52 Amendments of Nicolás GONZÁLEZ CASARES related to 2023/2075(INI)
Amendment 50 #
Motion for a resolution
Recital A
Recital A
A. whereas non-communicable diseases (NCDs) are diseases that are not passed from person to person; whereas non-communicable diseases (NCD’s)NCDs cause 90 % of all deaths in the EU4 ; _________________ 4 World Health Organization, ‘Monitoring noncommunicable disease commitments in Europe 2021’, 8 December 2021. and their prevalence continues to grow across the EU and cause a great burden on people living with NCDs and their families, healthcare systems and national budgets;
Amendment 63 #
Motion for a resolution
Recital B
Recital B
B. whereas premature deaths as a result of cardiovascular diseases (CVDs), cancers, diabetes and chronic respiratory diseases account for 68 % of all premature deaths in Europe; whereas other NCDs include mental and neurological disorders, kidney, liver and gastrointestinal diseases, oral diseases, osteoporosis, osteoarthritis and endometriosis among other conditions;
Amendment 73 #
Motion for a resolution
Recital C
Recital C
C. whereas NCDs account for the largest shparet of countries’ healthcare expenditures, costing EU economiesand are predicted to result in annual economic costs of EUR 115 billion, or 0.8 % of GDP annually as well as entailing other societal costs such as loss of productivity and workforce, all of which could be reduced through the implementation of measures aimed at increasing the early detection and optimal management of NCDs; whereas in 2018, no more than 2.8 % of total health expenditure in the EU was spent on prevention, whereas the costs of treating NCDs remains high5 ; _________________ 5 European Commission, ‘Healthier together – EU non-communicable diseases initiative’, p. 15, June 2022., despite most of these costs being preventable;
Amendment 82 #
Motion for a resolution
Recital D
Recital D
D. whereas the increasing burden of NCDs on individuals and societies and the health needs of ageing populations 40% of which live with multimorbidity represent challenges to the healthcare systems of the Member States, and require the development of specific NCD prevention, detection and treatment policies contributing to healthy ageing;
Amendment 107 #
Motion for a resolution
Recital E
Recital E
E. whereas most NCDs are impacted by fourseveral preventable risk factors, including: tobacco use, unhealthy diet, lack of physical activity and, harmful use of alcohol; whereas behavioural risk factors lead to biological risk factors, the most common being overweight and obesity, high BMI, high blood pressure, high blood glucose, and high blood cholesterol6 ; _________________ 6 World Health Organization, ‘Monitoring noncommunicable disease commitments in Europe 2021’, p. 13, 8 December 2021. and dental caries; whereas these risk factors often overlap, giving rise to severe complications and increased risk of developing other NCDs;
Amendment 134 #
Motion for a resolution
Recital F
Recital F
F. whereas most NCDs are impacted by environmental risk factors, such as air pollution;indoor and outdoor air pollution, and multiple global environmental changes, including climate change and biodiversity loss
Amendment 146 #
Motion for a resolution
Recital F a (new)
Recital F a (new)
Fa. whereas the development of NCDs and resulting health outcomes are significantly related to the socio-economic determinants of health;
Amendment 167 #
Motion for a resolution
Recital G a (new)
Recital G a (new)
Ga. whereas NCDs such as cardiovascular disease, diabetes and obesity are highly complex and interconnected conditions with a multitude of expressions and causes, exacerbating their respective morbidity and mortality;
Amendment 170 #
Motion for a resolution
Recital G b (new)
Recital G b (new)
Gb. whereas NCDs, such as obesity and diabetes, also increasingly affect children1, which requires a dedicated approach to prevention and management;
Amendment 173 #
Motion for a resolution
Recital G c (new)
Recital G c (new)
Gc. whereas not all NCD cases can be prevented, as some factors are not modifiable, such as age, family history, gender, ethnicity, genetics, auto-immunity (e.g., type 1 diabetes) and/or not known (e.g., some neurological disorders, such as Parkinson’s disease);
Amendment 174 #
Motion for a resolution
Recital G d (new)
Recital G d (new)
Gd. whereas people living with one or more NCDs were one of the most severely affected population groups during the COVID-19 pandemic;
Amendment 175 #
Motion for a resolution
Recital G e (new)
Recital G e (new)
Amendment 178 #
Motion for a resolution
Recital H
Recital H
H. whereas innovation with regard to development of technologies, medicines and healthcare practisces is crucial toin ensureing the elimination or reduction of harm caused by preventable risk factors, early detection integration of care, improved disease management, and new and better treatments for NCDs;
