Debating mandatory or voluntary vaccination is ‘absolutely useless’, says EU health chief

The Health at a Glance: Europe 2018 insists on behavioural risk prevention: 20% of adults are smokers, 38% of adolescents reported binge-drinking and 1 in 6 adults are obese in Europe. [EPA-EFE/HOSLET]

Medical experts, not politicians, should decide whether vaccination should be mandatory or not, EU health Commissioner Vytenis Andriukaitis told reporters on Thursday (21 November), adding that the only relevant objective is to reach maximum coverage.

Andriukaitis was speaking at the launch of the Health at a Glance report, which compares the performance of national health systems across Europe.

Vaccination stole the show at the event, which saw the Commissioner pressed by reporters to answer questions about the ongoing debate in Italy.

According to Andriukaitis, whether to opt for voluntary or mandatory vaccination is an artificial discussion that is “absolutely useless”, repeating his earlier claim that the only relevant issue is how to reach a maximum level of vaccination coverage.

The Lithuanian Commissioner cited the example of the Netherlands, which guarantees a very high level of coverage using a fully voluntary method.

“We can use different or even a combination of schemes,” he said, adding that it is up to epidemiologists, medical doctors, scientists and immunologists to suggest which instrument is more effective.

No freedom of choice in vaccination, top EU health official insists

There is no freedom of choice when it comes to vaccination because it involves putting other people’s health at risk, a top EU health official has warned, adding that ongoing debate in Italy about inoculations is verging “on the absurd”.

The Health at a Glance report said that vaccine-preventable diseases have resurged in some parts of Europe over recent years, pointing out the importance of promoting effective vaccination coverage for all children across all EU countries.

Andriukaitis cited the EU commitment to eradicate measles by 2020, but he recognised also that Europe is not yet a measles-free continent.

Italy recently faced severe measles outbreaks, with 4,978 cases reported from February 2017 to January 2018.

The Commissioner, who recently held a discussion with Italian Health Minister Giulia Grillo, suggested that the Italian government should have an approach that does not create a gap between Brussels and Rome because this would only help encourage Euroscepticism.

“It is a simple question for society: have I to rely on fake news and mistreated debates or have I to save children lives? Now those people are responsible,” he concluded.

State of EU Health

The Health at a Glance report sketched out some significative sources of concern that regard a slowdown in life expectancy gains in many countries, including France, Germany and the UK, but also the presence of large disparities across and within member states by socioeconomic status.

For instance, low-income households are five times more likely to report unmet care needs than high-income households, while people with a low level of educationcan expect to live less than those with a university degree, the report said.

Prevention remains a priority since more than 790,000 deaths per year are still caused due to behavioural risk factors like smoking, obesity and alcohol consumption.

However, the report provided information on how the system works, which is useful for sharing good practices.

The publication is indeed meant to assist the member states in improving the health of their citizens and seven countries requested a voluntary exchange to discuss the findings and share best practices after the launch of the previous State of Health in the EU.

“This is not another academic or statistical exercise but a tangible tool,” Andriukaitis insisted.

Mental disease

Two thematic chapters are included in the report, one promoting mental health, the other one assessing the strategies to reduce wasteful spending.

A neglected but still important topic, mental illnesses such as depression, anxiety disorder and alcohol or drug use disorders, cost taxpayers over €600 billion per year, more than 4% of the European countries’ GDP.

The bulk of these costs are indirect: €260 billion is due to lower employment rates of people suffering from mental diseases, €170 billion is spent on social security programmes.

“Preventing mental issues is very high on the political agenda,” confirmed Andriukaitis during the press conference.

Efficient spending 

According to the evidence gathered within the report, up to one-fifth of health spending is inefficient and could be used for other care needs.

An example came from unnecessary admissions to hospitals, which could be avoided with better management and which consume over 37 million hospital bed days each year.

“We’re not calling for decreasing spending but for reallocating smartly the inefficient spending,” Commissioner Andriukaitis said.

The potential saving amounts to 20% of spending, which could be reallocated or saved.

Currently, health spendings in the EU account for 9.6% of GDP in the EU as a whole, up from 8.8% 10 years ago.

Health spending fell sharply during crisis: OECD

Between 2009 and 2011, health spending per capita fell in one out of three OECD countries, with those hardest hit by the crisis most affected, according to a new report by the influential Paris-based think tank, published today (21 November).

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