REPORT FROM THE COMMISSION TO THE EUROPEAN PARLIAMENT AND THE COUNCIL Implementation of the third Programme of the Union's action in the field of health in 2015
Date: 2018-12-12
Institutions: Directorate-General for Health and Food Safety, European Commission
Subjects: EU aid, EU migration policy, EU programme, aid to refugees, disease prevention, health care, health care system, programme budgeting, project evaluation, public health

EN 

  EN 

   EUROPEAN COMMISSION  Brussels, 12.12.2018  COM(2018) 818 final  REPORT FROM THE COMMISSION TO THE EUROPEAN PARLIAMENT AND THE COUNCIL Implementation of the third Programme of the Union's action in the field of health in 2015 {SWD(2018) 489 final}  
 
 
INTRODUCTION 

This report presents the implementation of the 2015 annual work programme (2015 AWP), under the 

third  Health  Programme  2014-2020  established  by  Regulation  (EU)  No 282/2014  of  the  European 
Parliament and of the Council of 11 March 20141. 

Under Article 13 of the Regulation, the Commission must report to the Health Programme Committee 

on the implementation of all actions funded under the Programme and also to the European Parliament 

and the Council. This report meets the latter requirement. It provides detailed information on the 2015 

budget  and  how  it  was  committed.  It  also  takes  account  of  the  amendment  to  the  2015  AWP  to 

channel funding towards those Member States under particular migratory pressure that require support 

in their response to the related health challenges. 

The Commission Staff Working Document accompanying this Report sets out a number of examples 
of the key actions co-funded under the second2 and third Health Programmes, for which final results 

became available in 2015. It also gives examples of actions funded under the 2015 work programme in 

supportive  fields  such  as  evaluation  and  dissemination.  The  report  also  provides  tables  with  an 

overview of all co-funded activities and contracts. 

The 2015 AWP focused on innovation in health and healthcare, with two related action streams (health 

technology  and  migrants’  health)  highlighted  in  this  report.  The  Commission  decided  to  amend  the 
2015 AWP3 in response to the high influx of migrants in clear need of international protection and the 

need  to  provide  financial  support  to  organisations  able  to  support  Member  States  in  addressing  this 

emergency situation. 

The Commission ensures that the implementation of the third Health Programme is closely monitored 

and that results are publicised more widely. It also continues to encourage all Member States and other 

countries  involved  in  the  Programme  to  participate  and  continues  to  seek  synergies  with  other  EU 

funding programmes.  

1 OJ L 86, 21.3.2014, p. 1. 
2 OJ L 301, 20.11.2007, p. 3. 
3 https://ec.europa.eu/health/sites/health/files/programme/docs/wp2015_amendment_en.pdf 

 
 
 
 
                                                      
TABLE OF CONTENTS 

INTRODUCTION ...................................................................................................................... 1 

ACTIONS OF THE YEAR — SPECIFIC THEMATIC FOCUS OF 2015: ............................. 3 

BUDGET IMPLEMENTATION ............................................................................................... 5 

1. 

2. 

3. 

4. 

Budget .......................................................................................................................... 5 

Objectives, priorities and financing mechanisms in 2015 ........................................... 7 

Implementation of the operational budget by financing mechanism .......................... 9 

Beneficiaries .............................................................................................................. 11 

OTHER MAIN FEATURES .................................................................................................... 11 

2 

 
 
 
 
 
THEMES AND ACTIONS FOR 2015:  

The  priority  health  topic  for  the  2015  AWP  was  ‘health  technology  assessment  (HTA)  and 

innovation’.  This  was  addressed  through  several  actions  funded  by  different  financing  mechanisms 

and signed in the first quarter of 2016, most of them for 3 years, meaning that they will run until the 

end of 2018 and in some cases until 2020. They are: 

 

the  new 

joint  action  on  HTA, 

representing 

the  highest  ever  EU  contribution 

(EUR 11 999 798.74) to a single aspect of health policy under the third Health Programme; 

 

two projects and a joint action on integrated care (total EU contribution EUR 6 837 798.31); 

and, 

 

the  preparatory  work  for 

the  establishment  of 

the  European  Reference  Networks 

(EUR 381 372.23). 

Background:  The  new  joint  action  on  HTA  is  the  scientific  and  technical  component  of  EU 

cooperation in this area. It was launched in June 2016 and will run until 2020. It includes government 

appointed organisations (from EU countries, EU accession countries, EEA and EFTA countries), and a 

large number of relevant regional agencies and not-for-profit organisations that produce or contribute 

to HTA in Europe. 