Amendment 191 #
Motion for a resolution
Recital H a (new)
Recital H a (new)
Ha. whereas the development of NCDs and resulting health outcomes are linked to commercial and social determinants of health. These underlying factors correspond to substantial health inequities within and across EU countries;
Amendment 198 #
Motion for a resolution
Recital H b (new)
Recital H b (new)
Hb. whereas the European Parliaments’ resolution on prevention, management and better care of diabetes calls on Member States to develop, implement and monitor national diabetes plans and strategies with comparable milestones and targets, including a risk- reduction and screening/early action component;
Amendment 204 #
Motion for a resolution
Recital H c (new)
Recital H c (new)
Hc. whereas the Commissions Healthier together – EU non- communicable diseases (NCD) initiative emphasises the need for a more coordinated, integrated and transversal action on NCDs, through ambitious targets at EU level in order to provide a stronger response to the increasing burden of NCDs;
Amendment 208 #
Motion for a resolution
Paragraph 1
Paragraph 1
1. Highlights that NCDnon-communicable diseases account for 90 % of all deaths in the EU8 ,, most of which are preventable and which leads to high levels of productivity loss and makes NCDs account for the largest share of countries’ healthcare expenditures; stresses that it is important to reduce the prevalence of NCDs andthrough early diagnosis and screening, including through the implementation of integrated health checks, especially for at-risk individuals, at the primary care level and through better disease management; believes that enhanced health promotion and disease prevention can reduce the prevalence of NCDs by 70 %9 in conjunction with% as well as investment in health innovation and technologies; _________________ 8 European Commission, ‘Non- communicable diseases : overview’. 9 European Commission, ‘The EU ‘Healthier Together’ Non-Communicable Diseases Initiative’, 2022
Amendment 219 #
Motion for a resolution
Paragraph 1 a (new)
Paragraph 1 a (new)
1a. Highlights that beyond mortality, NCDs represent a major burden on the quality of life of citizens living with NCDs, as well as their families and carers;
Amendment 221 #
Motion for a resolution
Paragraph 2
Paragraph 2
2. Welcomes the ‘Healthier together – EU non-communicable diseases (NCD)’ initiative, Europe’s Beating Cancer Plan, the EU4Health work programme and the Commission Ccommunication entitled ‘A comprehensive approach to mental health’; calls on the Commission to strengthen the ‘Healthier together – EU NCD’ initiative by introducing a holistic and integrated EU strategy on NCDs complemented by action plans for specific NCDs with high morbidity and mortality (such as cardiovascular disease, diabetes, chronic respiratory diseases and neurological disorders), and that include the implementation of measures across all stages of the diseases, including actions to improve early detection and screening as well as disease management; welcomes the national plans and actions already taken against NCDs by Member States, and calls on the European Commission to facilitate knowledge sharing and the scale up of good practices introduced by existing national plans across other Member States;
Amendment 238 #
Motion for a resolution
Paragraph 2 a (new)
Paragraph 2 a (new)
2a. Acknowledges that socio-economic factors and health inequities increase the risk of NCDs and underlines the need to create favourable conditions that address socio-economic and environmental determinants, with policies and actions beyond health.
Amendment 242 #
Motion for a resolution
Paragraph 2 b (new)
Paragraph 2 b (new)
2b. Acknowledges the efforts of the European Commission to support Member States in reducing the burden of NCDs with the launch of the ‘Healthier together – EU non-communicable diseases initiative (NCD)’ in December 2021; but calls for more ambitious action at EU level not only to revert the rising number of people living with NCDs but also to improve quality of life and well- being of people affected by NCDs;
Amendment 254 #
Motion for a resolution
Paragraph 3
Paragraph 3
3. 3. Acknowledges that tobacco use, physical inactivity, the harmful use of alcohol, unhealthy diets and, environmental factors such as air, food, water and soil pollution and, chemical exposure increase the risk of NCDs10 ; _________________ 10 https://www.paho.org/en/topics/n, and socioeconcommu nicable-diseases - :~:text=These%204%20groups%20of%20d iseases,of%20the%20response%20to%20N CDs The Pan American Health Organization, ‘Noncommunicable Diseases’ic determinants of health substantially increase the risk of NCDs.
