REPORT FROM THE COMMISSION TO THE EUROPEAN PARLIAMENT, THE COUNCIL, THE EUROPEAN ECONOMIC AND SOCIAL COMMITTEE AND THE COMMITTEE OF THE REGIONS Mid-term evaluation of the 3rd Health programme 2014-2020 under Regulation (EU) No 282/2014 on the establishment of a third programme of Union action in the field of health (2014-2020)
Date: 2017-10-11
Institutions: Directorate-General for Health and Food Safety, European Commission
Subjects: EU financial instrument, EU programme, cross-border cooperation, disease prevention, health care, health care system, programme budgeting, project evaluation, public awareness campaign, public health

EN 

   EN 

   EUROPEAN COMMISSION  Brussels, 11.10.2017  COM(2017) 586 final   REPORT FROM THE COMMISSION TO THE EUROPEAN PARLIAMENT, THE COUNCIL, THE EUROPEAN ECONOMIC AND SOCIAL COMMITTEE AND THE COMMITTEE OF THE REGIONS Mid-term evaluation of the 3rd Health programme 2014-2020 under Regulation (EU) No 282/2014 on the establishment of a third programme of Union action in the field of health (2014-2020) {SWD(2017) 331 final} {SWD(2017) 333 final}  
 
 
1. INTRODUCTION 

This  report  briefly  presents  the  main  conclusions  from  the  mid-term  evaluation  of  the  Third 
Health  Programme  in  accordance  with  Article  13(3)(c)  of  Regulation  (EU)  No  282/20141.  The 
report  also  presents  ideas  for  improving  the  implementation  of  the  Programme  for  the 
remaining programming period (2018  – 2020). The report is accompanied by a detailed staff 
working document.  

2. WHAT IS THE 3RD HEALTH PROGRAMME 

The 3rd Health Programme is a sectorial financial instrument under the Multiannual Financial 
Framework  (MFF)  2014-2020,  established  by  Regulation  (EU)  No  282/2014.  It  underpins  EU 
health  policy  coordination  in  order  to  complement,  support  and  add  value  to  the  national 
policies of Member States. At the same time, it fully respects their autonomy to define their 
own health policies and to organise and deliver health services and medical care within their 
borders. It also supports implementation of EU health legislation.  

With a total budget of EUR 449.4 million over seven years, the Programme serves the needs of 
the Member States under overarching priorities: 

  the  link  between  the  health  status  of  the  population  and  its  contribution  to 
growth and jobs through labour market participation and labour productivity; 

  investment in health as a source of economic prosperity and social cohesion; 

  societal challenges (such as demographic ageing; inequalities, burden of chronic 

diseases, effectiveness and resilience of health systems). 

2.1. Objectives and priorities 
The Programme is designed to complement, support and add value to Member State policies. 
The  main  goal  is  to  improve  the  health  of  Europeans  and  reduce  inequalities  by  promoting 
health,  encouraging  innovation,  boosting  the  sustainability  of  health  systems  and  protecting 
Europeans  from  serious  cross-border  health  threats.    This  can  be  expressed  as  four  specific 
objectives: 

http://eur-lex.europa.eu/legal-

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content/EN/TXT/;jsessionid=5Qj3TvyCyBqbhfLZzzBttjDGh3gyXkQWYrjhrt36mChMJJlp02XX!2060916514?uri=urise
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(a)  promote  health,  prevent  diseases  and  foster  supportive  environments  for  healthy 
lifestyles,  

(b) protect Union citizens from serious cross-border health threats,  

(c) contribute to innovative, efficient and sustainable health systems, and  

(d) facilitate access to better and safer healthcare for Union citizens.  

The Programme focuses on issues where there is potential to generate EU-added value and to 
make a real contribution to the Commission's main priorities.  

HEALTH PROGRAMME CONTRIBUTIONS TO COMMISSION PRIORITIES  

  ‘growth, jobs and a resilient society’:  health of population and health care 

services as a productive factor for growth and jobs,  

  ‘digital single market’: eHealth,  
  ‘internal market’:  actions supporting  EU legislation on tobacco, 

pharmaceuticals, medical devices, cross-border health care directive, and 
Health Technology Assessment,  

  ‘justice and fundamental rights’: fighting against health inequalities ,  
  ‘migration’ policy: actions on migrants and refugees; and 
  ‘Security in Europe’: preparedness and management of serious cross-border 

health threats.  

