in October 2014 and a joint action quality assurance 
workshop  in  February  2015.  The  National  Focal  Points  for  the  Health  Programme  also 
organised national information days in BG, HR, CZ, EL, HU, IE, IT, LT, NL, NO, PL, PT, 
RO, SK, ES and UK. Guidelines for applicants were made available on the Participant Portal. 
The Chafea helpdesk also provided assistance and practical help. 

Altogether, 50 proposals for projects and 40 operating grant  proposals  were  received for an 
amount totalling EUR 42 887 771. Applications were evaluated in accordance with the rules 
and  criteria  set  out  in  Commission  Implementing  Decision  C (2014)  3383  and  the  calls  for 
proposals.  37  external  experts  from  18  countries  took  part  in  the  evaluation  process.  The 
experts were drawn from a list established following a call for expressions of interest entitled 
‘call for expressions of interest in the area of public health’.12 

The evaluation process took place in two stages. 

In the first stage, three external evaluators reviewed each proposal. A consolidated evaluation 
report for each proposal was drawn up at a meeting organised by Chafea. 

9 
http://ec.europa.eu/research/participants/portal/desktop/en/opportunities/3hp/index.html#c,calls=hasForthcoming
Topics/t/true/0/1/0&hasOpenTopics/t/true/0/1/0&allClosedTopics/t/true/1/1/0&+PublicationDate/desc 

10 http://ec.europa.eu/health/programme/policy/index_en.html. 

11 http://ec.europa.eu/chafea/health/index.html. 

12 OJ S 040-065407, 26.2. 2014 and http://ec.europa.eu/chafea/ami/. 

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In the second stage, the evaluation committee checked that the evaluators had complied with 
the  relevant  rules  and  criteria.  It  then  drew  up  final  lists  of  proposals  recommended  for 
funding, together with reserve lists. The evaluation committee comprised representatives from 
the  Directorate-General  for  Health  and  Food  Safety  (DG  SANTE),  the  Directorate-General 
for  Research  and  Innovation  and  from  Chafea.  The  award  decision  for  projects13  and 
operating grants14 were taken by Chafea. 

1.5.1  Project grants 

Project grants were awarded to actions involving several partners, usually public health bodies 
and non-governmental organisations. The maximum EU contribution is 60 % of eligible costs. 
However,  the  EU  contribution  may  go  up  to  80 %  if  a  proposal  meets  the  criteria  for 
exceptional utility. In 2014, two projects qualified for exceptional utility. 

In  all,  50  proposals  were  submitted  in  response  to  the  call  for  proposals  for  projects.  Six 
proposals were excluded in the screening phase. Out of the remaining 44 proposals 12 were 
recommended for funding and four were placed on a reserve list. In the end, 13 projects were 
funded  for  a  total  of  EUR  11 567 617.  Their  distribution  among  the  programme  objectives 
was as follows: 

1.  health promotion: EUR 3 535 947 (5 projects); 

2.  health threats: no projects funded; 

3.  health systems: EUR 8 031 670 (7 projects); 

4.  better and safer healthcare: no projects funded. 

The annex lists all projects funded. 

1.5.2  Operating grants 

Operating grants were awarded to non-profit organisations or networks that are: 

  non-governmental; 
  non-profit-making  and  independent  of  industry,  commercial  and  business  or  other 

conflicting interests; 

  working in the public health area; 
  play an effective role in civil dialogue processes at Union level; 
  pursue at least one of the specific objectives of the Programme; 
  active at Union level and in at least half of the Member States; and 
  have a balanced geographical coverage of the Union. 

13 http://ec.europa.eu/chafea/documents/health/list-projects-2014_en.pdf. 

14 http://ec.europa.eu/chafea/documents/health/award-fpa-agreements-2014_en.pdf and 
http://ec.europa.eu/chafea/documents/health/specific-grant-agreements-2014_en.pdf. 

11 

 
 
 
 
                                                            
The  maximum  EU  contribution  is  60 %  of  their  annual  operating  costs.  However,  the  EU 
contribution may increase to 80 % if a proposal meets the criteria for exceptional utility.  In 
2014, only four operating grants qualified for exceptional utility. 

With  the  start  of  the  Third  Health  Programme,  Chafea  introduced  the  call  for  multi-annual 
‘framework  partnership’  instrument.  The  holders  of  three-year  framework  partnership 
agreements can then apply for annual co-funding. A total of 40 proposals were submitted in 
response  to  the  call  for  proposals  for  operating  grants.  Of  these,  14  were  awarded  a 
framework partnership agreement (35 % of the proposals received). All of them received an 
annual operating grant for 2015. The total co-funded was EUR 4 716 099.80 

The annex lists all operating grants funded. 

1.5.3  Joint actions 

Grants  for  joint  actions  were  awarded  to  competent  authorities  or  public  sector  bodies  and 
non-governmental  bodies  mandated  by  those  competent  authorities.  The  maximum  EU 
contribution is 60 %. However, the EU contribution may go up to 80 % if a proposal meets 
the  criteria  for  exceptional  utility.  In  2014,  only  two  joint  actions  qualified  for  exceptional 
utility. 

