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13.5.8.  Public health protection in the EU

    Public health was brought fully into the action scope of the European Union by a special title of the Maastricht Treaty, which was amended at Amsterdam to heed the "mad cow" and dioxin lessons [see sections 5.1.3 and 11.2]. Title XIV of the treaty of Lisbon states that a high level of human health protection shall be ensured in the definition and implementation of all Union policies and activities. Union action, which complements national policies, is directed towards improving public health, preventing physical and mental illness and diseases, and obviating sources of danger to physical and mental health. Such action covers the fight against the major health scourges, by promoting research into their causes, their transmission and their prevention, as well as health information and education, and monitoring, early warning of and combating serious cross-border threats to health. The Union complements also the Member States' action in reducing drugs-related health damage, including information and prevention. Member States should, in liaison with the Commission, coordinate among themselves their policies and programmes in these areas and foster cooperation with third countries and the competent international organisations (Article 168 TFEU, ex Article 152 TEC).

    The European Parliament and the Council, acting in accordance with the ordinary legislative procedure [see section 4.3] may contribute to the achievement of the above objectives through adopting in order to meet common safety concerns:

    * measures setting high standards of quality and safety of organs and substances of human origin, blood and blood derivatives;

    * measures in the veterinary and phytosanitary fields which have as their direct objective the protection of public health;

    * measures setting high standards of quality and safety for medicinal products and devices for medical use (Article 168 § 4); and

    * incentive measures designed to protect and improve human health and in particular to combat the major cross-border health scourges, measures concerning monitoring, early warning of and combating serious cross-border threats to health, and measures which have as their direct objective the protection of public health regarding tobacco and the abuse of alcohol, excluding any harmonisation of the laws and regulations of the Member States (Article 168 § 5).

    In an enlarged EU of 28 Member States, health gaps are wider than ever before. Moreover, there are a number of growing challenges to the health of the population which require a strategic approach. These include the ageing of the population, which is changing disease patterns and putting pressure on the sustainability of health systems. Health threats such as communicable disease pandemics and bioterrorism are a growing concern, while the health impact of climate change raises new threats. On the other hand, new technologies are revolutionising the way health is promoted and illness is prevented and treated. To address these challenges, a White Paper of the Commission sets out a strategic framework for work on health at the EU level in the coming years [COM/2007/630]. The Strategic Approach for the EU 2008-2013 "Together for Health" puts forward an overarching framework which will focus on four principles and three strategic objectives for improving health in the EU. The principles are taking a value-driven approach, recognising the links between health and economic prosperity, integrating health in all policies and strengthening the EU's voice in global health. The strategic objectives are fostering good health in an ageing Europe, protecting citizens from health threats, and supporting dynamic health systems and new technologies. An effective implementation mechanism will be defined in close partnership with Member States, which will support the active engagement and close cooperation of all sectors.

    The third programme of European action in the field of health (2014-2020) aims to complement, support and add value to the policies of the Member States to improve the health of Union citizens and reduce health inequalities by promoting health, encouraging innovation in health, increasing the sustainability of health systems and protecting Union citizens from serious cross-border health threats [Regulation 282/2014]. More specifically the programme aims to: (a) promote health, prevent diseases, and foster supportive environments for healthy lifestyles; (b) protect Union citizens from serious cross-border health threats; (c) support public health capacity-building and contribute to innovative, efficient and sustainable health systems; and (d) facilitate access to better and safer healthcare for Union citizens. European statistics on public health and health and safety at work help attain the aims of the Programme [Regulation 1338/2008, last amended by Regulation 2015/359].

    The European network for the epidemiological surveillance and control of communicable diseases ensures continuous surveillance and provides an early warning and response system to deal with the appearance or recurrence of these diseases in the Member States [Decision 1082/2013, implemented by Decision 2014/504]. Member States must communicate information on the epidemiological development and emergence of public health threats due to communicable diseases using the European network in a way which allows comparisons to be made for preventive and control action to be taken at European and national levels [Decision 2002/253].

    An independent European agency named the European Centre for Disease Prevention and Control has the mission to identify, assess and communicate current and emerging threats to human health from communicable diseases [Regulation 851/2004]. Within the field of its mission, the Centre should: (a) search for, collect, collate, evaluate and disseminate relevant scientific and technical data; (b) provide scientific opinions and scientific and technical assistance including training; (c) provide timely information to the Commission, the Member States, European agencies and international organisations active within the field of public health; (d) coordinate the European networking of bodies operating in the fields within the Centre's mission; and (e) exchange information, expertise and best practices, and facilitate the development and implementation of joint actions. Actually, the EU leads actions against AIDS, cancer and drug dependence.

    As regards the acquired immune deficiency syndrome (AIDS), the Member States decided, first, to introduce a procedure for the periodical and rapid exchange of epidemiological data at European level and machinery for the exchange of information on national measures taken [Council Conclusions 88/C197 and 90/C329]. The EU participates in a research and development programme aimed at developing new clinical interventions to combat HIV/AIDS, malaria and tuberculosis through a long-term partnership between Europe and developing countries, undertaken by several Member States [Decision 1209/2003]. The EC is part to the World Health Organisation Framework Convention on Tobacco Control, which is concerned mainly with labelling, advertising, tax measures, manufacturers' civil and criminal liability, financing of national tobacco control programmes and action to combat illicit trade in tobacco products [Decision 2004/513]. The Council recommends that the EU Member States provide effective protection from exposure to tobacco smoke in indoor workplaces, indoor public places, public transport and, as appropriate, other public places as stipulated by Article 8 of the WHO Framework Convention on Tobacco Control (FCTC).

    In the framework of the action plans to combat cancer, the EU has adopted several measures against smoking, notably a Directive concerning the manufacture, presentation and sale of tobacco products [Directive 2014/40, last amended by Directive 2014/109]. A Resolution on banning smoking in places open to the public, which provided guidelines to the Member States for the protection of non-smokers from environmental tobacco smoke, was reinforced by a recommendation on the prevention of smoking and on initiatives to improve tobacco control. A milestone Directive prohibits all forms of advertising and sponsorship of tobacco products in the media other than television, i.e. in the press and other printed publications, in radio broadcasting and in information society services [Directive 2003/33]. Another Directive prohibits all forms of television advertising for cigarettes and other tobacco products and provides that television programmes may not be sponsored by undertakings whose principal activity is the manufacture or sale of cigarettes and other tobacco products [Directive 2010/13, see section 10.2].

    For the prevention of drug dependence, the EU has set up a customs cooperation and has taken a number of measures in the framework of its justice and home affairs policy [see sections 5.1.4. and 8.1.2]. The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), established in Lisbon, has at its disposal, as a key instrument in its fight against drugs, a European Information Network on Drugs and Drug Addiction [Regulation 1920/2006]. In connection with the European Union Drugs Strategy, the Council made a number of recommendations concerning information and counselling, emergency services, networking between agencies, appropriate integration of health and social services, and training and qualification for professionals, in order to reduce substantially the incidence of drug-related health damage and the number of deaths [Recommendation 2003/488].

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