consistency/complementarity of the PHP
8.3.2 Other EU policies/activities
In general, health is highly prioritised in the EU. This is not only reflected in the PHP but also in other EU policies/activities. One example is the Environ- ment and Health Action Plan 2004-2010 (EHAP) which main purpose is to im- prove the health of European citizens by knowing exactly what impact envi- ronmental damage has on human health. Specific themes as e.g. Health theme (Translating research for human health; Optimising the delivery of healthcare to European citizens; Responding to emerging needs and unforeseen policy needs) under EHAP (FP7) and Long-term health impacts of exposure to envi- ronmental stressors (chemicals, air pollution and noise) under EHAP action 6 obviously are complementary to the actions in the PHP. Similarly, in both FP6 (Thematic priority 1. Lifesciences, genomics and biotechnology for health) and FP7 (Health theme) specific health related research areas have been prioritised as e.g. child health, ageing and gender aspects reflecting a clear consistency and complementarity with actions in the PHP. Furthermore, organisations such as the World Health Organisation (WHO), UNESCO and OECD also prioritise and focus on specific health policies/activities as e.g. ageing and child health (WHO), HIV and aids (UNESCO) and Improving health care efficiency and policy settings (OECD). All of these organisations is covering aspects of health both in Europe and the rest of the world.
8.3.3 Interviews with internal stakeholders
In the interviews we asked stakeholders how and to what degree consistency/ complementarity is ensured between the programme's funded activities and other EU policies, nationally and internationally.
How and to which degree is consistency/complementarity ensured between the programme's funded activities and other EU policies, nationally and internationally?
Evidence provided indicates that consistency/complementarity is not ensured in a systematic way, which is considered to be a weak point of the programme. However, improvements have been made. Some stakeholders accentuated the work of the evaluation committee, which aims to avoid overlaps.
Some stakeholders pointed to the need for deeper involvement by other DGs and Member States. Inter-service consultations are already conducted today but are considered to occur too late in the process by some stakeholders. Further- more, replies may be missing. More than today, inter-service consultations should provide input to the formulation of the programme and annual work plans (AWPs). Member States should also be involved earlier in the process. Furthermore, it was mentioned that increased use of public consultations might be another way to ensure consistency/complementarity. However, public con- High consistency/ complementarity to other EU policies/ activities Consis- tency/complementari ty is not ensured in a systematic way
sultations are very time consuming. Thus, such consultations should probably not be undertaken more often than every two to three years.
8.3.4 Case studies
In general, the project groups selected for in-depth study are in contact with other EU, national or international organisations to ensure consis-
tency/complementarity with other activities in the field. However, there is no evidence of a more systematic approach in order to make sure that all relevant activities are taken into account. The results of the case studies with regard to consistency/complementarity are presented in more detail in appendix II. Exposure of consistency/complementarity regarding the case studies was ap- proached by searching the internet for activities/policies in the different case study areas and by contacting the national focus point (NFP) in the countries where the coordinators of the single case study were situated.
www.google.com was searched by using the following keywords: the name of the programme of interest combined with words 'programme' and 'policy' in combination; after that the relevant links were assessed for eligibility. In all, eight NFPs were contacted for a telephone interview about their knowl- edge of the case study(ies) in their home country and about their knowledge of policies or activities, if any (national or international) following the case study project.
It was not possible to establish contact with two of the approached NFPs (from Poland and France). The rest were interviewed by telephone; of these four (from Sweden, the Netherlands, Germany and United Kingdom) promised to mail information about eventual policies/activities, but only one did so (Ger- many).
Only one NFP (from Germany) responded to the effect that they knew the pro- ject in their home country. The NFP from the Netherlands knew of ongoing activities whereas the rest of the NFPs had no knowledge of activities or poli- cies initiated as a result of national case study projects. One of the reasons for the lack of knowledge of projects/activities/policies may be the relatively short periods of operation of the NFPs (less than a year, 1.5 years, 4 years).
By consulting national and international public health webpages, it was found that all case studies had left a mark, which was either reflected as policies or activities in the field of the single case study (Table 8-1)
Internet search strat- egy Interview of National Focal Points Knowledge of pro- jects, poli- cies/activities by NFPs Complementary pro- grammes at national, EU and international level
Table 8-1 Complementary polices/activities related to each of the case studies.
