This section of the glossary has outlined the commitments of the European Union to aspects of global health. These show how widely these complex issues are taken up across a broad range of EU’s policy commitments. What is less clear is how such commitments will be delivered in practice. It appears that while there are many ways of making commitments there are few mechanisms for following through and monitoring action. Thus we suggest that it is crucial to undertake research and monitoring the Global Health Initiatives of the EU Presidencies and other forms of commitment of the last five years in order to identify, the actions that have resulted and their outcomes. This should help establish a more widely applicable tool for monitoring and benchmarking the results of such commitments.
In the course of this research a survey will be undertaken of actions or research that demonstrate the impact of such commitments. We would be grateful to receive notes of any such research already undertaken or currently in hand.
More on the European Common Agricultural Policy (CAP) and Health
Further Definitions:
Support for agriculture:
can prepare for and respond to agricultural crises often associated with natural disasters such as droughts, some of the most devastating agricultural crisis in Europe have stemmed from disease (among animals) or chemical contamination. But agriculture policy in the EU, as in most developed countries, has diversified beyond securing food supply and maintaining markets to include rural development and environmental protection. Ministries of Agriculture and those for the environment are now working to improve policy coherence and complimentarily.
Agricultural subsidies:
of approximately US$1 billion per day (780,000 million Euros) in all countries of the Organisation for Economic Cooperation and Development (OECD), including EU Member States can no longer be justified on the basis of lack of food security. In fact, food surpluses stimulated by subsidies have negative health impacts in developed as well as in developing countries and have been a major problem for the agriculture sector in developed countries since the 1970s. These subsidies transfer money to farmers, and thereby affect production decisions, incomes, international trade and the environment. In 2003 a reform of the EU Common Agricultural Policy (CAP) partially decoupled agricultural support from production levels in order to lower production incentives. However, according to an OECD report from 2004 this is not expected to lower production levels to any significant extent, except in the case of rice. In other words, attempts to reform agricultural policies often fall short of what is needed to produce significant outcomes. This was again the case in the most recent attempted reforms of the CAP under the French EU Presidency of 2008.
Impact on non-communicable diseases:
Indirect evidence strongly suggests that some elements of the CAP have negative health impacts. In the year 2000, non-communicable diseases caused 86% of deaths and 77% of the disease burden in the region, with cardiovascular disease alone causing 23 % of the total burden. The top seven factors responsible for the bulk of the European non-communicable disease burden are:
- tobacco use
- excessive intake of alcohol
- high cholesterol
- low fruit and vegetable intake
- being overweight
- having low levels of physical activity
- high blood pressure
Agricultural products have a major influence on six of these key disease risk factors. Chronic non-communicable diseases are the major cause of adult illness in all regions of the world, responsible for an estimated 35 million (or 60 %) of all world deaths in 2005. There is growing concern at the rapid worldwide increase in obesity. Clearly this worrying trend is caused to a large extent by excessive consumption of fat, sugar and alcohol, constituting more than 50% of dietary energy in a typical Western diet. In the light of this disease burden, agricultural subsidies, for example, to support sugar, fat and alcohol production run counter to public health objectives. Furthermore, measures which keep prices of fruit and vegetables high by limiting availability and use of import tariffs clearly counteract the nutrition goal of increased fruit and vegetable consumption, especially for low-income households.
Agricultural practice:
in Europe can also impose a burden on the environment, due to nitrogen and pesticide leakage into ground water, a further cause for health concern. The processes and mechanisms for coping with such impacts require the cooperation and coordination between agriculture and health ministries as for example, in the 1996 BSE (mad cow) outbreak which saw the disease spread world wide and the price of beef plummet. The European Agricultural Guidance and Guarantee Fund exist to help farmers and markets cope with such emergencies; however, the decision of using this fund in a veterinary health emergency is taken by DG SANCO, the European Commission’s Directorate General for Health and Consumer Affairs. Agricultural practices such as the use of antibiotics to permit animals to be managed at higher densities than would otherwise be possible, may also pose a threat to the effectiveness of such antimicrobial agents similar to the over prescription of antibiotics in humans.
Global impacts:
The negative health impacts outside of the European region are mainly caused by trade policy as a consequence of market distortions caused by agricultural policy. While globalisation has extended access to a wide variety of foods all year round and thus contributed to public health, significant problems remain. Where as trade barriers have been abolished or greatly reduced for most industrial goods, and export subsidies have been abolished, barriers to free trade in agricultural commodities are still in place, justified on the grounds of food security or rural development. The health effects in developing countries are mainly through negative impacts on the income of farmers. One prominent example is the sugar sector. Sugar beet production is highly protected in the EU; guaranteed prices maintained by subsidies stimulate over-production at costs three times the world market price due to higher production costs. The EU sugar surplus is exported at subsidised prices (“dumping”) thereby destroying the markets and livelihoods of farmers in developing countries, who remain in poverty and in poor health even though they are capable of producing cane sugar at competitive world prices. In the sugar reform of 2006 some progress has been made in that guaranteed minimum sugar prices will be cut. This is expected to lead to a fall in production of about one-third of current levels over the next few years. Over-production of food and other agricultural products due to agricultural policies in OECD countries and the resulting distortions in international trade have been heavily criticised by developing countries, by several NGOs, EU Member States and academics. While the Directorate for Agriculture of the EU Commission is reluctant to accept that there are negative health impacts within the EU, there is a growing awareness of the damaging effect on health and poverty in developing countries of the CAP.