Ten years of European Health Forum Gastein revisited: a helicopter view on the 10th EHFG Forum

Bad Hofgastein 06 October 2007In the beginning there was, as always, a vision. The vision of a meeting place for all groups who are indispensable to a functioning health care system: health policymakers, leading representatives of government health offices, scientists, medical practitioners, health care managers and, not least, patient representatives and NGOs. An obvious idea, one would think, yet despite the large number of scientific congresses, policy meetings and NGO conferences in Europe, in the middle of the nineties there was no efficient platform for a meeting or an exchange of ideas between the various spheres of interest. Closing this important gap was and is the founding idea of European Health Forum. And what place could be better suited for it than the Gastein Valley, one of Europe's oldest and most well-known thermal and resort regions and a classic "health care region", which with its spectacular natural backdrop also furnishes an extraordinary idea with an extraordinary setting.

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From a vision to a European institution

"As obvious as the idea was to gather every group responsible for the functioning and further development of the health care industry shortly after a significant enlargement of the European Union and in a phase in which the consolidation of the European Union (EU) was really taking off, the general scepticism was just as enormous", stated EHFG President Dr. Günther Leiner, recalling the forum's beginnings. "It was simply doubted that instead of the usual encounters in the scope of tough negotiations the divergent groups would also be in a position to attempt the open exchange of ideas that is indispensable for such an event."

In the ten years of its existence the EHFG has been regularly granted the function of a platform for new concepts and ideas in European health care policy. In the first place, it should be mentioned that from the very start the EHFG subscribed to the thought that in the interest of citizens, patients (and taxpayers) health care policy must shift from a national to a European concern in order to attain a higher degree of efficiency, better medical quality and better accessibility for all EU citizens, also outside of their own country. "Moreover, the EHFG always had the function of discussing the various aspects of this subject, placing them in public debate and providing the impetus for political implementation", former EU Health Commissioner Flynn explained.

But in other areas as well the EHFG played and plays a cutting-edge role. This is obvious with the topic "Health Care in Other Policy Areas", that is, the evaluation of the health consequences resulting from measures in other areas such as economic, transport or environmental policy. Years ago the "Health Impact Assessment", established at the European level, was discussed at a professional level at the EHFG and gathered critical momentum from the EHFG for later implementation of the experts' demands.

Right from the start the EHFG and its pursuit of a new approach to a centralized health care policy event for the European Union found numerous prominent supporters. Among the most committed supporters of the EHFG who have also made an essential contribution to seeing the ambitious aims of the congress reached were Padraig Flynn and his successor as EU Health Commissioner, David Byrne, whose support ensured the active participation of numerous European health care institutions from the start.

Former German Chancellor Helmut Kohl, a regular holiday guest in Bad Hofgastein, and former German Minister of Health Horst Seehofer, also made an essential contribution by seeing that German health care officials were strongly represented at the EHFG from the start (and they still are today). For this reason the EHFG quickly succeeded in obtaining a large number of outstanding experts for the event. Not least the support of the Austrian government, which welcomed the implementation of the Gastein initiative during the first Austrian Council Presidency in the second half of 1998, was of enormous importance.

The broad support of numerous leading personalities played a significant role in ensuring that the EHFG was a success story from the first moment on: at the 1st European Health Forum Gastein 200 high-profile experts met in Bad Hofgastein, including EU Health Commissioner Padraig Flynn, numerous ministers and secretaries of state from all over Europe as well as high-ranking representatives of international organisations such as the World Health Organization (WHO) and, above all, a large number of top-level representatives from the divisions of the EU Commission which address health care and social issues. Within a short time the number of participants rose from 500 to 600 people, a size which has remained unchanged to this day and is ideal for facilitating a breadth of content on the one hand and making it manageable on the other and for distinguishing the event from the mega-congresses in the big city.

