EPHA 2020 Annual Report
Acting Secretary General, EPHA
The view from EPHA
A more challenging year than anyone could have predicted for public health, but also a year of transition with new policy priorities.
2020 was not only a transitional year in terms of moving from ‘old’ to ‘new’ EU policy priorities (Green Deal, Pharma Policy, Farm to Fork, etc.) and building bridges between the two, it was first and foremost an emotional rollercoaster that turned out to be so much more challenging than even we, policy and advocacy professionals working at the heart of the European public health community, could have predicted. While we’d known for years that the threat of a major global pandemic was lurking around the corner, when COVID-19 struck and made its way across the continent it still felt as if nobody in Europe was actually prepared to face the reality of a world in which physical contacts and mobility had to be severely restricted to protect-risk groups from contracting the virus and health facilities from collapsing. Working from home, shop and border closures, large-scale unemployment, fear and uncertainty about the future marked us all in 2020 and took a heavy toll on our mental and physical health.
As a people-centred, highly diverse network of organisations working on different aspects of public health, EPHA was confronted with the urgent task of contributing to the evolving evidence base about the impacts of the COVID-19 crisis (among many other issues, we highlighted the exacerbation of health inequalities and fundamental rights infringements experienced by vulnerable populations) while advocating that no-one must be left behind. The memory of the economic crisis was still too fresh – some countries had barely managed to pull themselves out – and with Brexit being finalised in parallel, Europe needed to succeed in managing the pandemic and in communicating why certain measures were taken at a certain time in a certain place. Civil society played a major role in supporting this effort and in relaying information from the ground to the EU, WHO and others.
2020 was also the year in which the European Commission laid the foundation for Europe’s ongoing green and digital transitions. Suddenly, ‘Health in All Policies’ thinking was reflected in many of the key EU policy papers, but it is still unclear how joined-up thinking will be put into practice as new governance mechanisms may be required to face the complex, interconnected public health challenges of today. Through our forward-looking work on food systems, air pollution and climate change, medicines shortages and digital health (to name but a few relevant themes), some of which led directly by members via sub-coalitions, EPHA was in a front position to provide inputs into the European Commission’s new objectives enshrined in the new EU4Health Programme including the preparation of the flagship Europe’s Beating Cancer Plan.
If there was one positive development that came out of COVID-19, then it was the release of the new EU4Health Programme, which represented an important victory – EPHA having made the case for scaling up public health via its targeted campaigns for many years. Together with the members of the EU4Health Civil Society Group, we were delighted to see that, finally, public health was no longer lurking in the shadows of other policy areas. A well-funded, stand-alone programme would be addressing many of the gaps uncovered by the pandemic, coupled with vast amounts of health-related funding in other major EU funding instruments. Unfortunately, the extent to which civil society organisations are actually be able to benefit from the funding (and thereby contribute to the successful implementation of EU4Health) still remains unclear, but EPHA continues to make the case for European networks as crucial actors who provide policymakers with evidence on the real needs of ordinary people, patients, healthcare professionals and other members of the public health community, identify and disseminate best practices, and act as critical watchdogs to ensure transparency, protect fundamental rights and good governance.
EPHA’s new Strategic Plan 2021-2025, adopted by the members at the Annual General Assembly in December, encapsulates our future approach as a highly competent and reliable partner. The new strategy emphasises both the creative and scientific contributions of the membership, and in light of COVID-19 it leaves more room for flexibility: rather than committing EPHA to a limited number of fixed campaigns for years to come, it offers a canvas to be filled with different colours over the coming years, enabling EPHA to be proactive where it counts and to be reactive in a much more timely way, which will be vital in the face of further cross-border health threats whether triggered by pandemics, climate change or other developments.
While physical meetings became impossible during most of 2020, EPHA’s Board and Secretariat team were highly impressed by how smooth the transition to digital was. We are grateful to our members and partners who supported our effort to create an online community of like-minded advocates by participating in our webinars and meetings, contributing vital insights from the ground (e.g. through our COVID-19 resource centre) and pointing out any missing links. It’s this sense of togetherness that made a very difficult year bearable, and that allowed EPHA to pull through, promote solidarity and public health values, and learn important new lessons.
