As public health bodies, EuroHealthNet’s member agencies are at front lines of work with European States and citizens to prevent illness, whether infectious or non-communicable, mental or physical. Throughout the COVID-19 pandemic EuroHealthNet’s members have not ceased working to prevent the causes and burdens of cancers, nor will they stop if vaccines are delivered. Perhaps more than ever, health is a driving factor for Europe working together in union. We must use the lessons of the pandemic to build more sustainable and equitable preventive and health promoting approaches.

The EU flagship initiative Europe’s Beating Cancer Plan, due to be launched this year, is still anticipated. But a consultation has been delayed and we understand the formal launch may require more time in the Commission work schedule1. Delays are understandable, given the need to prioritise the COVID-19 crisis. We urge the EU Institutions that, while being as short as practicable, this delay should be used as an opportunity to firmly focus on the three main identified cancer challenges.

First, the Commission has recognised the huge suffering cancers cause and seeks to put citizens, patients and families at the heart of the Plan. That suffering has been multiplied by COVID-19 both in volume and length. Preventive and diagnostic measures such as screening and health checks have been delayed or cancelled, resources diverted and treatments postponed, while families have been separated and left alone. To put people firmly first, the EU and all its Member States need to urgently and universally implement the agreed, but rarely fulfilled, European Pillar of Social Rights’ principle that ‘Everyone has the right to timely access to affordable, preventive and curative health care of good quality’ – as well as the other principles regarding social rights for all throughout the life course.

The second challenge is the burdens which cancers impose on society as a whole and particularly health systems. It is estimated that around 40% of cancers are avoidable 2. Yet only 3%3 of health budgets are spent on disease prevention and health promotion. Beating cancer begins with prevention. The current crisis shows how vulnerable our health systems are, despite the valiant work of many. It is clear that health needs a much more prominent place in the EU’s priorities.

Better health promotion and disease prevention means more resourceful, skilled and integrated communities. It requires primary and social services that put prevention and promotion first within a health-enabling practice and policy framework. It means empowering national and sub national health care and social systems to be truly able to tackle disease threats properly. This can be done through improved EU governance, resources, technical and structural support via the European Semester, aided by Cohesion and Social Funds. It also requires agile revision and resourcing of the next EU budget.

It means ambitious Health in All EU Policies approach is needed, underpinned by prevention. It is time to implement and update EU responsibilities for public health and wellbeing so they are fit for purpose and for the 21st century. A strengthened responsible Directorate is needed, with supporting EU Agencies and Programmes shifted to address the key systemic determinants of ill-health, including of cancers. Europe should stop supporting elements that cause diseases such as cancers. This includes factors like pollution, tobacco, alcohol, and unhealthy foods and products at work and in communities. We must avoid unfair blame on individual choices or ‘lifestyles’. Like COVID-19, the faults are systemic, not individual.

Thirdly, Europe’s Beating Cancer Plan will fail and underperform if it does not tackle inequalities which persist across Europe.Disadvantaged people and those in vulnerable circumstances are at higher risk of disease and death from cancer. We hear now about the need to ‘flatten the curve’ of COVID-19 incidence: we need to also flatten the social gradients for all diseases, including cancers. The plan must leave none behind. In an inclusive Europe, all would be protected against the risk factors of cancer.

Health Equity impact assessments are vital. They must be applied to the tackling cancer, and in responses to COVID-19 and its aftermath.

The EuroHealthNet Partnership looks forward to confirmation by the EC of revised schedules. We confirm our readiness to help progress the Europe’s Beating Cancer Plan towards achieving truly successful outcomes and to provide further advice, relevant knowledge and supportive actions where and when possible.

1 https://ec.europa.eu/health/home_en
2 EuroHealthNet contribution to the Roadmap on Europe’s Beating Cancer Plan
3 State of Health in the EU Companion Report 2017