Striking a healthy balance: the role of public health in promoting a safer Europe

22 November 2006

Markos Kyprianou, European Commissioner for Health and Consumer Protection, said his experience as a minister in a small government (Cyprus) had fitted him for his current responsibility for policies on everything “from cows to banks”.

As he will hand over the consumer protection part of his portfolio to the new Bulgarian Commissioner on 1 January 2007, Commissioner Kyprianou focused his remarks on current EU health policies ranging from animal health, food safety and genetically modified organisms (GMOs) to broader issues such as health care.

However, he started by highlighting the proposed EU ban on trade in cat and dog fur, saying that this demonstrated that EU policies do not just deal with “high politics”, but also address the concerns of individual citizens. He said that although the proposed ban might seem “such a simple thing”, it had taken considerable effort to overcome the legal difficulties.


Mr Kyprianou said obesity was one of the biggest threats to health in the EU in the 21st century. It is a major cause of death and chronic illness, and its impact on society and the economy should not be underestimated. While medicine has increased life expectancy, it is also important to help people remain healthy into old age.

The Commissioner pointed out that the Lisbon Agenda criteria include health indicators as a measure of the EU’s success in boosting economic growth and competitiveness. A healthy population is more productive and is not a drain on resources, so while health could be classed as a human right, there are also considerable economic advantages in keeping the population healthy.

There are now 40 million overweight and obese children in Europe, and the number is increasing by 400,000 every year. The Commissioner said this would result in millions of obese adults who will suffer from heart diseases, respiratory problems and diabetes type 2.

The Commission is addressing the two main causes of rising obesity levels: unhealthy diets and a lack of physical exercise. However, as it is not possible to legislate on what people eat or how much exercise they take, the Commission is focusing on trying to convince people to change their habits.

On dietary issues, it is working with the private sector (industry and restaurant owners), doctors and non-governmental organisations on campaigns to educate and inform consumers and protect vulnerable groups, such as children, from aggressive advertising. Initiatives are also under way to improve consumer choice, with more tasty, healthy products, and at the same time to ensure that if the food industry produces more healthy foods, there will be a market for them.

Given the importance of physical activity, Mr Kyprianou regretted that children took so much less exercise nowadays and said the Commission was considering suggesting the reintroduction of physical exercise in schools. In some countries, steps are also being taken to encourage adults to be more physically active at work by, for example, programming lifts so that they will not stop after only one floor, or ensuring that office buildings had accessible staircases.

However, Mr Kyprianou stressed that these problems cannot simply be solved through legislation, as this takes too long, so the Commission is working to achieve  quicker, better results by, for example, “naming and praising” companies which have introduced positive measures.

Alcohol abuse

Alcohol-related abuse is becoming a major concern for the EU, said the Commissioner, with 53 million adults regularly consuming excessive amounts of alcohol, including an increasing number of young people. The statistics show this is a major cause of death, both directly and as a result of road accidents.

The Commission is working with Member States on initiatives designed to encourage people to reduce their alcohol consumption and to learn from positive experiences in individual countries. It is also bringing stakeholders together to discuss the issue.

Mr Kyprianou said that future policies would be based on the experience gained in the campaigns against obesity, in particular by banning advertising aimed at young people.

Cross-border health issues

Turning to the issue of health services, Mr Kyprianou said this was one of the Commission’s biggest challenges.

In judgments on individual cases, the European Court of Justice (ECJ) has ruled that EU internal market rules apply to health, and that people have a right to be reimbursed for treatment in another European country. However, the detailed implications of these judgements need to be clarified. Insurance companies need to know what treatment they have to cover, health service providers need to know whether they will be reimbursed and patients need to know how to sue for ill-treatment.

Mr Kyprianou said the Commission was studying all aspects of cross-border health. He argued that cooperation between health systems benefits patients, allowing them to travel to other countries for specialised treatment not available in their own countries, and helps Member States which are unable to cope with demand. They would also benefit if doctors or surgeons with specialised skills were able to transfer between different countries.

As conflicting legal rules still hinder these developments, the Commission is consulting Member States and will produce detailed proposals next year.