The programme also helps Member States to reach their sustainable development goals (SDG), 
in particular SDG 3 "Ensure healthy lives and promote well-being for all at all ages"2. 

2.2. Implementation of the Programme in 2014-2016  

The  Programme  is  managed  by  the  Commission  and  implemented  through  annual  work 
programmes, which are adopted following approval by a programme committee made up of 
Member State representatives. A multi-annual planning ensures that all thematic priorities are 
covered and available resources are aligned with priorities and actions. The implementation is 
entrusted to the Consumers, Health, Agriculture and Food Executive Agency (CHAFEA).  
The budget has been attributed between the 23 thematic priorities (Figure 1).  

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Figure 1: Budget attribution by thematic priorities in 2014-2016 

Action  on  migrants  and  refugees  cuts  across  several  areas  of  action  like  health  inequalities, 
chronic diseases, mental health, communicable diseases and health information. If looked at 
as  a  single  entity,  action  on  migrants  and  refugees  represents  a  public  health  investment  of  
EUR 14.4 million (EUR 9.5 million funded under horizontal activities, another EUR 3.5 million 
under capacity building (priority 2.2) and EUR 1.4 million under priority of health information 
(priority 3.7). 

With  the  remaining  EUR  7.8  million  under  horizontal  activities,  the  Programme  supports 
activities  for  maintenance  and  licence  of  information  technologies  (e.g.  the  European 
Commission Public Health website, the Health Policy Platform), communication on EU health 
policies  and  dissemination  of  Programme results  through  instruments such  as  the Health-EU 
newsletter,  and  the  annual  EU  Health  Award  for  non-governmental  organisations  whose 
missions  make  a  real  contribution  to  public  health.  The  award  went  to  NGOs  whose  work 
made an impact during the Ebola crisis in 20153, contributed to the fight against antimicrobial 
resistance in 20164, and promoted vaccination in 20175. 

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The 1st prize was attributed to The Alliance for International Medical Action (ALIMA), the 2nd prize to 
Concern Worldwide and the 3rd prize to the Spanish Red Cross.  
The  1st  prize  was  attributed  to  BEUC/The  European  Consumer  Organisation,  the  2nd  prize  to  Alliance 
to  Save  our  Antibiotics  –  Compassion  in  world  Farming  –  Soil  Association,  and  the  3rd  prize:  World 
Alliance Against Antibiotic Resistance WAAAR 

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The  EU-28  Member  States  participate  in  the  Programme,  as  well  as  the  two  EFTA  countries 
Norway  and  Iceland.  Serbia  and  Moldova  have  also  participated  since  2016  and  Bosnia  and 
Herzegovina  joined  in  April  20176.  The  increasing  interest  in  the  Programme  shown  by 
candidate and potential candidates and neighbouring countries could be seen as a sign of the 
increasing  interest  the  Programme  has  for  those  countries  that  have  decided  to  align  their 
health policies with those of the EU.  

3. THE MID-TERM EVALUATION 

The  mid-term  evaluation  conducted  in  2016-2017  mainly  focused  on  the  relevance  of  the 
thematic  priorities,  the  achievement  of  the  objectives  and  the  effectiveness  of  the 
Programme’s management. However, it also touched upon other issues such as the efficient 
use  of  resources,  the  Programme’s  EU-added  value  and  its  internal  and  external  coherence. 
The  evaluation  was  based  on  an  external  study  and  included  an  open  public  consultation 
whose replies of the 133 participants fed into the final evaluation conclusions.  

To  comply  with  the  legal  obligation7,  the  mid-term  evaluation  was  carried  out  quite  early  in 
the  Programme  implementation  period,  and  it  was  not  yet  possible  to  quantitatively  assess 
whether  Programme  objectives  had  been  met.  The  actions8  under  the  first  year  of  the 
Programme, which began in early 2015, were only expected to deliver their interim results by 
the  end  of  2016  at  the  earliest.  Nonetheless,  a  series  of  case  studies  on  29  actions, 
(corresponding to eight thematic priorities, two per Programme objective) could be used as a 
basis  for  evaluation.  These  case  studies  produced  ample  evidence  on  the  benefits  and 
potential benefits of the funded actions.  

