Access to affordable medicines

The European Public Health Alliance (EPHA) strongly supports the President of the EU’s critique of the current over-protection and misuse of intellectual property and related rights for pharmaceuticals, and its goal to better balance the reward for innovation against the assurance of affordability of medicines.

Additional market exclusivity, data exclusivity, and supplementary protection certificates (SPCs) that add to the internationally-agreed 20-year period of patent protection will delay price-lowering generic competition. Generic competition has proved central to cost containment everywhere, including Europe and the impact of these proposed additional protections must be properly analysed.

Without transparency of the R&D costs to originator companies and information on the actual prices paid for medicines across EU Member States, any discussion about fair medicine prices remains impossible. Ultimately, the current monopoly-based model of biomedical innovation steers research priorities away from the greatest health needs towards areas with the highest potential profitability.

To read the full article on access to affordable medicines on the website

Health care quality in the UK

The OECD is producing a series of health care reviews and the UK’s has recently been published.

It has found that health systems in the United Kingdom have, for many years, made the quality of care a highly visible priority, internationally pioneering many tools and policies to assure and improve the quality of care. However, despite being a global leader in quality monitoring and improvement, the UK does not consistently demonstrate strong performance on international benchmarks of quality. This report reviews the quality of health care in the England, Scotland, Wales and Northern Ireland, seeking to highlight best practices, and provides a series of targeted assessments and recommendations for further quality gains in health care. These include the need to:

  • balance top-down approaches to quality management and bottom-up approaches to quality improvement
  • publish more quality and outcomes data disaggregated by country
  • establish a forum where the key officials and clinical leaders from the four health systems responsible for quality of care can meet on a regular basis to learn from each other’s innovations.

To read more about this review of the UK’s health system on the website

Improving health care across Europe

How can Europe ensure good quality healthcare for all people and counter the increasing pressures brought about by under-investment and lack of cooperation between different healthcare systems? This was the question asked at a European Public Service Union meeting attended by around 60 representatives from 25 countries.

Many participants mentioned difficulties with ensuring safe and adequate staffing levels in healthcare. The problems demand an approach that goes beyond looking at individual workplaces and addresses broader questions of the supply (and demand) for healthcare workers, investment in training and funding in general.

Trends regarding the privatisation, marketisation and commercialisation of health (and social) care run counter to the need to increase funding in public systems and to step up coordination and cooperation of polices across Europe to ensure universal access to high quality healthcare. Well-funded and democratically controlled healthcare systems are extremely efficient when compared to these where market forces are allowed to play too big a role.

To read the full report on strengthening public healthcare systems on the website.

EU Health Programme 2014-2020

The Health Programme has a total budget of close to €450 million for 2014-2020 and it supports Member States’ efforts in four specific areas:

Promoting health, preventing diseases, and fostering healthy lifestyles.
Protecting citizens from serious cross-border health threats.
Supporting capacity building and contributing to innovative, efficient and sustainable health systems.
Facilitating access to better and safer healthcare for EU citizens.

There is nearly €58 million of EU funding available in 2016, which will be implemented through a call for proposals, organised and managed by the Consumer, Health, Agriculture and Food Executive Agency (CHAFEA) later this month.

For more information about the Health Programme, on the website.

Strengthening health system governance

The governance of a health system shapes its ability to cope with both everyday challenges and new policies and problems.
This book provides a robust framework to explain the ability of health systems to provide accessible, high-quality, sustainable health.

Part 1 covers:
• the five key aspects of transparency, accountability, participation, integrity and capacity;
• the fact that every aspect of governance involves costs and benefits, and context is crucial;
• the importance of analysing and perhaps changing governance as part of policy formation and preparation;
• the reality that some policies simply exceed the governance capacity of their systems and should be avoided.
Part 2 explores eight case studies in a number of different parts of the WHO European Region, applying the framework to a range of themes including communicable diseases, public–private partnerships, governing competitive insurance market reform, the role of governance in the pharmaceutical sector, and many more.
This book is designed for health policy-makers and all those working or studying in the areas of public health, health research or health economics.

To find out more about strenthening health system governance on the website


Rethinking the Global Health System

A recent paper from the Centre on Global Health Security, Chatham House identifies priority areas for reform as the global health architecture confronts emerging challenges in the post-2015 era.

  • Every country needs strong, resilient and equitable systems that enable all people to live healthy lives so the global health architecture needs to be rethought so it best supports the building of these systems.
  • A fundamental shift affecting global health is the ageing of the population and the associated increase in non-communicable diseases (NCDs). Countries that are still battling infectious diseases are faced with a ‘double burden’ of disease that can overstretch already weak health systems.
  • The recent Ebola crisis in West Africa has shown the need for enhanced global disease surveillance and detection capacities, as well as improved international coordination in responding to emerging health threats.
  • Many low- and middle-income countries are projected to experience substantial economic growth over the next decade, enabling them to spend more on health. They need support to expand their health systems and increase public funding for poor and vulnerable populations – particularly women and children.
  • Global health funders must continue to address the challenges of poor populations and pockets of high disease burden in middle-income countries. Supporting fragile states more effectively will also be critical in the SDG era, as their populations are disproportionally affected by major health problems.
  • Expanding R&D financing and the range of incentives for investing in R&D is a priority area for action.
  • There is a need for stronger leadership in global health. Possibly a new organization – UN-HEALTH – which would bring together all UN agencies with health-related mandates. Alternatively, a UN Health Commission could be set up to improve coordination without the radical changes to the architecture required for a UN-HEALTH.

The full research paper on the website

Impacts of economic policies on access to healthcare

Since the economic crisis, policy changes across Europe appear to be moving countries away from universal health systems with broad coverage to systems where sections of the population are excluded from the full range of publicly available services. A new report from the European Public Health Association analyses these trends across Europe and contrasts the evidence that inclusive health, social, welfare and employment policies are beneficial to the economy with recent changes and health outcomes.

To read the report on the website

Health systems in transition – France

The French population has a good level of health, with the second highest life expectancy in the world for women. The French state has a strong role in the health insurance system, which offers a high level of choice of providers.

While the French population is largely satisfied with the health system, the overall state of health in France is mixed, as described within this review. Health inequalities across socioeconomic and geographical groups are much larger in France than in most other European countries, resulting not only from risk factors but also from financial and geographical inequities in access to care. The rising cost of health care remains a challenge for the health system, with public financing of health care expenditure among the highest in Europe. While the latest health reforms aim to address these challenges, long-term care reform efforts have thus far failed to identify a sustainable financing mechanism to meet this large and growing need.

To read about the health system in France, on the website

Health systems in transition – Switzerland

Life expectancy in Switzerland (82.8 years) is the highest in Europe after Iceland. The Swiss health system offers a high degree of choice and direct access to all levels of care with virtually no waiting times.

As this new review of Swiss health care makes clear, public satisfaction with the system is high and quality is generally viewed to be good or very good. Despite this positive assessment a number of challenges remain. In particular, improving financial protection and fairness of financing is becoming important because rising premiums and an exceptionally high share of out-of-pocket payments place an increasingly large financial burden on households with lower and middle incomes.

For more information on the Swiss health system on the website

Financing health care in the future

The health systems we enjoy today, and expected medical advances in the future, will be difficult to finance from public resources without major reforms. Finding policies that can make health spending more sustainable without compromising access and quality requires effective co-operation between health and finance ministries. Prepared by both public finance and health experts, this report provides a unique detailed overview of institutional frameworks for financing health care in OECD countries.

To read the full report on the website