Currently, the major objectives of the common European policy are to:
- Protect and improve the health of European Union citizens,
- Support the modernization of health infrastructure,
- Improve the efficiency of European health systems,
- Strengthen preparedness and response measures to cross-border health threats.
The post-pandemic situation and the proposals adopted by the Conference on the Future of Europe also require a commitment to public health in Europe to:
- Establish the right to health by guaranteeing all Europeans equal and universal access to affordable, preventive, curative, and quality healthcare,
- Strengthen the resilience and quality of our health systems with concrete measures,
- Adopt a holistic approach to health, in line with the "One Health" approach, which should be emphasized as a fundamental and transversal principle encompassing Union policies,
- Ensure that Europeans have access to education on healthy eating and access to affordable and healthy food.
- The current health crisis, which began in 2020 in Europe, has major consequences, particularly in the field of health. This crisis has led to an awareness of the need for even more advanced work within the European Union and Europe.
During the World Health Summit on October 25, 2020, Ursula Von der Leyen, President of the European Commission, stated: "We will lay the foundations for a stronger European Health Union that allows the 27 countries to work together to detect, prepare, and respond collectively." This is a major realization.
Indeed, while health systems are managed, developed, and taken care of within each country, it has become clear that the challenges we face, such as the current COVID-19 pandemic, are common to all states. From this essential awareness, a "European Health Union" is developing along three axes:
- Preparing and acting in response to health crises,
- Collaborating to improve the prevention, treatment, and monitoring of diseases such as cancer,
- Providing innovative medical supplies at affordable prices.
To facilitate the development of the European Health Union, the "EU4Health 2021-2027" program is in place with a budget of €5.3 billion.
The main axes are:
- Improving and promoting health,
- Protecting people,
- Facilitating access to medicines.
At the level of each EU state, similar issues are observed, although each health system has its specificities. In France, for example, the prevention, health security, and care provision annex of the 2022 annual performance project mentions:
- Objective 1: Improve the health status of the population and reduce territorial and social health inequalities,
- Objective 2: Prevent and control health risks.
Among this awareness related to the current pandemic at the European and state level, a major theme, though largely underfunded, could be a strong axis of commitment to public health in Europe: prevention.
In the aforementioned French document, it is stated: "The objective is to create a health-friendly environment throughout life, with a policy including prevention in all settings and throughout life. It also aims to combat social and territorial inequalities in access to health [...]".
What is prevention? According to the WHO in 1948, prevention is "the set of measures aimed at preventing or reducing the number and severity of diseases, accidents, and disabilities."
Three types of prevention have been distinguished:
- Primary prevention, which encompasses acts aimed at reducing the incidence of a disease in a population and reducing the risks of occurrence; it includes the prevention of individual risk behaviors as well as environmental and societal risks;
- Secondary prevention, which seeks to reduce the prevalence of a disease in a population and covers actions at the very onset of occurrence aimed at eliminating risk factors;
- Tertiary prevention, which aims to reduce the prevalence of chronic disabilities or recurrences in a population and to reduce complications, disabilities, or relapses following the disease.
In Europe, the ECDC, European Center for Disease Prevention and Control, created in 2005, has a major mission in the field of prevention, focusing on infectious diseases. The ECDC's 2021-2027 strategic plan, following the COVID-19 pandemic, indeed revisits this primary mission.
However, prevention in public health is much broader. It concerns not only infectious diseases but also, more broadly, non-communicable diseases. Recently, the French government announced measures for general prevention with free consultations at ages 25, 45, and 65. To recall, the budget for prevention in France represents 2% of health expenditures (compared to 4% at the European Union level).
What are the public health challenges? For each state, the following issues are common: shortage of healthcare personnel (doctors, nurses), territorial inequalities within each state, aging population.
Prevention is a strong commitment touching on these three issues. While it is not the immediate solution, it also shows that it is indeed a commitment to public health at a European level.
If the political bodies in place, both at the European level and at the state level, are committed and provide resources (even if these remain insufficient), it is also an action at the level of each citizen that is necessary. This theme represents a humanistic commitment to public health in Europe. Common prevention measures, explained to European citizens, could be a meaningful action.
Commitment to public health does not stop at borders. It is a very broad subject, linking health in the broad sense (including our environment). By bringing together what is scattered, we can move forward.
For this, targeted prevention themes from all countries could be studied to propose a common communication, explaining the necessity of preventing both communicable and non-communicable diseases.
Beyond the substance that unites us today and a humanistic thought, concrete actions can emerge from it, advancing the construction of our edifice for the improvement of humanity.
During the year 2023, the EU legislated on major health topics, such as:
- The European Health Insurance Card (public sector),
- Telemedicine / decentralized clinical trials,
- Blood, tissues, and cells: the Council and Parliament reach an agreement (press release, December 14, 2023).
The Council reached a provisional agreement with the European Parliament on new rules to improve the safety and quality of blood, tissues, and cells used in healthcare and to facilitate the cross-border movement of these substances within the EU.
The regulation on substances of human origin (SoHO) will ensure better protection for donors and recipients, as well as children born as a result of assisted reproductive technologies. The proposed new rules aim to strengthen the existing legal framework while offering increased flexibility to adapt to scientific and technological developments.
These subjects are of great importance to us Freemasons, as they are also related to human rights and the value of equity, which is very dear to us.
Furthermore, the first EU AI law was implemented in December 2023: this first worldwide artificial intelligence regulation is very important, but it must also be implemented in the health sector, adapting to the requirements of human rights protection and personal data protection.
Other topics that concern us at the dawn of 2024, affecting the health and daily lives of citizens, include:
- The shortage of medicines and raw materials,
- The report on threats related to communicable diseases,
- Patients' rights in cross-border healthcare,
- The new regulation on medical devices and clinical trials of medicines,
- Mental health and its importance.
In the context of a European public health policy, Freemasons express their concern that the patient remains at the center of a holistic approach to their personal state.
Health education should begin in childhood for all European citizens.
Based on the principle that prevention is better than cure, we believe that effective prevention, through the various health actors, would be likely to guarantee improved overall health and contribute to significantly alleviating the economic and financial aspects of a European public health strategy.
We also want to emphasize the importance of training and the role of all health operators in this global approach we advocate, to guarantee all European citizens equal access to quality care.
Additionally, the importance of using artificial intelligence and digital technology in a conducive and regulated manner, in favor of patients, while ensuring the security of personal data.
The fundamental right to health should be explicitly recalled in all future texts relating to the concrete implementation of the proposals to be validated by the European Parliament.
Man/Woman must be at the center of our concern, in terms of health, to preserve the human dignity of all Europeans.
Ina Piperaki