Our year in numbers
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EPHA Membership: a growing network
EPHA is committed to growing and nurturing a strong network of members and partners, fostering knowledge-sharing and empowering advocates and future public health professionals with the aim to deliver equitable solutions to European public health challenges, to improve health and reduce health inequalities.
In 2020 we welcomed these new Members:
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Working towards better health for all in Europe
Action on Antimicrobial Resistance (AMR)
In 2020 EPHA supported the launch of the MEP Interest Group on AMR and the development of the AMR Stakeholder Network, bringing together key European, national and international AMR stakeholders and civil society representatives to advocate for continued action to tackle AMR.
Antimicrobial resistance is a serious cross-border threat to healthcare that can only be mitigated by ambitious, coordinated, and well-funded action and research at EU level. Due to the overuse and misuse of antibiotics in human and veterinary medicine as well as in agriculture, AMR has been identified as one of the top ten global health threats by the WHO in 2019. A growing number of bacteria are now resistant to antibiotics meant to kill them, resulting in medical practices being less safe and effective.
The COVID-19 pandemic risks accelerating AMR due to high rates of antibiotics prescription even in cases where no associated secondary infections were detected in patients. The pandemic may also have an indirect negative impact through factors such as delayed diagnosis or interrupted treatments for non-communicable diseases. While many resources were reallocated at the beginning of the year to fight COVID-19, EPHA has continued to monitor the situation and advocate to ensure AMR remains high on the public and political agenda.
2020 saw the formal launch of the MEP Interest Group on AMR, attended by EU Health Commissioner Kyriakides in the European Parliament, while the AMR Stakeholder Network also continues to grow from strength to strength. 2020 also saw the publication of the EU Pharmaceutical Strategy which aims to deal with shortcomings in the development of new antibiotics, as one of the ways to halt antimicrobial resistance.
EPHA’s revised position paper on AMR, published in December 2020 proposed a set of recommendations to complement those of the AMR Stakeholder Network in order to strive for the ‘One Health’ goal and reflected on the need for urgent actions to address AMR, ensure AMR remains a key policy priority as well as a key component of a broader holistic approach to public health, in line with the One Health perspective. EPHA also highlighted the need to ensure that AMR remains high on the political and public agenda, learning the lessons from COVID-19 on the need to act in solidarity and join forces to tackle common health threats, to ensure better health for all. The post-COVID recovery plan offers a unique opportunity to align public health and economic objectives with efforts to reduce AMR and enhance environmental sustainability, and should be embraced by politicians and policymakers as part of their efforts to protect our health.
Priorities for 2021
- Strengthen and consolidate the AMR Stakeholder Network
- Provide support, together with Health Care Without Harm, for the activities of the MEP Interest Group
- Monitor the interplay between COVID-19 and AMR
Clean air for health
In 2020 we commissioned a new report identifying the health and social costs of air pollution in 432 European cities across Europe, as well as supporting members of the medical profession across Europe to speak out on the need to tackle air pollution. The measures introduced during COVID-19 lockdowns, although extreme, showed the immediate benefits of reducing the number of cars on our streets in improving the quality of the air we breathe. Surveys showed support for changes in urban planning which promote public transport, and cycling and walking. This has to become the norm for the future, so that everyone can breathe clean air.
Breathing is the most basic human function to sustain life, and yet, air pollution remains the largest environmental health risk in Europe.
During 2020, EPHA has continued to call on policy-makers to tackle air pollution building its advocacy on three pillars: the Clean Air Healthy Cities project; the Medics for Clean Air campaign; and the European Green Deal proposals from the European Commission, including the Zero Pollution Action Plan and the new Euro 7 standards. Data-driven and built on science, EPHA works in close cooperation with its members and partners, thus producing reports used to advocate for health-driven policies in the transport sector so everyone can breathe clean air.
