< Previous30TRACK II - ADVANCING INNOVATIONEHFG 2020 CONFERENCE REPORT Unlocking the potential of data in light of early lessons from COVID-19 Organised by the European Centre for Disease Prevention and Control (ECDC) the importance of collaboration between the European Commission, ECDC, and Member States to find joint solutions and foster health systems resilience. The importance of ECDC was also reinforced as a key element of the European Commission’s plan to bolster EU action on health, on the path towards a ‘European Health Union’ with an increased budget and bigger mandate for EU health agencies. Upcoming plans also include a revised cross-border healthcare directive for better coordination, building a common approach to data standardisation to increase comparability, and the improvement and harmonisation of surveillance systems. Mike Ryan, Executive Director, WHO Emergencies Programme and Andrea Ammon, Director, ECDC, expanded on the need to address weaknesses in the overall data ecosystem, stressing that a simple prescription of ‘more data’ is often not the solution. “The problem is not data per se – the problem is how we source, collate, manage, and use that data”, Ryan pointed out. We cannot ‘blame the data’ if we are lacking useful information, but we might have to go back to the drawing board to ensure that current data systems are designed to deliver precisely what we need in the fight against a novel disease. Identifying and collecting the right kind of data, analysing it and turning it into valuable information for policymaking are all pieces of a highly complex puzzle – even more so when trying to measure a ‘moving target’ during a fast-paced international health emergency. Talking about the European dimension, Ammon stressed the impact of standardisation (and the lack thereof), as well as the importance of timing. To build epidemiological surveillance, our backbone against communicable diseases, it is not only necessary to collect the right data, but to make sure it is transferable across borders and ready to be used for action in a timely manner. Data barriers exist within health systems as well as between countries, and a lack of cooperation owing to Innovative digital solutions for comparable data, strong health systems and good decision-making On the surface, we have never been better prepared to tackle a global health crisis demanding the swift exchange of comparable information: capacities to generate, store, and share health-related data have continuously grown over the last few decades. At the same time, ensuring that the data we gather brings actual benefit to people and translates into coordinated action on our biggest challenges is still proving to be a daunting task. In the framework of the first fully digital European Health Forum Gastein, the European Centre for Disease Prevention and Control (ECDC) organised a session focused on how early learnings from the COVID-19 pandemic, in particular on the role of data, could lead to stronger, more resilient and prepared health systems in the future. As pointed out by the moderator, Nick Fahy, Senior Researcher, University of Oxford, the discussion on data has permeated all of society during the COVID-19 crisis. Citizens, often for the first time, have started to engage with the data narrative and had to deal with an almost unprecedented level of public communication of health data on a regular, even daily, basis. However, the pandemic has also exposed that we still have a long way to go to when it comes to using health data effectively and efficiently. In this session, panellists set out to chart a course towards this goal, armed with learnings from the side of international organisations as well as national experts. Lessons learned at the institutional level: experiences from EU, ECDC and WHO The first part of the session, dedicated to the international dimension, featured high-level representatives of three key supranational bodies: the European Commission, the ECDC and the WHO. Stella Kyriakides, EU Commissioner for Health and Food Safety, opened the panel by pointing out that data is not just numbers: Behind the numbers there are stories, people and families. Making sure that we learn from the current crisis is crucial, and Commissioner Kyriakides highlighted particularly 31TRACK II - ADVANCING INNOVATIONEHFG 2020 CONFERENCE REPORT divides and resource gaps can present additional obstacles, especially during a highly politicised crisis. Speakers summed up potential solutions to our roadblocks in reaching data’s full potential: • Improving standardisation and interoperability e.g. through the creation of a global ‘minimal’ standardised data set; • Facilitating data collection through smart reduction of human inputs, enabling more direct data collection and reducing the stress on overworked health professionals; • Better use of innovation to enhance data potential, such as algorithms for better case definition; • Speeding up data sharing and transfer through Electronic Health Records, while being mindful of data ownership and privacy protection; • Integrating different data systems within individual health systems: better integration of laboratory data, clinical data, and public health data will be crucial to help countries fight COVID-19. It is vital to tackle these aspects