Roma, 20 dic. – Non communicable diseases (NCD) and prevention
Good morning and welcome to the new episode of Askanews EU Verified Series. In the previous series, we interviewed members of the European Parliament on the priorities of the ENVI committee and the challenges facing Europe in implementing Europe’s Cancer Plan, the plan to fight cancer. In this new series of interviews, we will discuss the European Commission’s Healthier Together initiative, progress in preventing and reducing the harm from non-communicable diseases (NCDs), and what we can expect after the approval of the dedicated report by the European Parliament.
I am Lorenzo Peiroleri, editor of Askanews, and I am pleased to host the first interview with our guest, Member of the European Parliament from the European Conservatives and Reformists Group, Pietro Fiocchi, a member of the ENVI Committee and the SANT Subcommittee. Good morning, Mr. Fiocchi.
Fiocchi: Good morning, everyone.
On the 13th of December, the report ‘Non-communicable diseases’ was approved in plenary. It refers to those diseases that are not transmitted from person to person, such as cardiovascular diseases, cancer, diabetes and chronic respiratory diseases. What do you consider to be the most relevant outcomes of this report?
Fiocchi: Let’s say that this vote confirmed what was in the BECA report, which is the European cancer strategy. So, it’s true that NCDs are expanding because it doesn’t only address cancer but also a range of other very important diseases, including cardiovascular diseases, which are the leading cause of death in Europe, even more than cancer. However, the BECA’s approach has been confirmed, and this is very interesting. There will be a lot of work at the European level because, let’s remember, Europe does not have legal power over the health decisions of Member States or regions, but it can certainly provide a significant push with strategies and, above all, can allocate funds to take the necessary actions in the right direction.
The promotion of a healthy lifestyle and early diagnosis are two crucial factors in reducing the prevalence of non-communicable diseases. Do you think that these are issues that are not yet sufficiently sensitised at European level?
Fiocchi: Certainly, there is not enough awareness, in my opinion, especially regarding lifestyle education. To prevent these diseases, education should start even at the elementary school level, something that is not yet done in any European State. Then, of course, there is also another important issue, which is health checks for these diseases. I am particularly focused on cancer screenings, and I must say that Europe unfortunately is uneven in this regard. On certain types of cancer, there are cancer screenings for at-risk populations at 95%, while on other areas, it is at 5%, with the resulting impact on the mortality rates of these types of diseases. We really need to work on this.
Do you think that an approach focused on sharing best practices between Member States is a valid way to accelerate the effectiveness of prevention measures and innovative practices?
Fiocchi: Yes, I am a strong supporter of sharing. Moreover, there is a fantastic European program called Best Practice. European funds are brought to regions to develop the correct protocol to achieve the best results for certain types of pathologies, and if successful, it is then exported to all other European regions. I believe in this because, as I mentioned earlier, there is an incredible difference in the treatment of certain diseases depending on the regions. And I am not just talking about Italy with the usual things like Lombardy being good and Calabria not doing well. But even in Germany, there are regions that are really in bad shape. So, from this point of view, standardizing Europe on the control, screening, and treatment of these diseases would be spectacular. The European Best Practice program is truly exceptional.
In the amendments you tabled and voted in the ENVI Commission, some of them refer to harm reduction policies, do you think that this principle could be the key to achieving tangible goals in terms of prevention?
Fiocchi: Well, harm reduction is fundamental because, unfortunately, whether we like it or not, humans are “ugly beasts,” in the sense that they will continue to smoke, drink alcohol, and engage in a whole series of behaviors that are harmful to health. So, banning is impossible because, otherwise, we give space to criminal organizations rather than even worse behaviors. So, I think it’s important to provide alternatives that are less harmful. Therefore, harm reduction, not harm cessation, would be a step forward because if we look at the impact assessments estimated by BECA, the European cancer strategy, with harm reduction alone and preventive interventions, 3.5 million lives can be saved in Europe by 2035.
In an amendment you tabled and which became part of the final text, you recognise the role of electronic cigarettes as a way out of smoking. How do you evaluate the path taken by this legislature in regulating new categories?
