Magyar Nemzeti Szívalapítvány Hungarian National Heart Foundation founded by the Hungarian Association of Cardiologists Tax No: Számlaszám/Bank account: Internet 18049471-2-42 11732002-20346146 www.mnsza.hu; nagya@kmk.hu Kecskemét, 12 February 2007 Response of the Hungarian National Heart Foundation to the European Commission's discussion document "Health in Europe: A Strategic Approach" Introduction In 1993, the Hungarian Association of Cardiologists set up the Hungarian National Heart Foundation (NHF) as a non-profit organisation of outstanding public utility. The aim of the Foundation is to combat cardiovascular disease to prevent it from becoming Hungary's primary killer and one of the chief causes of premature invalidity. In Europe, cardiovascular disease is the leading cause of death in men and women alike. It is responsible for almost half of all deaths, claiming 4.35 million victims per year in the WHO European Region and over 1.9 million in the European Union. It is also a major factor in disability and reduced quality of life. Cardiovascular disease costs the EU some 169 billion euros annually, representing 372 per head. This per capita figure, however, varies tenfold between countries from less than 50 per person per year in Malta to over 600 in Germany and the United Kingdom. The resulting loss in productivity in the EU represents over 35 billion, corresponding to 21% of total costs attributable to illness. Around two thirds of this ( 24.4 billion) is attributable to deaths, and the remaining third to sickness among the population of working age ( 10.8 billion). 500 million working days are lost every year to cardiovascular disease. General comments The NHF welcomes the Commission's discussion document, which seeks for the first time to develop an overarching health strategy in the EU. We urge the Commission to maintain its commitment in the Health Strategy to helping to develop supportive environments alongside health protection, as these broader environmental considerations are a crucial factor in public health and in the success of measures to eliminate inequality. The NHF urges the Commission to place due emphasis on non-communicable diseases when developing the Strategy. Non-communicable diseases account for 77% of the total sickness burden and 86% of deaths in the WHO European Region. Cardiovascular disease is responsible for 60% of deaths from non-communicable diseases. 70 84% of health expenditure in the region stems from chronic diseases. Cím/ Mail Address Telefon +36 (76) 519802 KECSKEMÉT, NYÍRI ÚT 38. Fax +36 (76) 519854 H-6000 HUNGARY
Detailed comments Health services The NHF recommends setting specific targets that will enable the capacities of the health services to be analysed to establish how well adapted they are to the prevention and early detection of disease and identification of individuals and groups at risk. Threats to health The Commission identifies HIV/AIDS, the re-emergence of tuberculosis, Creutzfeldt Jakob disease, the risk of bioterrorism and avian influenza as major threats to the health of EU citizens. The NHF points out that cardiovascular disease causes 46 times as many deaths in Europe as AIDS, tuberculosis and malaria put together. Health in all policies The NHF agrees that impact assessment is an important tool in evaluating health policy. We recommend that the Commission should not restrict its impact assessment to infrastructure, but should look also at the impact on health of the various programmes and projects within different population groups. STRATEGY Aim The European Union should seek to promote health, avoid premature death and invalidity and promote a more even distribution of Healthy Life Years expectancy within and between Member States, in cooperation with Member States and international organisations, in all areas of Community policy. Increase Healthy Life Years expectancy Reduce preventable deaths and sickness from major diseases (including cardiovascular disease) Reduce differences in life expectancy within the EU. Action in the short and medium term Health and health systems Council recommendation on preventing the most important diseases, including cardiovascular disease) 2
Analysis of the effectiveness of health services within the EU in prevention and the detection of premature illness. Information New legislation at EU level: compulsory detailed nutritional labelling of foods Adoption of EU legislation: compulsory restrictions on the commercial promotion of unhealthy food and drink in the audiovisual media targeting children Draw up quality criteria for patient information Nutrition EU-level recommendation on public nutrition Alignment of the common agricultural policy with the EU-level public nutrition recommendation Ban on industrially added trans-fats in foods marketed in the EU Smoking Increase tax on tobacco products Introduce a smoking ban in public places and at the workplace Physical activity Include in the rules for Structural and Cohesion Fund support criteria encouraging the development of regional infrastructure in such a way as to promote increased physical activity EU Forums Survey of training materials for health professionals within the EU, focussing on whether they include health maintenance and disease prevention principles Survey of quality standards within the EU as regards food provided by canteens, automatic food dispensing machines, etc. at institutions attended by children International cooperation on developing regulatory measures under the anti-obesity Charter approved by the Health Ministers of the WHO European Region, with a view to reducing significantly the impact of commercial promotion of energy-dense food and beverages, particularly to children Approve a recommendation on appropriate levels of physical activity for different population groups, in collaboration with the WHO Promote the practical implementation of the Framework Convention on Tobacco Control (FCTC) Milestones between 2008 and 2012 Council recommendations: Cardiovascular disease Diabetes 3
2008 Approval of the Commission's proposal for a Directive/Regulation restricting the commercial promotion of unhealthy food and drink in the audiovisual media targeting children Development of quality criteria for patient information Proposal by the Commission for legislation banning industrially added trans-fats in foods marketed within the EU Approval of international guidelines on the appropriate level of physical activity for different population groups 2009 Report on the inclusion of health maintenance and disease prevention principles in training materials for health professionals Report on quality standards of food provided by canteens, automatic food dispensing machines, etc. in institutions attended by children Adoption of the WHO recommendation on the commercial promotion of unhealthy food and beverages, particularly to children Adoption of an agreement on illegal trade in tobacco products, and gradual approval of other agreements under the Framework Convention on Tobacco Control 2010 Report on the effectiveness of the health services within the EU as regards prevention and the detection of premature illness Introduction of a comprehensive ban on smoking in public places and at the workplace Inclusion in the rules for Structural and Cohesion Fund support of analysis of the impact of regional infrastructure development on increasing physical activity 2011 Entry into force of the Directive on compulsory detailed nutritional labelling of foods Common agricultural policy aligned with EU-level recommendations on public nutrition. 4
This paper represents the views of its author on the subject. These views have not been adopted or in any way approved by the Commission and should not be relied upon as a statement of the Commission's or Health & Consumer Protection DG's views. The European Commission does not guarantee the accuracy of the data included in this paper, nor does it accept responsibility for any use made thereof.