now, panellists agreed, and reminded us of past successes through surveillance efforts, such in the fight against smallpox and polio. “Data CAN defeat disease”, summarised Ryan - if we use learnings from the current crisis to foster increased collaboration bolstered by innovation and technology. National perspectives and experiences Sotirios Tsiodras, Professor of Internal Medicine and Infectious Diseases, University of Athens, highlighted the potential of accurate data to provide predictive models that can be useful for policy definition and implementation. However, researchers have faced challenging times during the crisis, affected by media pressure to share updated information at a rapid pace while needing to sift through a mountain of data as well as an increasing number of non-peer-reviewed publications. Tove Fall, Professor in Molecular Epidemiology, Uppsala University, brought attention to the issue of inequity in the way data is gathered, discussing how COVID-19 test centres have often proven disproportionally hard (or even impossible) to reach for the poorest citizens. Digital innovation can help to mitigate some data inequalities: Fall presented insights based on the use of a dynamic COVID-19 experience app, used by over 200.000 people and giving citizens the chance to record Session recording Programme a wide range of information wherever they are. Isabel de la Fuente Garcia, pediatrician at the Centre Hospitalier de Luxembourg, described the challenges faced by a country with a large population of cross-border workers. Keeping up an effective epidemiological surveillance system amid high regular volumes of cross-border traffic is a challenging task, and one that cannot succeed without strengthening cross-border cooperation, cohesion and data standardisation. What’s next? Data collection and analysis remain vital for effective public health measures, and the need for a unified strategy and common ‘language’ to interpret data stands out clearly. Three overarching concepts - the three Cs - characterised the session’s debate and gained consensus amongst speakers and participants as the building blocks for unlocking the full potential of data: Coordination, Collaboration and Communication. Only by building a basis for joint action throughout the data ecosystem, from researchers to private companies to policymakers to citizens, can we ensure that the wealth of data we have at our disposal will serve to improve health for all - across Europe and beyond. Learn more32TRACK III - FROM DATA TO DECISIONSEHFG 2020 CONFERENCE REPORT “Europe Beats” Cancer Plan Dancing with the elephants Organised by the European Federation of Pharmaceutical Industries & Associations, European Cancer Patient Coalition and European Cancer Organisation The first session of the digital EHFG 2020 kicked off by focusing on the key health theme of the 2019 European elections, and what seemed to be the cornerstone of the 2019-2024 mandate: Beating Cancer. In the session, the European cancer community teamed up to discuss the burning political questions: What should be the core of Europe’s Beating Cancer Plan and its implementation? How do we make sure patients benefit from it? And of course, pointing to the elephant of 2020: What is the impact of the COVID-19 pandemic on cancer care? Setting the Cancer Scene Bengt Jönsson, Associate Professor at the Stockholm School of Economics, painted the scene with the latest statistics on cancer care. While he praised the significant advances in prolonged survival in the past decades, he also warned about ageing societies and the ever-growing cancer burden. He stated that although average spending on cancer care remains fairly stable, typically about 6-7% of total healthcare spending, further investigation into the allocation of cancer spending is needed, including gathering evidence behind cost-effectiveness claims and assessing the efficacy and equity of cancer care throughout Europe. Cancer at the centre stage, yet again. The first panel focused on priority setting within the busy European cancer policy agenda. Bettina Ryll, Founder of the Melanoma Patient Network Europe, started with underlining that cancer has been at the center of European Policy since the 1990s. Quoting the popular adage “The definition of insanity is to do the same thing and expect different results”, she underlined the need to change the way we are investing in cancer care and addressing key issues. She noted that there are areas which have made significant progress, and yet, some areas such as treatment options for pancreatic cancer keep being heavily underfunded. Ryll pointed out that in a sense the stars have aligned for the goal of improving cancer care at the moment: the Cancer Plan and Cancer Mission of Horizon Europe offer an opportunity for change - one that we should make sure to seize. Stakeholders weigh in One thing is clear, cancer care needs to focus on improved patient outcomes and at the same time enable access to effective technologies, for a price health that systems can afford. Yolande Lievens, Board Member of the European Cancer Organisation, stressed that focus should not be only on treatments and technologies, but also on skills and capability building of healthcare workers. Barbara Wilson, Founder of Working with Cancer, added that cancer care should be