Amendment 385 #
Motion for a resolution
Paragraph 8 – introductory part
Paragraph 8 – introductory part
8. Notes that an unhealthy diet is one of the major risk factors for NCDs, including cardiovascular diseases, cancer, diabetes, oral diseases and other conditions linked to obesity15 ; acknowledges that obesity is considered a risk factor for several NCDs; calls on the Commission and the Member States to: _________________ 15 World Health Orgaa) encourage and help consumers to make informed, healthy choices about food products; promote behavioural changes via communizcation Regional Office for the Eastern Mediterranean, ‘and mass media campaigns for healthy diets; encourage public food procurement and service policies for healthy and sustainable diets; b) Recommends the EU Member States to adopt the WHO guidelines on healthy diet by all European countries, as part of a shared commitment to address the burden of Nonc-Communicable diseases’.Disease c) propose a new action plan for obesity; d), enhance the availability, affordability, and accessibility of nutritional care provided by dietitians and nutritionists
Amendment 458 #
Motion for a resolution
Paragraph 9
Paragraph 9
9. Highlights the role of physical activity in NCD prevention and welcomes the Commission’s HealthLifestyle4All initiative; calls on the Commission and Member States to promote physical activity and awareness campaigns to prevent NCDs; recognizes that improving population lifestyle choices is not enough to tackle the burden of NCDs, and while primary prevention plays a crucial role in reducing the incidence of many types of NCDs, secondary prevention is key for the optimal management of chronic diseases and contributes to reduce the risk of complications, comorbidities and death; stresses that a holistic approach to NCDs care pathways should be reflected in national NCDs plans and strategies, which include clear implementation roadmaps;
Amendment 462 #
Motion for a resolution
Paragraph 9 a (new)
Paragraph 9 a (new)
9a. Notes that a large part of NCDs- related deaths are preventable; notes that, in addition to health promotion and primary prevention, screening and early detection, especially for at-risk individuals, are critically important to reduce premature deaths from NCDs such as cardiovascular diseases, diabetes and obesity; stresses that secondary prevention strategies targeted toward known common metabolic risk factors are crucial to best support patients and improve the quality of life of people living with these diseases;
Amendment 466 #
Motion for a resolution
Paragraph 9 b (new)
Paragraph 9 b (new)
9b. Calls on Member States to develop tailored national plans to address the specificities of different subcategories of NCDs, including specific plans for highly prevalent diseases, with high mortality and morbidity rates, such as cardiovascular diseases, diabetes and obesity.
