Health has been the main protagonist in recent years due to the Covid-19 pandemic, and its treatment has undergone changes in European policies. Laura Sesma, leader of Zabala Innovation’s Health Area, analyses in this interview the perspective from which it is approached in the EU and its main funding programmes, among other current aspects.
Has the pandemic marked a turning point in the way we approach health?
The pandemic has had an enormous impact on health policies, including European collaboration programmes such as Horizon Europe, which have highlighted the need to be prepared at European and international level to manage it. Pandemics do not understand borders between countries and therefore require coordinated actions and joint work from all points of view. We have also seen the importance that infectious diseases, which were thought to be somewhat under control, can have on health; and their impact and relationship not only with non-communicable and chronic diseases, but also at a global level, such as other factors such as animal health or the environment, which can create new global health alerts.
Mental health will be an area that will have been re-launched…
Even before the Covid-19 pandemic, mental health in the European population was of great concern because of its serious socio-economic impact. Data from the 2018 biannual ‘Health at a Glance: Europe’ reports showed that mental health problems affect some 84 million people across the EU. The total costs of mental illness are estimated at more than 4% of GDP (over €600 billion) in the 28 EU countries. And these figures have been exacerbated, as reflected in the 2020 report, by the pandemic and the subsequent economic crisis which has led to higher levels of stress, anxiety, and depression. Young people and groups with fewer resources are most at risk, which is why joint policies and actions are being developed to try to improve mental health management in Europe and prevent suicide.
What other health gaps has the pandemic exposed?
What has become most apparent in the aftermath of the pandemic is the need for greater coordination between Member States during a health crisis; greater capacity at EU level to prepare for and combat health crises; and greater investment in health systems to ensure they are ready to meet the challenges of tomorrow. And in addition to these health gaps, the pandemic has exposed the need to address misinformation in situations affecting global health.
And what strengths has it revealed?
The capacity for resilience and joint response based on solidarity at European level. Member States supported each other, aiding where it was most needed with specialised medical staff and equipment, sharing medical equipment and in the repatriation of European citizens during the crisis.
It must be highlighted the common strategy designed to obtain safe Covid-19 vaccines, coordinate testing strategies and facilitate the provision of medical and protective equipment across Europe. This was an unprecedented milestone at the European level, which should serve as an example of cross-border collaboration.
What is the EU’s attitude to health: has it become a priority issue, or does it still not have the weight it deserves?
The EU has always considered the issue of improving the health of its citizens to be a key one, seeking health systems that are resilient, but it has faced the problem of fragmentation and diversity of health systems at both European and national level, which make such common strategies at European level difficult. Hence, a new public health programme, EU4Health, has now been designed to be much more ambitious than the previous ones. This initiative seeks to invest in building up stocks of medical supplies in case of crises; create a pool of health staff and experts that can be mobilised to prevent or combat health crises in the EU; train health professionals for deployment across the EU; increase surveillance of health threats; and improve the resilience of health systems to ensure better health outcomes for all.
What are the most important European funding programmes in health?
The most important is Horizon Europe, with funding for major health challenges within Pillar 2, which is the Health Cluster; also, the Cancer Mission, or the aforementioned EU4Health. Nor should we forget the partnerships that are being set up such as EDCTP3 or IHI, or other opportunities for participation in Pillar 1 focused on basic science. Pillar 3 seeks to solve technological and scientific challenges in the area through the EIC Pathfinder.
Does health now have a stronger interrelationship with the environment?
Increasingly so. The importance of the environment in health is becoming more and more evident, as is the need for policies that consider the impact of environmental pollution on chronic diseases and that allow a global strategy for the citizen to be addressed. In fact, the pandemic has made it very clear how climate change and the impact on species can have major consequences on health, which is why we are increasingly looking to study this interrelationship with the environment in a more holistic way.
And how does digitalisation affect health?
It is a critical issue worldwide, and the EU has made it a priority in all its policies and strategies in recent years. The potential impact of the use of digital tools to improve the quality of care for citizens is enormous, but it faces numerous barriers and challenges from the point of view of technologies, infrastructures, and legal frameworks, which is why Horizon Europe wants to address it. The digitisation of the health system, the need to finance health as an investment and not as an expense, and the possibilities that the EU may have to lead a cohesive health project are key to achieving this change of governance in health models.
Is data exchange in the EU working?
Yes, and a European health data space has just been launched and will be gradually implemented over the coming years. It is an interconnected database that aims to facilitate access to patients’ health information and ensure continuity of care, even when they are in another EU country. The exchange of health information will lead to more efficient patient care and improved diagnostic capacity. It will also help scientific research and European companies to develop medicines, devices and health services that are better adapted. Finally, more data sharing would allow for better and more informed policy making. Based on the existing Cross-Border Healthcare Directive, Member States collaborate through a voluntary network connecting national eHealth authorities. And the European Commission created the MyHealth@EU infrastructure to facilitate the cross-border exchange of health data.
How has Zabala Innovation’s Health area grown and has its focus changed?
It is a team made up of seven people that has been growing in recent years, both in terms of projects presented and those financed. We support the entire company in the strategy and presentation of projects related to the area in all the associated programmes. In addition, we are partners both in management support and in communication and dissemination activities in different projects funded in Horizon 2020 and Horizon Europe: HIVACAR, DocTis and SPIOMET4health in H2020 and RBDCOV in HE.
The focus has changed because we have gone from supporting in the presentation and not going as usual as partners, to positioning ourselves as a strategic partner in the projects to develop dissemination and communication strategies and launching the exploitation strategy in phases prior to reaching the market, sometimes supporting the coordinator in specific tasks of the administrative management of the project.
And finally, what challenges does the area you lead face?
The main challenge in this area, which is common to all HE areas, is the enormous competitiveness of the calls, which have success rates that do not usually exceed 10-12% in general. The EU does not want to close itself to different approaches to the challenges it wants to support and on many occasions the calls are very broad and ask to address a lot of topics, which requires the consortium to be clear and to have an innovative idea explained in detail to address those challenges.
The challenges of the area also come from the different topics that are dealt with, more related to clinical, translational, epidemiological, ethical, environmental, and socio-economic research that also includes regulatory science. So, the challenge of involving all the actors who can play a key role in healthcare from all points of view is enormous, bearing in mind that we are dealing with issues with a fundamental ethical implication.
Market access is different, because you must consider health systems, reimbursement, health technology assessment, regulatory strategy… Because in the end, we all want health systems to be public, to offer quality services and to be free of inequalities.
If you want to learn more about the work of the Zabala Innovation Health Area, don’t miss this video!