Prevention at the centre of European health policy.

In the European Union (EU), around 60 million people suffer from cardiovascular diseases, which are responsible for about one third of all deaths each year. Current projections indicate that both the number of cases and mortality will increase significantly by 2050. This development is mainly due to the ageing population and other societal developments, such as the rise in risk factors or social, economic and environmental determinants. Yet around 80% of cardiovascular events could be avoided through effective prevention. Against this background, the European Commission now intends to step up its efforts and plans to present an EU Cardiovascular Health Plan later this year.

Documented need for action

The aim of the EU Plan is to establish a comprehensive, prevention-oriented framework that supports Member States in avoiding disease and preventing premature deaths among people with existing risks such as obesity, hypertension or comorbidities. Little is yet known about the content, but it is expected to be a strategic framework rather than a concrete piece of legislation. This reflects the EU’s limited scope for action.

Both the European Parliament and the Council have already addressed the issue. The Parliament has adopted a resolution on non-communicable diseases, and the Council has adopted corresponding conclusions.

What we can expect

Building on initiatives such as Europe’s Beating Cancer Plan, the EU Plan will, according to the exploratory report, likely include three main areas of action: prevention (for example, through awareness-raising on unhealthy behaviours to reduce risk factors for cardiovascular diseases); early detection and screening (for example, through an EU protocol on health checks related to cardiovascular diseases or EU guidelines on the use of digital tools for personalised treatments and remote monitoring); as well as management, care and rehabilitation.

DSV calls for “Health in All Policies”

In its feedback, the German Social Insurance (DSV) explicitly welcomes the initiative. From the DSV’s perspective, the Commission should prioritise strengthening health-promoting living conditions, complemented by evidence-based preventive services and high-quality care including rehabilitation and reintegration. Only a Health in All Policies approach can sustainably reduce the disease burden and mortality, thereby improving population health.

The DSV supports an integrated framework for prevention, early detection and rehabilitation that addresses key risk factors such as smoking, unhealthy diet, physical inactivity, alcohol consumption and psychosocial stress. An EU Plan should promote common objectives, evidence-based priorities as well as transparency and comparability standards, thereby creating clear added value for all Member States.

Lessons from German legislation

The DSV will accompany the Cardiovascular Health Plan with particular reference to the German “Healthy Heart Act” [Gesundes-Herz-Gesetz]. In this context, the German legislator intended to reallocate prevention funds and no longer use them for behavioural prevention; in other words, “pills instead of prevention.”

From the DSV’s point of view, it would be a mistake to repeat this approach at EU level. The effective way to tackle cardiovascular diseases is not further medicalisation through additional screening programmes or expanded use of pharmaceuticals, but a consistent focus on strengthening structural and behavioural prevention as well as health literacy. The priority must be to create health-promoting living, learning and working environments. This includes effective tobacco and alcohol policy, healthier food, the promotion of active mobility and physical activity throughout all stages of life. Health literacy must already be strengthened in educational institutions in order to effectively reach disadvantaged population groups.

Outlook

Europe’s Beating Cancer Plan has already had a significant impact on EU health policy. Whether the EU Cardiovascular Health Plan will have a similar effect remains to be seen – expectations are high.