Indeed, research carried out for
EuroHeart, a joint project of the ESC and European Heart Network co-funded by the European Commission, shows that all 16 countries in the work package reported some type of legislation covering public health, tobacco control and food.
Only Denmark and Greece had no national policies relating specifically to coronary heart disease. In contrast, Belgium, Estonia, Finland, France, Iceland, Italy and Slovenia reported at least five policies in place relating to cardiovascular health promotion, CHD, hypertension, stroke and hyperlipidaemia; Greece had just one.
And, with the exceptions of Denmark, Greece and Italy, all countries reported national guidelines on CHD and hypertension, with a minority (Belgium, Finland, Ireland) reporting official government endorsement of existing European guidelines.
The EuroHeart project, alongside the ongoing EuroAspire surveys, are collaborative research activities of the ESC designed to bring an unequivocal evidence base to their broader policy initiatives with the EU. But for Dr William Wijns, Chairman of the ESC Committee for European Relations, there are even bigger political goals ahead.
“We are hoping that the Spanish presidency of the EU, which will take place in 2010, will make the prevention of cardiovascular disease a formal EU Council recommendation,” says Wijns.
“This means that it will become soft law, with all member states accountable and having to report their initiatives,” says Wijns.
“This is the next goal of our advocacy and we’re hopefully getting very close.” “Recommendations” are not voted on by MEPs, but they are negotiated and do carry political weight.
Active alongside Wijns in the ESC’s lobbying efforts in prevention are Professor Lars Rydén, Chair of the Sub-committee for Prevention, and Professor John Martin, whose “toolbox” Heart Plan for Europe provides member states with the blueprint for the introduction of prevention policies. Those efforts in prevention have so far seen the formation of an
MEP Heart Group, more than 80 members who support the European Parliament Resolution on action to tackle CVD and the revised European Guidelines, and the implementation of the European
Heart Health Charter developed with the support of the European Commission and WHO Europe. A Symposium on Monday heard from Rydén that 30 European countries have officially adopted the Charter thanks to the combined efforts of national societies and heart foundations.
Yet despite such achievements, findings from the latest EuroAspire survey (on secondary prevention) published earlier this year still reflect a huge gap between ambition and reality.
“Yes, it’s a continuous battle,” says Wijns,
“but it can’t be won by public education alone. We need political commitment – even legislation - as well. The enforcement of the smoking bans in countries like Ireland or Scotland shows what’s possible. We have to make the healthy choice easy, and you can’t fix that without legislation and public endorsement. The costs of CVD are enormous and those who have to pay are entitled to strong political action.”