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Photo credit: CC-BY-4.0: © European Union 2019 – Source: EP

…what we’ve learnt from the Commissioner for Health hearing

The Environment, Public Health and Food Safety (ENVI) Committee has expressed its approval for Stella Kyriakides to become Europe’s next Health Commissioner, following her hearing which took place on 1st October. It shed light on Kyriakides’ plans and priorities, and clarified some of the grey areas from her previous written answers.

Throughout the hearing, the Commissioner Designate stressed the importance of One Health and a unified, non-siloed strategy to tackle today’s public health threats. Ms Kyriakides also expressed a wish to see Europe leading the way in the health field, and highlighted the need to deliver on citizens’ expectations for transformational change. Ultimately, the European Union (EU) can strive for more, she concluded.

Here is what we know of Stella Kyriakides’ stance on these 5 key issues.

1. Antimicrobial Resistance

Commissioner Designate Kyriakides expressed the urgent need for action against antimicrobial resistance. Her focus was on curbing the death toll – “we cannot excuse deaths from AMR”, she stated – on innovation and stronger regulation for antibiotics use.

Kyriakides would like to see the EU lead by example, working together to challenge misinformation directly impacting on human health. She mentioned new regulation on veterinary feed and medicines, calling it “ almost a cornerstone of AMR”, and reviewing regulations on where antibiotics cannot be used to assess if they are being implemented effectively. Member States need Europe to act – national solutions are not enough.

On the 2017 European Commission Action Plan on AMR, the Commissioner Designate highlighted it was created under a One Health agenda, and acknowledged of the theme in her Mission Letter. We need to take up the challenge and take action, she stated, and to help Member States. Europe needs to lead the way, and to act globally.

“We need to encourage industry innovation to come up with new antimicrobials” said Kyriakides. The Commissioner Designate mentioned the importance of encouraging industry to come forward, through innovation, with new antibiotics.

It is vital that Ms Kyriakides remembers that incentives or encouragement tough should always respect principles of accessibility and affordability.

2.Cancer

Commissioner-Designate Kyriakides upheld her commitment to strong action to fight cancer throughout the hearing. She mentioned that only a unified effort that spanned across sectors would succeed – a One Health approach encompassing what we eat, our medicines, and other determining factors. “Cancer is part of everyday life; people’s lifestyles are part of it. […] Raising awareness is a key part of prevention” said Kyriakides. Awareness, one of the different aspects Kyriakides focused on in outlining her approach, is indeed a component in tackling cancer, but prevention and treatment span much wider than that; it will be interesting to witness (and support) the Commissioner-Designate’s efforts to eradicate the root causes of cancer and other non-communicable diseases (NCDs). Most NCDs, of which cancer is one, share a limited number of main risk factors. With over 85% of all deaths in Europe being attributable to chronic diseases, preventing all NCDs in a comprehensive approach would make most sense.

Kyriakides said she would have “no qualms taking up those who are not in favour of moving in the right direction”. Firmly tackling the commercial determinants of health as a precondition for effective public health policy-making should indeed be a priority for the Commissioner-Designate.

Maintaining that “we cannot lower the bar when dealing with this disease”, Kyriakides also mentioned that the Europe’s Beating Cancer Plan also needs to look at accreditation, standards and medicines, which she called “a patient’s right”.

3. Access to medicines, shortages and innovation

During the hearing, access to safe, affordable medicines was a point Commissioner-Designate Kyriakides came back to several times.

Noting that “the pharmaceutical industry has a legal obligation to allow access of medicines to patients” she stated that “it is the patients’ right to have access to affordable medicines that are safe.”.

Ms Kyriakides pledged to “work closely with Member States” on pricing and how medicines are reimbursed. A new strategy which addresses medicine shortages and pricing is an issue she aims to “look closely at with Member States”. A report from a Member States-led taskforce with the European Medicines Agency (EMA) will contribute to inform decisions on how to move forward. Throughout, Stella Kyriakides agreed on need to do more, and confirmed that medicines pricing will be high on the agenda.

Asked about tackling shortages, she mentioned a taskforce on the topic, and the need to find a system for the early detection of shortages.

Discussing AMR, Kyriakides expressed the “need to encourage industry innovation to come up with new antimicrobials”. Innovation was indeed another pillar of her access to medicines addresses; she mentioned being “committed to innovation and investing in research”, and that she would consider “moving ahead in innovation as a priority to help tackle drug shortages and affordability”.

A discussion on pricing and affordability cannot be separated from the debate on transparency. Although asked a direct question on the issue of transparency, we have failed to identify a direct answer.

4. Food policy

Committing to include “the food we eat” in her plan to fight cancer, food and nutrition was another main theme in Commissioner-Designate Kyriakides’ address which she also tackled from the perspective of production (pesticides, Farm to Fork) and information.

After stating that she would have “no qualms taking up those who are not in favour of moving in the right direction,” perhaps hinting that firmly tackling the commercial determinants of health is a precondition for effective public health policy-making, Ms Kyriakides tackled questions related to the paradox of the current obesity epidemic and misinformation.

According to Kyriakides, citizens want nutrition profiles, and erroneous food claims must be dealt with. A front-of-pack report coming out at the end of the year will contribute to informing her decisions. The Commissioner-Designate would like to see “a common approach” and will also “consider a Nutriscore approach”. Noting that 7 member states have moved ahead on origin labelling, Kyriakides stressed the need to find common ways for consumers have access to reliable information.

Surprisingly, despite the food system touching on so many critical aspects related to the environment and health, MEPs from the ENVI Committee paid little attention to the ‘Farm to Fork’ strategy for sustainable food in their questions. This while the future Health Commissioner has been tasked to lead on the strategy.

5. Civil society

In her concluding remarks, acknowledging the multiple concerns raised by the questions, Commissioner-Designate Stella Kyriakides stated that she is “determined to do everything in her power” to deliver on her promises. She pledged to always engage transparently, acknowledging her accountability to the European Parliament and to the citizens demanding results. Before voicing her belief that “the EU can strive for more,” she firmly expressed the need to listen to civil society.

Although asked a direct question on the closing of the EU HIV/AIDS, viral hepatitis and tuberculosis Civil Society Forum, we have failed to identify a direct answer.

Other priorities

Commissioner-Designate Stella Kyriakides did not shy away from questions on other critical issues including pesticides (“it would be unheard of to be health commissioner and not to take this on”) and ecosystem protection, citizens’ trust, eHealth and health literacy (“ensuring citizens have access to scientific information”), mental health (which she “will do her utmost to put it back on the agenda”).