more than what happens in the doctor’s office. Wilson stressed that a focus on survivorship and psycho-social and economic support - including supporting patients to go back to work - should be cornerstones of the Plan. Maarten Postma, Professor of Health Economics at the University of Groningen, further highlighted the need for more transparency on decision-making processes and industry practices, which would build trust between different stakeholders to collaboratively address areas of unmet need. Did anyone say Cancer Dashboard? The idea of a Cancer Dashboard was raised as a potential tool to monitor the implementation of Europe’s Beating Cancer Plan. Four pillars – (i) prevention, (ii) detection and early diagnosis, (iii) treatment and (iv) survivorship and quality of life were introduced by Maati Aapro, President of the European Cancer Organsation. Many ideas were added by panellists, including starting with simple indicators and enlarging the data sets over time, proposed by Kathi Apostolidis, President and Antonella Cardone, Director, European Cancer Patient Coalition, and inclusion of all stakeholders (crucially: patients, patients, patients!) in the dashboard-building process, which was stressed by Alexander Roediger, Executive Director of Oncology Policy at MSD. Participants of the session also weighed in via digital polling, and an overwhelming majority agreed that the Dashboard would be an asset to measure progress on the Plan - as well as that it should be public-facing, and its parameters TRACK III - Future formulas33TRACK III - FROM DATA TO DECISIONSEHFG 2020 CONFERENCE REPORT need to be defined in tandem by all stakeholders. The question is though, is this Dashboard going to make the cut in the Commission’s Communication on Europe’s Beating Cancer Plan and more importantly, will the EU4Health Programme be ready to fund this data extravaganza? The Commission has a plan and the Parliament will respond! Sandra Gallina, Deputy Director-General of the European Commission’s Directorate-General for Health and Food Safety assured the audience that despite the pandemic and significant diversion of time and funds, cancer and the implementation of the Cancer Plan remain a priority. A Cancer Dashboard could be a possible tool for monitoring the core activities of the plan. As it is impossible to reach any set objectives without dedicated funds, she pointed to the EU4Health and Horizon Europe’s Cancer Mission. She then moved on to stress that we need to learn from the pandemic and ensure our health systems can deal with such challenges more efficiently. In her conclusion, Gallina called for synergies beyond the health sector and streamlining activities among Member States, to avoid unnecessary duplication while respecting subsidiarity. Romanian MEP Cristian-Silviu Buşoi further elaborated on the importance of the role of the European Parliament, particularly when it comes to bringing equity and fighting inequalities throughout the Union. The establishment of the Special Committee on Beating Cancer (BECA) is a significant landmark in ensuring the delivery of solid Cancer Plan and Cancer Mission that have citizens’ priorities at heart. Additionally, the use of well-established fora such as the MEPs Against Cancer Interest Group and the Challenge Cancer Intergroup are important for bringing the voice of patients, public health associations, healthcare professionals and other stakeholders to the forefront of the decision-making process. In conclusion, there was broad agreement that the momentum to beat cancer has never been higher. However, the panelists urged to guard against complacency, and recognise that the biggest hurdle remains translating this momentum into tangible progress. This session at the EHFG 2020 proposed and developed a pragmatic dashboard to do just that, as after all “what gets measured, gets done”. Learn more Session recording Programme34TRACK III - FROM DATA TO DECISIONSEHFG 2020 CONFERENCE REPORT The advisor’s dilemma Organised by Gesundheit Österreich GmbH (GÖG) COVID-19 has affected all areas of our lives in unpredictable ways. Experts, scientists, politicians, and other decision-makers have faced the dilemma of how and when to act, balancing the need to protect healthcare systems and at the same time keep the economy from collapsing while fighting the unknown virus. This session chaired by Josep Figueras, Director, European Observatory on Health Systems and Policies and Claudia Habl, Policy Officer, GÖG, convened speakers ranging from politicians to scientists and public health experts for a candid discussion. To set the scene, Josep Figueras challenged participants to think about a key question: who are the protagonists in the COVID-19 crisis? Throughout the session, speakers discussed the factors influencing the fight against the virus, which still manifests itself as a fight against time, and highlighted the most challenging aspects affecting the situation overall, as well as each individual group of ‘protagonists’: • The ‘evidence problem’ - How to ensure credible advice in a rapidly changing situation is a question we still do not have easy answers to. Looking back more than 100 years, insights from the situation in 1918, when the world grappled with the Spanish flu, proved useful as a foundation to understanding this