New psychoactive substances in Europe: challenges and solutions

The new psychoactive substances (NPS) market has increased so fast that existing drug control laws have been left behind. European countries have responded in a variety of ways: some have introduced new legal responses to NPS, based on existing consumer or health protection laws,  or laws governing medicinal products, while others have developed innovative new legislation. However, in 2014 the EU’s Court of Justice ruled that substances are not medicinal products if they do not have beneficial effects on human health, thus restricting the use of such laws for NPS control.

This report is in two parts; the first is aimed at policymakers, and lists the challenges in NPS control and the solutions adopted in selected Member States. The second part is for legal practitioners, and focuses on the judgment of the Court of Justice and its practical effects on the transnational prosecution of NPS cases, describing the responses of some of the Member States most affected by the ruling.

Download the full report on New Psychoactive Substances on the emcdda.eu website

Communicating health: experiences from small countries

Small countries with limited budgets have found new ways of engaging with the media to support the implementation of international agendas on health. Examples include:

Welfare Watch – Iceland

National experts from different sectors developed a set of social indicators on the country’s current and future health and social care needs and the Ministry of Welfare used these indicators to present journalists with interesting, high-quality information to catalyse public discussions on citizens’ health and welfare.

Eat well, move more – Luxembourg

This programme promotes healthy eating and physical exercise, and involves the Ministries of Health; Education, Children and Youth; Sport; and Family Affairs and Integration. It had collaborated with the media to involve civil society through schools, preschools, youth associations, and workplaces; and supports individuals by sending out booklets on healthy eating and the benefits of regular exercise.

More information on Small countries use of the media to promote healthy living on the euro.who.int website

Organ donation and transplant in the EU

Across Europe, 16 patients die every day waiting for the organs they need. However, there were over 800 more organ transplants in the EU in 2015, compared to 2014. This confirms an encouraging trend, with over 4000 additional transplants over 5 years, a 14% increase compared with 2010.

The ‘EU Action Plan on Organ Donation and Transplantation‘ has promoted training, cross-border exchange and sharing of best practices between Member States. Through the Public Health Programme, the Commission has co-funded several European projects to give practical support to Member States to help them improve their donation programmes.

In addition, a recently developed IT tool has been used to offer organs not allocated in their home country, enabling 23 transplants to take place during the pilot phase, mainly in children; that otherwise would not have been possible.

Read more about Organ Donation and Transplant from the ec.europa.eu website

How to do better health reform

Health systems are continually being reformed but why? And how?

An article in ‘Healthcare Reform, Quality and Safety: Perspectives, Participants, Partnerships and Prospects in 30 Countries’ analyses the impact that health-reform initiatives have had on the quality and safety of care in low-, middle- and high-income countries—Argentina, Australia, Brazil, Chile, China, Denmark, England, Ghana, Germany, the Gulf states, Hong Kong, India, Indonesia, Israel, Italy, Japan, Mexico, Myanmar, New Zealand, Norway, Oman, Papua New Guinea (PNG), South Africa, the USA, Scotland and Sweden. Popular reforms in less well-off countries include boosting equity, providing infrastructure, and reducing mortality and morbidity in maternal and child health. In countries with higher GDP per capita, the focus is on new IT systems or trialing innovative funding models. All countries are embracing ways to enhance quality of care and keep patients safe, via mechanisms such as accreditation, clinical guidelines and hand hygiene campaigns.

The article also highlights two important points: firstly that a population’s health is not determined solely by the acute system, but is a product of inter-sectoral effort—that is, measures to alleviate poverty and provide good housing, education, nutrition, running water and sanitation across the population. Secondly, all reformers and advocates of better-quality of care should include well-designed evaluation in their initiatives. Too often, improvement is assumed rather than measured.

Read the full abstract on Health Reform on the intqhc.oxfordjournals.org website

A Healthy Weight for Ireland

In the past two decades levels of overweight and obesity in Ireland have doubled with only 40% of the population having a healthy weight. This represents one of the biggest public health challenges Ireland is facing today and according to the WHO these levels are forecast to increase, so Ireland may top the European “League Tables” in this regard. The fact that the majority of the population is overweight or obese means that Ireland faces a dramatic increase in chronic diseases which, in the worst case scenario, will reverse the improvement in life expectancy seen in the last few decades.
Ireland has now produced ‘A Healthy Weight for Ireland – Obesity Policy and Action Plan 2016 – 2025’ to help people achieve better health and in particular to reduce the levels of overweight and obesity. It also acknowledges that the solutions are multiple andthat every sector has a role to play.
The full Obesity and Action Plan can be downloaded from the health.gov.ie website

Lead Poisoning in Europe

Lead poisoning is entirely preventable. Yet, the Institute for Health Metrics and Evaluation estimates that in 2013 lead exposure accounted for 853,000 deaths globally and 16.8 million disability-adjusted life years due to its long-term effects on health.

