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What sort of new start for health under new EU leadership?

by Peter O'Donnell
BRUSSELS, 19 July (APM) - The election this week of German paediatrician Ursula Von Der Leyen as the next President of the European Commission has raised hopes in the health sector over the policy prospects - although cautious optimism is balanced with concerns that the complex make-up of the new European Parliament may spell trouble for the drugs industry.
Patient organisations, health professionals and civil society groups immediately welcomed the positive vote for Von Der Leyen and a joint statement from some of their leading lobbyists urged the new European Parliament to push for the new Commission "to regain citizens' trust" with a "robust health policy" and a senior level health commissioner with a strong mandate.
The European Patients Forum's Usman Khan also wants to see how the new configuration of Europe's leadership will integrate patients into research and into cancer care.

Shortages

For Europe's pharmacists, "the main priorities on the EU health agenda should be shortages and anti-microbial resistance", said Ilaria Passarani, who expects MEPs to push for more vigorous Commission intervention.
Europe's doctors are delighted that the new head of the Commission is one of their own, and are expecting "special attention for health policy at EU level", and the retention of a unified Commission health department, according to professor Frank Ulrich Montgomery, president of the Standing Committee of European Doctors.
He said that "systematic actions" are needed to protect health systems against being overwhelmed by ageing populations and the rise of chronic diseases.
These include support for research and innovation, to avert the risk of millions of deaths from antimicrobial resistance.
He emphasised prevention and promotion and is urging more effective vaccination programmes.

Industry concerns

Numerous industry sources welcome the mention of cancer in Von Der Leyen's agenda and some express hopes that her mention of ''a sustainable Europe (…) that opens up opportunities, innovates, creates jobs and offers a competitive edge to its industrie'' will lead to a renewed EU industrial strategy.
But the likely balance between health and environmental issues (notably in the Parliament's committee on environment and health) is a matter of lively speculation at present.
Some of these concerns were spelled out to APM by Elaine Cruikshanks, founding partner of the Acumen consultancy and a long-standing Brussels insider.
She expects strengthened action on cancer and a further review the pharmaceutical regulatory framework to be among the Commission priorities for health.

'Fundamental tension'

But progress will depend on finding workable coalitions among policymakers - which she sees as imperilled by the "fundamental tension" underlying Von Der Leyen's reliance "on a ragtag coalition" of political groups, and internal Parliament disputes over the allocation of committee posts.
"The chair and coordinators of the committee responsible for environment and health seem predominantly focused on environmental rather than health issues," she said, predicting "a bumpy ride".
She cited the committee coordinator for the Greens, the influential Dutch MEP Bas Eickhout, who has called on the Commission to take a firmer stance against industry.
(He recently said the Commission's health department "is not sufficiently standing up against the pharmaceutical industry'')
Cruikshanks expects a lot more activity on the green agenda - "issues like pharmaceuticals in the environment could find themselves in the crosshairs".
And "Von Der Leyen’s reliance on the right, witnessed during her confirmatory vote, could also become an obstacle on health topics", she says, because central and eastern European MEPs from the right "pushed hard to water down intellectual propert protection during the last mandate'', and they are now heavily represented in the committee.
"It will be interesting to see how this plays out in the upcoming discussions around orphans," she added.

New MEPS

She sees a further risk in the "exodus of informed MEPs - well-versed in technical matters like health technology assessment and anti-microbial resistance - and an influx of new MEPs from different political shades".
The prospect of an overhaul of EU pharmaceutical legislation - increasingly seen as likely over the next five years - "means stakeholders will be rushing to brief the new deputies. Key to this will be balancing technical considerations with policies that appeal to a broad, more industry-sceptic parliament''.
She notes that German socialist MEP Tiemo Wölken, "who made a name for himself in the last Parliament clipping innovative industry's wings on the supplementary protection certificate manufacturing waiver" is likely to continue this fight in his role as a coordinator for his political group in the legal affairs committee."
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