ECDA Letter - call for NCDs prevalence reduction in the EU and mobilising investment in prevention

In the context of the Global Week for Action on NCDs (14-21 September), ECDA encouraged EU policymakers to focus efforts on NCD prevalence reduction, mobilise investment in prevention and control, and implement necessary measures to effectively address NCDs in the EU.

Chronic non-communicable diseases have been a major health challenge for decades across Europe. No EU country is spared from the impact they have on citizens’ health, national healthcare systems, societies and economies, as further shown by the COVID-19 pandemic. The prevalence of NCDs continues to grow, fuelled by under-investment in prevention and control.

It is high time to take adequate action to reverse this trend. The EU NCDs initiative “Healthier Together” and the efforts driven at EU level thanks to the Expert Group on Public Health are welcome. They represent significant steps to achieve this goal. Yet, much remains to be done to effectively address NCDs in the EU. Aiming to reduce mortality from NCDs is not enough. Targets on reduced mortality are on track to be achieved in the EU, but people are living in a declining health condition.

ECDA encourages EU leaders to:

  • Mobilise resources for NCD prevention, notably by convening a High-Level Forum on Sustainable NCDs prevention in the EU by 2025.
  • Initiate a process to establish a holistic NCDs strategy for the EU, complemented by disease-specific plans where necessary, with clear targets for NCDs prevalence reduction in the EU by 2040 for all age groups (with intermediate targets for 2030).
  • Define a strategic and long-term vision for the EU as a whole, that does not leave behind any NCD nor EU country, addressing inequities and the specific needs of more vulnerable groups, including children and the elderly (often multi-morbid).
  • Commit to act and allocate funds to improve NCD prevention and care in the EU in the next years, for the benefit of the millions of citizens living with one or more chronic diseases and their families.
  • Address persisting data gaps in NCDs, which undermine effective responses and result in a misevaluation of the prevalence of certain types of NCDs and their burden. This is critical to improve disease knowledge, assess the real impact of the diseases and the cost of inaction, inform prevention and management plans; and anticipate any future challenges.
  • Set up an EU Ambassador for NCDs and an official EU NCDs Awareness Day (for instance, taking place during the Global Week) to stimulate greater knowledge-sharing and action.

Read the full letter here


Passing of MEP Véronique Trillet-Lenoir

 

ECDA members are very saddened to learn about the unfortunate news of the untimely passing of Véronique Trillet-Lenoir, an invaluable member of the European Parliament and a relentless advocate for the health and well-being of European citizens.

Véronique’s unwavering dedication and tireless efforts to champion improved EU policies for better healthcare and quality of life, in particular to support better prevention and management of chronic diseases, stand as a shining example of commitment. Her passion for creating positive change was matched by her determination to make a lasting impact.

On behalf of ECDA, we consider ourselves fortunate to have had the privilege of working closely with her, witnessing firsthand the depth of her dedication. As we mourn her loss, let us also celebrate her accomplishments and remember the indelible mark she has left on the path towards a healthier and more prosperous Europe - including her significant work to shape the Europe's Beating Cancer Plan, to improve health promotion and the response to chronic disease risk factors in Europe; and her support to more integrated approaches to chronic disease care.

In this difficult moment, on behalf of ECDA, we extend our heartfelt condolences to her family, colleagues and her loved ones.

 


ECDA recommendations to advance NCDs prevention and management in the EU

As the European Parliament's SANT committee progresses work towards a resolution on non-communicable diseases, ECDA formulates key recommendations to support the work of the committee and improve the response to chronic diseases across the EU, towards a Europe free of preventable chronic diseases.

Encompassing all priority areas, ECDA has called for decades for a dedicated, structured EU strategy (or framework) common to all chronic diseases – complemented or supported by disease-specific plans or actions where appropriate, and with a strong focus on prevention. Such an approach seems the most appropriate, realistic way to bring a coherent response to the diseases across the EU, that does not leave behind any chronic disease nor EU country. It would provide member states with clear guidance to achieve goals uniformly across the EU.