The procedure for joint actions  under the Third Health Programme has changed. In order to 
assure more transparency and inclusiveness, the Member States and countries participating in 
the Third Health Programme now nominate the competent authorities or other bodies as a first 
step. Then, those nominated are invited to submit a proposal under the direct grant procedure. 

Eight joint  actions were  co-funded for a total of EUR 18 506 972.39. They were  distributed 
among the programme objectives as follows: 

1.  health promotion: EUR 5 698 457.39 (three joint actions); 

2.  health threats: EUR 3 499 873.00 (one joint action); 

3.  health systems: EUR 2 599 999.00 (two joint actions); 

4.  better and safer healthcare: EUR 6 708 643.00 (two joint actions). 

These  joint  actions  each  involved  between  10  and  24  Member  States  and  other  countries 
taking part in the programme; involving on average 19 per joint action. 

The health topics covered by the joint actions are: 

  unbalanced dietary habits and physical inactivity; 
 

improvement of HIV and co-infection prevention and treatment in priority regions and 
priority groups in the European Union; 

  coordinated action to improve the situation and career of people with dementia; 
  highly dangerous and emerging pathogens; 
 

technical and scientific cooperation on medical devices and in vitro diagnostic medical 
devices; 

12 

 
 
 
  support for the eHealth Network; 
 

implementation of the Council Recommendation and Commission Communication on 
Rare Diseases15; and 

  monitoring  and  control  in  the  field  of  blood  transfusion  and  tissue  and  cell 

transplantation. 

The annex lists all the joint actions funded. 

1.6  Direct grant agreements with international organisations 

Direct  grant  agreements  with  international  organisations  were  awarded  to  international 
organisations active in the area of public health. The direct grants also include service-level 
agreements. The maximum EU contribution is 60 %. 

All  in  all,  seven  direct  grant  agreements  were  signed,  for  a  total  of  EUR 3 849 825.96  as 
follows: 

Four were signed by Chafea, namely: 

1)  the  contribution  agreement  with  the  Council  of  Europe  for  the  integration  of  EU 
legislation on substances of human origin (EUR 500 000); 
2)  the 
(EUR 1 100 000); 
3)  two direct grant agreements with the World Health Organisation: 

the  European  Pharmacopoeia 

annual  direct  grant 

agreement  with 

  monitoring  of  the  national  policies  related  to  nutrition,  physical  inactivity, 

overweight and obesity (EUR 600 000); and 

  monitoring  of  the  national  policies  related  to  alcohol  consumption  and  harm 

reduction (EUR 500 000). 

Three were signed by DG SANTE, namely: 

1)  two direct grants (cross sub-delegation/service-level agreement) to Eurostat regarding 

morbidity statistics for a total of EUR 1 099 825.96; and 

2)  one direct grant to the Pharmaceutical Inspection Cooperation Scheme for training in 

the area of active pharmaceutical ingredients for EUR 50 000. 

The annex lists all direct grant agreements that were funded. 

1.7  Procurements (service contracts) 

Procurement (service contracts) was used to purchase services. The Programme fully covers 
the cost of procurement. 

These service contracts cover needs as specified in the work plan for 2014: 

  evaluation and monitoring of actions and policies; 

15 http://ec.europa.eu/health/ph_threats/non_com/docs/rare_com_en.pdf  

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  studies; 
  advice; 
  data and information on health; 
  scientific and technical assistance; 
  communication; 
  dissemination; 
  awareness-raising activities; and 
 

IT applications to support policies. 

In  2014,  DG  SANTE  signed  several  service  contracts  and  specific  requests  using  existing 
framework contracts. Most of these contracts and requests were for horizontal actions such as 
communication and IT services for maintenance and functioning of existing IT tools (i.e. the 
EMP  database,  EUDAMED,  Health  Policy  Platform,  etc.).  Procurement  contracts  also 
included  contracts  with  experts  working  for  the  scientific  committees  and  evaluation  and 
monitoring  studies.  The  overall  public  procurement  budget  managed  by  DG  SANTE 
amounted to EUR 7 486 213.88. 

In  2014,  Chafea  managed  22  new  market  procedures  for  the  acquisition  of  services  (four 
contracts  under  health  promotion,  four  contracts  under  health  threats,  six  contracts  under 
health systems, five under better and safer health care) and three on horizontal communication 
for a total of EUR 5 283 078.56. 

The amounts per objective and authorising organisation were as follows: 

Health Programme objective 

Health promotion 

Procurement managed by DG 
SANTE (EUR) 
1 353 200.72 

Procurement  managed  by 
Chafea (EUR) 
1 280 967.00 

Health threats 
Health systems 
Better and safer healthcare 
Horizontal 
TOTAL 
The annex lists all service contracts signed. 