"From the start there was this spirit of Gastein", stated President Leiner. "Representatives of various groups with which there are to some extent natural conflicts of interest have always found a way to coexist instead of to conflict at the EHFG. The European Health Forum is not only distinguished by its unique substantive concept, but also by its unparalleled atmosphere, and at the 10th EHFG there won't be few participants I meet who've been here since the start of the forum and haven't missed a year."

This continuity has also made a substantial contribution to the quality of the EHFG. Participants especially appreciate the fact that newly emergent problems are analysed and discussed at an early stage here. Particularly for this reason the EHFG has established itself as the most important health policy event in the European Union in just a few years - a role that the former EU Health Commissioner, David Byrne, described very early on. "The European Health Forum Gastein is the health policy university of the European Union."

Cost containment may harm health care

Pharmaceutical cost-containment policies in Europe may not achieve long-term health care cost savings or improve health, and may instead discourage innovation and inhibit access to innovative treatments for patients who need it. This was the main message of a pre-conference workshop at the European Health Forum Gastein on 3 October 2007.

Most governments employ some method of pricing and reimbursement controls on innovative pharmaceuticals in order to limit the growth of health care costs. Reference pricing rewards generics with higher prices than they would have under competitive market conditions. A new study by LSE Health shows that promoting generics results in budget savings for governments only if there is real competition on the market; the study showed that low levels of competition in that sector in Europe produce higher than average prices for government and health insurers. This deprives governments of the resources to invest in innovative medicines and other parts of the health care system.

Furthermore, parallel trade of pharmaceuticals from low-price countries rewards stakeholders that do not contribute to the innovation process. Another LSE study showed that parallel trade within the EU benefits mostly parallel traders, who do not contribute to the innovation process, and deprives governments and patients of resources that could improve health.

Health technology assessment is also increasingly being used by governments as a means of ensuring value for money. However, under standard methods of assessment, which rely purely on cost-benefit analysis, many socially desirable drugs, such as orphan drugs, may not be deemed cost-effective and therefore access may be limited. "Standard HTA evaluations are not adequate for assisting decisions on whether patients have access to orphan drugs", stated Michael Drummond of the University of York, United Kingdom.

Furthermore, pricing and reimbursement policies should not rely exclusively on economic principles such as cost-effectiveness evaluation, but should also encourage the development of and access to new drugs for people with unmet medical needs. Societal values must play a role in the decision-making process.

Presenters stressed the need to introduce competitive generics markets and discourage the use of reference pricing. In order to maximize efficient use of health care resources and ensure continued access to new medicines, there must be a greater commitment to rewarding the products of research and development.

Medications unaffordable for more and more patients

For an increasing number of people the rising costs of medications through deductibles are becoming a problem that has virtually obstructed the access to needed medications and in many cases made it impossible. This development, which the WHO and the World Bank have criticized particularly in developing countries, is reaching European countries to an increasing degree. At the 10th European Health Forum Gastein, a high-profile panel of experts discussed possibilities for ensuring that the necessary medication remains or becomes accessible to poorer patients as well.

The varying degree of good access to medication is reinforced by the fact that in poorer countries health care systems often reimburse only small percentages of the costs of medications, thus the deductibles for patients are higher than in more affluent countries. This in turn leads patients in poorer countries having to pay more for medications in absolute terms than patients in wealthier countries. "The only way to mitigate this problem at least for the majority of the population is to set clear priorities", renowned expert Hugo Hurts of the Dutch Ministry of Health pointed out. "With restricted funds the decision must be made not to fund certain expensive medications thereby enabling access to cheaper medications for a far bigger group of those in need."

"By global comparison the situation in Europe is relatively good", German Member of European Parliament and health expert Jorgo Chatzimarkakis stated. "But the current development does not reflect our aim that regarding access to medications Europe plays a global cutting-edge role in which the respect toward life and health is the most important precept around which political and economic decision-makers are oriented. The EU is to become, so to say, the bio-zone of the world."