Priority 1: Reducing the prevalence of NCDs across EU countries, for all age groups, over the next decades  

Targets on reduced mortality are on track to be achieved but people are living in a declining health condition. The EU should aim to reduce the number of people living with the diseases, by protecting the population from the risk of developing a disease, complications, or co-morbidities.

Recommendations:

  • Adopting EU specific targets on reducing prevalence by 2040, with an intermediate target for 2030
  • EU Council Presidencies' priorities related to chronic disease prevention in future trio programmes until 2030
  • Continuous and increased funding for NCDs in the EU4Health, Horizon and Connect programmes; inclusion of all chronic diseases amongst priorities of future European research and health action programmes beyond the period 2021-2027
  • Appointment of an EU NCDs Ambassador to drive and oversee progress and mobilise resources across sectors to achieve goals
  • EU and national priorities on prevention and management; and on mitigating the impact of NCDs on health systems

Priority 2: Addressing chronic diseases in a holistic and structured approach

Chronic diseases are clinically interrelated (common risk factors, similar patterns, disease-disease interactions, complications). Effective NCDs prevention and management requires a concerted effort that includes all diseases.

Recommendation:

  • An EU wide, coordinated framework/strategy on chronic diseases, complemented by disease-specific plans (or measures) as appropriate
  • Presentation of such EU strategy/framework by European Commission leadership at the fourth High-level Meeting of the United Nations General Assembly on the Prevention and Control of NCDs in 2025
  • In the meantime, extending the scope of the ‘Healthier Together’ initiative to other types of chronic diseases not yet covered

Priority 3: Focusing action & investment on primary and secondary prevention

Prevention can reduce the prevalence of NCDs by as much as 70%. Yet investment in prevention remains limited (3% of health expenditures).

Gaps & areas for urgent attention include:

  1. Common modifiable risk factors (tobacco & alcohol use, poor nutrition, physical inactivity, air quality) and socio-economic determinants of health
  2. Co-occurring risk factors
  3. Healthier living environments and economies of “well-being”
  4. Awareness & education of NCDs and risk factors in the general population; health literacy in high-risk and hard to reach populations
  5. Workplace prevention
  6. Secondary prevention, health checks and early detection of NCDs, complications and comorbidities in people at high risk
  7. Sustainable financing for prevention

Recommendations include:

  • Implementing urgently the WHO evidence-based, widely endorsed ‘best buys’ and other recommended interventions to address NCDs risk factors
  • Specific measures addressing co-occurring risk factors in primary prevention plans/programmes
  • An EU NCDs prevention code
  • Reigniting EU collaboration towards economies of well-being
  • Continuous EU research funding to study human exposures to environmental factors throughout life
  • An official EU Chronic Disease Awareness Day celebrated annually during the Global Week for Action on NCDs (September)
  • EU Action Plan Against Disinformation and future Digital Europe Annual Work Programmes to place greater emphasis on addressing disinformation online in relation to NCDs risk factors
  • EU Expert Group on Public Health (sub-group on NCDs) to work on a combined approach for targeted identification of people at high risk and
    preventive health checks for NCDs and co-morbidities
  • An EU High-Level Forum by 2025 on financing for NCDs prevention, to explore options for sustainable financing models for NCDs prevention programmes
  • EU Council recommendation on strengthening investment in primary and secondary prevention of chronic diseases at EU level

Priority 4: Upscaling primary care and fostering integrated & multidisciplinary NCD management

The care of many chronic diseases is increasingly complex and requires to break silos between disciplines.

Recommendations:

  • Building European expertise/excellence networks for prevention and control of NCD co-morbidities and complications (for highly prevalent or highly complex co-morbidities)
  • EU and national funding for research in NCD co-morbidities and their management
  • Greater national efforts to develop multidisciplinary, integrated care in all NCD areas; to improve collaboration between primary, secondary care levels; and to upscale and strengthen primary care services.

