#עאַפּם: דזשונקקער דורך די זוכט גלאז ...

At the European Alliance for Personalised Medicine (EAPM), we are not particularly famous for being able to see into the future, although some things are obvious to EAPM and our stakeholders, as well as to politicians and the public at large, שרייבט עאַפּם אויספֿיר דירעקטאָר דעניס האָרגאַן. 

Well, at least they should be…  In an EU of currently 28 member states with an ageing population of some 500 million, it is not too difficult to figure out that, aside from the so-called pensions cliff - we are living much longer than populations were 100 years ago - there is also the likelihood that most of us will eventually find ourselves suffering from not one, but two or even more diseases towards the end of our lives.

This multiple-disease scenario is called co-morbidity and what this in effect means is that a great number of us will be receiving multiple treatments at the same time, which of course has a societal cost as well as a personal one for the patient involved.

While it is generally accepted that a healthy nation leads to a wealthy nation, there are still obvious added health-care costs to soak up as a population gets older and, with the new phenomenon that is the aforementioned co-morbidity, we are really in new territory when it comes to how a patient’s quality of life will be affected by being prone to several diseases as he or she ages.

We will all have to accept these facts, one way or another, like it or not, as well as the reality that we may spend the latter part of our lives taking several drugs and undergoing more than one treatment as time marches on.   The strain on both patients and the EU’s healthcare systems could be immense, but not enough is being done to take the (very near) future  into account at either EU or national level.

Europe is suffering from clearly evident inequalities when it comes to access to the best healthcare available - the right treatment for the right patient at the right time, in effect.

Let’s try a bit of more-specific crystal-ball gazing: in November 2019 European Commission President Jean-Claude Juncker could well step down (he will be coming up to 65-years-of-age). But what if this were because of ill health, a scenario that may well make him sit up (if he can) and think that perhaps he should have done more to safeguard the health of the EU citizens in his charge during the five years in which he had the opportunity to do so?

אַדווערטייזמאַנט

Perhaps a little backtracking is necessary here, first: In the 1980s, Juncker served under Jacques Santer as Minister of Labour, before spending two weeks in a coma after a serious traffic accident. He recovered to become Minister of Finance and, from 1995 to 2013, he was the 23rd prime minister of Luxembourg as well as holding the post of Minister for Finance between 1989 and 2009.

He has also previously acted as Luxembourg's representative on the 188-member board of governors of the World Bank.  By the time he left prime ministerial office in his home country, he was the longest-serving head of any national government in the EU, and one of the longest-serving democratically elected leaders in the world.  Given that impressive career it’s probably safe to say that, compared to most of the population of Europe, Commission President Juncker is not exactly strapped for cash.

But - back to our crystal ball - what if his ailing health and the rare condition (or conditions) he’s suffering from in our imaginary future could possibly be best treated in, for example, Asia, because a clinical trial is ongoing there that nobody could get into in Europe? That could cost a fair bit.

Or what if bureaucracy now stood in his way as an ‘ordinary’ citizen and what if access to an all-important, perhaps life-saving, trial were being denied him on his doorstep due to bureaucracy and the unavailability of the kind of data that would have allowed the development of a trial in his native Luxembourg or, indeed, a neighbouring EU country?   Imagine that ex-president Juncker’s own doctor has recommended that, due to his conditions, he should be living in a European country with a warmer climate. So our man Jean-Claude has a look around and decides that Greece fits the bill - at least theoretically.

However, Greece suffered harshly during the financial crisis, notably in the area of healthcare for its citizenry and there may well be a dearth of public services in that arena for a long time down the line - due in great part to the slashing of public budgets at the behest of, you guessed it, the European Commission of which he was once head.

Not to worry, as a former politician our ill Mr Juncker may well want to try to galvanize patient groups into attempting to force changes, but to his dismay he finds this easier said than done - there may not be the will on the ground due to disillusionment and, anyway, there’s all the bureaucracy to get through even if anyone high up is actually listening. Which they may not be.  And as Greece is so under the financial cosh, maybe the local pharmacy can’t even get his necessary medicines. So where does he go? Can he get it ‘in the black’ from another member state and, if so, will it even be effective?

Tough one…  Perhaps he can go cross-border himself. Even though that would be expensive and also steeped in bureaucracy surrounding E112, electronic health records, and more. Remember, he doesn’t have the power to break down these barriers any longer. Theoretically, he’s just an ordinary guy aged 65 or more.  It’s not looking too good for the former European Commission president in this scenario, is it?  But, in this case, it is simply one that EAPM has imagined for Mr Juncker.

Unfortunately, for many people across the EU’s member states it is not merely a scenario but a grim reality. Therefore, crystal ball or no crystal ball, the Alliance believes that now is the time for the European Commission to deal with the harsh health facts in the here-and-now, as well as down-the-line into the fast-approaching future.

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