1. ‘Is Europe good for our health?’ EPHA/ERS conference, 27 November 2003 Where could we be? Gérard Dubois Professor of public health, Amiens

2. ‘Is Europe good for our health?’ EPHA/ERS conference, 27 November 2003 natural and man-made environment genes behavioursbiological abnormalities disease death risk factorsrisk indicators screening diagnosis Primary prevention SecondaryTertiary clinical public health

3. ‘Is Europe good for our health?’ EPHA/ERS conference, 27 November 2003 A vision statement of health A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. World Health Organisation, 1946

4. ‘Is Europe good for our health?’ EPHA/ERS conference, 27 November 2003 How did we get there? Hygiene: water, air, food… Legislation: seat belts, health warnings on tobacco… Health promotion: information, education Prevention: vaccination, screening Improved health care system

5. ‘Is Europe good for our health?’ EPHA/ERS conference, 27 November 2003 Public health facts Viruses, bacteria, fungi have no boundaries (flu, SARS, diphteria…). Epidemics and pandemics are likely to occur (flu pandemic). What will be the availability of the flu vaccine when the flu pandemic occurs in the EU countries not producing the vaccine?

6. ‘Is Europe good for our health?’ EPHA/ERS conference, 27 November 2003 Public health facts The main causes of early death (<65) in all EU countries are tobacco, alcohol, car accidents, obesity, sedentary life. The first four are linked to industrialised products. The main causes of early deaths are due to industrial epidemics

7. ‘Is Europe good for our health?’ EPHA/ERS conference, 27 November 2003 Public health facts Any decision on these products have public health implications. Not to take account of this will lead to an hemiplegic system (legislation and administration). favoringEU is favoring smuggling within UK when it is on Court against two cigarette makers in the USA because they organise smuggling!!!

8. ‘Is Europe good for our health?’ EPHA/ERS conference, 27 November 2003

9. A vision of a “Europe of health” LEGAL BASIS: Health protection receives a priority in the new EU treaty with health rights explicitly recognised. LEADERSHIP: a charismatic and committed Commissionner with political weight. TEAM: a reinforced DG Health with a mandate that integrates public health, pharmaceuticals, workplace safety, cordination of various EU agencies (EMEA, AFSA, ECDC etc). FUNDS: sufficient resource allocation (€).

10. ‘Is Europe good for our health?’ EPHA/ERS conference, 27 November 2003 A vision of a “Europe of health” STRATEGY: A comprehensive EU framework for health including legislation, soft law, recommendations, targets, initiatives. PARLIAMENT: MEP’s that regularly demand health impact assessment (HIA) on all legislation and policies. INFORMATION: Comparable, reliable data on major risk factors, disease, mortality is consistently gathered by MS and regularly analysed by the EU. TARGETS: EU sets high common standards in health education, training, medical technology.

11. ‘Is Europe good for our health?’ EPHA/ERS conference, 27 November 2003 Good health is a fundamental right for children and adults. Health is a high priority for EU citizens.

12. The Convention’s working group on ‘Social Europe’ recommended the inclusion of Public Health into Article I-3 of the draft Constitutional Treaty with the support of many Convention members, MEP’s and public statements by the Greek Presidency of the EU. But what was the end result of health in the Convention?……………..

13. ‘Is Europe good for our health?’ EPHA/ERS conference, 27 November 2003

14. Remember: There is no economic health without people’s health. Thank you