3. 1. Results and key achievements 
After  three  years  of  Programme  implementation,  the  evaluation  concludes  that  most  of  the 
funded actions are well on their way to delivering promising results, while some others have 
only just started. A few examples of priorities under each of the Programme objectives are:  

3. 1. 1. Health promotion and disease prevention 

The  Programme  has  supported  cooperation  among  Member  States  through  the  generation, 
use, sharing and exchange of knowledge and best practices. This is in line with Article 168 of 

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Deadline for submission of applications: 30 June 2017. 
This participation is out of the scope of the mid-term evaluation.  
Article 13(3)(c) of Regulation (EU) No 282/2014 for a mid-term evaluation by 30 June 2017. 
Most of the actions have a life span of three years with the exception of operating grants, procurement 
contracts and some projects for migrants at the end of 2015, which had duration of one year.  

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the  Treaty  on  the  Functioning  of  the  European  Union  (TFEU)  and  contributes  to  the 
achievement of SDG 3 to "ensure healthy lives and promote well-being for all at all ages"2.  

The Commission, jointly with the OECD and the European Observatory on Health Systems and 
Policies,  is  bringing  together  expertise  in  the  State  of  Health  in  the  EU  cycle  to  strengthen 
country-specific  and  EU-wide  knowledge  in  health,  supporting  Member  States  in  their 
evidence-based policy making. This recurring two-year cycle of knowledge brokering comprises 
the Health at a Glance: Europe report9, 28 country profiles, a Companion Report and voluntary 
exchanges that Member States can request. 

Ultimately improving the health information underlying the State of Health in the EU cycle, the 
BRIDGE  project10  brings  together  expertise  in  the  area  of  population  and  health  system 
monitoring, aiming to set up a sustainable and integrated EU health information system. 

Exchange of best practice has also been at the heart of several co-funded actions, in areas as 
diverse as HIV/AIDS and TB prevention11 or alcohol harm reduction12. Other actions are related 
to:  

(a) the development and maintenance of an online reference guide hosted by the Commission 
Joint  Research  Centre  as  a  one-stop  clearing  house  for  independent,  reliable  and up-to  date 
information  on  a  wealth  of  topics  related  to  nutrition,  physical  activity  and  prevention  of 
chronic conditions;  
(b)  the  EU-Compass  for  Action  on  Mental  Health  and  Wellbeing13  which  is  a  web-based 
mechanism used to collect exchange of best practices and analyse information on policy and 
stakeholder activities in mental health;  
(c) the European Quality Assurance scheme for breast cancer services14,and the publication of 
European Breast Cancer Guidelines15,  
(d) the European Network of Cancer Registries16 providing a ‘data-brokering’ service to ensure 
integrity of a single European dataset for different purposes; and  

(e)  the  recently  published  second  report  on  the 
Recommendation on cancer screening in the European Union17. 

implementation  of  the  Council 

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http://ec.europa.eu/health/state/glance_en 
http://www.bridge-health.eu/ 
https://e-detecttb.eu/ 
http://www.rarha.eu/Pages/default.aspx 
http://ec.europa.eu/health/sites/health/files/mental_health/docs/ev_20161006_co05_en.pdf 
https://ec.europa.eu/jrc/en/event/workshop/european-quality-assurance-scheme-breast-cancer-
services 
http://ecibc.jrc.ec.europa.eu/european-guidelines 
http://www.encr.eu/ 
https://ec.europa.eu/health/sites/health/files/major_chronic_diseases/docs/2017_cancerscreening_2n
dreportimplementation_en.pdf 

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3. 1. 2. Crisis preparedness and management  
Activities to support capacity building against health threats have helped to avoid duplication 
and  improve  capabilities,  delivering  added  value  for  the  EU  and  the  wider  international 
community. They have served to identify gaps in Member States’ capacities, prioritise actions 
and implement capacity building activities to fill in those gaps, and have also delivered toolkits 
and  guidelines,  provided  training  and  testing  of  EU  preparedness  and  response  mechanisms 
and coordinated external quality assurance exercises.  These activities also made it possible to 
share lessons learned during recent outbreaks.  