Priority 5: Ensuring continuity of NCDs care; reinforcing EU and national crisis planning

COVID-19 has shown that most health systems in the EU are not adequately suited to provide continuity of care for NCDs.

Recommendations:

  • Making continuity of NCD care integral to crisis preparedness and management plans for national healthcare systems – especially considering the learnings from the COVID-19 pandemic.
  • Greater EU collaboration to avoid future disruptions in NCD care delivery and ensure member states are better equipped to respond to future crises (e.g. exchange of good practices, EU support for scenario modelling and risk assessments etc), building on recommendations from the WHO Regional Office for Europe.
  • An “EU NCD specialists emergency reserve”

Priority 6: Improving EU-level data collection on NCDs

Major data gaps persist in the EU, including health economic data. Systems and indicators are not harmonized, data is often disparate, not comparable across countries and types of NCDs.

Recommendations:

  • An EU NCDs registry by 2030 to allow a harmonised, centralized mechanism for the collection, monitoring and analysis of data on NCDs at EU level
  • Mandating OECD to perform further cost-analyses of the impact of NCDs, comorbidities and complications to provide stronger health economic data.

Priority 7: Supporting more integrated approach to health challenges

COVID-19 has shown the clinical links between communicable, infectious diseases and NCDs; and the need for more integrated surveillance and responses.

Recommendations:

  • Initiating the evaluation of the ECDC mandate by end of 2024 (activating the revision clause in Amended Regulation (EC) No 851/2004, which specifies that “the first evaluation shall examine the feasibility of extending the ECDC mandate to address the impact of cross border health threats on non-communicable diseases")
  • Extended mandate for the European Centre for Disease Prevention and Control (ECDC) to work on the links between infectious diseases and non-communicable diseases

New European Parliament's subcommittee on public health agrees a priority on NCDs

The newly created European Parliament's sub-committee on public health (SANT), chaired by MEP Arlukowicz, has defined priorities for its mandate.

The committee will be developing an own-initiative report on chronic non-communicable diseases; and will convene a hearing on chronic disease prevention.

Other priorities of the committee include:

  • Own Initiative report on Joint Procurement of medicines
  • Own Initiative report on Mental Health
  • Implementation report on Nutrition and Health Claims Directive
  • Oral question to Commission on Anti-Microbial Resistance

ECDA welcomes the committee's decision and congratulates MEPs for making NCDs a priority of their work. ECDA will work closely with them, offering expertise to support the work of the European Parliament to improve the response to chronic diseases in Europe.


European Parliament's COVI committee publishes draft report capturing impact of the pandemic in the area of chronic diseases

The European Parliament's COVI committee published its draft report on “COVID-19 pandemic: lessons learned and recommendations for the future”.

ECDA welcomes the report, which reflects on ways to ensure EU’s better preparedness for future crises and to strengthen health systems, giving particular consideration to the field of chronic diseases. Indeed the report captures the impact of the pandemic for patients with chronic diseases and introduces recommendations to improve health promotion and disease prevention in Europe as well as patients' care.

ECDA particularly welcomes the acknowledgement of the pandemic’s significant impact on chronic disease patients due to their vulnerability to developing severe health complications, higher hospitalisation and mortality rates, and challenges linked with delays and disruptions in care – in a dedicated section.

Collateral damage is expected to arise in the years to come, alongside long COVID and increased prevalence of chronic diseases, which will have important consequences for healthcare systems, if no changes are operated now – including greater investment in disease prevention, early detection and management. As outlined by the World Health Organisation, preventing and treating chronic diseases has benefits far beyond health – notably for economic growth.

Facilitating the collection of comparable data for chronic diseases in the EU with an integrated data collection system that would be synergistic with data collection related to health threats and infectious diseases and that would cover health economic data related to the diseases will be critical. 

Picture: European Parliament COVI website. 


