Chronic respiratory disease: Why the EU must act

Health may not be an EU competence, but that doesn’t mean Brussels doesn’t have a responsibility to do what it can to tackle COPD, writes Alberto Cirio.

Alberto Cirio | Photo credit: European Parliament audiovisual

By Alberto Cirio

15 Nov 2017


Chronic obstructive pulmonary disease (COPD) is the second-highest cause of death worldwide, killing one in 20 people, surpassed only by cardiovascular disease. 

Prevention, care and post-care should be better organised if we want European citizens to live longer, better lives. EU policies should therefore be more assertive in this regard, despite the limits imposed by the treaties.

While health policy is the competence of the member states, the EU has some power in complementing national policies, namely improving public health, preventing physical illness and diseases and obviating sources of danger to physical health. 

It also encourages cooperation between and among member states, their policies and programmes. With greater political will, there could be a lot of room for manoeuvre. 

This is an opportunity to save lives - or at least improve their quality - and the EU has no excuse not to act. In the case of COPD, prevention is linked to a range of other policies that are within the Union’s remit. 

Environment, energy and industrial policy converge on this issue, allowing for a reduction of risk factors that is valuable for COPD patients and non-patients alike. In other words, reducing air pollution benefits not only those who suffer from respiratory diseases, but also the quality of the environment (with its downstream effects) and our quality of life. 

It also aids the business model of green economy enterprises, which are already finding out how they can create jobs and thrive within the opportunities created by the EU-driven demand for sustainability.

The EU can do a lot and the Commission in particular should be proactive. Parliament has provided input and, if action was taken, MEPs would be very supportive. One aspect that is generally neglected is patients’ lives outside care. 

Health policy generally covers diagnosis, care and sometimes recovery. However, what is not considered, is the fact that many diseases imply lower productivity and, in the most serious cases, the loss of income. People are entitled to sick leave, but in most SMEs the absence of a worker is a huge problem, irrespective of the reason. 

The same holds for an independent worker that loses the ability to work for few days per month and will be unable to satisfy some customers and damage his/her reputation because of missed deadlines. 

Support services would be a great EU added value, as would the reduction of red tape for the flow of reimbursement requests. Parliament continues to work on the better regulation initiative, while member states’ health services keep asking workers who are quite clearly sick to prove their inability to work.

Another principle that we sometimes underestimate is that if a disease is preventable, we should put in place proportionate provisions to do so. This isn’t a matter of playing with words - it’s a real concern for the health and wellbeing of citizens, public finance, and many other aspects of public policy. 

The division of powers among the different levels of government should not be an excuse for inaction, but should respond to the need for increased efficiency. Policy papers constantly refer to “causes of preventable death”; each time that adjective appears it begs the question of whether there is a good reason for not taking clear and decisive action to prevent it.

Legislators have no power over life and death, only the task of organising public services in the most efficient and desirable way. However, they can adopt measures that allow for a better life. As representative of the people, Parliament should lead the efforts to increase quality of life, be it through better care, more prevention, or at least by promoting the debate within the bodies responsible for making decisions and implementing them.

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