Goal: The objective is to support voluntary scientific and technical level between HTA bodies. This 

cooperation should provide input for the development of a model for joint work to be continued after 

EU funding under the Health Programme ends. 

Means:  There  is  a  strong  focus  on  the  joint  production  of  health  technology  assessments  and  early 

dialogues on the results and how to apply them in national settings. The early dialogues, particularly 

the parallel consultations, have become highly valued by companies seeking early advice. As of May 

2018,  29  requests  for  early  dialogues  have  been  received  by  the  joint  action  partners.  HTA  also 

assesses  other  aspects  of  health  technology,  for  example  its  cost  implications  for  the  patient  and  its 

impact  on  the  organisation  of  healthcare  systems  in  the  delivery  of  care  and  administration  of 

treatment.  It  is  therefore  a  multidisciplinary  process  that  systematically  reviews  the  medical, 

economic, organisational, social and ethical issues related to the use of a health technology. 

Background:  On  integrated  care,  one  co-funded  project  brings  together  innovative  European 

healthcare regions, industry and academia in a partnership that has the potential to transform ‘cure and 

care’  delivery  services.  The  project  includes  both  a  pilot  project  phase  and  scaled-up,  routine  care 

3 

 
 
 
 
 
practice.  The  project  involves  13  partners  from  six  EU  countries  (Denmark,  Germany,  Greece, 

Netherlands, Spain and United Kingdom). 

Goal:  The  overall  objective  is  to  identify,  transfer  and  scale  up  existing  and  operational  care 

coordination and good tele-health practices, with the aim of reaching 75 000 care recipients or patients 

across regions and programmes in multiple European countries. The project is expected to deliver two 

major benefits: 

 

a strong basis for successful twinning and coaching that facilitates shared learning; 

  practical support for scaling up good practices that promote active and healthy ageing and the 

participation of older people in the community.  

This combined with a joint action, should contribute substantially to improving the organisation and 

implementation of integrated care concepts across the EU. 

Additional  actions  in  response  to  the  migration  crisis  in  the  summer  of  2015  and  following  the 

subsequent amendment to the 2015 AWP, are: 

 

four projects on migrants’ and refugees’ health (EUR 6 239 154) 

  one direct grant to the International Office of Migration (IOM) (EUR 1 000 000). 

These  aimed  to  ‘support  Member  States  under  particular  migratory  pressure  in  their  response  to 

health related challenges, with a view to provide concrete support to organisations active in the field 
and help address the public health impact in the most affected EU Member States’4. 

Background:  One project, led by the Andalusian School of Public Health,  brought together partners 

from seven countries (Belgium, Denmark, Italy, the Netherlands, Poland, Slovakia and Spain). 

Goal:  to  support  Member  States  in  establishing  or  strengthening  a  health  sector  coordination 

mechanism for a coherent and consolidated national and cross-country response to address the health-

related  issues  of  arriving  migrants  (refugees, asylum seekers and other migrant populations)  while 

preventing and addressing possible communicable diseases and cross border health threats. This 

was  achieved  through  an  assessment  of  the  coordination  mechanism  in  place  and  by  improving 

coordination and health professionals' capacities and skills.  

4 The call for proposals was launched in October 2015. 

4 

 
 
                                                      
Background:  Another  project  involved  eight  partners  to  support  health  authorities  in  11  Member 

States. 

Goal:  The  project  focused  on  health  assessments  of  incoming  migrants  via  a  common  instrument 

allowing  Member  States  to  detect  and  assess  potential  threats,  distribute  health  promotion  materials 

and raise awareness among stakeholders.  

The  detailed  overview  of  all  actions  funded  under  the  2015  is  provided  in  the  Commission  Staff 

Working Document accompanying this report. 

BUDGET IMPLEMENTATION 

1. 

Budget 

The  overall  budget  for  the  third  Health  Programme  2014-2020  is  EUR 449.4  million.  This  includes 

EUR 30 million for the functioning of the Consumer, Health, Food and Agriculture Executive Agency 

(Chafea) which the Commission has mandated 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 20055. It organises annual calls for proposals, coordinates 

the  evaluation  of  submissions,  negotiates,  signs  and  manages  related  grant  agreements,  and 

disseminates the results of actions. It is also responsible for many procurement procedures. 

The  budget  set  out  in  the  work  plan  for  the  2015  AWP6  was  EUR 59 750 000,  broken  down  as 

follows: 

  operational  expenditure:  EUR 54 041 000,  corresponding  to  the  third  programme  for  EU 

action  in  the  field  of  health  (2014-2020)  budget  line  17 03 01  (‘Encouraging  innovation  in 

health,  increasing  the  sustainability  of  health  systems  and  protecting  Union  citizens  from 

serious cross-border health threats’); 

  administrative expenditure: EUR 1 500 000, corresponding to the support expenditure for the 

third Programme for EU action in the field of health (2014-2020) budget line 17 01 04 02. 