Fiocchi: This has been a battle that I fought because there are scientific studies indicating that alternatives to traditional smoking have a lower likelihood of developing lung cancer. So, from this point of view, they are perfectly in line with the indications of the European cancer strategy for risk reduction. So, welcome. The important thing is to continue the trend we are seeing, that traditional smokers are moving towards smoking alternatives, reducing the risk. And this is important. But on many of these issues, such as alcohol, there has been a significant distinction, in my opinion, a very topical and critical distinction in the discussion, between excessive use and moderate use. Because, on the one hand, we have moderate use, which, by the way, is even part of the much-publicized Mediterranean diet as one of the best diets to reduce cardiovascular problems, and excessive use. It’s one thing to have a glass of wine at the table and another to have nine gin and tonics early in the morning. There are significant differences in the use of these substances.
The Parliament has reiterated its previously established position on health topics in BECA, do you consider this to be a clear signal for the Commission to consider when formulating subsequent legislative proposals?
Fiocchi: Certainly. On the one hand, I am pleased to see that most likely, in the next term, they will remove all health-related aspects from the ENVI committee, the Environment Committee, and create a separate committee. In my opinion, it is a necessary step because I can understand wanting to put environment, health, and food safety in the same container. But, in my opinion, for health, we need a separate committee that focuses on all health issues.
Reflecting on the previous report on cancer (BECA) and now on the position taken on non-communicable diseases, how do you assess the developments in the European Parliament?
Fiocchi: There is more attention, there will be even more attention in the next term, and we will move in the right direction. But again, it is also a legal issue because power must be given. In the European Parliament, the Commission cannot issue regulations on these issues because they are the competence of Member States. But it can certainly bring much more attention from the majority of European Parliament members and, indeed, bring funds and projects in the right direction. It will certainly change the approach of many European States. And this is important because then the role of Europe becomes very important in providing leadership in the right direction on all these issues.
I would like to remember my former colleague, unfortunately, she has passed away, Veronique Trillet-Lenoir, who did a lot in this field; she was spectacular. A French doctor, specialized in oncology, who died of cancer. But until the last day, despite her illness, she fought like a lion to advance these issues. I must say, Veronique was spectacular.
I’m very sorry because we interviewed her; the first interview we did two years ago was with her. I’m very sorry about this. Instead, returning to BECA.
One of the subjects you dealt with most was the issue of radon, a naturally occurring radioactive gas that can be found in high concentrations in indoor environments, such as homes and workplaces, and whose exposure increases the likelihood of lung cancer. What could the Member State do to try to mitigate the problem of radon in buildings?
Fiocchi: Unfortunately, Europe has been deaf to my efforts to include, especially in the Regulation on the Energy Performance of Buildings, the issue of radon. Let’s be clear, I lived a lot in America, and already in the 80s in America, the radon issue was perfectly known. Measurements were taken, and if radon was found, you couldn’t rent or sell the house. Instead, we are really behind. In Italy, they have finally developed a very active national radon plan for public buildings and companies, but we are still far behind on private homes. The reason I mentioned the building energy efficiency plan is that if you insulate a building that already has radon problems, it means you keep radon, which is a natural radioactive gas, inside the building. And this is wrong. We should measure and control the presence of radon first and, if positive, take corrective actions because otherwise, you will have a much more energy-efficient building, so you pay less for the bill, but then you get lung cancer. In certain areas of Valtellina, Brescia, Lazio, and Campania, we see peaks that are even 50% higher than the national average of lung cancer. This is something I will fight for like a lion because it is really important.
Last question. What are the main challenges the EU will face in public health and your priorities during the campaign in this field?
Fiocchi: Certainly, Europe is doing the right thing in terms of strategies and fund allocations to provide direction. Let’s remember that there are plenty of funds, and Europe is doing the right thing, investing in new technologies that are less invasive, both diagnostically and therapeutically.
But then there is a very big job to do. On the one hand, on education: we need to have more courage and go in very strongly to talk even with elementary school children. Excuse me, it’s a difficult topic, but we need to tell them, to children, because it’s useless for me to talk to a 5th-year scientific high school student who already smokes and drinks gin and tonic. It’s better to take them earlier and explain to them that maybe it’s better to eat a pear than a snack, that it’s better not to start smoking, etc., with campaigns carried out quite aggressively.
And then, of course, there is the other huge challenge, but that is very difficult: we must improve air and water quality. In the Po Valley, air quality is a very big problem, we know it very well, and it gives rise to a whole series of pathologies that are difficult to control. The solution is not simple; it is a long-term job that will require a lot of commitment.
We thank MEP Pietro Fiocchi for the time he has dedicated to us and for the numerous topics we have addressed. We wish you good work and continuation, and we all look forward to the next episode of Askanews EU Verified Series.
