- By Chris Kremidas Courtney
The first year of EU4Health, the European Union’s health programme which runs until 2027, has not been a success for those dedicated to reducing the burden of cardiovascular disease (CVD). The condition was nearly excluded from the 2021 work programme even though it is the leading cause of death in the EU. This was a missed opportunity.
A like-minded community of physicians, policymakers, politicians, patient representatives and industry can collaborate to tackle the burden of CVD on our healthcare systems, economies and citizens. For example, the recently launched European Alliance for Cardiovascular Health (EACH) brings together these stakeholders to advocate for the prioritisation of the disease through the implementation of a common EU cardiovascular plan. We have the understanding of the disease, the available technologies and awareness of the required actions to transform the diagnosis, care and treatment of CVD. The missing piece of the puzzle is strong political leadership from within the European and national institutions.
The impact of CVD was exacerbated during the COVID-19 pandemic. According to the World Health Organization (WHO), 65% of COVID patients who passed away in Europe had some form of cardiovascular disease, which includes heart failure, atrial fibrillation-related stroke, heart valve disease and coronary heart disease. The rate of CVD increases with age. In 2040, 155mn Europeans will be over the age of 65, so the scale of the challenge will only multiply with the anticipated ageing demography.
What the EU needs is a dedicated plan to tackle CVD
It is ultimately beneficial to keep this age group in good health, as the third generation plays an essential role in our communities and economies. Many senior people volunteer, continue to work, care for family members and contribute to communities financially. It is essential to keep them healthy so that they continue to play these positive roles.
So, how can we achieve this? The first step is to place health ever more at the centre of the EU. Health binds us together. Through actions that promote health and disease prevention, Europeans see the added value of the EU. This began with the cross-border healthcare directive, which enabled people to be taken care of and treated anywhere in the EU, and can continue with the realisation of the EU Health Union.
It is imperative that the EU supports dedicated action to improve the lives of people beyond tackling immediate health threats or promoting healthy lifestyles. What the EU needs is a dedicated plan to tackle CVD.
To make such a plan a reality, a Joint Action funded by EU4Health is required. This should begin with developing a better public understanding of the disease through targeted CVD awareness-raising campaigns so that no one suffers at home because they do not understand the possible cause of their symptoms. It is also important that the public understands that not all CVDs can simply be prevented, but are linked to genetics or occur due to functional decline, such as structural heart diseases.
This approach would mark a significant reduction in the hospital and social care footprint
The plan should then focus on early detection. It should implement an EU-wide cardiovascular screening programme, similar to that of Italy’s Cardio 50 programme, which proposes that all individuals over the age of 65 are screened for cardiovascular conditions once a year. This screening can be undertaken close to the patient with innovative new technologies, which give a much more accurate picture of CVD and ensure that referrals for further diagnosis and treatments are far more reliable.
With more effective diagnosis, patients can also be treated earlier to prevent progressive conditions from becoming irreversible and leading to physical decline and dependency. This early treatment should be undertaken, whenever possible, using minimally invasive therapies while patients are under local anaesthesia. This allows patients to recover their physical and cognitive skills more rapidly with fewer complications and without burdening the healthcare system. In this way, people can be discharged from the hospital to their families and communities sooner, and remote patient monitoring can be used when required. The result of this approach would mark a significant reduction in the hospital and social care footprint.
This Joint Action is perfectly feasible and realistic if all stakeholders commit to putting health at the centre of the EU. We have come a long way since the first EU health programme between 2003 and 2007, which received just €312mn in funding over six years. EU4Health still has six years to run and a budget of close to €5bn. However, we must act now by ensuring that the EU4Health’s 2022 work programme prioritises action that goes beyond primary prevention and improves the early detection of CVD for the sake of all patients suffering from these diseases.
If we can achieve this by the close of the EU4Health programme in six years’ time, we will be able to reflect with satisfaction on the fact that CVD is no longer the number one killer across Europe.
This article is part of a series published around our annual flagship event, State of Europe – the festival of politics and ideas: a new Renaissance, held on 14 October 2021.
- By Jamie Shea
- By Chris Foulds & Rosie Robison
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