5 Decision 2004/858/EC of 15 December 2004 (OJ L 369, 16.12.2005, p. 73) amended by Decision 2008/544/EC 
of 20 June 2008 (OJ L 173, 3.7.2008, p. 27). Since December 2014 Chafea has replaced the Executive Agency for 
Health and Consumers (EAHC) under Commission Implementing Decision 2014/927/EU 
6 
C(2015) 
https://ec.europa.eu/health/sites/health/files/programmes/docs/wp2015_en.pdf . 

Commission 

Decision 

2015 

3594 

June 

(see 

at: 

of 

2 

5 

 
 
 
                                                      
The  total  operational  budget  was  EUR 55 629 805  and  the  total  administrative  budget  was 
EUR 1 551 822,  66.  This  included  EFTA/EEA  credits  and  recovery  credits  from  previous  budget 
years. 

In  2015,  Chafea  executed  EUR 47 967 105.24  of  the  operational  budget,  while  the  European 

Commission’s  Directorate-General 

for  Health  and  Food  Safety 

(DG  SANTE)  executed 

EUR 6 810 913.51,  covering  procurement,  direct  grants  and  other  measures,  amounting  to  a  total  of 

EUR 54 778 018.75. 

6 

 
 
2. 

Objectives, priorities and financing mechanisms in 2015 

In  2015,  the  total  operational  budget  was  divided  among  the  four  specific  programme  objectives  as 

follows. 

1.  Health  promotion:  EUR 15 669 170.92  (29 %  of  the  operational  budget  in  2015)  for 

promoting  health,  preventing  diseases  and  fostering  supportive  environments  for  healthy 

lifestyles taking into account the ‘health in all policies’ principle. 

2.  Health  threats:  EUR 5 016 028.59  (9 %  of  the  operational  budget  in  2015)  for  protecting 

EU citizens from serious cross-border health threats. 

3.  Health  systems:  EUR 25 106 924.35  (46 %  of  the  operational  budget  in  2015)  for 

contributing to innovative, efficient and sustainable health systems. 

4.  Better  and  safer  healthcare:  EUR 6 127 923.17  (11 %  of  the  operational  budget  in  2015) 

for helping EU citizens access better and safer healthcare. 

The specific call to ‘support Member States under particular migratory pressure in their response to 

health  related  challenges’  was  a  horizontal  action  related  to  Objectives  1  (health  promotion)  and  2 

(health threats). The corresponding amount of EUR 7 234 199.58 (13 % of the operational budget in 

2015) was divided evenly between Objective 1 and Objective 2 and resulted to the calculations above. 

In addition,  horizontal activities (IT,  communication) amounted to EUR 2 857 971.72 (5 % of the 

operational budget in 2015). 

7 

 
 
 
 
Figure 1:  Operational budget by third Health Programme objective in 2015 

The figure below provides information on the Health Programme credits invested as EU contribution 

under the different thematic priorities in year 2015. 

Figure 2:  Operational budget by thematic priority in 2015 

8 

 
 
 
 
 
The Programme is implemented through a wide range of funding instruments. These are: 

 

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

  project grants; 

  operating grants in support of non-governmental organisations; 

  direct agreements with international organisations; 

  public procurement; 

  other  actions,  such  as  the  scientific  committees,  administrative  agreements  with  the  Joint 

Research Centre and grants for Council presidency conferences. 

Competitive selection and award procedures were used to select initiatives for funding. However, they 

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  for  studies,  meetings  of  experts,  information  and 

publication costs, and technical and administrative assistance for IT systems. 

3. 

Implementation of the operational budget by financing mechanism 

Type of financing mechanism 

Implementation 

(EUR) 

Share of mechanism in 

Commitments 

total implemented 

budget (commitments) 

Calls for proposals: 

Project grants 

Operating grants 

Grants for joint actions 

14 944 000.04 

5 005 520.00 

17 791 725.60 

Conference grants to the Member States 

120 434.90 

holding the presidency of the EU  

Direct grant agreements 

Managed by CHAFEA 

3 715 000.00 

Managed by DG SANTE 

120 747.29 

Procurement (service contracts) 

27.3 % 

9.1 % 

32.5 % 

0.2 % 

6.8 % 

0.2 % 

Managed by CHAFEA 

5 890 424.70 

10.8 % 

9 

 
 
 
 
 
 
 
 
 
Managed by DG SANTE 

5 744 988.82 

10.5 % 

Other actions  

Managed by CHAFEA 

Managed by DG SANTE 

500 000.00 

945 177.40 

Budget implemented in 2015 

Total available budget 

Credits not used7  

54 778 018.75 

         55 629 805.00 

by CHAFEA 

 by DG SANTE 

218 478.65 

633 307.60 

0.9 % 

1.7 % 

100 % 

7 Pre-accession credits were not yet used, leading to differences between amounts in the award decision and 
the actual amounts. 

