Public health in the new European Union research programme.

The new programme reflects the lobbying and interests of many interested parties, including national research councils, industry, professional organisations , and politicians. Over the past 20 years, EU research programmes have given increasing prominence to health. The new programme has health as its first " priority thematic area " , with a budget of 2.3 billion euro over six years. But almost all of this budget will be for biotechnology research: epidemiology and public health have not fared well in the programme. 1 A positive development has been creation of a new broad field of research—to support policy (http://fp6.cordis.lu/fp6/ call_details.cfm?CALL_ID=17). The Commission's research directorate took the innovative step of asking other policy directorates to propose areas for research. One of the three sections for policy research is entitled " Providing health, security and opportunity to the people of Europe ". The health directorate (Sanco) has a new public health action programme 2 for the parallel period 2003– 2008, addressing a broad range of issues. But the limited set of topics proposed for health policy research—communicable diseases, rare diseases, blood products and organ donation—have been on San-co's agenda for some years. A second dimension for health policy research has been the growing interest of the Commission's employment and social affairs directorate in health care. 3 There are various converging strands: interest of the Council of Ministers of Health during both the Belgian and Spanish presidencies, anxieties for funding social insurance in aging societies, and the recognition (following decisions by the European Court of Justice) that cross border care is a legal right for EU citizens. While health care had previously been considered, under article 152 of the Treaty of Amsterdam, to be a responsibility only for member states, it is now acknowledged to fall within EU law on the internal market, including competition and free movement. The Commission's employment and social affairs directorate sent a questionnaire during 2001 asking member states to indicate their concerns about health care at EU level. The replies will form the basis for a report from the directorate on health and health care planned for March 2003. Some issues have been rec-ognised for many years, for example, the impacts of new technologies on health care costs, the increasing knowledge and demands of patients, the rising proportion of elderly people. Other issues were more specific: keeping universal access in the face of rising costs; concern for waiting …