Opinion of the Economic and Social Committee on the 'Proposal for a European Parliament and Council Decision adopting a programme of Community action from 1999 to 2003 on injury prevention in the context of the framework for action in the field of public health'
21. 1. 98 EN Official Journal of the European Communities C 19/1 II (Preparatory Acts) ECONOMIC AND SOCIAL COMMITTEE Opinion of the Economic and Social Committee on the ‘Proposal for a European Parliament and Council Decision adopting a programme of Community action from 1999 to 2003 on injury prevention in the context of the framework for action in the field of public health’ (1) (98/C 19/01) On 6 June 1997 the Council decided to consult the Economic and Social Committee, under Article 129 (4) of the Treaty establishing the European Community, on the above-mentioned proposal. The Section for Protection of the Environment, Public Health and Consumer Affairs, which was responsible for preparing the Committee’s work on the subject, adopted its opinion on 7 October 1997. The rapporteur was Miss Maddocks (Co-rapporteurs: Mr Linssen and Mrs Wahrolin). At its 349th plenary session (meeting of 29 October 1997), the Economic and Social Committee adopted the following opinion by 75 votes to three with one abstention. 1. Introduction 1. 1. The Commission Communication on the frame- work for action in the field of public health (2) set out criteria on which to determine priority areas for future Community action programmes. It also identified and announced several such areas, including injury preven- tion, pollution-related diseases and rare diseases. The Commission has just adopted relevant programmes in these three fields. 1. 1. 1. The present proposal for an action programme on injury prevention (1999-2003) is based on Article 129 of the Treaty and comes under the principle of shared competence between the Community and the Member States. 1. 1. 2. The programme responds to the specific call made by both the European Parliament and the Council (3), and it seeks to promote public health by contributing to actions which reduce the incidence of injury, by promoting the more effective dissemination and application of prevention techniques whose worth is widely accepted by experts, and by helping to strengthen the general capacity of public health bodies to mount effective injury prevention activities. Injury is a broad concept which in principle 1. 2. covers all kinds of ill-health resulting from external causes (as opposed to disease processes) and, in the EC, is the leading cause of death at all ages between 1 and 34, and also the over 75s. (1) OJ C 202, 2. 7. 1997, p. 20. (2) COM(93) 559 final, 24. 11. 1993, ESC Opinion: OJ C 388, 31. 12. 1994. (3) EP: Resolution of 19 November 1993, OJ C 329, 6. 12. 1993 — Council: Resolution of 27 May 1993, OJ C 174, 25. 6. 1993. C 19/2 EN Official Journal of the European Communities 21. 1. 98 1. 3. The present Commission proposal targets a small number of key areas within the broad field covered by the concept of injury, selected on the basis that they: will incorporate information on Community financing in the various fields of action as well as the results of evaluations. — are an important cause of avoidable injury and death; — are not already addressed by action at Community level; — present opportunities for cost-effective intervention; — would deliver Community added value by bringing together and complementing work done at national and sub-national level. 1. 7. The financial framework for the implementation of the programme for the year 1999 shall be ECU 1,3 million in keeping with the current financial perspec- tives. The cost for the remaining four years (2000-2003) shall be determined after the establishment of the future Community financial perspectives. 1. 3. 1. These target areas are: 2. General comments — home and leisure accidents to children, young adults and elderly people; — accidents to children while at school; — suicide and lesser forms of deliberate self-harm (sometimes called parasuicide); — injury prevention capacity. The incentive measures proposed are of two 1. 4. kinds: — support for the sharing — and shared development — of expertise, particularly in the selection of inter- ventions and the epidemiology of injury; — encouraging improvement in the quality of data about injuries, which are vital to determine what situations, products, behaviours and places are dangerous. The means which will be appropriate for achiev- 1. 5. ing the above at a Community level are: — encouraging and supporting the creation of net- works; — dissemination of information about prevention cam- paigns; — work on improving the quality of data; — supporting surveys and technical investigations of injury risk factors; — helping Member States to coordinate policies and programmes; — adding public health value to other Community programmes. 1. 