10 

 
 
 
 
 
 
 
 
 
 
 
                                                      
Beneficiaries 

4. 
In  2015,  more  than  2008  different  grant  agreements  and  service  contracts  were  signed  with  various 

beneficiaries  and  service  providers,  ranging  from  governmental  and  non-governmental  organisations 

to  academic  institutions  and  private  companies.  The  category  ‘other’  includes  beneficiaries  such  as 

healthcare  providers  and  international  organisations.  Figure  3  provides  an  overview  of  the  different 

groups of beneficiaries. 

Figure 3:  Types of beneficiaries of the third Health Programme in 2015 

OTHER MAIN FEATURES 

2015 was the second year of the third Health Programme that was seriously affected by the pressure 

caused by the unprecedented influx of refugees entering Europe. This situation tested the Programme’s 

flexibility to quickly adapt to new policy needs, as well as Chafea’s ability to respond accordingly and 

implement  decisions  related  to  the  AWP.  Chafea  launched  the  related  direct  grants  and  call  for 

proposals  for  projects  in record time  and  was  able  to sign  the selected  grant  agreements  within less 

than 3 months of the 2015 AWP amendment. 

This was helped by simplified administrative procedures introduced in 2014 as well as the participant 

portal  for  online  submissions  and  the  online  evaluation  and  electronic  signature  of  the  grant 

agreements. Despite the minor hurdles in the system, this reduced the time taken to sign the grants.  

8 This excludes contracts signed with individual experts e.g. those on the scientific committees. 

11 

 
 
 
 
                                                      
The number of participants involved in joint actions continued to be relatively high, as was the case 

for the second Health Programme and first year of the third Health Programme. In 2015, there were 

between 10 and 45 partners (beneficiaries) per joint action. This high number was a challenge for the 

Programme’s overall management and coordination, as all partners had to sign the grant agreement. 

Following  the  recommendations  of  the  ex  post  evaluation  of  the  second  Health  Programme  2008-
20149 and mid-term evaluation of the third Health Programme10, Chafea invested significant resources 

in  information  and  dissemination  activities,  in  close  collaboration  with  DG  SANTE  and  the  Health 

Programme’s network of National Focal Points. It organised several workshops, helped organise major 

national and international conferences, and organised stand-alone events in collaboration with national 

authorities  in  Member  States.  A  more  detailed  description  of  the  dissemination  activities  in  2015  is 

provided in the Commission Staff Working Document accompanying this report. 

Building  on  the  processes  and  tools  developed  under  the  third  Health  Programme,  electronic 

monitoring  and  reporting  has  been  introduced  to  save  time  on  both  sides.  As  a  result,  both  the 
beneficiary and Chafea have become paperless, especially in the case of grants. The CORDA11 system, 

implemented by the common support centre of the EU research and innovation programme, centralises 

the data collected for all co-funded actions managed by Chafea and monitored using H2020 electronic 

tools. It is the key source of information, providing feedback on whether the Programme’s objectives 

and priorities have been met and on the types of actions and organisations that have been co-funded.  

Further  improvements  are  to  be  introduced  in  the  coming  years,  including  an  improved  electronic 

monitoring and reporting system and better and more targeted dissemination. In addition, efforts will 

continue to increase the participation of organisations and institutions from countries which, until now, 

have been under-represented among the beneficiaries. 

The identification of key priority areas for each year of the Programme has shown the added value of 

ensuring continuity between the annual work programmes. It has improved the overall coherence and 

consistency  of  the  third  Health  Programme  and  supported  the  use  of  the  deliverables  and  results  of 

previous funding rounds. 

9 COM(2016) 243 final of 10.5.2016. 

10 COM(2017) 586 final of 11.10.2017. 

11 CORDA is the Common Research Data Warehouse, i.e. the place of storage of all the information on EU-
funded projects and their results. Started as the reference data base for EU funded research, stretching back to 
1990, it now includes the actions co-funded by the 3rd health programme which are managed through the 
H2020 tools. 

12