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Poor Europeans are Going Without Their Medicines


Yesterday, with the ISGlobal team, I took part in a European Parliament seminar entitled Can EU Citizens Afford Their Medicines? hosted by the socialist MEP Alejandro Cercas. The question, which only a few years ago would have caused general raising of sceptical eyebrows among our representatives, has become fiercely relevant due to the current economic crisis and the apparent collapse of a health care model based on innovation and access to essential medicines—a breakdown that is leading to the exclusion of ever larger sectors of the population.

I contributed a brief description of the current situation in Spain to a panel session that included a series of reports from the frontlines in the most affected European countries. Nicky Voudouri of the Greek NGO Praksis was the winner of this sad rivalry with his description of the dramatic plight of the health system in his country, where immigrants, pensioners and families with children are now turning to NGOs for routine medical care. It seems that withdrawals and shortages of essential drugs, under the table payments to general practitioners, and the exclusion of foreigners from health care are the order of the day in Greece. And I was complaining...

Greece is the technicolour version of a film that is becoming all too familiar to us here. While one in every four families in Spain is now living in social exclusion, the safety net provided by the health system weakens with every passing day. From the increase in the individual’s contribution to the cost of prescriptions (from 40% to 50% for families with an annual income of more than 18,000 euros) to the dismantling of programmes for the care of dependents and other vulnerable groups and the outrageous restriction on access to medical care for irregular immigrants, health care insecurity is spreading like an oil slick in our society.

Although it will take time to properly evaluate the consequences of this retrograde shift, depressing reasons for concern are already evident: cancer patients in low-income families who see their medical expenses tripling; nutrition patterns among children affected by the elimination of free school meals and the sharp decline in their parents’ income; immigrants dying of tuberculosis due to lack of care; tens of thousands of dependents and caregivers literally abandoned; and medical professionals facing pay cuts, denigration, and job losses. In short, we are witnessing the withdrawal of public health care from our society in a situation similar to those affecting other European Union countries.

As a result I would like to share with you, my longsuffering readers, some reflections prompted by an analysis of the current situation here in Spain and what I heard at the seminar concerning the situation in the rest of Europe.

- It is very difficult to assess the merits of reforms implemented without prior informed public debate or transparency in the supporting data. For example, the concealment and distortion of the figures used to justify the decision to deprive certain immigrant groups of health care in Spain is a cause for concern. The Spanish government cited a figure five times higher than the real population of non-EU workers in an irregular situation, did not allow for the cost of overloading emergency departments, and chose to ignore the health risks related to uncontrolled infectious diseases.

- The measures being introduced in our countries represent a whittling away of the social contract that underpins the European system of public health protection. If immigrants have been excluded from our health care system to reduce “fraud” (that is, to prevent people from benefiting from a health system to which they have only partially contributed), how many more years of economic recession will it take before the same logic is used to exclude people with disabilities or homemakers who have never paid social security contributions? In leaps and bounds, we are moving away from a system in which health care is conceived of as a right towards one based on contributory insurance coverage.

- For someone who has taken part in debates about access to medicines and treatments in countries like Bolivia and Mozambique, the differences between those discussions and what is being discussed today in Europe is only a question of degree. Ultimately, we are talking about the same variables of transparency, equity and innovation that will be the subject of a meeting to be held next week in Geneva to discuss the possibility of an international convention on research and development of drugs in the global arena. When Europe is defining its stance on that subject it should bear in mind that its own interests are in play just as much as those of low-income countries.

I wish I could be more optimistic about the outcome, but the contributions of many of those attending the yesterday’s meeting left me with a bitter aftertaste concerning European institutions. All of us—Greeks, Spaniards, Portuguese, and Italians—face a daily diet at breakfast time, week after week, of the latest decisions of the European Commission concerning employment contracts, deficit reduction and the flexibilisation of financial systems. But we have never noticed the same institution breathing down our necks about guaranteeing the citizen’s right to health, a right the European Union has sworn to uphold. The organisers of the recent seminar, including TACD,  the European Public Health Alliance and Health Action International, are calling for just such a guarantee. Let’s join forces with them to stop this succession of mistakes.


[This post was originally published in the 3500 millones blog]