- Clean Air Healthy Cities Project: study released in October 2020 linking transport to the health costs of air pollution in 432 European cities
- Launch of Medics4CleanAir, a European coalition of doctors, nurses, researchers, medical students, and other health professionals who have signed a Manifesto for urgent and sustainable actions to tackle air pollution and to protect their patients and our environment
- Air pollution and COVID-19: air pollution worsens the severity of COVID-19 on people’s health
- Debate on the impact of Dieselgate – 5 years on, what lessons have we learned?
Priorities for 2021
- Advocate for the adoption of ambitious EU legislation for clean air and climate (European Green Deal, Fit for 55, etc.)
- Highlight the health costs of air pollution caused by heating and transport in Europe
- Highlight the link between viruses, epidemics, and air pollution
Digitalisation in health and care became real for many Europeans in 2020. Triggered by the COVID-19 pandemic, many health providers and patients alike experimented with digital health technologies for the first time and put aside their reservations in the process, especially regarding telemedicine and other forms of telehealth services. Europeans were gradually introduced to contact tracing apps that sent alerts to help avoid the spreading of the coronavirus.
During 2020, EPHA continued to ask these important questions: How do algorithms work and how do you remove bias? How can data security, privacy and fundamental rights be safeguarded in a world where more and more personal data are accessed, shared, processed, analysed and stored? Who has the right to access what data exactly, and how can individuals control the use of their own data? How can we ensure people from vulnerable groups are able to access the same benefits as the rest of the population from e-health?
The introduction of data-driven solutions – especially the contact tracing apps – has not been easy, and there were many issues regarding their reliability, interoperability and the quality of the data, and even greater concerns about the increased need to share potentially sensitive data. Many other new technologies rely on vast amounts of personal health data, often powered by Artificial Intelligence (A.I.), the subject of a White Paper consultation to which EPHA responded. The ‘brave new world’ had reached the healthcare domain, with further discussions around the Digital Services Act and the role of online marketing. The public health community was faced with the necessity to better understand some of the technical aspects behind these technologies. Our joint vision for digital health with the European Public Health Association elaborated these concerns.
- EPHA commissioned a study highlighting how the public health community needs to catch up and learn the lessons from digital rights organisations to protect Europeans’ rights in the shift to e-health
- EPHA continued its advocacy to ensure that digital health solutions address the real needs of their end-users and reminded policymakers that these needs can only be adequately addressed by involving civil society in the planning, implementation and evaluation of digital health.
- The Polish eHealth Forum provided a welcome opportunity to share our thinking around an inclusive eHealth ecosystem that promotes innovation yet also protects public health values.
Priorities for 2021
- Working to ensure that the health sector catches up quickly and understands the many complex implications of scaling up data-centred healthcare (including the collection, storage, analysis, use and “disposal” of patient data) for individuals and society.
- Develop a Reflection Paper on Digital Epidemiology
- Continue to advocate that everybody should be able to gain from Europe’s digital revolution, not only those who already enjoy good access to healthcare.
Europe, let’s do more for health
COVID-19 exposed the vulnerability of our healthcare systems, and showed the effects on the economy, society and our daily lives when we can no longer take good health for granted, with the greatest effects falling on the most vulnerable. The EU4Health civil Society Alliance continued to advocate for a Europe that supports timely access to affordable, high quality healthcare for all.
EPHA continued to play a leading role in the EU4Health Civil Society Alliance, which outlined a vision for a post-COVID-19 EU health policy after 2020, in response to the effects of the pandemic. We supported the unprecedented budget rise of the re-established EU4Health Programme, which paid the highest compliment by adopting the name of our long campaign to ensure health remains high on the EU’s agenda. We advocated against the cuts in its funding proposed by European jeaders and supported the European Parliament’s call for more civil society engagement. The EU4Health CSA work was recognised by the Commissioner for Health and her cabinet, by DG SANTÉ and reported in the EU media.
- Influencing the development of the EU4health programme to reflect the needs of all Europeans and ensure better health for all
- ·Mobilising the health community and EU politicians to support an ambitious level of EU4Health programme funding
- Health Commissioner Kyriakides in her speech at the EPHA AGA highlighted EPHA’s work within the EU4health Civil society alliance as an excellent support to EU health policy.
