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Cap for health


Based on the briefing “CAP: 11 ways to deliver for better health“ this section discusses policy options.
This is a ‘living’ online document that will evolve as the CAP reform progresses.
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1. Minimise antibiotics use


The spread of drug-resistant bacteria, or antimicrobial resistance (AMR), is driven by the inappropriate use of antimicrobials in human and veterinary medicine as well as other factors, such as pharmaceutical pollution in the environment. The EU’s One Health Action Plan against AMR aims to make the EU a best-practice region for tackling drug resistance. This is an important opportunity to which the CAP can contribute: both to protect our common future – bacteria know no borders – and to ensure that Europe can lead by example by promoting low antibiotics use and high animal welfare production methods.

Given that reductions in antibiotics use in animal farming falls within the scope of agricultural operations, incentives under the CAP have an important role to play. While the Commission’s proposal to include the reduction of antibiotics use among the indicators is a welcome step in the right direction, a future-oriented CAP should benefit from a more targeted approach.


Our proposals:

1. Member States should set national antibiotics use reduction targets. Such targets should be time-bound, ensure that no country sees an increase in antibiotics use, and should cover different species of animals and different classes of antibiotics. A starting point for target-setting could be derived from the average levels of use in countries which demonstrate low antibiotics use (see: European Surveillance of Veterinary Antimicrobial Consumption).

2. Make the observance of relevant provisions under the Veterinary Medicines and Medicated Feed Regulations into a precondition for receiving funding under the CAP.

3. Independent farm advisory services should support antibiotics use reduction through improved animal husbandry practices. In particular, advice should focus on the phasing-out of routine preventive mass medication of animals with antibiotics, both for prophylactic or metaphylactic purposes, as well as the use of critically important antibiotics for preventative use and group treatments.

4. Use CAP funding to support farmers in transitioning to low-antibiotics use, high animal welfare farming models. This can be achieved by earmarking a share of the CAP budget for measures under the new specific objective on food and health. Such methods can be identified by focusing on recognised certification systems that explicitly restrict the use of antibiotics, such as the organic standard, and through the elaboration of other indicators on the basis of farm system characteristics, such as animal housing conditions, stocking densities and biosecurity measures.

2. Contribute to clean air


Ammonia (NH3) emissions in the EU derive almost exclusively from agriculture. Around 80% of agricultural ammonia emissions come from 5% of farms, and many options to reduce emissions are available. The Commission’s proposal to include an indicator on NH3 emissions reductions is a welcome step in the right direction, but a future-oriented CAP should benefit from more specific target setting.

The current NH3 emissions reduction targets set out in the National Emissions Ceiling (NEC) Directive (2016/2284) are specific and, given agriculture’s overwhelming contribution to NH3 emissions, can be taken onboard as a target for the CAP. At the same time, the current NEC targets fall well below the ‘maximum technically feasible reduction’ level as identified in the European Commission’s impact assessment for the NEC Directive. This level of reduction, which yielded the highest positive health impact among reviewed scenarios, refers to a 35% EU-wide reduction in emissions by 2025/2030. CAP funding is a welcome tool to support feasible reductions beyond the already existing legal target.


Our proposals:

1. Member States should set national ammonia emissions reduction targets based on the targets in the NEC Directive. Such national targets should not fall below the reductions previewed by the Directive. Rather, more ambitious strategies that would help achieve NH3 emissions reductions beyond the already legally binding targets should be pursued.

3. Support healthy diets


Health is now firmly part of the CAP debate. The European Commission committed the CAP to become “more apt at addressing critical health issues” and to make “nutritious valuable products such as fruit and vegetables easily available for EU citizens”. The European Parliament, in its own initiative report, also recognised the need for greater health focus by stressing “that a future-oriented CAP should be designed to better address critical health issues, such as those related to antimicrobial resistance (AMR), air quality and healthier nutrition”.

While the Commission’s proposal has included a health dimension among the CAP objectives, it does not clearly elaborate on how its reinforced commitment to nutrition should be met beyond the already existing instruments, and does not include an indicator for nutrition.

Farmers produce food, not diets. The CAP, however, is not only concerned with production, it finances demand-oriented measures as well. The need for a ‘nutrition-sensitive’ agricultural policy is increasingly apparent and support for it is steadily growing. A future-oriented CAP is one that makes much better use of the positive synergies that may accompany the creation of markets for foods for healthy and sustainable diets. Such measures can create mutually reinforcing dynamics to the benefit of producers, through market signals, and consumers, through healthier food environments, alike.  When further linked to regional and local (e.g. urban) food strategies, this can provide particular benefit for regional employment and the flourishing of new business models.


Our proposals:

1. Member States should set national consumption targets for fresh fruit and vegetables, based on the World Health Organization (WHO) target of at least 400 grams of fruit and vegetables per day. Success under this indicator could be measured by an evaluation, both qualitative and quantitative, of how CAP funding has contributed to increased consumption. Existing tools, such as findings from the European Health Interview Survey (EHIS) can be used. Earmarking a share of the CAP budget for measures under the new specific objective on food and health would allow to contribute to this aim.