Season's greetings

As the year 2022 draws to a close, we wish a Merry Christmas to all and nice end-of-year holidays. We look forward to pursuing work in 2023 with partners and colleagues, towards greater prevention and management of chronic diseases in Europe.


ECDA message for the Awareness Week for Alcohol Related Harm

This week marks Awareness Week for Alcohol Related Harm, under the theme “Alcohol: The right to Know!”. ECDA joins partner organisations in their urgent call to address the high level of alcohol consumption in Europe, and people’s right to know about the impact of alcohol intake on their health.

Alcohol is a major risk factor for chronic diseases. In the EU, approximately 268,000 deaths and almost 8 million DALYs attributable to alcohol consumption are related to chronic diseases. More information on the links between alcohol and each disease is available here.

Europe is also the region with the highest proportion of total ill health and premature deaths linked to alcohol. Young people are heavily impacted by the burden of alcohol-related diseases in Europe. Further, one fifth of the population aged 15 and above drink heavily at least once a week.

Greater EU support is necessary to prevent alcohol consumption. This would bring significant health, economic and societal benefits, and contribute to reducing the prevalence of major NCDs.

ECDA recommends:

  • Introducing warning labels on alcohol products with details on the risks associated with consumption at the EU level, as advised by WHO, considering that there is no safe level of alcohol consumption.
  • Ensuring the right of Europeans to know and be protected from misleading or highly promotional information. Stronger regulatory and policy action should be taken to tackle the exposure to alcohol marketing and advertising on broadcast media, digital media and through the sponsorship of events, particularly those aimed at young people. A mandatory, front-of-pack energy labelling and a mandatory ingredients list for all types of alcohol products should be introduced at EU level to inform and protect Europeans.
  • Reducing alcohol availability by setting up a harmonized and higher level of alcohol taxation across Europe. Taxation allows to decrease affordability of alcohol and is a proven cost-effective measure to reduce consumption of alcohol, while contributing to addressing health inequalities.

It's World Diabetes Day

Today marks the World Diabetes Day. In line with this year's theme "Education to Protect", ECDA supports awareness around major chronic non communicable diseases such as diabetes and calls on policymakers to increase access to health literacy, to improve the lives of the million people living with diabetes in Europe. We reiterate our call for improved prevention & management of chronic diseases like diabetes in Europe, which share common risk factors and clinical links. Diabetes that is undetected or inadequately treated can lead to serious complications and other chronic diseases. 

More information on World Diabetes Day can be found here.


ECDA welcomes plenary vote on the ECDC mandate extension

On the 4th of October, Members of the European Parliament adopted the provisional agreement reached by EU institutions to extend the mandate of the ECDC, a key element of the European Health Union. Such revised mandate will strengthen the role of the ECDC in supporting EU Member States in the prevention and control of infectious disease threats, and will help improve European preparedness and response ahead of future public health challenges.

The agreed text refers to the links between communicable and non-communicable diseases; and highlights the impact that the COVID-19 pandemic had in the area. The text includes a new revision clause, under which the ECDC mandate should be re-evaluated by 2025, with the first evaluation examining "the feasibility of extending the mandate of the Centre to address the impact of cross-border threats to health on non-communicable diseases".

ECDA welcomes the endorsement of the extended ECDC mandate. Considering the important links between communicable and non-communicable diseases, data gaps in the area, learnings from the COVID-19 pandemic and the need for a more holistic approach to major health challenges in Europe, ECDA recommends that the evaluation be initiated before the end of this Commission's mandate. 

Image source: European Parliament audiovisual services.


ECDA message for World Heart Day

Cardiovascular diseases are clinically linked with other major chronic non communicable diseases. A holistic, multi-disciplinary approach to NCDs prevention and control is needed to address overlaps, complications and co-morbidities.
On World Heart Day, ECDA supports policy action for better cardiovascular health in the EU.
More information on World Heart Day here.