dilemma. • Researchers and academia - Asking the right questions and choosing research designs and methods appropriate to the policy questions at hand is important – and ensuring both quality and speed in this regard is not a trivial task. • Policy makers - Finding themselves in a position needing to protect the health system on one hand and the economy on the other is a tricky bind. Decisions cannot be based solely on scientists’ advice but must factor in insights from other sectors and affected areas. • Knowledge brokers - Transparency and communication create trust, as do objectivity and independence form the political process. In short, it is crucial to be clear and honest about the situation, to tell the public what is going on, and not to cover up uncertainties. With greater trust in decision-makers, individuals will be more likely stick to new measures. Trish Greenhalgh, Professor of Primary Care Health Sciences, University of Oxford, pointed to two kinds of problems: those where the parameters and goalposts of evidence-based medicine are easily applicable (such as assessing whether a specific drug can reduce mortality in severely ill patients with acute COVID-19), versus those where etiology, diagnosis, care pathway, treatment and systemic factors are much more complex and contested (such as the phenomenon of ‘Long COVID’). Given the uncertainties surrounding the new virus and the speed at which governments have had to respond, relying on evidence-based medicine during a pandemic seems like it might not always be the most pragmatic approach to adopt. Is it therefore possible that COVID-19 is evidence-based medicine’s nemesis? Panellists and participants of the session agreed that at any rate stubborn adherence to a purely biomedical paradigm cannot suffice to address the threat of a pandemic, or adequately mitigate its syndemic effects. Real-world data observed from pragmatic interventions can complement other forms of evidence such as randomised controlled studies, and honesty about the fact that most data in a complex system will be flawed or incomplete is vital, counselled Greenhalgh. Christopher Fearne, Deputy Prime Minister and Minister of Health, Malta, echoed this sentiment when discussing the relationship between scientific advisors and policymakers from an advisee’s point of view. As this crisis has blurred the line Informed decision making in times of limited evidence?35TRACK III - FROM DATA TO DECISIONSEHFG 2020 CONFERENCE REPORT between politics and policies, the need for advisors to ensure they are giving unbiased recommendations that are grounded in fact has never been more essential. However, to build trust it is just as important to admit to uncertainties and the limits of expert knowledge. “Don’t be afraid to say what you don’t know!”, appealed Fearne. Camilla Stoltenberg, Director General, Norwegian Institute of Public Health, expanded on the theme of trust, moving from trust between advisors and decision-makers to that between decision-makers and the public. In dealing with COVID-19, countries have implemented some of the most intrusive measures ever seen in peacetime and gaining the support of the general population for such measures is no easy feat. Stoltenberg reinforced the message that honesty about knowledge gaps is crucial during a crisis. Public health experts can start this chain of trust-building by being open with policymakers about the fact that when a novel virus starts to spread, we often know far too little and must base advice on previous experiences and projections, while remaining open to changing course when new knowledge emerges. Only when authorities are in turn honest with people about the considerations that new measures are based on, can we build the necessary level of trust. Rafael Bengoa, Co-Director, Spanish Institute for Health and Strategy (SI Health), pointed out that trust has to go both ways between experts and decision-makers. If expert opinions are not sought out or listened to by policymakers, scientists may find themselves needing to exert pressure via other channels such as public media and independent investigations. Bengoa urged administrations to take this crisis as an opportunity to proactively open their decisions and become more accountable to social scrutiny. Herwig Ostermann, Executive Director, Gesundheit Österreich GmbH, discussed how our response to the pandemic has already shifted over time: in the first naïve phase, physicians were the experts most actively consulted. However, we then shifted toward a response more focused on public health, with relevant experts increasingly brought into advisory panels. It seems that many countries have started to recognise the need to move away from a purely biomedical academic approach and are aiming for an increasingly societal and systemic response to COVID-19, acknowledging the weight of public responsibility and syndemic effects of the virus. Participants of the session weighed in on the debate as well via interactive polls: a majority believed that quick information during a global health crisis is often more vital than fully evidence-based advice at a later stage, that disclosure to the public of all that is known (and all that is not known!) by decision-makers is vital, and that politicians carry a crucial mandate to lead communication in pandemic