6. An evaluation of the actions implemented under the programme will be provided in two reports, one during the third year (evaluation) and a final report on the implementation of the programme. These reports 2. 1. The Economic and Social Committee congratu- lates the Commission for the latest proposals for action programmes in the context of the Communication on the framework for action in the field of public health. These programmes show a will towards a more horizon- tal approach in public health policy, according to which health promotion should deal with all aspects of the living environment. Such approach was advocated by the Committee in its opinion on the above-mentioned communication (1). 2. 2. The Committee welcomes the Commission pro- posal aiming at health promotion through injury preven- tion. It also notices with satisfaction that the new Article 129(1) of the Treaty makes a more specific reference to this type of action, as it states that ‘Community action. shall be directed towards. obviating sources of danger to human health’. 2. 3. The Committee is particularly pleased that the Commission is carrying out a more in-depth analysis of the health circumstances of specific age groups (i. e. children, young and elderly people) and environments (i. e. home and schools) as reflected in the current proposal. Such analysis is in line with the ‘New Approach’ on public health policy suggested by the Committee in the context of the Communication in the field of public health (2). 2. 4. The present proposal aims at facilitating the sharing of existing expertise, both technical and non- technical, on injury prevention at both Member State and Community level. This aim reflects the principles of the Committee’s opinion on the aforementioned communication (2), which stressed the need to involve all interested parties, to assure a more solid scien- tific/technical basis and to prevent duplication of efforts (1) Cf. p. 6 of the Opinion, OJ C 388, 31. 12. 1994. (2) Cf. p. 7 of the Opinion, OJ C 388, 31. 12. 1994. 21. 1. 98 EN Official Journal of the European Communities C 19/3 with regards to health policy. Such involvement should be guaranteed at the earliest possible stage. 2. 4. 1. The Committee stresses the importance of the role to be played by voluntary organizations which have recognized and valuable experience to offer in this field. 3. 2. 1. 3. It is also vital, in the view of the Committee and as stated in its opinions on the subject (4), to improve the system which has also been outlined in the present Commission proposal. In this context, the Committee feels that the Commission should issue guidelines on the methodologies to be followed for data collection in order to achieve comparability of information between Member States. 3. Specific comments 3. 1. Article 3: Budget. On one hand, the Committee understands the reasons behind the relatively modest budget — 1,3 MECU — for the implementation of the action programme. On the other hand, the Commission presents very strong evidence on the cost-effectiveness of the proposed measures (1). Therefore, and given that funds are only allocated up to 1999, the Committee considers it critical that, from the onset, the continuity of the programme is guaranteed until the year 2003, which is the end of the proposed period of action. Article 4: Consistency and complementarity. The 3. 2. Committee considers it essential that consistency and complementarity with other relevant Community pro- grammes and actions are guaranteed especially with regards to: 3. 2. 1. The EHLASS system — Data on home and leisure accidents have been collected since 1986 under the EHLASS system (2). This information has been used, inter alia, in prevention campaigns, negotiations with industry to modify products, and the introduction of standards and regulations. The Committee is aware that the relevant 3. 2. 1. 1. Commission services have just completed a final report on the implementation and effectiveness of the EHLASS system on the basis of which the system might be extended beyond its current expiry date of end of 1997 (3). 3. 2. 1. 2. The Committee feels that the action pro- gramme on injury prevention cannot function without the EHLASS system and calls for it to be extended. (1) Cf. p. 4, point I(4), COM(97) 178 final, Communication from the Commission concerning a Community action programme on injury prevention in the context of the framework for action in the field of public health. (2) Council Decision 86/138/EEC, OJ L 109, 26. 4. 1986. Council Decision 93/683/EEC, OJ L 319, 21. 12. 1993 — Opinion ESC: OJ C 201, 26. 7. 1993. Decision No 30922/94/EC of the European Parliament and of the Council, OJ L 331, 21. 12. 1994 — Opinion ESC: OJ C 195, 18. 7. 1994. (3) Decision No 30922/94/EC of the European Parliament and of the Council OJ L 331 21. 12. 1994 — Opinion ESC: OJ C 195, 18. 7. 1994. 3. 2. 1. 