2. Ensure that all children in the EU between the ages of 6-12 years can be covered by the School scheme for the distribution of fruit and vegetables by expanding its budget.

3. Introduce an additional budget for each Member State for national projects that financially support public procurement practices high in fruit and vegetables on the basis of healthy dietary guidelines. Such projects could include the provision of transition funding for the training of staff and adequate kitchen infrastructure, as well as temporary top-ups for contracts that are costlier due to healthier products being purchased in addition to the quantities normally bought. This could be achieved by including a new measure, or by allowing increased flexibility of budgetary use under the School scheme, under condition of general budget increase.

4. Invest in the creation of local market infrastructures and short and/or direct food supply chains. Increased horticultural production in and around cities, in particular when linked to urban and regional food strategies, could provide additional employment opportunities. Local markets and innovative supply chains, including in rural areas, can promote new business models focusing on the supply of, and access to fresh and diverse products.

5. Earmark a greater share of the resources made available to producer organisations in the fruit and vegetables sector for measures to increase consumption of fruit and vegetables in the EU.

4. Phase out health-incompatible subsidies


An efficient use of public money implies the need to maximise the co-benefits from this investment and to prevent support for activities that can be associated with downstream health and environmental costs. A greater focus on expenditure is also warranted in view of the reductions previewed in the CAP’s budget.


Our proposals:

1. Exclude tobacco cultivation from EU funding. The definition of ‘eligible hectare’ should exclude activities related to the cultivation of the tobacco crop. Transition funding should be provided to affected farmers who can show a history of tobacco cultivation.

2. Phase out funding for wine promotion. Today, more money under the CAP is spent on promoting wines – nearly €220 million per year in the period 2014-2018, than on fruit and vegetables for schoolchildren – an allocated budget of around €150 million per year.

The option to fund wine promotion measures both on the internal market and in third countries should be phased out and the overall budgetary allocation for interventions in the wine sector reduced by 20%, which is the approximate share of funding allocated to promotion measures under national wine envelopes. The funding liberated from the wine promotion budget could be added to the school scheme, or used to fund other public goods measures.

3. Exclude sugar beet cultivation from eligibility for voluntary coupled support.

4. Make coupled voluntary support for animal farming subject to strict social and environmental criteria to prevent untargeted financing. Should coupled support be used, the instrument should be accompanied by a clear explanation for why similar aims cannot be attained through rural development funding.

5. Preclude investments in large-scale animal farming operations and infrastructures by explicitly adding these to the list of ineligible investments under rural development support.

5. Address socio-economic inequalities


The use of direct payments as the main financing tool under the CAP has often been criticised for its alleged regressive effects and for not being the most efficient tool to support farm income. In as far as direct payments are maintained, they should focus more explicitly on targeting farmers, including new entrants, who face specific socio-economic challenges and on reducing inequalities. Rural development programmes, in conjunction with cohesion funds, should be used to stimulate sustainable employment opportunities and improve access to health and social services.


Our proposals:

1. Ensure the progressive capping of direct payments.

2. Implement a system of complementary redistributive income support with preference for lower size ranges to ensure an effective redistribution of support from ‘bigger to smaller’ farms. This should be accompanied by checks to prevent farms from artificially splitting-up into smaller holdings to receive higher aggregate payments.

3. Phase out historical levels of support when calculating current payment levels.

4. Support programmes to improve access to healthcare and social services in socio-economically underprivileged rural areas.

5. Support programmes to improve access to land for new entrants.

6. Support rural economic opportunities for farm income diversification, including ecotourism and initiatives that provide access to non-farmed land for recreational walkers. In particular, the latter could draw people to the countryside, have a positive effect on biodiversity and increase opportunities for physical activity.

6. Promote safe and decent work


Ensuring appropriate working conditions in the agricultural sector is an important socio-economic objective. No public money should be made available under the CAP to farm operations that fail to uphold workers’ labour and social rights.


Our proposals:

1. Make the observance of adequate labour and social standards for agricultural workers into a precondition for receiving funding under the CAP.

2. Independent farm advisory services should be available to promote the knowledge and tools to reduce occupational risks, and ensure managers of farm operations are aware of the labour and social rights of farm workers.

7. Contribute to climate change mitigation


The recent special report by the Intergovernmental Panel on Climate Change (IPCC) on the impacts of 1.5 °C global warming highlights the urgent need for action to secure health and well-being. It also identifieslow GHG-intensive food consumption” as one of the mitigation pathways having the “most pronounced synergies and the lowest number of trade-offs with respect to sustainable development and the SDGs”.

The food system is responsible for between 19-29% of total global anthropogenic greenhouse gas (GHG) emissions, and animal farming accounts for around 14.5% of total emissions. In order to achieve the required step-change, climate mitigation efforts from agriculture should include improvements in production methods, including better use of carbon sinks, but will require a reduction in animal numbers as well. Such reduction can provide multiple co-benefits, particularly when part of a transition towards a “less but better” animal products scenario, which offers the possibility to achieve higher added value per product and support healthy, sustainable and low GHG-intensive diets.


Our proposals:

1. Member States should set concrete national methane emissions reduction targets from agriculture as a contribution to the Effort Sharing Regulation (2018/842).