times, while teams of experts as defined in generic preparedness plans should probably play a bigger role in overall crisis coordination in the future. COVID-19 has been one of the greatest challenges of modern times, and tensions between science and politics, between leaders and the public, and between individual countries have come to the fore more than once. As we are slowly developing our response and increasing our knowledge around the virus, we need to be comprehensive and understand that it is acceptable not to have the perfect answers and all the solutions. As summarised by Greenhalgh: “In this pandemic, and in complex systems more generally, we cannot wait for perfect evidence. We must share our uncertainties, consider multiple interpolations of partial evidence and make ethically grounded, pragmatic decisions while carefully evaluating their impact.” Learn more Session recording Programme36TRACK III - FROM DATA TO DECISIONSEHFG 2020 CONFERENCE REPORT Pharmaceutical Strategy for Europe Organised by the Directorate-General for Health and Food Safety of the European Commission The Pharmaceutical Strategy for Europe is an EU initiative aimed at both improving patients’ access to safe and affordable medicines and supporting innovation in the EU pharmaceutical industry. Earlier this year, the European Commission (EC) published a roadmap highlighting some of the challenges and objectives of the Strategy. A public consultation ended in September 2020 (after having received 470 responses from all over Europe), and the Strategy itself will be adopted by the College of Commissioners later this year and be implemented through a combination of legislative and non-legislative actions from 2021-2024. “The Strategy is the beginning of the work” said Sandra Gallina, Deputy Director-General, European Commission Directorate-General for Health and Food Safety. A Strategy to connect the dots and ensure supply The EC, represented by Sandra Gallina and Andrzej Rys, Director, Health Systems and Products Directorate, European Commission Directorate-General for Health and Food Safety, shared their insights on the Strategy. This initiative responds to the widespread request to foster access and security of supply and a more crisis-resistant system generally, as the EU needs strategic oversight of medicines manufacturing, to reduce medicine shortages and secure strategic autonomy, and to ensure a more affordable and accessible supply while supporting sustainable innovation including for unmet medical need. The EC intends to cover the full lifecycle of medicines, from research and clinical trials to market functions, competition policy and trade. The Strategy does not stand alone, there are many other initiatives coming together that will also inform and impact the Strategy, including the EU digital agenda, the European Green Deal, Horizon Europe and the Industrial Strategy. The Pharmaceutical Strategy will bridge these initiatives, connecting EU actions in boosting innovation through a holistic approach. Lessons learned from COVID-19 EU institutions and bodies have been working over the past seven months to mitigate the effects of the pandemic: supporting the provision of medicines and equipment and strengthening surveillance systems and data sharing (i.e. through Building a comprehensive pharmaceutical policy to address today’s challenges and tomorrow’s realities37TRACK III - FROM DATA TO DECISIONSEHFG 2020 CONFERENCE REPORT the ECDC). As noted by Lorraine Nolan, Chief Executive, Irish Medicines Agency, one thing that we can learn from the pandemic is that remote solutions can help national authorities to become more efficient. For example, during the pandemic, inspections of manufacturing facilities were carried out remotely, saving time and resources. More recently, EU collaborative efforts to ensure a sufficient supply of COVID-19 vaccines has demonstrated much needed solidarity that seemed in short supply at the start of the pandemic. The Pharmaceutical Strategy can build on these experiences and apply lessons learned on crisis preparedness, namely in the coordination of national efforts in crisis response, close partnership with researchers, strategic stockpiles and investing in an EU-wide clinical trial network. Addressing medicine shortages, affordability and innovation Affordability of medicines was one of the key topics highlighted by Sandra Gallina, who quoted Stella Kyriakides, EU Commissioner for Health and Food Safety, saying that to keep citizens healthy a “steady stream of affordable medicines is vital”. Reaching a good balance between affordability and innovation remains a great challenge for the majority of MS. Access to innovative medicines varies across the EU, as companies are not obliged to market a medicine in all EU countries. Smaller and less wealthy markets are the ones most impacted by the consequences. With a number of innovative medicines currently not reaching those patients in need, future regulations and strategies could tackle the lack of transparency on prices and better interlink innovators with healthcare systems. The solutions cannot come only from industry. Specifically, on rare diseases, Lydie Meheus, Managing Director, Anticancer Fund, stressed that populations cannot expect pharmaceutical developers to spend energy and money on