This article is part of “Health Care 2024,” a survey-driven series of online debates in which POLITICO explores how the European Union can best tackle health policy.
The next European Commission will be in charge of allocating a proposed €1.1 billion a year for health research from 2021 on. In this installment of Health Care 2024 — a series of symposiums asking leading experts to weigh in on the health care priorities for the next Commission — POLITICO asks: How should that money best be spent?
Address unmet needs
Jill McArdle is European Advocacy Officer at Global Health Advocates.
The added value of EU public funding can’t be justified if it’s spent on areas of high commercial interest, where the pharma industry is already investing. Instead, we should set health research priorities according to public health priorities, focusing on unmet medical need and areas with limited market incentives to invest. Examples include poverty-related and neglected diseases such as tuberculosis and HIV/AIDS, which still kill millions of people worldwide, including in the EU.
The EU’s public-private partnerships in health are dominated by private interests, making it all the more important that the next big effort must be made to work in the public interest. We need to strengthen the role of independent scientific advice and strike a real balance among stakeholders, including civil society. This is especially important if these partnerships cover sensitive topics such as the regulation of health data and the ways we pay for innovation. Also essential is better transparency, along with stricter rules on financial contributions from industry and limits on “opt outs“ from open access requirements for commercial reasons.
Ensure equitable access
Caroline Costongs is director of EuroHealthNet.
Given that this is a large pot of public money, it’s vital that research results contribute to well-being, with long-term and sustainable impacts felt by all Europeans. To that end, we need to make sure that equity and social fairness are addressed across health research activities.
Our society is changing quickly. Rising inequality, social polarization, demographic shifts, urbanization, perceived security threats, digitization, technological advances and the climate crisis all have potentially huge implications for public health and equity. Health authorities are desperately looking for evidence-based and effective policy responses so they can turn these challenges into positive opportunities. But health research risks lagging behind.
There’s increasing awareness that health systems alone cannot address complex health challenges, but mainstream funding tends to over-prioritize biomedical research and innovation. The risk is that insufficient attention will be given to public health, health promotion, disease prevention and research that links health and well-being to wider societal developments. The commercial determinants of health — with powerful multinationals monopolizing markets — are among the most difficult ones to address. The digital marketing to children, the depletion of environmental resources and the unethical use of (health) data are examples of priority areas that would merit research budgets.
Health research is an immense field. As we argue over who gets what, we need to make sure we’re all pulling in the same direction to improve health and well-being. An equity-focused, holistic approach that engages a wide range of stakeholders across society can form the common thread.
Don’t forget rare diseases
Simone Boselli is public affairs director at the European Organisation for Rare Diseases.
We must not overlook rare diseases — which affect 30 million Europeans — as we discuss research priorities for the next Commission. These diseases are highly complex, progressive and severely disabling, affecting life expectancy and generating specific care needs. Due to their low prevalence, little is known about most of them. As a result, they’re poorly diagnosed and their symptoms are under-recognized in healthcare and social systems.
Rare diseases have already become a research-funding priority area, given the added value of cross-country and multidisciplinary cooperation and the latter’s contribution to innovation and competitiveness. But further efforts are necessary, as most rare diseases lack effective treatments. The unmet medical needs of people living with rare diseases are still vast.
Research funding should be addressed in three key areas. The first is improving diagnosis by harnessing the potential of digital technologies. The second is delivering high quality healthcare by researching the clinical efficacy and financial effectiveness of virtual healthcare such as the European Reference Networks (ERNs) to support national health systems. The third is developing treatments by funding research to understand the mechanisms underlying rare diseases and better identify therapeutic targets.
Focus on the practical
Sibylle Reichert is executive director of the International Association of Mutual Benefit Societies.
When we speak about research priorities, we should think of e-health and innovation — for example, efforts to improve health apps, enhance the interoperability of e-records, or use data to improve care. We also should look at pharmaceutical advances, such as how to incentivize research in areas where investment is lacking. Good examples include antimicrobial resistance, orphan drugs, pediatric medicines and new and better ways to administer vaccines.
Research on healthcare systems is also important, especially if we want to ensure they’re sustainable amid changes in the labor market and in the broader population. This means tackling the financing of long-term care and addressing persistent staff shortages. Finally, we need to better understand how to implement useful innovation so that it reaches as many people as possible. Too much money is invested in pilot projects that offer interesting results but offer few practical applications. We should also learn more about the efficiency of health promotion and disease prevention policies. That includes pushing to develop digital health literacy and gathering evidence on the cost-effectiveness of prevention, as well as better understanding health insurance markets and their economic contribution.
Don’t skimp on funding
Otmar D. Wiestler is president of the Helmholtz Association of German Research Centers.
This budget — which is under threat — is urgently needed in its full amount. Biomedical research is among the grand challenges that can be addressed only on a pan-European scale. The timely “cancer mission,” with its clear focus, is a perfect example of EU-added value, and other important topics, like dementia, must not be forgotten. We need cross-border collaboration among the best European experts in fundamental biomedical research to achieve groundbreaking advances.
One important concept is translational research — going all the way from lab bench to bedside. When we better understand diseases and their underlying mechanisms, we can come up with solutions for targeted disease prevention, diagnosis, treatment and therapy. Such solutions should be more personalized, which requires the development or expansion of federated data banks. Just think of the small number of cases when it comes to rare diseases.
Personalized medicine also requires innovative data analysis technologies. However, all this depends on a solid funding. Only if the EU members commit to a strong Horizon Europe will we be able to bring forward EU health research and position it at the forefront of international developments.
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