2. Earmark at least one third of the total CAP budget to reward the uptake of farming practices and interventions that effectively contribute to ecosystem restoration, biodiversity enhancement and climate mitigation.

3. Dedicate financial resources for programmes aimed at decreasing animal numbers.

4. Promote agro-forestry systems and reforestation.

8. Advance the planet's health


The global loss of biodiversity poses a severe threat to human civilisation on a magnitude similar to climate change. Considering the significant role of agriculture in driving these trends, the CAP should promote the progressive implementation of farming practices and interventions that contribute to nature and biodiversity restoration. Considering that the adoption of such methods does not usually provide quick economic returns, it is important to ensure that a significant share of CAP money is used to reward farmers for such activities.


Our proposals:

1. Member States states should set specific and time-bound targets on nature and biodiversity as part of CAP implementation.

2. Earmark at least one third of the total CAP budget to reward the uptake of farming practices and interventions that effectively contribute to ecosystem restoration, biodiversity enhancement and climate mitigation.


9. Limit pesticides use


CAP funds should ensure farmers can make a secure and well-informed transition towards farming practices and models that limit the use of pesticides, in the framework of time-bound national reduction targets.


Our proposals:

1. Member States should set time-bound national pesticides use reduction targets. Earmarking a share of the CAP budget for measures under the new specific objective on food and health would allow to help achieve these targets.

2. Independent farm advisory services should promote the knowledge and tools to limit the use of pesticides.

3. Support knowledge exchange between farmers on integrated pest management and other low-pesticides use methods.

4. Make the provision of funding for the restructuring and conversion of vineyards conditional on the adoption of on-farm pesticides use reduction targets and appropriate farming methods.

10. Ensure sufficient, safe and nutritious food


The core function of agriculture is to satisfy human nutritional needs. For this, ensuring adequate production is necessary, but the production imperative needs to be embedded within a consumption framework.

To reflect this understanding, the CAP’s overarching objective should be to pursue sustainable food and nutrition security. The term ‘nutrition’ reflects the need to shift towards a ‘nutrition-sensitive’ agricultural policy which aims to contribute to good nutrition, not only a sufficient food energy supply. ‘Sustainability’ reflects the need to ensure that food and nutrition security today can be achieved in ways that ensures future generations and peoples outside the EU can also achieve it. Promoting food safety and quality food plays an integral role in the achievement of sustainable food and nutrition security.


Our proposals:

1. Make ‘sustainable food and nutrition security’ into one of the CAP’s overarching objectives.

2. Promote research into tools that would allow to better guide future agricultural policy in the promotion of food and nutrition security, with special attention to further elaborating the concept of ‘nutritional yield’.

3. Stimulate the wide uptake of soil conservation practices and climate-resilient farming methods through CAP funding, including through clear and ambitious Good Agricultural and Environmental Conditions (GAEC) standards.

4. Nutritional criteria, including on the use of whole grains, should be progressively integrated into EU quality policy, in particular the designation of origin schemes.

5. Ensure that national implementation of all CAP measures mainstream the need to reduce food waste. This includes to limit to exceptional cases funding for the withdrawal of fruit and vegetables from the market.

6. Incentivise food production and supply chains that deliver safe, diverse and nutritionally valuable foods.

11. Create a policy framework for impact and inclusion


A ‘performance-oriented’ approach to the CAP based on objectives, indicators and targets, if well-designed and implemented, could help deliver on health and other societal objectives. Likewise, the concept of ‘strategic planning’ has the potential to contribute to greater policy coherence. At the same time, the current proposal falls short in the design of its delivery model.

A key shortcoming is that many of the indicators in the current proposal that will be used to evaluate the policy’s success do not focus the results the policy achieves in terms of tangible deliverables. For instance, the proposed “result indicator” on antibiotics use reduction provides to measure the “share of livestock units concerned by supported actions to limit the use of antibiotics”. A target based on this indicator would not measure the actual reductions in antibiotics use.


Our proposals:

1. Ensure the CAP’s specific objectives are clearly and unambiguously worded with a view to promote the transition towards a healthy and sustainable European food system. All objectives should be equally and indivisibly pursued.

2. Ensure that Member States set quantified targets for each “impact indicator” and use these as reference for national CAP strategic plans, alongside the “result indicators”.

3. Ensure the mandatory involvement of competent authorities and stakeholders from all areas covered by the specific objectives, including public health. This involvement should occur during the stages of CAP policy design, implementation, monitoring and evaluation, both at European and national levels and should explicitly clarify how inputs are taken into consideration. The expertise that comes with such multi-sectoral cooperation will be necessary to ensure the policy’s quality and effectiveness.

4. Quality assurance mechanisms should be put in place during the preparation of CAP implementation plans, in particular with regard to the prevention of conflicts of interest and the quality of data and analytical tools used.

5. The CAP should have clearly spelled-out accountability mechanisms linking the achievement of targets and objectives to financial allocations.

6. New monitoring tools and policy evaluation methodologies should be elaborated to improve the performance-orientation of the policy in the future.

© 2020 - Development by Simpl.


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