Interview with Vytenis Andriukaitis
Vytenis Andriukaitis was appointed EU Health Commissioner in November 2014. Here he gives an update on the priorities for his term of office.
What are the main health trends and challenges facing the EU at the moment?
It is good timing to talk about health trends as at the end of last year the European Commission and OECD published a joint report Health at a Glance: Europe 2014. The report presents the latest comparative data on health systems for all 28 EU Member States. This state-of-play on Europe's health presents many interesting figures and trends.
I am delighted to see that life expectancy has increased by more than 5 years since 1990. However, inequalities persist and we must help Member States who are striving to narrow the disparities in health.
Whereas rates of smoking are declining, overweight and obesity continue to be a grave concern for the EU. Therefore, I am keen to bring to the fore discussions on nutrition and healthy lifestyles. 53% of adults within our borders are now either overweight or obese. Obesity, which presents even greater health risks than being overweight, currently affects one in six adults (16.7%) in the EU, an increase from one in eight a decade ago. Together, we must tip the scales in the other direction.
Another matter on which I will focus on is Europe's preparedness to address serious cross border health threats. We are currently focusing our efforts on addressing the Ebola epidemic in West Africa. In November 2014, I visited the three most affected African countries- Sierra Leone, Liberia and Guiney- together with Commissioner Stylianides. I went to health centres, met governments, health care workers and survivors. I saw great need for healthcare personnel able to diagnose and treat people in rural communities, for equipment, water, sanitation. The Ebola challenge concerns us all. Europe is no exempt from the public health risk posed by Ebola. But the risk of Ebola spreading widely in the EU population is very low. Europe has very high standards of infection control procedures and we must ensure these standards are maintained.
What actions do you envisage taking to address the main challenges?
Life expectancy has continued to increase in the EU, but inequalities persist. Helping to reduce health inequalities in all our healt action is one of my priorities. I will continue to urge Member States to make a positive contribution to reducing disparities in health, for example by removing barriers in access to healthcare.
As I said during my hearing, my priorities for health are promotion, prevention, protection for all. I plan to further enhance prevention. The more health systems focus on prevention now, the less they will pay in treatment in fifteen or twenty years' time. I am not here to tell people to quit smoking, and not to drink or overeat. I am here to say how much better life can be without smoking, alcohol abuse or excess weight. My work will be driven by the values of equity and solidarity. I believe in health for all and all for health.
Finally, the Ebola outbreak serves as a stark reminder of the damage that contagious diseases can cause; and here we need to help those in need wherever they are. I will work with the Member States to ensure that our emergency preparedness capabilities remain in good shape to fight rapidly any crisis that can impact on health.
What is the EU doing about the growing threat of antibiotic resistance?
Antimicrobial resistance is one the most pressing public health issues of our time and I intend to prioritize it throughout my five year mandate – taking a comprehensive "One health approach". The European Centre for Disease Prevention and Control estimates that antimicrobial resistance is responsible for 25,000 deaths and over €1.5 billion of healthcare expenses and productivity losses per year in the EU.
Three years ago, the Commission adopted an Action Plan to prevent the further spread of resistance and preserve the ability to combat microbial infections, involving many different sectors: human medicine, veterinary medicine, research, animal husbandry, agriculture, environment, trade and communication.
In the areas of human medicine and health, several EU-wide recommendations and guidelines against antimicrobial resistance have been adopted in the past decade. For example, 26 countries have implemented actions to prevent and control healthcare associated infections, in most cases in the context of a national and regional strategy or action plan.
In the areas of veterinary medicine and animal health, the Commission has adopted a decision on the prudent use of veterinary antimicrobials belonging to the class of 3rdand 4th generation cephalosporins (considered as critically important by the World Health Organisation and the World Organisation for animal Health). In addition, the Commission requested the European Medicines Agency to provide advice, this year, on the impact of the use of antibiotics in animals on public health and animal health, and measures to manage the possible risk to humans.
In addition, the EU has devoted over 1 billion euro to antimicrobial resistance related research. Much of this investment has already borne fruit. For example, the EU-funded NABATIVI project has found a completely new antibiotic that is now in clinical trials in collaboration with a world-leading pharmaceutical company. This is important as only two new classes of antibiotics have been put on the market in the past 30 years.
However, it is equally important to make sure that resistance – largely due to patients taking antibiotics even when they do not need them – does not develop in the first place. As a doctor, I often noticed that many of my patients have the misconception that antibiotics can treat any illness and are harmless.
That is why the Commission will launch a €1 million inducement prize to address the issue of the unnecessary use of antibiotics in February 2015. This Horizon Prize for Better Use of Antibiotics will be awarded for a cheap and rapid test that allows health care providers to distinguish between upper respiratory tract infections that require antibiotics and those that can be treated safely without them.
The Commission also supports Member States' efforts to co-ordinate national research activities on antimicrobial resistances, particularly with the United States via the trans-Atlantic taskforce on antimicrobial resistance. The fight against the threat of antimicrobial resistance will not succeed without the efforts and commitment of all governments, all involved stakeholders, civil society organisations and the general public, and I am committed to continuing to facilitate this.
What benefits does the EU bring to patients?
All patients in the EU have the right to benefit from medical treatment and access to healthcare regardless of their gender or nationality. I am committed to upholding these patient-centered principles which are enshrined in the EU Treaty and Charter of Fundamental Rights. But to my mind, the EU citizens should also have the right to benefit from medical assistance regardless of their financial means. I will do my utmost to encourage the Member States to ensure that all patients in the EU, including those who lack financial means, have access to the health care they need.
In addition to the right to seek high quality healthcare in another EU country and be reimbursed for it at home under certain conditions as a patient in the EU, you have many other rights. Let me mention a few examples.
You can ask your healthcare provider for a cross-border medical prescription, which is recognisable in all EU countries. The Commission has set rules to facilitate the recognition of prescriptions issued in another Member State. This can help you avoid delays, interruptions in treatment and additional costs when in needing drugs another EU country.
You have the right to get a copy of your medical records. When you are treated, your healthcare provider must make a medical record of the treatment provided. As a patient you have the right to a copy of this medical record in order to secure continuity of care and be treated by a doctor of your choice, also if you continue treatment in another Member State.
You have the right to be treated with safe and effective medicines. The EU has strict standards on quality, safety and efficacy of a medicine before it can be placed on the EU market. Once a medicine has been authorised in the EU its safety is monitored during its entire lifespan to ensure that, in case of adverse reactions – which patients can now report directly to national authorities, additional action is taken swiftly, including additional warnings, restrictions of use or even withdrawal of the product.
In addition to patients’ rights, I fully support patient empowerment, and believe that improving the lives of patients goes hand-in-hand with efficient healthcare systems. Empowering patients means ensuring they are fully informed and in control of their own health care. This is a key principle of the EU Directive on patients’ rights in cross-border healthcare, and I will continue to ensure that Member States deliver on their commitments in this regard.