4. In this way, EHLASS could further improve its cost-effectiveness and give the necessary added value at Community level for the provision of information on home and leisure accidents. Once good quality/reliable information is available, it will then be possible to develop quantitative targets for injury reduction which, in the view of the Committee, are fundamental for achieving the objectives of the proposed action pro- gramme. 3. 2. 2. Product safety — The Committee also feels, in line again with comments made on the EHLASS system, that there should be a strong cross-link established between injury prevention and Directive 92/59/EEC on general product safety (5). In this connection, it endorses those proposed measures (i. e. under the injury prevention capacity area) directed to add public health value to other Community policies for injury prevention such as the above-mentioned directive. 3. 2. 3. Indeed, the Committee welcomes those changes to Article 129 of the Treaty directed to ensuring a high level of human health protection in the definition and implementation of all Community policies and activities. 3. 2. 4. Health monitoring — ‘Accidents at home’ is one of the domains in which health indicators may be established under a future Community action pro- gramme on health monitoring (6). It is therefore vital, in the view of the Committee, to avoid any duplication or overlap of work between that programme and the proposed one, in order to achieve efficient interaction between them. 3. 3. Article 5: Comitology. The Committee feels that the views of the various socio-economic partners and interests involved in injury prevention should be con- sidered by Member States when making nominations for the Advisory Committee that is to assist the Com- (4) OJ C 201, 26. 7. 1993; OJ C 195, 18. 7. 1994. (5) OJ L 228, 11. 8. 1992 — ESC Opinion: OJ C 75, 26. 3. 1990. (6) OJ C 338, 16. 12. 1995 — ESC Opinion: OJ C 174, 17. 6. 1996. C 19/4 EN Official Journal of the European Communities 21. 1. 98 mission on both the criteria and procedures for selecting and financing projects under the programme, and the evaluation procedure. 3. 4. Article 7: Monitoring and evaluation. The Com- mittee is pleased to note that it will receive copies of the evaluation and implementation reports. Brussels, 29 October 1997. The President of the Economic and Social Committee Tom JENKINS Opinion of the Economic and Social Committee on the ‘Proposal for a European Parliament and Council Decision adopting a programme of Community action 1999-2003 on rare diseases in the context of the framework for action in the field of public health’ (1) (98/C 19/02) On 27 June 1997 the Council decided to consult the Economic and Social Committee, under Article 129 of the Treaty establishing the European Community, on the above-mentioned proposal. The Section for Protection of the Environment, Public Health and Consumer Affairs, which was responsible for preparing the Committee’s work on the subject, adopted its opinion on 7 October 1997. The rapporteur was Mr Fuchs; co-rapporteurs were Mr Lemmetty and Mr Linssen. At its 349th plenary session (meeting of 29 October 1997), the Economic and Social Committee adopted the following opinion by 101 votes to three, with one abstention. 1. Introduction 1. 1. The proposed five-year action programme (1999- 2003), which is based on Article 129 of the Treaty and which is accompanied by a explanatory communication, seeks to address the problem of rare diseases in the Community by complementing ongoing work on this subject in the Member States. The problem of rare diseases, which, in contrast to the United States, has not been dealt with systematically in most of the Member States to date, was identified as one of the eight priority areas for Community action in the 1993 Commission communication on the framework for action in the field of public health (2). 1. 2. In response to this communication both the Economic and Social Committee (3) and the European Parliament (4) supported the idea of an action programme on rare diseases. Furthermore, the Council invited the Commission to take stock of existing knowledge and experience regarding rare diseases and to examine the situation of orphan drugs in the Community (5). 1. 3. To address the problem of rare diseases the Commission proposes a number of specific actions i) actions to provide better under three headings: information on the different aspects of rare diseases (e. g. the establishment of a European rare diseases database); ii) actions in support of patient and family support groups (e. g. the establishment of such groups and their collaboration); and iii) actions on handling rare diseases clusters (e. g. the monitoring of rare diseases and the creation of rare diseases cluster response teams). (1) OJ C 203, 3. 7. 1997, p. 6. (2) COM(93) 559 final. (3) See its opinion of 6 July 1994 — OJ C 388, 31. 12. 1994. (4) See its Resolution A4-0311/95 on the Medium-Term Social Action Programme 1995-1997 — OJ C 32, 5. 2. 1996. (5) See its Resolution of 20 December 1995 — OJ C 350, 30. 12. 1995