Lead poisoning can lead to developmental, behavioural and neurological disorders, anaemia, tiredness and muscle weakness, as well as kidney and liver damage. Scientific studies demonstrate that there is no safe threshold for lead in the human body; efforts should therefore focus on minimizing exposure as much as possible.

According to a WHO survey, 34 of the 53 countries in the WHO European Region report having legislation regulating lead paint in place. However, in some countries this regulation is not yet enforced. In addition to lead paint, lead is found in emissions from industrial processes and waste management, in drinking water (due to the use of lead in water pipes), in consumer products such as toys, cosmetics or jewellery, and in lead-acid batteries.

WHO/Europe encourages all European countries to join forces to advocate for reducing the risks to human health from lead through minimizing environmental and occupational exposure, particularly for children and women of childbearing age.

More information about Lead Poisoning is on the euro.who.int website.

Reducing alcohol-related harm

The Joint Action on Reducing Alcohol-related Harm (RARHA) has been a three year project co-financed by the EU Health Programme. It has now completed its work and published its findings which include:

  • Monitoring of drinking patterns and alcohol-related harm, including data and survey results on heavy episodic drinking, attitudes towards alcohol policy, and harm to others.
  • Low risk drinking guidelines in RARHA partner countries and a common criterion for low risk, including findings such as the importance to legislate and enforce an 18-year minimum age for all alcoholic beverages across the EU.
  • A toolkit for evidence based good practices in action to prevent alcohol related harm, including concrete examples of good practices in certain Member States.

More information about Reducing Alcohol-Related Harm can be found on the rarha.eu website

Organising out-of-hours primary care

Out-of-hours (OOH) services provide urgent primary care when primary care physician (PCP) offices are closed, most often from 5pm on weekdays and all day on weekends and holidays. Based on a policy survey (covering 27 OECD countries) and the existing literature, this paper describes the current challenges associated with the organisation of OOH primary care and reviews the existing models of delivering OOH primary care.

Findings of the paper show that most OECD health systems report key challenges to provide OOH primary care in an accessible and safe way. These challenges relate to (i) PCPs’ reluctance to practise due to high workload and insufficient remuneration; and (ii) geographical variations in access to OOH primary care within each health system. Together these challenges are leading sources of inappropriate hospital emergency department (ED) visits. Results also indicate that several models of OOH primary care exist alongside each other in the 27 OECD countries participating in the policy survey. Hospital EDs, rota groups and practice-based services remain the most common OOH arrangements, but there is a tendency to shift OOH primary care towards primary care centres and large-scale organisations known as general practice cooperatives (GPCs). A range of solutions have been implemented to improve access and quality of OOH primary care across OECD countries. These include providing organisational and financial support to PCPs; using other health care professionals (such as nurse practitioners), making OOH care participation compulsory, setting up a telephone triage system, using new technologies, and developing rich information systems.

Download the full report on Out-of-Hours primary care from the oecd-ilibrary.org website

Erasmus + opportunities

The European Commission has made three new videos available to show the great potential of the Erasmus+ programme.
These success stories feature the fields of:

  • staff mobility,
  • voluntary service
  • higher education traineeship.

The stories aim at presenting some of the Erasmus+ actions available for European citizens and the considerable advantages they can bring to all beneficiaries – students, staff, trainees, teachers and volunteers.
To find out more about the Erasmus + programme on the ec.europa.eu website

Breast cancer care and psychological support

Psycho-oncological support has become increasingly recognised and used as part of breast cancer care services in recent years. According to a recent review of EU and EFTA member states’ national/regional cancer plans and certification schemes, the need for psycho-oncological services is widely recognised. However the concrete allocation of resources and personnel to provide these services has not been specifically addressed in most of them.

Scientists reviewed 25 national and 4 regional cancer plans/strategies among 32 researched countries. They found that while 28 recognise the need for organised psycho-oncological support only 10 have actually identified the criteria for good psychosocial care, including the resources required or educational needs.

Read more about Breast cancer care and psychological support on the ec.europa.eu website