EU4Health programme

The European Commission proposed a new, ambitious stand-alone health programme for the 2021-2027 period – the EU4Health Programme of €9.4 billion. However, Member States reduced the amount to €1.7 billion, jeopardising the EU’s ability and ambition to strengthen healthcare systems and public health protection across EU countries.

The funding for the Horizon Europe programme has also been hit by the Council’s cuts, with a budget dropping from the proposed €94.4 billion to €80.9 billion. This will have a considerable impact on health research and innovation, an area where the EU aims to gain global leadership.

Civil society organisations (EU4Health civil society alliance – including Eurocare) have been calling on European leaders to recognise that the pandemic has shown once again that more EU action on health is more urgently needed than ever. We have also emphasised that the COVID-19 recovery plans should not be focused on going back to the ‘old normal’ but rather should be taking our health systems to the next level.

Unfortunately, despite the European Commission’s proposals and the European Parliament’s support, the Council’s decision seems to reflect a will to drive Europe in the opposite direction, without granting European health systems a much-needed boost from an ambitiously-resourced EU Health programme. Even though the pandemic is still raging, and despite the efforts of healthcare professionals, authorities and researchers and the losses suffered by European people, public health is clearly still not being treated as a key priority.  

While welcoming the European Parliament’s reaction and looking forward to the voting that is taking place now in mid-October, we urge the EU institutions to work together with European leaders to review this decision and to stand firm behind a strong budget for long-term health action.  

People’s health and well-being must be at the heart of EU recovery plans.  

EU4Health civil society alliance - https://eu4health.eu/ has sent a Joint Statement How to harvest long-term health benefits of the EU4Health programme? – Guiding Principles  

The 26 European health organisations of the EU4Health Civil Society Alliance carried out an informal, joint analysis of the EU4Health Commission programme, following their previous statement, issued in reaction to the cuts in the health programme.
The key conclusions of the analysis are as follows:  
1. Ensuring long-term health improvements by boosting disease prevention, health promotion and public health action,
2. Ensuring access to care by reducing inequalities in Europe
3. Strengthening European health systems beyond the COVID-19 crisis  

The EU4Health Civil Society Alliance also agreed on some common views and principles that should guide the new EU4Health programme.  
1. The EU4Health programme and its budget should address not only the COVID19 recovery, but a sustainable system able to cope with emergency situations and crises in the future. It should be designed and implemented in a way that drives public health goals, tackles inequalities and achieves long-term health system innovation and strengthening.  

2. Civil society health organisations are an essential resource in shaping health policy at national and European levels. They can voice the lived experience and needs of the populations they represent, including patients, healthcare professionals, caregivers, public health professionals and ordinary people. Therefore their role in determining the direction health systems should be taking is also key. As such, they can help co-design the priorities of the programme and can be key partners in its implementation. A sustainable, accessible and transparent funding scheme should therefore be constructed in order to effectively guide and equip civil society organisations to immediately deliver on the goals of the EU4Health Programme.  

3. The role of health promotion, primary prevention and recovery support should be strengthened and prioritised to improve physical and mental health, and the wellbeing of all people living in Europe.  

4. The EU4Health programme should include actions to support health literacy and digital health literacy improvements for people of all ages living in Europe, while strengthening education and training for future-ready healthcare professionals, patients and caregivers both for prevention, disease management, behavioural and coping skills, as well as recovery. Emergency preparedness, behavioural and coping skills are particularly relevant in this context.  

5. The focus on cancer offers an exciting case study and template for what focused EU health cooperation can achieve, but attention should also go towards ensuring positive impact from the EU4Health programme is delivered for other disease areas.  

6. Special focus should be given to other non-communicable diseases and their risk factors such as nutrition, smoking and alcohol consumption and develop the infrastructure to provide help to those in need. Many patients suffer from several diseases (co-morbidities) and often chronic conditions such as respiratory diseases, which typically share the same risk factors.  

7. Coherence should be ensured with other elements of the EU budget, such as Horizon Europe, Digital Europe, ESF+ and structural funds, to mobilise resources and to ensure more health investment and avoid duplication and inefficient spending. The EU4Health programme should be designed in line with a health-in-all-policies approach, to facilitate coherence with other key policies at EU level (e.g. research, agriculture, education, social, environment, employment).This could also give priority to projects that establish collaborations between projects funded by different - or the same - programmes in order to avoid duplication of work and to already use evidence-informed strategies. This will save resources and provide better outcomes.  

8. Solid governance and dedicated coordination structure for the EU4Health programme will be key to ensure efficient, well-designed and thoroughly evaluated use of resources, also in coordination with the abovementioned EU programmes and policies. Public interest health civil society organisations, including patient organisations, should be meaningfully involved in an inclusive and integrated way in designing and implementing the EU4health programme throughout its implementation, including monitoring mechanisms.  

9. Better harmonised data systems can play a crucial role in strengthening health systems, improving healthcare quality in Europe and promoting effective disease self-management. The EU4Health programme should play a crucial role in improving data sharing, compatibility and inter-operability at European level, both for communicable and non-communicable diseases, streamlining the implementation of tools such as Electronic Health Records, e-Prescriptions, and patient registries.  

10. Strengthening of EU agencies, in particular the ECDC and EMA, is fundamental to improve the public health capability at European level and achieve the long-term objectives of the EU4Health programme. The Covid-19 pandemic has taught painful lessons about the need to urgently address this issue."  

Despite the concerning European Council’s budget cuts, already commented by the EU4Health Civil Society Alliance in July, the EU4Health programme still represents a unique chance for the EU to improve population health, healthcare access and quality, while preventing diseases, reducing unfair and avoidable health inequalities and bringing innovation to our health systems for the benefit of all people in Europe.

However, its goals will be achieved only through adequate long-term resourcing, and a forward-looking inclusive and co-developed design, implementation and evaluation of the Programme itself. Public interest health civil society will be a partner throughout the process!  

The European Parliament ENVI xcommittee adopted on the 13 October the amendments establishing that the Parliament will fight for €9.4 billion — the budget originally proposed by the Commission — for the program. The health committee’s report sets the Parliament and Commission on the same side of negotiations against the Council.

The programme should be adopted by the end of 2020 at the latest, as it supposed to be implemented from 2021  
13.10.2020