In Europe and even more so in developing countries the improvement of access to medications for poorer groups in society is increasingly becoming a key question for the quality of the supply of medications as a whole. An intergovernmental working group from the World Health Assembly, the IGWG - Intergovernmental Working Group on Public Health, Innovation and Intellectual Property, is to help in this regard as well. Its aim is to promote the development and low-cost production of medications for diseases afflicting especially the poorer groups in the population.

As this problem can only be solved through holistic access, which includes the financing of research and development as well as new methods for pricing, all interest groups must be involved: the pharmaceutical industry, patients and consumer organisations, universities, private institutions as well as EU experts and all member states. At the second meeting of the IWGW from 5-10 November the member states will determine their strategy and plan of action.

Due to the considerable migration from developing countries to the European Union, the success of these efforts is also of enormous importance for the EU itself, otherwise diseases such as tuberculosis and HIV, the battle against which has been relatively successful within the EU, threaten by indirect means to become a serious problem for the entire health care situation again. "Fair, affordable costs for medications in and outside of Europe are therefore of crucial importance for the European health care systems", stated Jorgo Chatzimarkakis.

Wave of diabetes takes off: Obesity leads to dramatic increase in disease numbers

The increase in the number of patients with diabetes could exceed even the worst fears. According to estimates by the International Diabetes Federation there are currently about 250 million diabetics worldwide and an increase of 150 million to nearly 400 million is predicted by the year 2025. For this reason the question of how medicine and health care systems can effectively respond to this problem was one of the central themes at the 10th European Health Forum Gastein taking place from 3 to 6 October 2007 in Bad Hofgastein.

The most important message from the experts: critical for success in the battle against the disease of the affluent is whether the behaviour of those at risk and those afflicted is successfully changed. Adipositas (obesity) is one of the main causes of Type 2 Diabetes. Approximately 60 percent of occurrences of the disease could be prevented with a change in lifestyle, as several studies impressively show. In an EU-wide project - DE-PLAN, Diabetes in Europe - Prevention Using Lifestyle, Physical Activity and Nutritional Intervention - directed by Jaakko Tuomilehto of Finland, researchers are currently testing to what extent the theoretical potentials for improvement can be put into practice. The efforts are focused on persons who exhibit a major risk for diabetes from the start, that is, people with a restricted tolerance for glucose.

There are new, promising developments in the area of diabetes medications as well. Substances particularly able to slow or stop the loss of beta cell functions typical of diabetes appear to be promising. The relevant medications have been available for a short time. Experimental data already indicates that as a result of these medications the survival of beta cells can be significantly improved. A favourable side effect of these medications is also the lack of weight gain. The prognosis for Type 2 Diabetes can therefore be significantly improved.

Bernhard Paulweber, expert on metabolic processes at the Salzburg Landeskliniken (SALK), emphasized the significance of the fight against diabetes. The increasing number of people with the illness will lead to an enormous financial strain. "There is an urgent need for our health care systems to act. Intensive preventive measures have to be introduced immediately and treatment strategies made medically and financially more efficient so costs remain manageable to some degree."

Number of diabetic children rapidly rising

At the 10th European Health Forum in Bad Gastein, the International Organization for Pediatric and Adolescent Diabetes (ISPAD) called attention to the alarming increase in the incidence of Type 1 Diabetes to five percent of preschool-age children. Type 1 Diabetes is one of the most significant childhood diseases. Altogether there are approximately 440.000 children afflicted worldwide. The number of new cases is estimated to be 200 daily. Within Europe, Finland is in first place. In Japan, on the other hand, the illness is hardly present.

A study at 18 diabetes centres throughout Europe showed significant variations in the treatment of diabetes among children. The study measured the HbA1c value, which shows how much glucose is attached to the hemoglobin cells and therefore determines the quality of treatment over the preceding eight-ten weeks. It showed considerable differences not only between individual countries, but between children's diabetes centres within one and the same country. So far special treatment for children in their own diabetes centres has only been stipulated by law in Italy.

