1. ILGA Europe AGM, 17 October 2003 Is the EU good for your health?  What can it do?  What does it do?  What should it do?  What will it do?

2. ILGA Europe AGM, 17 October 2003 What does the EU treaty state? Article 152 of the Amsterdam Treaty (1997): “a high level of health protection shall be ensured in the definition and implementation of all Community policies and activities” n Legislation permitted only on blood and blood products, human tissues and cells. n EU must respect Member State responsibility for organisation, financing and delivery of health care

3. ILGA Europe AGM, 17 October 2003 What EU rights to health exist? n “Everyone has the right of access to preventative healthcare and the right to benefit from medical treatment under the conditions established by national law and practices” Charter of Fundamental Rights of the EU, Adopted in Nice, December 2000

4. ILGA Europe AGM, 17 October 2003 The competing interests at EU level n EU Member States: damage limitation -- protect and control own healthcare systems. n Commission: ability to use the full range of instruments to address major health threats. n NGOs: recognition of health as a human right and counterbalance to economic imperative of the single market. n Industry : Simplify and harmonise the business environment.

5. ILGA Europe AGM, 17 October 2003 Why health needs to be addressed at EU level n Addressing health inequalities. Maintaining the solidarity-equity-sustainability triangle. n EU policies impact on our health and internal market legislation is de-facto creating policy on health related issues n The Commissioner has greater powers to promote animal welfare than to protect human health n Evidence that tackling major health burdens (tobacco, alcohol, obesity, drugs) needs legislation, fiscal measures, healthcare professionals and education.

6. ILGA Europe AGM, 17 October 2003 Some EU policies that affect health n Common Agricultural Policy n Regulation of Pharmaceuticals, chemicals, pesticides n Animal health and food safety n Internal market (marketing of alcohol, tobacco, junk foods) n Energy and transport policies n International trade agreements (GATS, TRIPS)

7. ILGA Europe AGM, 17 October 2003 ECJ: Lawyers setting the health agenda Judgements: Kohl & Decker 1998, Vanbraekel and Smits-Peerboom 2001, Muller-Faure and Van Riet 2003 set the following principles: n Healthcare is a service and it must be freely provided and accessed n Prior authorisation is a barrier to free movement and cannot be required n ‘Undue delay’ new concept being tested in the courts n Patients become ‘consumers’ of healthcare

8. ILGA Europe AGM, 17 October 2003 A vision of a ‘Europe of health’ n Political leadership by a charismatic Commissioner n A reinforced DG Health with a mandate that reintegrates public health, pharmaceuticals, workplace safety. Coordination of various EU agencies (EMEA, EFSA, ECDC etc) n MEPs that regularly demand health impact assessment (HIA) on all legislation and policies n Health rights explicit in EU treaty n Priority for health reflected in resource allocation

9. ILGA Europe AGM, 17 October 2003 Will treaty reform change things? n Convention : health barely addressed, debate was ill-informed and focussed on communicable diseases and healthcare. n Result: health is not in Art I-3, confusing split of competencies between EU and MS n IGC : Some political momentum to change Article 179 but with an emphasis on excluding healthcare from internal market. n Result?:

10. ILGA Europe AGM, 17 October 2003 European Public Health Alliance 33 Rue de Pascale B-1040 Brussels Belgium Tel : +32-2 230 30 56 Fax : +32-2 233 38 80 epha@epha.org www.epha.org