The relations between the ESC and the European UnionMajor initiatives to come in health and cardiovascular research

Excerpts from the presidential address at the opening ceremony of the Annual Congress of the European Society of Cardiology, Vienna 2003

Jean-Pierre Bassand*

* Corresponding author: J.-P. Bassand, Centre Hospitalier Universitaire Jean Minjoz, Department of Cardiology, Boulevard Fleming, 25030 Besancon, France. Tel.: +33-381-66-85-39; Fax: +33-381-66-85-82
E-mail address: jean-pierre.bassand{at}ufc-chu.univ-fcomte.fr

Received 20 October 2003; accepted 23 October 2003

The Vienna congress of the European Society of Cardiology (ESC) was a resounding success, with even more active participants than in Berlin in 2002. This increasing attractiveness of the congress of the ESC is due to a range of factors including the venue of the congress, the quality of the programme, and its special ‘European’ flavour. The annual congress was, therefore, the best forum to announce a series of major initiatives that are in the pipeline in health and cardiovascular research. These projects will be driven by the ESC in partnership with the European Commission in one project, and the Irish Department of Health and Children for the other two projects, during the Irish Presidency of the European Union from January to June 2004.

Despite the remarkable progress, unprecedented in human history, that has led to dramatic changes in the management and prognosis of diseases, particularly in cardiology, cardiovascular disease remains nonetheless the leading cause of permanent disability and mortality in developed countries, and will become the leading cause worldwide by the year 2020. By that time, it is expected that coronary artery disease will be the number one cause of disability on the planet.

Nowadays, we are confronted today with new health challenges. Diabetes and obesity have become major health concerns. Smoking remains extremely popular, particularly amongst youngsters and females. Promotion of a healthy lifestyle and diet are scarce in Europe. Lastly, the ageing of the population and deteriorating economic status in some European countries also contribute to aggravating this situation, and help cardiovascular disease flourish.

New solutions have to be envisaged to tackle these new challenges. Increased efforts in research and in the translation of this research into medical practice will be needed in the future. These are hot political issues.

The European Society of Cardiology assumes its role as a professional organization with great determination and energy. We strive to ensure that guidelines incorporate the most recent data from clinical research, promote them through educational programmes, and try to measure through the use of surveys, the impact of these recommendations on clinical practice. In this regard, the ESC has taken responsibility in training of cardiologists and allied professionals, and in disseminating knowledge. It has invested considerable human and financial resources in organization of congresses, publishing activities, with six extremely successful journals with growing impact factors, organization of surveys, writing guidelines, and active development of educational material in various forms, the most recent being the ESC website for Distance Learning, EscEd.org. Most of this teaching material has received accreditation from the European Board for Accreditation in Cardiology (EBAC).

Of course, all this has been achieved through fruitful collaboration with the constituent bodies, NationalSocieties, the Working Groups and the Councils, and through strong support from the dedicated staff of the European Heart House. It is most rewarding to acknowledge that the constituent bodies feel more and more involved in the activities of the ESC, and contribute more enthusiastically.

The training of cardiologists, physicians and allied professionals is certainly determinant, but teaching and informing patients and the public is also part of our mission. Due to a range of constraints, in particular the obvious language barrier, it is difficult to imagine how the ESC could have a meaningful impact on the European population as a whole. This might come under the responsibility of national health authorities, but we think that it is also a key responsibility of the health authorities at the level of the European Union.

This is the reason why the ESC has undertaken political action at the level of the European Union, to voice the ESC message and to defend the interest of our patients and our discipline. Our actions in this area have been pursued by the very active and dedicated European Union Relations Committee, as well as the concerted efforts on the part of the National Societies of cardiology of the 15 member states; indeed, soon to be 25 member states.

The ESC has prepared a document entitled ‘Heart Plan for Europe’, in which explanations about the epidemic of cardiovascular diseases and the means to curb it have been outlined in detail. The Heart Plan for Europe was promoted with the joint effort of the ESC, the Spanish Society of Cardiology and the other 14 National Societies from the EU member states, during the Spanish presidency of the European Union in 2002. At the end of its term in June 2002, the Spanish Presidency of the EU, recalling former resolutions of the EU to adopt a programme of community action in the field of public health, noted that cardiovascular diseases are a significant cause of morbidity, mortality and incapacity in the European Union, and that they result in considerable economic and social costs. It also recognized that there is considerable evidence that cardiovascular health promotion and primary prevention and interventions are cost-effective when applied in a timely and proper manner. They, therefore, considered that the promotion of cardiovascular health should be a major priority for the European Union.

Ever since, the main objective of our political action towards the European Union has been to approach the three major institutions of the European Union, namely the Council of Ministers, through the rotating presidency of the European Union; the members of the European Parliament, and the European Commission, especially Directorate General SANCO (Health and Consumers), and Directorate General Research.

The ESC conveyed two important messages to the European Union decision-makers. The first is that there is a deficit in funding for research in life sciences and cardiovascular disease in particular at the level of the European Union, and the second is that the means exist to curb the epidemic of cardiovascular disease, and they have to be put into action.Indeed, the funds allocated to life sciences research at the European Union are no match for the investments by the National Institutes of Health in the USA, whose budget was 28 billion dollars for the fiscal year 2002 alone, compared with 2.25 billion Euro for 4 years for life sciences in the 6th Framework programme (FP6). In FP6, half of this sum will be allocated to genomics and applications for health, and the other half is earmarked for combating major diseases. It must be noted that under the latter heading cardiovascular disease is ranked along with diabetes, resistance to antibiotics and drugs, etc. More emphasis will be put on cancer, AIDS, tuberculosis and malaria. The second message is that the means to curb the epidemic of cardiovascular disease do exist, and that a political decision had to be made to put them into action on a Europe-wide basis.

Major health initiatives will be promoted during the Irish presidency of the European Union from January to June 2004. Thanks to a very active partnership between the ESC and the Irish Department of Health & Children, applications to the European Commission for funding were filed and accepted.

The first is a Consensus Conference on Prevention, to be held on 24/25 February 2004 in Cork, in Ireland, with the aim of reaching European agreement on a set of recommendations on prevention to be recommended by the European Commission to the member states. It will be organized in partnership with the ESC, the Irish Department of Health & Children, and the European Heart Network; with of course the representatives of the member states of the European Union, and the 10 candidate countries; and funded by the European Commission.

The second initiative, also in collaboration with the European Commission and the Irish Ministry of Health and Children, is a more technical project, aimed at agreeing on data standards in cardiology and defining common criteria for data collection through a conference to be organized in Spring 2004.

A third initiative, also funded by the European Commission, is a conference on the future of cardiovascular research in Europe. This conference will be organized in partnership with the European Commission DG Research and the ESC. It will involve the most prominent scientists and researchers in Europe, as well as representatives of Medical Research Councils from member states and government representatives. The project is also strongly supported by the Irish government.

All these initiatives, approved by the European Commission, while an achievement in themselves, are only the start of a long process, which hopefully will result in long-standing relations with the institutions of the European Union, to the benefit of our patients and our discipline.Excerpts from the presidential address at the opening ceremony of the Annual Congress of the European Society of Cardiology, Vienna 2003





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