With the SWEET project a public health programme has been created at the request of ISPAD which aims to establish service centres for paediatric and adolescent diabetes. "The most important aim of SWEET is the improvement of secondary prevention as well as the diagnosis and control of Type 1 Diabetes among children and adolescents. To this end SWEET supports the development of diabetes reference centres throughout Europe", stated Thomas Danne, the Secretary General of ISPAD. The primary aim is to analyse how many children there are in Europe with Type 1 Diabetes and what educational and further training opportunities there are for multi-disciplinary teams of doctors, nutritionists, etc. The content of training is to be streamlined and analyses carried out about the existing guidelines for the treatment of children and specifically how service centres for children's diabetes can be built.

Successful response to increase in chronic disease: Patient University empowers patients

The ageing of society and the increase in chronic disease are becoming major challenges for the health systems of the 21th century. At the European Health Forum in Bad Gastein various strategies of health systems in their responses to these developments were presented. As one central point experts stressed the importance of individual empowerment and health literacy of citizens and patients.

In fact, the increase in chronic disease in a consumer-centred and aging society is associated with a new role for patients. Becoming emancipated partners in the treatment process, patients have to distinguish between a growing amount of adequate and unqualified health-related information. These new challenges can be overcome by enhancing the health literacy of patients by teaching them independent, basic medical knowledge as well as information about prevention, patient rights, supporting facilities and the health system.

The Patient University created recently in Hannover was presented at the EHFG in Bad Hofgastein. It addresses the present need for education with an innovative concept, consisting of the following different strategies and focus groups:

  • An increase in health literacy - a strategy successfully implemented in the United States for more than 10 years. The lectures cover organs of the human body including the anatomic and physiological aspects, dysfunctions and preventive and therapeutic potentials. In the courses, participants are encouraged to ask questions and expand their knowledge in dialogue with young physicians of the school.
  • A strengthening of coping capacities teaches patients and their family members as well as multipliers from self-help organisations about the application of clinical and care findings, in order to actively involve the patients in the treatment process and improve their quality of life.
  • The teaching of system knowledge addresses patient representatives on the boards of health systems.

"The Patient University is not only valued by the citizens, insured and patients who enhance their health literacy", pointed out Friedrich Wilhelm Schwartz, Director of the Hannover Medical School. "Physicians also learn that good communication with patients is a central medical task and that they can practise their speech competency and their comprehensibility." The success of the Patient University provides well-founded hope that one day it will grow into a movement which also involves and effectively changes the self-image of medicine and physicians. The increasing participation of vulnerable and disadvantaged groups in the Patient University is planned for the future.

Policymakers should make the economic case for investment in public health

Health policymakers across Europe are under pressure to justify the costs of public health measures. However, making the economic case for health will only be successful if used in combination with other arguments including equity and addressing the causes of bad health - such as poverty. The case for public health will not be won either by simply developing moral or value arguments. Cost efficiency arguments currently dominate the debate in health, but policymakers need to think about the benefits of long-term investment in health and not simply the costs to health care systems.

As experts at the 10th European Health Forum Gastein (EHFG) in Bad Hofgastein stressed, policy makers, economists and the wider population fail to understand the cost of non-health. Policymakers need to communicate more simply to appeal to individuals and encourage them to change behaviour. "Public health only becomes a public policy priority when it is too late", stated Dr. Carolyn Bennett, Member of Parliament for the Canadian House of Parliament and former Public Health Minister, commenting on the cost of the Canadian SARS outbreak in 2003.

"Policymakers need to work across policy areas and learn from each other in order to find practical win-wins - economic arguments can have a role in this type of thinking", stated Dr. Fiona Adshead, England's Deputy Chief Medical Officer.

In the past health policymakers have not made much use of economic arguments, presumably because of the perception that economics arguments are too difficult to develop in the context of public health. The meeting also looked at other policy areas: a striking example of best practice is the recent publication of the Stern Report on Climate Change, which has had a major impact in focussing global leaders on the issue of climate change.

