European perspectives on global health: a policy glossary

1. Europe must make global health a priority
Strengthening global health security : The EU has
responded more urgently to issues of health security
and the threat of global pandemics and outbreaks
that could affect the health of EU citizens, than to the
poverty, equity and development challenge. There has
been, for example, a long-term accord between the
EU and the US to work together to strengthen global
health surveillance, initially focused on communicable
diseases but now with a wider remit. Since 1998 the
EU has funded its own health surveillance programme.
Coordination within the EU in preparing response plans
for health emergencies has also been emphasised in
EU policies and has been strengthened in response to
the avian influenza and the threat of a global influenza
pandemic.
In 2005 the <strong>European</strong> Centre for Disease Prevention
and Control came into operation. This new agency
provides a point of coordination and technical
support for the many <strong>European</strong> public health agencies
and laboratories that provide international health
surveillance and support for response to health
emergencies. It is currently a rather small agency with
less than 50 staff, but it is intended to grow to at
least 5 times this size over the next five years. While
its remit is focused on the protection of EU citizens,
this necessarily requires it to play a role in the wider
<strong>European</strong> neighbourhood and globally.
Promoting global health equity : The
“Programme for Accelerated Action on HIV / AIDS,
malaria and TB in the context of poverty reduction”
adopted by the Commission and endorsed by
the Parliament attempts to establish a balanced
programme of action across these diseases and in
relation to broader issues of poverty and disease.
While there has, in the past five years, been a marked
increase in attention and funding given to HIV, TB
and malaria, it is still the case that these are grossly
underfunded in relation to their impact. Similarly,
although the Millennium Development Goals ( MDGs )
have been declared by Development Commissioner
Louis Michel to be central to EU policy, the capacity
of underfunded and understaffed developing country
health systems to deliver medicines, vaccines
and preventive measures is not being adequately
addressed. Consequently it is unlikely that the MDGs
will be attained in most of Sub-Saharan Africa and
several Asian countries.
Enhancing good governance for global health :
The difficulty that the EU faces in taking action to
regulate an increasingly globalised food production
industry, even when the health of its own citizens is
at risk, is that action could be seen as counter to the
interests of EU based multinational companies or its
agricultural and trade policies. This dilemma can be
seen in relation to action on tobacco and health, where
subsidies to tobacco growers in Europe were some ten
times the total level of health promotion within the EU.
Similar conflicts between short-term EU interests and
long-term global priorities arise in relation to regulation
of multi-national pharmaceutical companies and in
relation to the recruitment of health professionals from
developing countries to the EU, as discussed in other
sections. Following the adoption of the Lisbon Agenda
the EU has recognised the need to resolve some of the
issues inherent in the EU’s position on globalisation.
The 2004 communication from the Commission to
Parliament on “The Social Dimension of Globalisation
- the EU’s policy contribution on extending the benefits
to all” points out the need to address the issues, but as
yet progress has been limited and health has not been
considered sufficiently.
Action : Strategic priorities for <strong>European</strong> action on
global health should be clarified and restated within
a coherent policy framework which is value-based.
Three such priorities are proposed : strengthening
global health security, promoting global health equity,
enhancing good governance for global health. The EU
should also devote greater attention to the impact
of EU policies on the health and well-being of other
countries.
References :
EU White Paper on Governance. Working Group 5.
Strengthening Europe’s Contribution to World Governance.
May 2001.
<strong>European</strong> Network on Debt and Development. EU Aid :
Genuine leadership or misleading figures ? An independent
analysis of <strong>European</strong> aid figures. Brussels, April 2006.
Richards, T. “Europe must coordinate its response to
common health threats”, British Medical Journal, 2005,
331 :864
18 <strong>European</strong> Foundation Centre – <strong>European</strong> Partnership for Global Health