June 25, 2019
Brussels, 25th June 2019
Subject: Suggesting 7 actions to your next five years plan to re-launch Europe by improving health
Dear Commission President Elect,
By the time of writing this, it is not known to whom that letter will be addressed but I am sure you can certainly have an interest to listen to me regardless who you are. I would like to draw your kind attention to a possible solution how your Commission could improve health in the next 5 years. I dared to write to you to use the occasion that I am a public health advocate monitoring public health European policies in the past decade both from a Member State and then a Brussels based civil society perspective so hopefully this will give me some authority and credibility to highlight what action is needed to improve people’s health.
You can certainly agree with me that health-promoting action is urgently needed to re-launch the European project. Despite uncertainity it is quite sure that your political affiliation is based on common European values and you do oppose the views of anti-European extremists. Well, the challenge you have is to identify an issue which would then counter argue the populist, anti-European bla-bla and you could offer facts and deliver actions, bringing European added value. My argument to you is that you should consider EU action on health to deliver this.
As the Commission president job was not the most popular one in the past, you should consider a topic which is popular among your electorates and which would resonate in people’s mind in connection with Europe. Well, the majority of European people wish to see more European level action in the area of health – which is a favourable argument for you. This support grew from 63% in 2016 to 69% in 2018, quoted in a recent research produced by the European Parliament’s research service.
But I can immediately hear your argument saying: no, health is a national competence. Well, I assume you wanted to mention national healthcare system management firstly and national policies to implement legislation in the area of health prevention secondly. On that point, may I refer to my earlier analysis (Myth Buster: why European economic governance is a key policy for health?) to demonstrate: hiding behind ideological argument of competences is just a weak excuse for no action. In fact, quite a lot can be done with the existing framework. To sum it up, the EU has:
1.) Extensive soft law powers to act for health
2.) Duty to mainstream public health in all policies
3.) Limited competence to introduce legislation on a health legal basis
4.) Extensive powers to ensure the functioning of the internal market with a high level of health protection
And here we are with your potential, next question: public health is so complex, so what can the EU do to do a meaningful difference? Actually, this is a valid question and it deserves some reflection. Obviously, the easy way to handle it would be to simply ignore ‘public health’ as a political priority and create the new Commission priorities forgetting about health. It is easy if you try. Your predecessor actually managed to achieve this. I am not entering into polemical discussion but it is widely understood and recognised in the European health community that the 10 key priorities of the Juncker commission did not prioritise health. At all.
While assuming that your intention would be not repeating the same old, same old again but aiming at making a positive contribution, may I suggest 7 concrete actions from my area of expertise which you can certainly consider. Those 7 identified actions are taking into account the legal competences the EU has, looking at evidence, making sure that they are in line with Global Health developments and they can realistically delivered. To be clear, simple and understandable, may I spell them out directly here:
1.) Rolling out Non-Communicable Disease (NCD) prevention policies recommended by the World Health Organization (WHO)
2.) Conduct a ‘health ceck’ study to identify EU barriers to the implementation of national NCD prevention policies
3.) Designing EU financial instruments that support national investment in prevention
4.) Establish a pan-European system for data collection, policy evaluation and accountability
5.) Ensure thorough inter-institutional coordination on health and well-being (including a Vice-President for Health and Well-being)
6.) Launch a ‘Health in All Policies’ on-line policy portal
7.) Pursue ‘EU flagship initiatives’ in areas that can deliver co-benefits for NCD prevention and other Sustainable Development Goals (SDGs)
How can it be done? Can it be done at all? This is too easy: the answer for both qestion is ‘yes’. Yes, it can be done – if there is a will. And to demonstrate that, may I kindly draw your attention to a well prepared explanatory document about ‘Towards an EU Strategic Framework for the Prevention of Non-Communicable Diseases’.
Hoping that after consulting with your health advisor, you have found my current letter interesting enough to have a deeper look, I assume your interest has been raised so in case of openness, I am looking forward to continue that discussion about pragmatic issues and how to make it happen.
Mr. Zoltán Massay-Kosubek,
European Public Health advocate,