During  the  Ebola  and  Zika  virus  outbreaks,  the  programme  was  used  to  support  EU-funded 
activities  to  limit  the  spread  of  these  threats  by  strengthening  Member  State  preparedness 
and  response  in  particular  through  the  actions  of  the  Health  Security  Committee  (entry 
screening, medical evacuations, prevention of transmission in transport and hospital settings).  

Examples  of  further  action  include  implementing  the  joint  procurement  of  vaccines18  and 
medical  counter-measures19;  and  improving  the  capacity  of  laboratories20  to  rapidly  detect 
new or emerging risks and ensure uniform standards of testing.  

The  Programme  demonstrated  its  capacities  and  flexibility  when  put  to  the  test  during  the 
unprecedented high influx of refugees in 2015-2016. It provided a foundation for neighbouring 
countries and the International Office for Migration to work together to raise awareness and 
to strengthen their commitment to improve maternal health and healthcare for refugees and 
migrant women. The Programme was also instrumental in helping to develop and implement 
roadmaps  and  models  for  improving  the  access  to  healthcare  for  vulnerable  immigrants  and 
refugees  in  Europe  and  to  deliver  recommendations,  technical  guidance  and  training21  to 
health  professionals  and  to  the  law  enforcement  officers  working  at  local  level  with 
migrants/refugees.  

3. 1. 3. Innovation in health systems 
The Programme works in synergy with other EU Programmes and different policies strands to 
increase the efficiency of the EU expenditure and maximise its impact:  

The Joint Action supporting the eHealth Network22 on interoperability and standardisation for 
cross-border  health  data  exchange  enables  compatibility  with  Connecting  Europe  Facility23 

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http://ec.europa.eu/health/sites/health/files/preparedness_response/docs/jpa_agreement_medicalcou
ntermeasures_en.pdf 
https://ec.europa.eu/health/preparedness_response/key_documents_en#anchor0 
http://www.emerge.rki.eu/Emerge/EN/Home/Homepage_node.html 
The material for trainings and other relative information is published on the Health Policy Platform at: 
https://webgate.ec.europa.eu/hpf/ 
http://jasehn.eu/index.php/about-jasehn/background/ 
https://ec.europa.eu/digital-single-market/en/connecting-europe-facility 

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in  public  health. 
requirements  and  therefore  promotes  digital  service 
Collaboration among EU Health Technology Assessment24 bodies has delivered common tools 
and  standards,  offering  potential  for  significant  economies  of  scale.  The  sustainability  of  the 
network  and  improved  national  uptake  are  at  the  centre  of  the  current  Joint  Action,  which 
supports major policy aims such as accessibility, quality and sustainability of health care.  

infrastructures 

3. 1. 4. Access to better and safer health  

24  European  Reference  Networks25for  rare  diseases  have  been  established  to  unite  the 
expertise of more than 300 healthcare providers and 900 centres of expertise across Europe 
and make it available to rare disease patients, who often find it difficult if not impossible to 
find  specialised  knowledge  and  care  close  to  home.    To  review  a  patient’s  diagnosis  and 
treatment,  coordinators  will  convene  a  ‘virtual’  advisory  board  of  medical  specialists  across 
different  disciplines,  using  a  dedicated  IT  platform  and  telemedicine  tools.  Pooling  together 
knowledge,  expertise  and  resources  across  the  EU  helps  make  high  quality  healthcare 
accessible  to  all  and  helps  reduce  health  inequalities  both  within  and  between  EU  Member 
States.  In  years  to  come,  this  concept  could  be  expanded  beyond  rare  diseases  to  other 
complex conditions.  

The  Programme  also  plays  a  crucial  role  in  addressing  Antimicrobial  Resistance  (AMR)  by 
defining common approaches to fight AMR and to control healthcare-associated infections in 
line with ongoing EU and international policies, in particular the SDG 32. 

3. 1. 5. Implementing EU health legislation 

To reach its objectives and have its expected impact, EU legislation often requires support to 
consistently  implement  it  across  all  Member  States.  Developing  common  standards  and 
guidelines  is  at  the  heart  of  various  actions  funded  by  the  Health  Programme,  whether  for 
reporting  purposes,  carrying  out  audits  and  inspections,  operating  authorisation  or  for 
vigilance systems.  