Priorities for 2021
- Monitoring EU4Health programme implementation
- ·Ensuring meaningful involvement and support of civil society
- ·European Health Union Manifesto initiative asking for an EU Treaty Change on Health competence as part of the Conference of the Future of Europe
Food systems and Non-Communicable Diseases (NCD) Prevention
In 2020, EPHA continued to advocate for enabling environments for the prevention of non-communicable diseases (NCDs) and the uptake of healthy and sustainable diets.
EPHA has continued to argue for a strong focus on prevention in the EU’s Beating Cancer Plan, seeing it as a first step towards a wider EU strategic approach to the prevention of NCDs, Europe’s foremost health issue.
Together with a range of partners EPHA has been at the forefront of advocating for a transformative Farm to Fork Strategy to kick-off the transition to sustainable food systems with health as a key pillar.
- The concept of ‘food environment’ is embedded in the Farm to Fork Strategy.
- An elaborate prevention pillar in Europe’s Beating Cancer Plan with actions to tackle key disease risk factors.
- Successful launch of the EU Food Policy Coalition.
Priorities for 2021
- Ensuring ambitious implementation of the actions under the Farm to Fork Strategy and Europe’s Beating Cancer Plan
- Mobilise the engagement of health actors for sustainable food systems
- Deepen the connections between public health, food systems and planetary health, with a view of tackling multiple interrelated crises, including climate, AMR and NCDs
COVID-19 highlighted and exacerbated existing health inequalities between vulnerable and disadvantaged groups in our communities. EPHA continued to advocate for European policies and instruments to promote inclusion and equal opportunities for all to live, work and age in sustainable, healthy environments.
Providing equitable solutions and improving public health systems is at the heart of EPHA’s mission and vision, therefore, EPHA’s advocacy addresses health inequalities, with particular focus on children, Roma, and the effects of these inequalities on people’s health and our wider community.
Under EPHA’s leadership, the Roma Health Network, which aims to engage with the community and policy makers, and create Roma inclusive policies on health, housing, and education, was launched in October 2020
- EPHA facilitated a broader network composed of public health organisations, the Roma Health Network, European and national civil society partners, policy and decision makers and other allies, to press for holistic, integrated, and sustainable policies and adequate funding to tackle the demographic, social and economic aspects of health inequalities in their different dimensions (e.g gender, age).
Priorities for 2021
Aim to increase knowledge about the health determinants of various vulnerable groups and provide concrete evidence of health inequalities in post-COVID context compiling resources produced by strategic stakeholders.
Promote the principles of health equity among national civil society and mainstream health in relevant policies at all levels whilst mobilising policy makers to advance sustainable policy solutions to health disparities.
EPHA’s large membership and partnership represents an added value for reaching such objectives and providing key support to policy makers by identifying, proposing and implementing purposeful public health actions in line with the needs of the most vulnerable.
Trade for health
In 2020 we continued to work to protect and promote public health in trade agreements, to ensure policy coherence between trade and public health and to guarantee policy and regulatory space for governments and the EU.
he COVID-19 pandemic slowed down relevant developments pertaining to many of the international Free Trade Agreements (FTAs) the EU is currently negotiating with partners around the world. However, as the implementation of Brexit began to reach its conclusion with the end of the transition period, EPHA monitored the creation of the EU-UK Trade and Cooperation Agreement (TCA) together with our partners based in Brussels and in the UK, with a briefing to be released in 2021 and membership of the PETRA group.
The main focus of EPHA’s trade work – given the discontinuation of the European Commission’s Trade Advisory Group – focused on analysing the Commission’s adherence to article 5.3 of the WHO Framework Convention on Tobacco Control and highlighted the need to protect tobacco control policies from the harmful influence of industry representatives.
Whilst EPHA continued to be present in relevant civil society consultation meetings about EU-US, EU-Canada and other trade deals, continued to monitor the negotiations on the controversial EU-Mercosur trade agreement and the impact of COVID-19 on trade, the primary opportunity to shape the EU’s future trade policy was presented by the European Commission’s public consultation on a renewed trade policy for Europe, a timely vehicle to reiterate many of EPHA’s key messages around the role of public health and the need to ensure that important public health measures do not get dismantled by economically-driven trade interests.