0 
1 327 335.79 
733 684.35 
4 071 993.02 
8 260 006.92 

1.8  Other actions 

1 802 209.40 
864 927.50 
1 213 163.00 
121 811.66 
5 283 078.56 

EUR 2 184 000 was earmarked for other actions in 2014. The ‘other actions’ include experts’ 
fees, for example: 

 
 
 

the expert panel on effective ways of investing in health; 
for experts carrying out system inspection on pharmaceutical ingredients; 
for  experts  participating  in  the  international  conferences  on  the  harmonisation  of 
technical  requirements  for  the  registration  of  pharmaceuticals  for  human  and 
veterinary uses. 

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This  also  includes  cost  of  administrative  agreements  with  the  Joint  Research  Centre  and 
covers  the  Commission’s  membership  fee  to  the  European  Observatory  on  Health  Systems 
and  Policies.  For  more  information  on  what  specific  actions  fell  under  the  banner  ‘other 
actions’, please refer to the annex. 

1.9  Budget consumption in 2014 

All in all, the total operational budget for 2014 was divided among the four specific objectives 
of the Third Health Programme as follows: 

1.  health promotion: EUR 16 113 811.99 (30.6 % of the operational budget in 2014); 
2.  health threats: EUR 5 302 082.40 (10.1 % of the operational budget in 2014); 
3.  health systems: EUR 16 537 850.33 (31.4 % of the operational budget in 2014); 
4.  better and safer healthcare: EUR  10 653 702.35 (20.2 % of the operational budget in 

2014); 

5.  horizontal activities (IT, communication): EUR 4 193 804.68 (7.8 % of the operational 

budget in 2014). 

Chart 1 — Operational budget use in 2014 by Third Health Programme objective 

1.10  Type of beneficiaries 

In 2014, nearly 40016 different grants and contracts were signed with diverse beneficiaries and 
service  providers  ranging  from  governmental  and  non-governmental  organisations  to 
academic institutions and private companies. The category ‘other’ includes beneficiaries such 
as health care providers and international organisations. Chart 2 provides an overview of the 
different groups of beneficiaries. 

16 This excludes contracts made with single experts e.g. those participating in the Scientific Committees. 

15 

 
 
 
 
 
 
 
 
                                                            
Chart 2 — types of beneficiaries of the Third Health Programme in 2014 

CONCLUSION 

2014  was  the  first  year  of  the  Third  Health  Programme,  which  was  adopted  by  European 
Parliament and Council on 11  March 2014. Consequently, the annual work programme was 
adopted two months later on 26 May 2014 and thus the whole implementation cycle was also 
delayed. Thus, most of the grant agreements and several service contracts were signed in the 
first  trimester  of  2015.  The  Third  Health  Programme  Regulation  makes  some  significant 
improvements compared to the Second Health Programme. These include: 

  specific objectives with related indicators; 
  a clear definition of ‘EU added value’; and 
 

introducing criteria to define ‘exceptional utility’ for joint actions. 

This meant, for example, that applicants and evaluators were better guided by the definition 
of  ‘EU  added  value’  and  it  was  easier  for  joint  action  consortia  to  develop  the  proposal  in 
such a way that it would qualify for exceptional utility, i.e. 80 % co-funding. 

There were also several positive changes  as regards the implementation  of the Third Health 
Programme. These included the introduction of online submissions via the Participant Portal; 
and online evaluation and electronic signature of the grant  agreements. The Regulation also 
introduced simplified administrative procedures and direct grant agreements for joint actions 
and framework partnership agreements for operating grant holders to enable the recipients of 
these grants to carry out longer-term planning. 

The  new  procedure  for  joint  actions  is  also  more  transparent  because  as  a  first  step  the 
consortium  needs  to  be  established  through  nominations  by  Member  States/countries 
participating  in  the  Third  Health  Programme.  However,  this  means  that  EU  umbrella  non-

16 

 
 
 
 
 
governmental  organisations  in  particular  face  the  challenge  of  being  nominated,  whereas 
during the Second Health Programme they were nominated by the Commission. 

The number of participants in joint actions continues to be relatively high, as already seen in 
the Second Health Programme: on average 25 participants per joint action in 2014 — ranging 
from 12 to 39. This is a challenge for the overall management and coordination of the joint 
actions.  When  looking  at the  calls for  proposal  for  projects,  it  can  be  observed  that  for  two 
calls no project has been awarded. In one case this was because no applications were received, 
possibly  because  the  theme  was  defined  rather  narrowly  and  the  co-funding  proposed 
relatively low. In the second case several proposal were received, but all were excluded in the 
evaluation due to insufficient quality. 

Following the recommendations of the ex post evaluation, further improvements are due to be 
implemented in the coming years, including an enhanced electronic monitoring and reporting 
system,  better  and  more  targeted  dissemination  and  continued  efforts  to  increase  the 
participation  of  organisations  and  institutions  from  those  countries  which,  until  now,  have 
been under-represented among the beneficiaries.  

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