Amendment 473 #
Motion for a resolution
Paragraph 10
Paragraph 10
10. Considers the European Green Deal to be instrumental in preventing NCDs in the EU by reducing air, food, water and soil pollution and chemical exposure; highlights that prevention ofve measures for chronic respiratory diseases besidesother than tobacco cessation, also includes the prevention of exposure to dust and other indoor pollutants” and recommends the full alignment of EU Air Quality Standards with the WHO Air Quality Guidelines for all major pollutants;
Amendment 481 #
Motion for a resolution
Paragraph 10 a (new)
Paragraph 10 a (new)
10a. Highlights the importance of NCD prevention and early intervention; acknowledges that many NCDs have their origins in early childhood and the importance of investing in strategies and programmes that promote children’s healthy growth and development, from infancy and early years;
Amendment 505 #
Motion for a resolution
Paragraph 12
Paragraph 12
12. Stresses that per- and polyfluorinated alkyl substances (PFAS) can lead to health problems such as diabetes, obesity and cancer16 ; calls on the Commission to implement the PFAS restriction proposal submitted to the European Chemicals Agency on 13 January 202317 ; _________________ 16 European Environment Agency, ‘What are PFAS and how are they dangerous for my health?’. 17 European Chemicals Agency, ‘ECHA publishes PFAS restriction proposal’, 2023.;
Amendment 545 #
Motion for a resolution
Paragraph 14 a (new)
Paragraph 14 a (new)
14a. Recognises the impact that the permacrisis, including the COVID-19 pandemic, Russia’s war of aggression against Ukraine, climate change, and the energy crisis, have on the insufficient actions taken on NCDs; calls on the Commission and Member States to prioritise NCD prevention and management as this would strengthen the resilience of healthcare systems and prepare for future shocks;
Amendment 559 #
Motion for a resolution
Paragraph 15
Paragraph 15
15. Highlights the importance of identifying people with a high risk of developing NCDs -for example the elderly population- and diagnosing people as early as possible, for instance through the implementation of early detection programmes and health checks at primary care level in order, especially for at-risk individuals, to improve disease management, prevent life-altering complications and save downstream costs for healthcare systems;
Amendment 579 #
Motion for a resolution
Paragraph 16
Paragraph 16
16. Encourages the Member States to reduce undiagnosed NCDs by introducing targeted health checks for high-risk individuals, addressing the main shared metabolic risk factors, ensuring timely access to high-quality care and supporting NCD patients’ self- management; calls for the implementation of accessible and equitable self-management tools, including peer support networks, collaborative care platforms, and mental health services, considering factors like technology access;
Amendment 597 #
Motion for a resolution
Paragraph 17
Paragraph 17
17. Notes that some NCDs are closely linked such as diabetes, oral diseases and cardiovascular diseases or cancer and depression, and that important synergies can be achieved by improving diagnosis and integrated care19 ; _________________ 19 European Commission, ‘Healthier together – EU non-communicable diseases initiative’, p. 30, June 2022.;
Amendment 604 #
Motion for a resolution
Paragraph 17 a (new)
Paragraph 17 a (new)
17a. Calls on Member States to develop, implement and monitor national NCD prevention plans that include risk reduction and secondary screening programmes for at-risk populations;
Amendment 614 #
Motion for a resolution
Paragraph 18
Paragraph 18
18. Stresses that nurses, doctors, general practitioners and other primary care professionalsdietitians and nutritionists, dental health professionals, pharmacists and other healthcare professionals, as well as patient organisations and the third sector at large have a significant role in referring patients for diagnostic tests, supporting and treating NCDs; encourages the Member States to offernotes that for some NCDs, -for example obesity-, relevant training is not comprehensively included in the curricula, which creates a barrier to provide effective care services; encourages the Member States to offer competency- based, inter-professional training to healthcare professionals toso that they can better identify high-risk individuals and treat NCDs;
Amendment 633 #
Motion for a resolution
Paragraph 18 a (new)
Paragraph 18 a (new)
18a. Encourages the Commission and Member States to embed engagement with patient organisations and people living with NCDs into all activities and initiatives related to the design and implementation of prevention and care activities;
Amendment 639 #
Motion for a resolution
Paragraph 18 b (new)
Paragraph 18 b (new)
18b. Believes that the high interconnection between some NCDs, such as diabetes, cardiovascular diseases, renal diseases, obesity and mental health requires a holistic and integrated approach, complemented by disease specific priorities for action; notes the potential benefits of a comprehensive strategy, taking into account disease progression over the life course; calls on the Commission to develop an NCD prevention and management blueprint, complemented by disease-specific programmes including clear targets, benchmark indicators and a monitoring framework;
Amendment 641 #
Motion for a resolution
Paragraph 18 c (new)
Paragraph 18 c (new)
