Health inequalities persist 20 years after the 2004 enlargement

On this day in 2004, ten EU candidates, including eight former communist countries, completed their path to EU membership. For the EU10, the economic transformation has been impressive but significant disparities remain to this day and this is particularly the case when it comes to health.

Since 2004 most of the EU10 doubled their GDP per capita in purchasing power standard (PPS). The income gap between the EU10 and the existing members narrowed and trade with the new members grew dramatically. Despite huge economic progress, there are persistent gaps in healthcare provision and resulting outcomes.

Average EU spending on healthcare is around 11% of GDP but the figures in almost all EU10 were much lower, with 6.5% in Poland and 6.3% in Romania (Eurostat 2020).

The European Federation of Pharmaceutical Industries and Associations (Efpia) WAIT index on access to innovative therapies estimated last year that there can be as much as a ten-fold difference in time to patient access and an 80% difference in availability across Europe to new and innovative medicines.

CEE countries also regularly experience medicine shortages.

The free movement of healthcare professionals within the EU has proven to have a substantial impact on the healthcare systems of CEE countries, resulting in workforce shortages. The EU has a more general problem with shortages, however the problem is more pronounced in these countries. 

The relative weakness of CEE healthcare systems was exposed during the COVID-19 pandemic, with excess mortality rates twice as high as those in Western Europe. There has been substantial investment in healthcare systems since COVID, but further progress is needed.

We can still see marked differences in mortality in cardiovascular disease and cancer.

The European Cancer Organisation’s action report on beating inequalities in cancer care noted that mortality rates for several cancers, including lung, cervical, rectal, and breast cancers, were distinctly higher in CEE countries. 

As we look forward, it is clear that more concerted efforts will be needed to close the inequality gap and ensure that all EU countries can prove resilient in the face of healthcare threats. 

Other news

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EMA’s Emergency Task Force (ETF) has recommended updating COVID-19 vaccines to target the new SARS-CoV-2 variant JN.1 for the 2024/2025 vaccination campaign.

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News from the Capitals

STOCKHOLM
A new antibiotic against gram-negative bacteria hasn’t been developed since the 1970s. Now, a European research team led by Swedish scientists has discovered multi-drug-resistant bug-killing compounds that could lead to a new class of antibiotics. Read more.

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WARSAW
Long road ahead for EU Pharma Package says Polish pharmaceutical sector. Poland’s pharmaceutical industry says there’s still a long journey ahead for the revision of the EU’s pharmaceutical legislation. Despite the Pharma Package now heading to Council, the Polish Ministry of Health chooses to remain silent. Read more.

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BUDAPEST
Budapest changing hospital medicine procurement, stakeholders alarmed.
The Hungarian pharmaceutical market could be fundamentally reorganised following a government decree entrusting the supply of hospital medicines to a ‘project company’ with special rights. The change will take effect in January. Stakeholders are alarmed. Read more.

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SOFIA
Treatment of rare diseases in Bulgaria will be free but conditional and limited. The Bulgarian parliament has adopted a decision requiring the state to pay for the treatment of some patients with rare diseases. The decision follows decades of legal battles and accusations of discrimination. Read more.

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ATHENS
WHO’s ambitious plans to tackle Greek health quality. The first National Strategy on Quality of Care, Patient Safety, and Patient Experience is being developed in Greece. It aims to build, strengthen, and consolidate the quality of care through national policies. Read more.

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BRATISLAVA
Slovakia’s major hospital reforms plagued by delays and controversies. Slovakia’s much-needed hospital reforms aim to create an optimised network of categorised hospitals in Slovakia, ensuring higher quality of provided health care for patients. However, the system is plagued by delays and controversies. Read more.

On the agenda

3 May: Eurostat will publish the latest data on life expectancy by age and sex.

7 May: Employment, Social Policy, Health and Consumer Affairs Council, with a focus on equality issues. Topics dealt with under other business will include the EU’s accession to the Istanbul Convention, the state of play of the Violence Against Women Survey.

7-8 May: Belgian Presidency two-day conference on antimicrobial resistance.

7 May: EMA is organising a Linkedin live discussion between Steffen Thirstrup, Chief Medical Officer, about the development and therapeutic use of psychedelics to address mental health issues.

[Edited by Zoran Radosavljevic]

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