Chronic Obstructive Pulmonary Disease is not the object of a specific piece of European legislation at present, but several issues in direct relation with COPD are regulated by the EU. What is the role of the EU to help defeat COPD?
Disease prevention measures, organisation of care including the reimbursement of healthcare costs, and management of services are traditionally national matters, the European Union has a subsidiary role in relation with health issues in general. Public health is a policy area where the Union supports, complements or supplements the actions of the 27 Member States.
However, some competences are shared between the Union and the Member States:
- common safety concerns in public health matters,
- EU may adopt harmonisation measures setting high standards of quality and safety for organs, substances of human origins and medicinal products and devices,
- EU may adopt protective measures in the sanitary and phytosanitary fields.
The EU may also adopt incentive measures in other matters pertaining to:
- the protection and improvement of human health, i.e. for combating major cross-border health scourges,
- monitoring, early warning of and combating serious threats to health as well as,
- measures which have as their direct objective the protection of public health regarding tobacco and the abuse of alcohol.
The European Union approach to disease prevention and care is horizontal: the European Commission Health Directorate is organised around health determinants and health systems & products, rather than per disease. The European Parliament, the co-decision body (with the Member States) follows the same organisation pattern and directives, regulations and recommendations are usually encompassing a set of diseases or addressing a risk factor (nutrition, smoking, lack of physical activity and alcohol).
However, some major diseases, i.e. cancer and Alzheimer disease, are the object of specific attention and benefit from European wide actions.
European research, on the other hand, although mirroring this pattern, does dedicate support and funds to single diseases, in particular if research for a said disease is difficult to obtain and to organise at national level.
In addition, several fields of European competences impact public health policies: agriculture, transport, environment and internal market, to name just a few. The presently debated Directive on Tobacco Products (TPD) is falling in the competence of Internal Market for instance – which role here is to regulate the freedom of movements of goods (and persons) and take measures against illicit trade. These policy areas need to assess and to take into account their impact on health before being adopted.
Based on the above, how can COPD be included in the European political agenda?
The EU is regulating on issues that are in direct relation with COPD, the major ones are:
– tobacco products,
– air quality (indoor and outdoor),
– health and safety at work,
– medicinal products with a European marketing authorisation,
– availability of vaccination (i.e. for protection from the flu),
– medical devices (such as oxygen devices),
– clinical trials,
– austerity measures,
– recognition of professional qualifications, for the mobility of healthcare professionals ,
– research in rare diseases (including in Alpha1 antitrypsin),
– patient’s safety, and
– citizens and patient’s rights.
COPD can be linked to all of the above and appear in the debates and/or texts related to them.
In addition to the above, there are European funding mechanisms that allow not only to provide financial support to research and policy development, but also to raise awareness on the diseases themselves.
Soft legislation is another way to get COPD on the EU radar: through “recommendations”, “communications” and other non-binding texts, public health advocates are able to underline the importance of the issue, which may lead to stringent legislation at national or European levels. This is the case with the European reflection process on chronic diseases, for instance, or the European Innovation Partnership on Active and Healthy Ageing.
The European COPD Coalition shares its views and sends recommendations based on evidence and data, to the EU legislators in the fields which have an impact on COPD; ECC participates to debates and communicates with the press to establish a dialogue and raise awareness about COPD, to name just a few of its activities.
Therefore, if COPD is not the object of a stand-alone EU piece of law, it is part of wider legislations which help advance the battle against the disease.
The European COPD Coalition calls for European strategy on COPD that will include measures on prevention, care, research and IT and eHealth. Please sign our Call to Action here.