18c. In line with a (mental) health in all policies approach, acknowledges that providing integrated care and support, in collaboration with local social and community services, is essential, as health and social needs are often intertwined;
Amendment 645 #
Motion for a resolution
Paragraph 18 d (new)
Paragraph 18 d (new)
18d. Emphasises the need to deploy person-centred and fully integrated care across the entire chronic diseases care pathway and to strengthen community and priority care, with a focus on chronic diseases requiring access to care across specialties and care levels such as diabetes;
Amendment 657 #
Motion for a resolution
Paragraph 19
Paragraph 19
19. Believes that every patient is different and that no NCD is the same; calls for NCDs to be prevented and treated as effectively as possible, with a personalised, integrated and evidence- based approach tailored to the patient and the disease;
Amendment 673 #
Motion for a resolution
Paragraph 19 a (new)
Paragraph 19 a (new)
19a. Recommends formulating comprehensive guidelines to enhance NCD management within primary care settings, with an emphasis on advocating for consistent and efficient treatment approaches;
Amendment 682 #
Motion for a resolution
Paragraph 19 b (new)
Paragraph 19 b (new)
19b. Notes that improving disease management, notably through therapeutic adherence, and reducing complications of NCDs plays a key role in improving health systems’ resilience and preparing for future health crises;
Amendment 688 #
Motion for a resolution
Paragraph 19 c (new)
Paragraph 19 c (new)
19c. Calls on Member States to continue investing in innovation in NCDs care, in order to reduce overall morbidity, mortality and the quality of life of patients; calls on the European Union to support more these investments through EU funding mechanisms, such as the EU4Health and Horizon Europe programmes;
Amendment 692 #
Motion for a resolution
Paragraph 19 d (new)
Paragraph 19 d (new)
19d. Believes that the high interconnection between some NCDs, such as diabetes, cardiovascular diseases, renal diseases, obesity and mental health requires a holistic and integrated approach, complemented by disease specific priorities for action; notes the potential benefits of a comprehensive strategy, taking into account disease progression over the life course; calls on the Commission to develop an NCD prevention and management blueprint, complemented by disease-specific programmes including clear targets, benchmark indicators and a monitoring framework;
Amendment 698 #
Motion for a resolution
Paragraph 19 e (new)
Paragraph 19 e (new)
19e. Calls on the Commission to support Member States in reviewing national models of care with a focus on prevention-oriented primary care systems and the upskilling of primary care professionals, through the Recovery and Resilience Facility, guided by the European Semester process, to reduce inequities across Member States, and improve the resilience of national health systems;
Amendment 714 #
Motion for a resolution
Paragraph 21
Paragraph 21
21. Notes the need to focus on the quality of life of NCD patients whose illnesses cannot be cured but may be stabilised for a number of years; emphasises the importance of specific EU recommendations to improve the quality of life of patients, including by integrating comprehensive supportive and psychological care into care, starting with the diagnosis and continuing over the course of the disease and by granting access to specialised support centres;
Amendment 742 #
Motion for a resolution
Paragraph 22 a (new)
Paragraph 22 a (new)
22a. Calls on Member States to identify and remove policy barriers to optimal NCDs care, improving adherence to clinical guidelines and reducing the risk of complications;
Amendment 769 #
Motion for a resolution
Paragraph 24
Paragraph 24
24. Calls on the Commission to strengthen support and investment in the development of, and access to, new innovative medical devices, and to support the digitalisation of national health services; believes that new technologies and digitalisation can lead to new and better treatments formanagement and treatments for NCDs as well as improved quality of life for people living with NCDs;
Amendment 803 #
Motion for a resolution
Paragraph 26
Paragraph 26
Amendment 816 #
Motion for a resolution
Paragraph 27
Paragraph 27
27. Calls on the Commission to create a European NCD Health Knowledge Centre to improve data collection and research on NCDs; encourages Member States to exchange best practices on prevention, management and care of NCDs in relevant forums; stresses the need for further research in NCD co-morbidities and management; calls on Member States to put in place NCD-specific data registries;
Amendment 823 #
Motion for a resolution
Paragraph 27 a (new)
Paragraph 27 a (new)
27a. Believes that good quality data and evidence are crucial and that correlating health data with social, economic, and environmental data, and strengthening the equity elements of existing health monitoring systems, such as European Health Data Space, will support the development of evidence-based and targeted policies and interventions for improved health equity;
Amendment 832 #
Motion for a resolution
Paragraph 28
Paragraph 28
28. Welcomes the Commission Expert Group on Public Health and the sub-group on NCDs; calls on the Commission to establish a European expert network for the prevention and control of NCD -co- morbidities and complications, that includes people with lived experience;