Case study
Home country of
coordinator/study Policy/activity Health Information Strand
Closing the gap - re- ducing premature mortality. Baseline for monitoring health evolution following enlargement
Poland Policy:
National Programme for Prevention of Alcohol-Related Problems 2006-2010 implemented by the State Agency for Prevention of Alcohol Related Problems (This national policy strategy is relevant for premature mortality since alcohol accounts for a high proportion of premature mortality in Central and Eastern Europe35)
Better statistics for better health for pregnant women and their babies: Euro- pean health reports.
France Activity at European level:
EURO-PERISTAT has sought to build links with other research projects and net- works that are adding to our knowledge about perinatal health. The following European initiatives have collaborated on producing this European Perinatal Health Report. Databases: SCPE, EUROCAT and EuroNeoStat
European surveillance of congenital anoma- lies (Phase 3)
United Kingdom Activity at European level:
26th Registry Leaders' Meeting and 11th European Symposium on Prevention of Congenital Anomalies (EUROCAT).
Rare disease portal France Policy:
French national plan for rare diseases
http://www.eurordis.org/IMG/pdf/EN_french_rare_disease_plan.pdf
Bulgaria: The adoption of a national plan for rare diseases
http://www.raredis.org/pub/events/NPRD.pdf
Greece on the way with on its own national plan for rare diseases
http://www.eurordis.org/content/greece-way-its-own-national-plan-rare- diseases
A national plan for rare diseases in Portugal http://www.rare- diseases.eu/2007/IMG/File/ecrd_chp03.pdf
National plans for rare diseases: Ireland moving forward
http://www.eurordis.org/content/national-plans-rare-diseases-ireland-moving- forward
Health threats strand
Case study
Home country of
coordinator/study Policy/activity
European living dona- tion and public health
Spain Policy:
Proposal for a directive on standards of quality and safety of human organs intended for transplantation
http://ec.europa.eu/prelex/detail_dossier_real.cfm?CL=en&DosId=197723
JACIE The Netherlands Policy/activity:
In 2009, 43 centres applied to JACIE for the first time and a further 14 for reac- creditation making last year the busiest yet for applications.
In 2009, 27 centres achieved accreditation for the first time and 15 centres were reaccredited. This compares with 39 first-time accreditations and 5 reaccredita- tions in 2008.
(http://www.ebmt.org/enew/march2010/jacie.html)
JACIE interacts with a number of regulatory authorities on a variety of levels including regulations (France, Italy, Switzerland, the Netherlands), guidelines (UK) and collaboration (Italy, Spain).
http://www.jacie.org/portal/en/public/regulators
The public health response to chemical incident emergencies
United Kingdom Activity:
European training for health professionals on rapid response to health threats
http://euprojects.org/ethreat.info/index.htm
MASs - casualities and health care following the release of toxic chemicals or radioac- tive materials
Sweden Activity:
Nuclear Medical defense conference and EU-MASH symposium
http://www.radiation-medicine.de/uploads/media/Program_2009.pdf
Health determinants strand
European centre AIDS and mobility (A&M)
The Netherlands Policy/activity:
European AIDS treatment group has announced AIDS & Mobility Policy Seminar:
http://www.eatg.org/eatg/Events/Upcoming-events/Aids-Mobility-Policy- Seminar-30th-November-Brussels
The INTEGRATION project with the purpose to support community-based mobi- lisation on HIV/AIDS and related issues in Central and Eastern Europe:
http://www.integration-projects.org/ European network for
transnational AIDS/STI prevention among migrant pros- titutes
The Netherlands Activities:
Joint United Nations programme on HIV/AIDS "HIV and sexually transmitted infection prevention among sex workers in Eastern Europe and Central Asia" :
http://data.unaids.org/publications/IRC-pub07/jc1212- hivpreveasterneurcentrasia_en.pdf
Case study Home country of coordinator/study Policy/activity http://www.lige.dk/files/pdf/linksamlingkvindehandel.pdf Medical Advocates: http://www.medadvocates.org/marg/sexworkers/national/europe.html
UK Network of sex work project (UKNSWP):
http://www.uknswp.org/a_activities.asp
European network on drugs and infections prevention in prison
Germany Activities:
Ninth European conference on drugs and infections prevention in prison:
http://www.soros.org/initiatives/health/focus/ihrd/events/endipp_20060307
The CONNECTION project. One of the main objectives of the CONNECTIONS project is to inform policy development at EU level in the area of drugs and HIV/AIDS (and other drug related infectious diseases) prevention in prison and in the criminal justice system with focus on policy development at national level through pilot projects on harm reduction and the criminal justice system in Hungary, Poland and Romania (HCLU, Probacja, ARAS):
http://www.connectionsproject.eu/activities
NFP comment:
"There have been some policy activities in the field of "prison health", which has been associated with ENDIPP and its results. First of all the ENDIPP/WHO- database concerning prison health, which helps us as a Federal Institution to get data-information about the situation in the German prisons, which are in the responsibility of the Bundes Laender. Some of the results of the ENDIPP-project we discussed with the committee of the Laender for the penal system in Ger- many and during a meeting with the responsible persons for medical atten- dance in prison. In addition, we used the results of ENDIPP within the scope of some conferences with the topic prison health and/or substitution treatment in Germany. We promote a conference in Hamburg in January 2011, where the specialists of the institutions for the so called "Maßregelvollzug" (a two year method of a compulsory treatment for alcohol or drug addicts) going to discuss the possibilities of substitution in the "Maßregelvollzug". The results of ENDIPP also influenced the German position in the platform "Criminal Justice" (Pompi- dou Group, Council of Europe)".
