On January 24th 2011, MEPs were joined at the European Parliament by representatives from the Commission, from national health ministries and from cancer patient associations to address some of the factors leading to inequalities in the field of cancer research, prevention and treatment across Europe. Some of these inequalities are between member states, where government funding or infrastructure vary, while others are linked to individual wealth, education and lifestyle. The solutions may be European-wide, such as greater collaboration on cancer research, or very small, involving individuals making lifestyle changes. Addressing these factors, the FACE Workshop brought stakeholders together to find solutions to reduce health inequalities.

MEP and FACE Champion Petru Luhan chaired the conference. He began the conference by highlighting that a cancer patient in some areas of the EU is five times less likely to survive than a patient in the best-performing areas for early diagnosis and care. Thanking ECPC for bringing together stakeholders, he urged policy makers not to exclude health from European discussion on the grounds that it is not currently an EU competence, pointing out that policy-making in every area has a health impact. He was supported by ECPC President Tom Hudson, who remarked that “health inequalities need to be addressed today – there is no point in putting them off until tomorrow”. He urged participants and policy-makers to address three key areas: lessening the impact on health of poverty, exclusion and other social factors; address the poverty cycle; and elaborating policies with the involvement of target groups themselves.

Reminding us that “poverty kills”, Clive Needle from EuroHealthNet highlighted that “inequalities are persisting and increasing.” We need to realise that health is an asset, not a burden. He used a phrase from WHO’s publications on the Social Determinants of Health – “why are we treating people without changing what makes them sick?” Proposals need to be practical and recognise the interests and constraints in the political word. He offered the model of a nutcracker – by pushing from both sides, politicians and patients, we can crack the nut of health inequality. From the European Commission’s DG Employment, Social Affairs and Equal Opportunities, Arnaud Senn emphasised the need to raise awareness about health inequalities and contributing factors, and stressed that these inequalities exist not just between member states but within them as well. Referring to the Social Protection Committee, he called attention to the health impact of “upstream decisions”, for example inthe Europe 2020 strategy, which embraces smart growth, sustainable growth and inclusive growth.

A country-specific perspective was offered by Nina Krtelj from the Slovenian Ministry of Health. By mapping cancer incidence against socio-economic background, she finds that certain cancers are linked to wealth and lifestyle. This was followed by a video messagefrom Quentin, a myeloma patient who tried to imagine what would have happened had he not had the advantages which enabled him to find lifesaving treatment abroad.

“It makes me think of the game ‘SuperMario’ – because wherever he stands, he cannot stay long because it is not very safe, and this is what it is like”. – Quentin, cancer patient Sidonia Jedrzejewska, a Polish MEP, reminded us that no one can remain personally objective when it comes to cancer. “The east-west gap is particularly striking in cancer”, and Sidonia attributes this to three main factors: higher pollution levels in Eastern and Central Europe; lack of resources for treatment and care; and the need for information to show people why and how they should change their lifestyles. Andrzej Rys from DG Sanco at the European Commission called for milestones to measure progress towards ambitious goals. “In many journeys, the most difficult moment is when you cannot see the destination.” The Commission is working on the tobacco product directive, and will
announce the third EU screening guidelines next week, but reaching a consensus, judging the best option for future patients, is difficult when the science moves so quickly.

ECCO Policy Committee chair Julio Celis examined inequalities in the field of cancer research. There is a research paradox – “rapid progress in research and understanding of cancer, but slow translation of discoveries into concrete benefits for patients.” Attributing this to the complexity of the discovery-to-treatment pathway and the lack of a coordinated European strategy, he called for more collaboration and dissemination of findings. He outlined three initiatives in these areas: EPAAC, which brings together different stakeholders coordinate research; the EUROCANPlatform, a collaborative platform of research-intensive institutions; and eurocancercomms, putting all the information in one place.

The patient’s perspective was represented by Patricia Garcia-Prieto from ECPC, who addressed the inequality between those who can create their own access to healthcare, and those who do not have the necessary tools to do so. She shared patient testimonies showing that some privileged patients are able to take matters into their own hands, but others cannot. Viorica Cursaru from Myeloma Euronet Romania welcomed the crossborder healthcare directive passed by the European Parliament last week and thanked ECPC for their work on this. She drew attention to the relatively low doctor/patient ratios in some central and eastern European countries, and the need for infrastructure and government investment. Recognising that there will always be differences, she called for the development of “a legal framework where anybody can access the treatment available easily.” Petru Luhan closed the conference by stating that the European decision-makers “have a role in proposing clear, productive and constructive measures which can be put in place.”