less profitable business, without counting on incentives from the public sector. “Let´s be creative and think of public-private partnerships (PPP) to come up with creative solutions,” she advocated. She also recommended adopting a collaborative effort to pool resources in order to better define unmet needs. As stressed several times by the EC, decisions on pricing and reimbursement are the purview of national policymakers: the EU can only step up to support. On EU import dependence, Rex Clements, CEO, Centrient Pharmaceuticals, urged EU countries to act to boost production of pharmaceutical materials within the EU (specifically generic drugs), to ultimately diversify the suppliers of widely-used products. Innovative ways of working Innovation was discussed in its widest sense, not just in discovering new molecules, but in repurposing old ones and in developing new collaborations between the pharmaceutical sector and medical devices sector. Lorraine Nolan discussed how regulators were partnering with the technology sector to better understand future trends and gaps in knowledge. As a regulator she also emphasised the importance of blended skillsets to increase workforce diversity, employing staff with data analysis and clinical experience: it is important to invest in upskilling existing employees and attracting those with transferable skills, she emphasised. Rex Clements described how emerging technologies in terms of the manufacturing of Active Pharmaceutical Ingredients (APIs) had improved sustainability and reduced waste for his organisation. He called for harmonised standards around the way APIs are procured that would address environmental standards, sustainability and the geographic diversity of supply chains. Thomas Bols, Head of Government Affairs, PTC Therapeutics, noted that for rare diseases with a limited number of patients, real world evidence (RWE) can have a significant impact, and recommended the development of an EU framework for the use of RWE to supplement clinical trial data for rare diseases. This is just the beginning The Strategy is not the end but the beginning of further work by the European Commission on pharmaceuticals. As Thomas Bols mentioned, “The Pharmaceutical Strategy needs to maintain a balance between fast access, ensuring healthcare budgets maintain sustainability and innovation in pharmaceuticals.” The upcoming plan will not solve all the problems right away: the road to affordability, access and autonomy of EU supply is long and some challenges might remain unanswered. Summing-up some of the concepts discussed in the session, moderator Petra Wilson, Co-founder and Managing Director, Health Connect Partners, called for the EC to harness the flexibility we have learned from COVID-19 to develop a flexible Pharmaceutical Strategy that builds on new collaborative models going forward. Learn more Session recording Programme38TRACK III - FROM DATA TO DECISIONSEHFG 2020 CONFERENCE REPORT Closing the evidence-practice gap on NCDs This session discussed the results of CHRODIS+, a joint action funded by the Health Programme of the European Union (EU) that involved 42 partners from 21 EU countries. Moderator Graziano Onder, Director of the Department of Cardiovascular, Endocrine-Metabolic Diseases and Ageing, Istituto Superiore Di Sanità, described its mission: to share innovative practices and policies on effective and efficient ways to prevent and manage non-communicable diseases (NCDs). It was focused on the implementation of 21 projects concerning health promotion and primary prevention, fostering quality of care, integrating multimorbidity care models, ICT-based patient empowerment and employment and chronic diseases. In addition, through 16 Policy Dialogues, CHRODIS+ aimed to increase decision- makers´ awareness and acceptance of best practice to combat NCDs. Multi-morbidity care in Lithuania In Lithuania, there are growing challenges arising from an ageing population with multimorbidities, with some people already developing NCDs in their twenties. Aurelijus Veryga, Minister of Health, Republic of Lithuania, described the scale-up of a multi-morbidity care model from pilot to implementation at the national level in Lithuania. Two different models were developed under the previous CHRODIS joint action, these will be tested and evaluated and the most promising implemented in 2023, with the participation of 23 municipalities, 726 multidisciplinary team members, and impacting 4764 patients and 46 primary health care centres. For patients, medical staff and the health system, the initiative is expected to bring about improvements in life expectancy and clinical outcomes, reduce hospitalisations, hospital readmissions and outpatient visits, and reduce the administrative burden on medical staff while improving their working conditions and professional competence. Rokas Navickas, Cardiologist, Vilnius University Hospital, and the Joint Action Scientific Coordinator, reflected on the difficulty of measuring long-term outcomes e.g., hospital readmissions or healthy life year gains. However, he discussed other short- term outcomes that can be more easily measured to evaluate the project, such as patient reported outcomes and health professional motivation and drive. The power of national policy dialogues Alison Maassen, Senior