Opportunity in a crisis: European Union must enable people with chronic conditions to remain active in social and economic life

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Iain B. McInnes. [EULAR]

This article is part of our special report An EU health policy for rheumatic and musculoskeletal diseases.

The election of the new Parliament and the establishment of the new Commission represent an opportunity to re-calibrate the role of the EU in improving the health of its citizens. This debate, however, cannot be disconnected from a more general debate on the future of the EU.

Professor Iain B. McInnes is the President of the European League Against Rheumatism (EULAR).

Today, the threat of Brexit and the growth of anti-EU movements should give us pause for thought about the value of the EU in our lives – and this includes the area of health. The EU must be ambitious. It should demonstrate that it is contributing to concerns of its citizens; notably when people are asked what they expect from the EU, health appears as one of the main priorities. The EU should therefore play a key role in improving the health and wellbeing of people, including those with rheumatic and musculoskeletal diseases (RMDs) and other chronic, disabling conditions.

RMDs are placing a huge – and growing – strain on European societies and their taxpayers. This disease area includes well-known afflictions such as rheumatoid arthritis, osteoarthritis, low back pain and many others, making it the greatest cause of physical disability and impairment. RMDs together account for nearly 30% of years lived with a disability (YLDs) in the EU alone.

These are diseases with painful consequences, imposing enormous loss of quality of life for patients and their families, that affect 1 in 4 people, making them the main cause of work loss, absenteeism and premature retirement. As a result, they are silently and negatively impacting on European economies. The estimated direct cost associated with such conditions stands at 2% of the EU’s gross domestic product.

EU health policies should be designed to help people with chronic diseases remain active in social and economic life. The new Commission should demonstrate that it is committed to providing support to EU countries and people with chronic conditions, according to three key areas.

First, it should ensure that synergies are in place and a strong level of coordination exists between health and other policy areas. This is necessary to further reduce health risks, and to also cope with the socio-economic consequences of health conditions. This relates in particular to employment and social affairs policies, which could help to reducing work-related diseases, including a number of RMDs, while helping people with chronic, disabling conditions to remain active in the labour market, which would be beneficial for their health.

Second, the Commission should strengthen the impact of health policy. This could be done by promoting the use of Health Impact Assessments to define priority areas (prioritising the socio-economic impact of health interventions made). More concrete strategies on major chronic diseases such as RMDs could also be developed.

Finally, the EU should be more involved in improving equitable access to health care of the highest quality. Citizens in all regions have the right to enjoy equal rights when it comes to access to doctors and appropriate treatments. It should also strengthen its support to Member States to further develop integrated health care models and eHealth solutions to cope with the increasing burden that RMDs and other chronic conditions place on societies – and the individual.

EULAR is convinced that these measures will enable the EU to become closer to its citizens’ aspirations for the future, and will thereby reduce the seeming ‘legitimacy crisis’ that appears to affect the EU as a whole.

On 16 October, EULAR will release a vision paper that focuses on the future of health policies. The paper stresses the need to ensure proper coordination between the area of health and other policy areas such as employment and social affairs, as well as the environment. Coordination is crucial in order to better address health challenges and their consequences on the social and economic integration of people with chronic diseases; without effective integration, there is no opportunity to curb the growing strain that these diseases are placing on society and the individual taxpayer.

EULAR is committed to increasing the participation of people with RMDs in work by 2023 and the Time2Work campaign is an important part in achieving this goal – and contributing positively to the EU as a whole, including through individual tax relief. It is possible to identify solutions to enable those affected with RMDs to live a life that can be managed – and professionally productive.

Time2Work is part of EULAR’s ongoing Don’t Delay, Connect Today campaign which is committed to raising awareness of the importance of early diagnosis of RMDs. Early diagnosis, early referral to a rheumatologist and early access to effective treatments are known to improve outcomes, quality of life and the ability to work, but diagnosis is often delayed or never received.

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