Democracy, cities and drugs II
France Policies/activities:
Safer nightlife and policies at the EU level (5th meeting EXASS network):
http://www.coe.int/t/dg3/pompidou/Source/Activities/EXASS/Guide_SaferNigh tLife_Print_en.pdf
New EU drugs action plan has been adopted:
http://www.eukn.org/E_library/Security_Crime_Prevention/Anti_Crime_Policy/ Drug_Crime/New_EU_drugs_action_plan_adopted
Case study
Home country of
coordinator/study Policy/activity
European monitoring centre for drugs and drug addition has presented every year annual report "The state of the drug problem in Europe"(includes chapter "policy and law"):
http://www.emcdda.europa.eu/publications/searchresults?action=list&type=P UBLICATIONS&SERIES_PUB=w36
http://www.emcdda.europa.eu/policy-and-law
It is not surprising that analysing complementarity at policy, programme and project level respectively shows that only few of the case studies display com- plementarity at all levels. However, all case studies have generated at least one activity in the related field. An example at policy level is the case study "Clos- ing the gap - reducing premature mortality. The baseline for monitoring health evolution following enlargement" has been reflected in a national policy and in the "Rare disease portal" case study a number of national policy has followed the case study whereas an EU policy was inspired by the case study "Democ- racy, cities and drugs II". In the same way, many of the projects have led to na- tional or international activities at programme or project levels, including the case studies "European surveillance of congenital anomalies (Phase 3)","The public health response to chemical incident emergencies" or "MASs - causali- ties and healthcare following the release of toxic chemicals or radioactive mate- rials". Finally some case studies have contributed to both policies and activities as e.g. "JACIE", "European centre AIDS and mobility (A&M)" and "Democ- racy, cities and drugs II".
Even though national and international public health web pages and NFPs were consulted, it is feasible that not all policies/activities based on the case studies have emerged in our search and interviews. Furthermore, despite all the case study projects have been terminated, policies/activities may still be emerge as a result of the case studies given that policy making is often a lengthy process. Table 8-2 presents the scores for each of the case study according to consis- tancy/complementarity accompanied with brief rationales for the scores.
Table 8-2 Scoring of case study consistency/complementarity
Case study Score Rationale
Health information
Comparable European information
Closing the Gap – Reducing Premature Mortality. Baseline for Monitoring Health Evolution Following Enlargement
2 A national policy is developed whereas there is lack of international policy activities as well as national and inter- national activities
Better Statistics for Better Health for Pregnant Women and Their Babies: European Health Reports
3 EU policy is developed as well as European activities and collaboration e.g. cross country databases
Creation & support of knowledge management networks
European Surveillance of Congenital Anomalies (Phase 3) 1 Activity at European level (International conference).. Lack of policy actions and national activities
Rare Diseases Portal 3 Several national policies are developed. Lack of activities.
Health threats
Organs
European Living donation and public Health 1 EU policy proposal. No other policy initiatives or activities. JACIE - Joint Accreditation Committee ISCT EBMT 4 Several national and international policy initiatives and
activities.
Chemical threats
The Public Health Response to Chemical Incident Emer- gencies
1 Only activity is a training seminar. Mass casualties and Health-care following the release of
toxic chemicals or radioactive materials - MASH
1 Only activity is a conference.
Health determinants
HIV/AIDS
European Centre AIDS & Mobility A&M 2 European policy seminar and European integration pro- ject
European Network for Transnational AIDS/STI Prevention among Migrant Prostitutes
2 European and international joint programme. No policy initiatives.
Addictions - drugs
European Network on Drugs and Infections Prevention in Prison
3 European conference and several policy initiatives. Democracy, Cities & Drugs II 3 EU policies are developed as well as a European monitor-