Professor Robert Watson of the University of East Anglia stated: "The Stern report was fundamental in changing perceptions in climate change - but it was developed as a result of the political will of the British government to make a lasting contribution and ensure that the world take action."

"In conclusion, economic arguments are an end to a means and should not become the only objective of health policymakers. Political will is also critical to this process", concluded Dr. Fiona Adshead.

Better health for greater wealth

The positive impact of better health on the economic status and development of nations is a widely neglected fact. It is commonly understood that economic and social development improves health status. What is less widely acknowledged is that health status also contributes to economic development and wealth at both the domestic and national levels. To raise awareness for the key role of effective public health systems for economic success was one of the core issues at the WHO-sponsored workshop "Performing health systems: contributing to health, economic growth and social welfare" held in the scope of the European Health Forum Gastein.

If health could be improved, a whole range of economic benefits would result. In eastern Europe and central Asia, for example, evidence suggests that if a country's adult mortality was reduced by as little as 2 percent annually over 25 years, the economic gain would account for 25-40 percent of the country's current total income.

The Regional Office for Europe of the World Health Organization (WHO) is undertaking a comprehensive analysis of the contribution that well-functioning health systems make to health, wealth and economic growth. The WHO European Ministerial Conference on Health Systems: "Health Systems, Health and Wealth", to be held in Tallinn, Estonia on 25-27 June 2008, will be a milestone in this process.

A European Charter on health systems is also being developed. On 6 October 2007, a drafting group of senior decision-makers has met for the first time, in Gastein, to develop a draft of the Charter for further discussion. The objective of the Charter is to provide guidance and a strategic framework for strengthening health systems throughout the region. The draft Charter will be submitted to the Ministerial Conference in Tallinn for adoption by the 53 Member States of the WHO European Region. Further information is available at the "Health Systems, Health and Wealth" conference website.

Assisted Reproductive Technologies (ART) to play a key role in combating ageing of the European population

Europe is not yet making proper use of all possibilities to combat one of its major long-term problems: the dramatic decline in birth rates. As a panel of high-ranking experts at the 10th European Health Forum Gastein, stated, Assisted Reproductive technology (ART) could make a substantial contribution to improve the increasingly dramatic situation. Indeed, ageing increases in life expectancy and fertility rates lay - with 1,5 children per woman - below the usual replacement level of 2,1 per woman. As a consequence, in the next 40 years, old age dependency ratios are expected to rise from 39 to 80 percent.

Policy makers recognized that there is a strong need to address the demographic decline. In fact, there is a range of public policies that can be utilized in reversing the trends in fertility rates. Alongside with measures like improving the income situation of families, enabling women to combine better motherhood and career and many others. Medical treatment can also play an important role.

As a result of birth rates declining below replacement level, falling productivity and increasing dependency will cut potential GDP growth from 2,1 percent to 1,3 percent by 2050. Age related public spending as a proportion of GDP will increase significantly over the coming years. (Sources: Fougere et al, 2005; Mc Morrow & Roger,2003; OECD, 2005)

At the European Health Forum in Gastein, in this connection, the potential of Assisted Reproductive Technologies as a contribution to removing the barriers to childbirth was discussed. "Infertility is a disease that affects one in six couples. The European Health Forum at Gastein is a valuable opportunity to consider the relationship between infertility and demographics in some detail. As the birth rate declines, the availability of assisted reproduction techniques and providing couples with the appropriate support, become all the more important in the broader demographic context", stated Jill Evans, Member of European Parliament, United Kingdom.

Evi Hatziandreou, Director of Health and Health Care at RAND Europe, showed the potential of Assisted Reproduction Technologies as a contribution to removing the barriers of childbirth. "ART is not a magic bullet, but as a part of population policy mix an important contribution - i.e. adopting ART would bring 10.000 babies per year in the United Kingdom."