Several  actions  have  supported  implementing  legislation  on  substances  of  human  origin, 
through  initiatives  such  as  developing  an  IT  platform  to  enable  the  exchange  of  organs 
between Member States; improving an information system and supra-national data sharing on 
living organ donation; optimising the process for post-mortem organ donation in hospitals by 
enabling  the  cooperation  between  critical  care  professionals  and  donor  transplant 
coordinators; and improving inspection guidelines for blood and tissues establishments. 

Several actions provided support to prepare delegated and implementing acts of the Tobacco 
Products  Directive,  including  several  studies26  and  an  implementation  analysis  for  the  future 
EU  system  for  traceability  and  security  features  in  the  field  of  tobacco  products.  The  SCOPE 
Joint Action27 has developed a curriculum and full set of capacity building and training material 

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http://www.eunethta.eu/ 
http://ec.europa.eu/health/ern/networks_en 
https://ec.europa.eu/health/tobacco/key_documents_en#anchor0 
http://www.scopejointaction.eu/ 

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to  support  national  regulators  in  the  implementation  of  the  2012  pharmacovigilance 
legislation28.  

3. 2. Lessons learned  

  The  Programme  is  highly  relevant  to  Member  States  needs  and  the 
objectives set are clear, explicit and specific 

The  23  thematic  priorities  help  to  better  focus  the  Programme’s  actions  and  avoid  overlaps 
and  potential  duplications  among  the  different  objectives.  At  the  same,  these  thematic 
priorities have the flexibility to allow for synergies that in some cases are clearly required. For 
example  actions  for  migrants  and  refugees,  an  area  in  which  the  Programme’s  design  has 
proven  to  be  flexible  and  sufficient.  However,  the  Programme  could  benefit  from  more 
coherence and refinement in the future.  

The  actions  financed  under  the  first  three  years  are  also  relevant  to  specific  Programme 
objectives and priorities. They benefit from the Programme’s design through better alignment 
of  their  own  objectives  and  outputs  with  the  requirements  of  good  Programme 
implementation. However, some actions under broader priorities which are not linked to EU 
legislation, and/or open-ended funding mechanisms such as operating grants, may lack focus 
and can risk deviating from their initial objectives. In these cases, particular attention should 
be  paid  during  the  planning  stage,  and  the  actions  in  question  should  be  monitored  and 
evaluated in good time to take any necessary corrective measures. 

 Programme management has become increasingly effective 

The Programme has been restructured following experience from the implementation of the 
two  previous  programmes  (first  programme  in  2002-2007  and  the  second  in  2008-2013).  Its 
objectives  were  set  in  a  very  explicit  and  practical  way,  announcing  the  kind  of  outputs 
expected and providing indicators for measuring progress.  

The  Annual  Work  Programmes  are  established  on  the  basis  of  a  preliminary  multi-annual 
planning  exercise,  meeting  specific  criteria  set  in  the  Programme  Regulation  (Annex  II).  The 
process  for  defining  Annual  Works  Programmes  works  smoothly  and  the  consultation  with 
Member  States  takes  place  in  a  clear,  transparent  and  equitable  way.  The  multi-annual 
planning has proven to be a valuable tool for providing a more strategic view of the mid-term 
planning and allowing for the smoother adoption of annual Work Programmes and limiting the 

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https://ec.europa.eu/health/sites/health/files/files/eudralex/vol-1/reg_2010_1235/reg_2010_1235_en.pdf 

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number  of  amendments.  However,  stakeholders  want  to  have  more  opportunities  to  help 
determine annual priorities and the actions needed on a multi-annual and annual basis.  

The Commission encourages all EU-28 Member States and other third countries to take part in 
the  Programme.  The  Programme  gives  them  recourse  to  exceptional  utility  criteria  and 
provides  up  to  80%  EU  co-funding  to  all  actors  involved.  The  co-funding  is  granted  under 
particularly favourable conditions if a part of the overall budget is transferred for action in low 
GNI29  countries.  The  exceptional  utility  criteria  have  not  been  effective  so  far.  However, 
despite the difficult economic context and the significant barrier of assuring the remaining co-
financing,  the  Programme  is  still  attracting  a  similar  level  of  participation  from  low  GNI 
countries as in the previous Programme.  