Coordinator, Eurohealthnet, elaborated on the power of national policy dialogues and how they can be used as a tool to combat NCDs. There were 14 national policy dialogues, involving 13 countries, from broad topics Translation, transfer and sustainability for comprehensive responses across Europe Organised by CHRODIS PLUS Joint Action on Implementing Good Practices for Chronic Disease39TRACK III - FROM DATA TO DECISIONSEHFG 2020 CONFERENCE REPORT such as tobacco control, healthy diet and active lifestyles, to more specific topics such as mental health literacy during divorce and water consumption in schools, illustrating the variety of risk factors for NCDs and the variety of policy levers that can be manipulated to reduce chronic disease burdens. Two EU level policy dialogues discussed the financing of health promotion and employment and chronic diseases. Maassen considered a key step in the process was the context and stakeholder analysis to decide on appropriate topics for each country and the relevant stakeholders to invite. The policy dialogues themselves consisted of half-day closed sessions each comprising 10-15 participants. The follow-up stage was the development of an action plan based on the consensus and conclusions of the participants, with metrics and a timeline. Feedback of this process was provided through a follow-up survey of the participants. Maassen described a number of success factors: the dialogues provided a valuable framework for encouraging a “Health in All Policies” approach (because they included actors from outside the health sector) and addressing complexity, as well as a methodological structure to improve transparency and standardisation of policymaking processes. Areas to improve were also mentioned, such as the inclusion of more end-user representatives and better ensuring sustained political commitment. In terms of actionable insights, Maassen reflected that the process was surprisingly robust across several countries and contexts. Some countries used the dialogue to broach a topic for the first time, while others wanted to take existing topics to the next level. “Policy dialogues shouldn’t happen in a vacuum and multiple dialogues are needed as dossiers move along the agenda towards implementation,” she concluded. Health promotion and disease prevention in Andalusia Workplaces have been identified as important settings to tackle a number of NCDs. Based on a good practice model identified in 2016 in Lombardy, Francisco Ruiz, Advisor, Andalusian Regional Ministry of Health, Spain, described the transfer and implementation of one such initiative (the Lombardy Workplace Health Promotion Network) in Granada in 2019, benefiting 200 employees in two organisations. At the initial stage, health promotion sessions and workshops were available to all employees. After nine months of intervention, the results were promising, with data indicating an increase in physical activity and fruit and vegetable intake among the participants, as well as a reduction in the consumption of sugary products. Andalusia and Lombardy continue to collaborate on this model, and it will be scaled-up in Andalusia to reach over 200 organisations and 7000 employees. Ruiz lauded the excellent collaboration that Andalusia had so far enjoyed with Lombardy, and in terms of scale-up mentioned several other countries and organisations including the OECD who wanted to learn more about the initiative. The role of civil society in good practice implementation Valentina Strammiello, Senior Programme Manager, European Patients’ Forum (EPF), discussed patient and citizen involvement in CHRODIS+: how to transform the culture from “doing things to patients to doing things with patients.” EPF were actively involved in all of the joint action’s processes, including the guidance design phase, recommendations and criteria and particularly multi-morbidity care model. More than 21 pilots were designed with patient input integrated from the outset, generating effective practice and delivering better outcomes. Strammiello emphasised the importance of firstly providing the opportunity to involve patients and then engaging them from the earliest stages of the project design process – involving them only in the validation stage risks the project not meeting the needs of patients or health systems, she stated. She also reflected that capacity building of patients is sometimes needed to enable them to contribute effectively – technical knowledge might be required, at other times more experiential knowledge is important. Overall having an understanding of public health and strong advocacy skills are necessary. While human and financial resources can be a barrier to involvement, she further acknowledged that sometimes it is the expectation of what patients can bring to the table from the side of health professionals and policymakers that needs to be changed. The value of CHRODIS+ CHRODIS+ initiatives have served as inspiration and guidance for best practices to improve care, promote health and tackle NCDs across Europe, impacting many thousands of European citizens. The CHRODIS+ approach has proven its value in terms of evidence-based policymaking and opened the way for further scale up and continued action and implementation of good practice models. Learn more Session recording ProgrammeNext >