Health systems to blame for the earlier death of men across Europe

A "guilty" verdict for the European health system was the outcome of a simulated "court cas" at the European Health Forum Gastein. The jury of health professionals, NGOs and policy makers sought to identify responsibility for the early death of men across Europe. They incriminated the variations of emphasis by member states on early diagnosis, as well as the "one policy fits all" approach when it comes to men's health.

The European Men's Health Forum (EMHF) workshop aimed at bringing to the attention of a greater number of EU governments and other stakeholders the fact that late diagnosis is a common denominator of earlier deaths in men across Europe. Taking account of men and women's specific health needs, the development of policies and services must tackle poor health literacy and late presentation for the sustainable improvement of LTHC outcomes. Taking cancer as an example, the recent EUROCARE IV study demonstrated that overall survival for all cancers combined was significantly higher in women than in men.

Awareness of men's health among European governments varies widely. The male survival rate is lowest in East European countries and in the United Kingdom (UK) in Western Europe. In the UK, for instance, men under the age of 45 are much less likely to visit their doctor than women. A survey of men conducted by the Men's Health Forum - England and Wales - suggested that many men are unhappy with the service provided for reasons that are rectifiable: unhelpful business hours, perceived emphasis on services for women and children, and undue bureaucracy.

So, the jury returned a verdict on men being less guilty than the health systems meant to support them. To improve male health, in fact, specific actions rather than a "one policy fits all" approach are needed. The development of public health policies and services should take account of evidence that men and women have different needs, experiences, concerns or priorities. By fully integrating an awareness of male and female health needs strategically and operationally, the EU gender mainstreaming agenda can actively promote equality and improved health outcomes for men and women.

Biotech: Innovation machine of tomorrow's medicines seeks more flexible policy environment

A rapidly developing and changing industry such as the biotechnology industry requires a more flexible political and legal environment to stay competitive and innovative. This was one of the main messages of an expert panel at the 10th European Health Forum Gastein. The panel discussed the role of health care biotechnology in developing innovative new medicines and the importance and future of biotechnological research.

Over the last 20 years, health care biotechnology has become paramount in medical innovation, developing many treatment options that meet previously unmet medical needs, i.e. certain types of cancer. Today 325 million people worldwide benefit from over 150 biotech treatments. Over half the medicines currently in late stage clinical trials are biotech derived, and many of the drugs in development treat serious diseases such as cancer and HIV/AIDS. Health care biotechnology is a young field, and yet it has contributed to a remarkable increase in the quality of life to people with chronic diseases, such as kidney disease: in this field biotech medicines have dramatically reduced the need for risky blood transfusions.

As the field of biotechnology is continually developing, it is essential to have flexible legislation to assure that important advances in medical science bring hope to patients. Up until now, due to the complex nature of the products offered by health care biotechnology companies, their value has not always been fully understood by policy makers, patients, doctors, pharmacists or other health care professionals.

Currently the majority of biotech companies are small and medium-sized enterprises, most of which are not yet profitable. They therefore need a supportive environment e.g. fiscal flexibility, access to finance and biotech-friendly industrial policy, so that they can continue to fund vital and expensive research and development activities which may lead to treatments for unmet medical needs. There are some national examples of supportive environments through the creation and support of Biotech hubs such as Medicon Valley in Scandinavia and Cambridge in the United Kingdom.

New EU Health Information and Knowledge System is to facilitate international comparisons

According to the European Commission, the existing European health information system performs its functions only highly inadequately. The aim of rapidly providing high-quality and usable data and information in order to make health policy decisions on international, national and regional levels has not been achieved in a wide range of areas. This was the conclusion of a high-profile forum of experts at the European Health Forum Gastein. As the EU Commission states in an information paper, the poorly organized and vague division of responsibilities between various areas - for example Eurostat, Directorate General, Health, etc. - are primarily responsible for this.

For this reason the EU experts have demanded rapid implementation of the plans for a fundamentally reorganized EU Health Information and Knowledge System. The system must provide a common framework for data acquisition that enables the non-bureaucratic exchange of information at all administrative levels. The first step necessary to achieve this is a clear designation of areas of competency.

