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