  The  Programme  demonstrated  its  responsiveness  and  flexibility  in  the  face 
of  emerging  needs  such  as  the  refugees’  crisis  in  summer  2015,  which  made  a 
significant contribution to the Commission’s migration policy.  

In  addition,  the  Programme  also  provides  support  for  the  first  implementation  phase  of  the 
newly established European Solidarity Corps, which reflects European values of solidarity and 
humanitarian  action.    Through  the  Solidarity  Corps,  European  youth  will  not  only  provide 
assistance  where  it  is  needed,  but  will  also  broaden  their  experiences,  deepen  their  cultural 
understanding, learn the value of service to others, and strengthen their sense of identity as 
Europeans.  

 Efficiency is being improved 

The Programme focused its limited budget on a strict selection of key objectives and priorities 
aligned with Commission’s main priorities. On this basis, most of the funding was allocated to 
outcome-oriented  actions  for  modern  health  policies,  stimulating  innovation  in  health  and 
healthcare  and  providing  appropriate  tools,  methods  and  training  for  increased  safety  and 
security in the EU. 

Objectives  (2)  for  cross-border  health  threats  and  (4)  for  access  to  better  and  safer  health 
received comparatively less financing. However they benefit from synergies with the European 
Centre on Disease Control for risk assessments, collection and analysis of epidemiological data 
and AMR. Broader thematic areas like health promotion and health systems were identified as 
priorities  by  Member  States’  representatives  in  e-surveys  and  by  a  large  number  of  health 
stakeholders  in  the  public  consultation  and  received  the  highest  amount  of  funding.    Health 
promotion  includes  actions  in  areas  such  as  risk  factors,  chronic  diseases  and  health 
information, health systems including Health Technology assessment.  

29 Gross national income 

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The  Programme  has  introduced  programmatic  indicators  and  action-level  monitoring  and 
invests into strategic dissemination activities. These are decisive steps responding to previous 
recommendations but there is still room for improvement and for speeding up progress. 

Moreover,  the  Programme’s  administration  costs  are  low,  compared  to  the  administrative 
costs of other comparable Commission programmes. Administration costs represent just 9% of 
the overall budget.  

 Simplification measures have been taken for rules and procedures including 
the use of electronic tools for the submission and evaluation of proposals, the 
management  of  grants,  e-monitoring  and  e-reporting.  While  this  development  is 
resource intensive in the beginning for the design and testing of tools, the level of satisfaction 
from applicants and grant beneficiaries justifies these efforts, and financial gains are expected 
in the next years.  

 A small Programme with big EU-added value 

The cooperation at EU level and coordination of preparedness plans and responses to health 
threats is one of the strongest and best known aspects of the Programme’s EU-added value. 
Activities to support capacity building against health threats have helped to avoid duplication 
and  improve  capabilities,  delivering  added  value  for  the  EU  and  the  wider  international 
community. They have served to identify gaps in Member States’ capacities, prioritise actions 
and  implement  capacity  building  activities  to  fill  in  those  gaps.  They  have  also  delivered 
toolkits and guidelines, training and testing of EU preparedness and response mechanisms and 
external  quality  assurance  exercises  and  they  have  enabled  the  sharing  of  lessons  learned 
from recent outbreaks and refugees’ crisis.  

The Programme also helps Member States to increase their capacities in other areas: pooling 
knowledge, expertise and resources across the EU increases citizens' equitable access to high 
quality  healthcare  and  contributes  to  the  reduction  of  health  inequalities  both  within  and 
between EU  Member States.  For  instance,  through  the  24  European  Reference  Networks  on 
rare diseases where the possibility exists to expand the pooling of expertise to other complex 
diseases  in  the  near  future.  Also  through  the  collaboration  between  EU  Health  Technology 
Assessment  bodies  to  deliver  common  tools  and  standards  that  support  major  policy  aims 
such  as  accessibility,  quality  and  sustainability  of  health  care  while  offering  potential  for 
significant economies of scale.   Another example is the support given to the eHealth Network 
for improving the interoperability and standardisation needed for the cross-border exchange 
of health data and to promote digital service infrastructures in public health. 