Just as important are clear specifications for data structures. These are the prerequisites for obtaining comparable data from all the member states, which in turn is necessary in order to create a basis for health policy decisions at the European level. The member states must also define standardized processes for the acquisition and transmission of data - which in several countries has yet to take place at all, even on a rudimentary basis.

The planned EU Health Information and Knowledge System is understood as a process of data collection and transmission at the EU level. Institutions of the public health, statistical and research programmes are to be availed in order to generate co-operation and synergies between public health systems, the statistical and scientific community.

European Health Technology Institute launched at EHFG

The European Health Technology Institute for Socio-Economic Research (Research Institute) has been launched and introduced to policymakers and other attendees at the European Health Forum Gastein. The goal of the Research Institute is to carry out European research to provide policymakers with robust evidence on the social and economic value of medical technology, in particular medical devices, to enable decisions furthering the principles of equity, effectiveness and efficiency in health care systems.

Medical technology is amongst the most dynamic sectors in Europe, contributing to significant increase in life expectancy and improvements in quality of life. However, there are concerns regarding the sustainability of European health care systems. Research suggests a correlation between medical technology innovation and economic growth, but too little is known on how innovation impacts the economy and welfare of European countries. The Research Institute aims to become an important source of data and evidence on this particular topic.

The European Health Technology Institute for Socio-Economic Research builds upon a close collaboration between leading academic institutions - including the Università Bocconi, Milan, the London School of Economics and Political Science (LSE), and the Technische Universität Berlin (TUB), policymakers and industry in order to fill the gaps in research and evidence on medical technology in Europe.

Rosanna Tarricone, Executive Director of the Research Institute, stated: "We realized that in order to continue to improve access to innovative and reliable medical technology for patients in Europe, we need to present policymakers with evidence that national and European economies will continue to thrive better with a healthy population." In a joint statement, Professors Elio Borgonovi from Bocconi, Reinhard Busse from TUB, and Panos Kanavos from LSE added: "It is the role of academia to conduct baseline research and present scientific facts in an independent and balanced view. We are excited to be able to carry out these research projects as part of the Research Institute."

Spanish Senator Carles Alfred Gasòliba I Böhm, member of the Research Institute's Research Council, concluded: "This institute will bridge the gap between medical technology, innovation, and health care policy. I look forward to discussing the results with national and European policymakers in the months and years to come. This initiative will partly fulfil the goals of the Lisbon Agenda, with research and development set to become one of the key policies of the European Union."

The Research Institute will publish the first results early 2008. More information is available at the website of the European Health Technology Institute for Socio-Economic Research.

"European Alliance against Depression" first winner of the "European Health Forum Award"

The "European Alliance against Depression" is the winner of the "European Health Forum Award" (EHFA) presented this year for the first time. With the prize the European Health Forum Gastein honours outstanding initiatives in the area of health care that have had verifiable scientific successes.

25 applications were submitted for the European Health Forum Award, with all EU countries involved in one or more projects. Six finalists were initially selected in the scope of a two-stage process. In addition to the winning project these were:

  • "Medicine Safety Belt": help for proper use of medications by patients - Austria, Germany.
  • FINDRISC: screening system for early recognition of the risk for Type 2 Diabetes - 16 EU member states.
  • The Maas-Rhein Cross-Border Healthcare Programme: a trilateral network for improved cross-border use of health care facilities in border regions - Germany, Belgium, Netherlands.
  • Quality Assurance in Breast Cancer Screening: network of pilot projects to develop best-practice recommendations and guidelines - 19 European countries - for the prevention and early recognition of breast cancer.
  • Smokefree Class Competition: European prevention programme for adolescents on the basis of social learning and group dynamic processes - 19 European states.