- Emphasised the relevance of Public Health in the European Commission’s consultation on “A renewed trade policy for a stronger Europe‘,
- Together with STOP and partners submitted a response particularly highlighting the role of EU trade policy in promoting tobacco control.
- Called, together with partner organisations, for the renewal of the free trade agreement expert group, of which EPHA was a member
Priorities for 2021
- Continue to advocate for future EU trade agreements to ensure policy coherence between trade and public health.
- Launch a report on the EU’s compliance with the WHO Framework Convention on Tobacco Control and the undue influence of tobacco industry representatives.
- Monitor the implications of the EU-UK trade and Cooperation Agreement on public health
Universal Access and Affordable Medicines
The start of the COVID-19 pandemic brought pharmaceutical issues to the forefront as governments turned to companies for therapeutics (vaccines & treatments) against the novel coronavirus. EPHA led and coordinated the push for transparency in the negotiations between pharmaceutical companies and the EU on the procurement COVID-19 vaccines.
EPHA and its members highlighted the need for affordable vaccines and medicines against the pandemic and beyond. Many of these messages were echoed in the European Commission’s landmark pharmaceutical strategy which was published in November.
Our flagship series of discussions – the #A2MDialogues – briought together leading thought leaders and policy-makers, academics, industry representatives and NGOs, for a frank discussion of European medicines policies and possible solutions to the challenges faced.
Since 2016, the European Public Health Alliance’s advocacy has highlighted the problems caused by excessive medicines’ prices for patients and health care systems, together with the questionable quality of innovation. EPHA has prioritized the need for transparency in pharmaceutical systems in Europe; for affordable prices; and pushed for a healthy realignment of IP incentives with appropriate rewards for industry, balanced with equitable access to effective and affordable medicines for patients.
- EPHA led and coordinated the push for transparency in the negotiations between pharmaceutical companies and the EU on the procurement of COVID-19 vaccines leading to the unprecedented release of a redacted version of the contract with Curevac, followed by the publication of additional deals albeit redacted, setting an important precedent in the secretive world of pharmaceutical procurement.
- EPHA and its members highlighted the need for affordable vaccines and medicines against the pandemic and beyond. Many of these messages were echoed in the European Commission’s landmark pharmaceutical strategy which was published in November.
- EPHA’s positions and those of our members were reflected in the European Parliament’s positions on shortages as well as on the ongoing negotiations for the extended mandate of the European Medicines Agency.
- Launched a flagship series of online discussions – the EPHA #A2MDialogues – bringing together leading thought leaders and policy-makers, academics, industry representatives and NGOs, for a frank discussion of European pharmaceutical policies; on issues such as regulatory reform; IP; COVID-19 vaccines negotiations; and the role of the new European Health Preparedness and Emergency Response Authority (HERA).
Priorities for 2021
- Advocate for affordability and accessibility of COVID-19 vaccines for the most vulnerable in our community
- Continue our successful #A2MDialogues, focusing on issues such as the COVID-19 vaccines’ procurement strategy, research and development of new antibiotics, and in new initiatives to ensure affordability and accessibility of medicines
- Input into the revision of EU regulations on medicines for children and rare diseases
- Advocate for a vision for the new Health Emergency Preparedness and Response Authority which serves patients and promote public health
Who we are
The leadership, team and scientific advisors that make it all possible
Our financial information
EPHA’s Operational Budget
In 2020, the total income of EPHA was 1.237.149 €.
The operational budget is devoted to our core activities to improve health and strengthen the voice of public health in Europe.
Our biggest contributor is the Operating Grant received from the European Commission. In 2020 their contribution represented 42.70% of EPHA’s total income. In 2020, the total contribution of the membership fees represented 6.03% of the total income.
In addition to the Operational budget, EPHA is a partner in EU health research projects. Other projects and grants from foundations represented the remainder of our income