Cooperating,  using  and  sharing  knowledge  has  high  EU-added  value:  the  collection  and 
analysis  of  comparable  data  depicting  the  situation  of  Health  in  each  of  the  EU-28  Member 
States  (country-profiles)  contributes  to  political  dialogue  and  informed  decision  making  for 
health  policy.  The  exchange  and  implementation  of  best  practice  for  promoting  health  and 

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preventing  diseases  have  also  an  EU-added  value,  which  can  help  Member  States  in  their 
health  reforms  to  overcome  threats  to  their  health  systems  from  demographic  changes  and 
the burden of non-communicable diseases and other chronic conditions.  

 Working in coherence and developing synergies 

The Programme is in alignment with the Commission’s main priorities under Article 168 TFEU 
and the SDG, and strives to maximise synergies with other EU policies and financial 
instruments such as Horizon 2020.  

The  Programme’s  particularity  remains  its  focus  on  health  policy  cooperation.  It  uses  the 
results  of  research  actions  and  tests  their  results  in  real  settings  in  close  cooperation  with 
competent  authorities  in  the  Member  States.  The  aim  is  to  help  Member  States  design  and 
implement  their  own  policies  so  as  to  build  a  strong  social  Europe  while  taking  budgetary 
constraints and needs for system reforms into consideration.  

To up-scale those effective actions and make them integral parts of Member States’ national 
health policies, the Programme should continue to encourage cooperation with the European 
Structural  and  Investment  Funds30  and  other  EU  financial  instruments.  The  effective  use  of 
such big financial instruments can have a greater impact than using the Programme alone, by 
building  knowledge  and  capacities  for  monitoring  and  implementation  and  by  supporting 
innovation and effectiveness for health investments.  

4. HOW CAN THE IMPLEMENTATION OF PROGRAMME BE IMPROVED 

Following the ex-post evaluation of the second Health Programme, the Commission undertook 
to work on  three  main aspects of the third Health Programme, as stated in its report to the 
European Parliament and the Council in May 201631: These commitments were to: 

(a) improve monitoring, reporting and dissemination efforts  

(b)  encourage  participation  of  all  Member  States  and  other  participating  countries,  and  to 
work with all Member States, particularly those with greater public health needs; and  

(c) develop synergies with the Commission’s main priorities and other programmes. 

These  points  are  still  valid  and  the  Programme  will  continue  to  work  on  these  areas.  In 
particular for the dissemination of results which is an area where work must be speeded up as 
much as possible. 

30 
31  

 https://ec.europa.eu/health/health_structural_funds/used_for_health_en 
COM(2016) 243 final at http://ec.europa.eu/health/programme/policy/2008-2013/evaluation_en 

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Moreover,  and  as  suggested  in  the  mid-term  evaluation,  the  Programme  should  remain 
focused on issues where EU added value can be achieved. These areas fall mainly under the 
objectives of protecting against cross-border health threats and the access to better and safer 
healthcare.  For  the  priorities  under  the  objective  of  health  promotion  and  prevention  of 
diseases, the Commission is currently working on defining concrete needs in Member States32 
where  integrating  best  practices  into  national  policies  could  bring  the  expected  results  and 
impact on the population’s health and the sustainability of the health systems.   

Links to SDG and the wider Commission and EU policy agenda will be improved so as to better 
prioritise  actions  and  increase  impact.  This  approach  could  also  increase  the  Programme’s 
visibility and boost its role in the international arena despite its modest budget.  

The  EU-added  value  criteria  could  be  further  simplified  for  potential  applicants  and  made 
easier to understand by using concrete examples.   

5. CONCLUSION 

The mid-term evaluation was positive and found that implementation of the Programme is on 
track. All thematic priorities remain valid and most actions deliver useful outcomes with high 
EU-added value, in particular for crisis management and for the safety and security in Europe.  

The open public consultation attracted the attention of a broad selection of interested parties 
and provided strong support for continued cooperation through the Programme, particularly 
in areas such as health promotion, disease prevention and eHealth.  

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