With its persuasive initiative the European Alliance against Depression is focused on the alarmingly high number of suicides. Twelve percent of Europeans suffer from serious depression at least once in their lives, with a large percentage of the 58.000 suicides per year in the EU a result of depression. With a four-stage approach - intervention with primary care physicians, the start of a media campaign, special training for key groups such as teachers, clergymen, police, pharmacists, etc., the initiation of self-help groups and an emergency card for people at risk - significant declines in suicide rates have been achieved in the target region. (17 countries)

"The European Alliance against Depression is a truly worthy prizewinner", stated EHFG President Günther Leiner about the high-quality project submitted for the EHFA. "I'm convinced that with this newly established prize an important signal has been sent that self-initiative and the personal commitment of individuals continue to be of overwhelming importance in an age when the health care industry as a whole is dominated by large apparatuses. We owe our thanks to the men and women who initiate such exemplary projects and they deserve to have their work honoured. The EHFA is also certainly a motivation for the many others who do valuable work for people in Europe in countless important health care projects."

Günther Leiner also stressed the scientific orientation of the prize: "We placed great emphasis on comprehensive reviews and analyses of the results of each project. Only initiatives with a solid scientific founding and supported by empirical evidence were considered for the European Health Forum Award. The European Health Forum Award is not bestowed for good intentions, but for health policy measures that have resulted in long-term benefits."

EHFG makes important contribution to the development of EU health policy according to EU Commissioner Kyprianou

EU Health Commissioner Markos Kyprianou underscored the significance of the EHFG event for European health policy: "The European Health Forum Gastein is a continuous, important source of momentum for determining our further health policy targets." The presence of Austrian Chancellor Alfred Gusenbauer not only demonstrated health policy's considerable place of significance in Austria, but also the high degree of acceptance that the EHFG enjoys.

To the 600 high-profile experts who attended the EHFG this year the EU Commissioner was clear about the priorities of EU health policy. Markos Kyprianou said that for him it is always frustrating that in the European Union, which has made such enormous progress in areas such as education and prosperity, hundreds of thousands of people are still dying from preventable diseases: "Alcohol abuse, smoking and obesity have to be fought effectively and it is an important task of the EU Commission to actively support the member states in all their efforts."

An improvement in dealing with the mentally ill is also enormously important. There will also be an EU initiative for next year. A primary task for Europe is also the battle against diseases that are flaring up again more frequently in Europe such as tuberculosis and the fight against tropical diseases aided by climate change.

Markos Kyprianou also granted considerable priority to the improvement of access for EU citizens to health care services outside of their home country: "Citizens are vehemently demanding this right on an increasing basis and it is an obligation of the member states and the EU to enact measures in order to improve this situation."

EHFG President Günther Leiner gave an all-around positive summary of the European Health Forum Gastein 2007: "Not only did we celebrate the 10th anniversary of the EHFG, but we are very proud that the forum has also reached a new dimension this year. With more than 600 congress participants and nearly 30 individual events, we have underscored our role as the most important health policy event in the European Union. Nowhere else does a comparable platform exist for the exchange of ideas between policymakers, administration, industry, science and NGOs. No other event has a similar number of experts participating from the most diverse areas of the health care industry and nowhere else is a similar breadth of content offered."

The large number of events has also led to the fact that this year several events are being held on the final day and that de facto the forum will last one day longer than it did before. Günther Leiner used the enormous success of the anniversary event to take an optimistic look into the future. In the next few years new priorities will be set. For example, the Young Gastein Scholarship, a project in which prospective health experts are able to use the opportunity at the European Health Forum Gastein to make contacts with one another and with leading health policy and administrative representatives, really proved itself this year. "In the long term this will contribute to the continuity and quality of European health policy", Günther Leiner concluded.

More information on "10 Years Gastein - Shaping the future of health" is available at the European Health Forum Gastein website; in the VMW September 2007 article 10 years European Health Forum Gastein: EHFG 2007 reaches new dimensions; in the VMW October 2007 article EHFG board to select six finalists for European Health Forum Award; and in this VMW issue's article Recommendations for better mental health in Europe.


Leslie Versweyveld

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