Archive for May, 2018

The EU’s next Research Framework : Horizon Europe

The European Commission is working on the successor of Horizon 2020, the next EU Research Framework Programme which will outline research priorities beyond 2020.

A draft version of the framework (dated 11 April), noted that the biggest changes in the next research funding scheme will be the creation of a European Innovation Council and a move to bring academic research closer to industry/commercial applications. The final version of the Horizon Europe framework is set to be published on June 7.

Like its predecessor, “Horizon Europe” will be structured around three pillars: “Open Science”, “Global Challenges” and “Open Innovation”. The Health cluster forms part of Pillar 2, covering impact-focused collaborative Research and Innovation. The Commission is trying to make research activities and their outcomes more concrete to EU citizens by fostering citizens’ involvement, encouraging projects with concrete and immediate positive impacts on society and by fostering engagement of civil society, industry and policymakers and research initiatives, something that already sparked concerns from NGOs and businesses alike.

Indeed, as per the draft document, “activities involving social sciences and the humanities will be fully integrated across all clusters of Pillar 2. Part of the activities will be implemented through a limited number of missions”.

Interestingly, the new Framework Programme outlines the concept of “missions” thought as “large-scale assignments given to a portfolio of R&I actions to achieve an ambitious but realistic goal within a set timeframe. Missions’ will are to “create a very powerful and measurable impact, with a transformative potential for science, technology, industry and society”. Missions will require “sustained cross sectorial and interdisciplinary effort and a deep involvement of stakeholders from beyond the R&I community, including policy makers, end-users and civil society.” These missions “should have the potential to set the direction for related work in the Member States, regions, local actors and cities” and must “be readily understandable to the public, captivating in nature and therefore liable to incite the active engagement of concerned citizen groups”. Selected missions will be “bold, inspirational and with wide societal relevance”.

Likewise, a strong emphasis will be on “R&I complemented with activities which operate close to the end-users and the market, such as demonstration, piloting and proof of concept”.

When it comes to research priorities in the health sector, the European Commission aims to support multidisciplinary, cross-sectoral and trans-national collaborations which will contribute to addressing global health challenges, including:

  • The lack of effective health promotion and disease prevention
  • The rise of non-communicable diseases
  • The persistence of health inequalities amongst and within countries affecting disproportionally people that are disadvantaged or in vulnerable stages of life
  • The increasing costs of healthcare systems
  • The mainstreaming of personalized medicine approaches
  • Digitalization in health and care

For the kidney community, Horizon Europe outlines broad lines of activities in the field of non-communicable diseases, revolving around:

  • Diagnostic for earlier and more accurate diagnosis and for better adapted treatments
  • Prevention and screening programmes
  • Management of co-morbidity
  • Treatment for lowering morbidity or mortality or cure including use of complementary non drug interventions and their combination with conventional
  • Palliative care
  • Determination of comparative effectiveness of interventions and solutions
  • Multilateral initiatives to address rare diseases and the increasing burden of other non communicable diseases.

For more information, see here.

What role for the European Commission on organ donation and transplantation?

With health being a competence of the Member States (MS), the European Commission  mandate on the issue is limited to improving cooperation between Member States, to foster best-practice exchange and to establish measures setting high standards of quality and safety of organs – as outlined by Stefaan Van der Spiegel, Team Leader ‘Substances of human origin’, DG Santé, European Commission during the European Kidney Forum 2018

Against this background, in 2011 the EC adopted a Directive to support organ exchange between Member States. With a view to supporting Member States in the donation process, the European Commission launched an Action Plan to improve quality and safety of the donation process, make transplantation systems more efficient and accessible and increase organ availability.

Based on an evaluation of the EU Action Plan in 2015, it could be demonstrated that the “EU Action Plan helped spur a 17% increase in organ transplants between 2008 and 2015 (4600 additional transplants: from 28100 to 32700) with an increase in organ donors from 12000 to 15000 and Spain, France, UK, Poland and the Netherlands being the five main contributors. Bulgaria, Lithuania, Finland, Croatia, Hungary, Czech Republic, Slovenia, Latvia and Denmark demonstrated the sharpest overall increase with some exceptions like Germany where numbers fell with 20%.

The Action Plan led to appointment of local coordinators for deceased donation and registries for living donors.

The Commission takes part in a number of actions to identify good practices from Member States and share these across the EU such as:

  • FOEDUS Joint Action a European consortium aiming to facilitate the exchange of organs donated in the EU Member States (a pilot project involving 8 countries was conducted during 9 months).
  • EDITH project aimed at assessing the differing treatment modalities of Chronic Kidney Diseases and transplantation in the EU and their impact on health expenditures and patient outcomes; (see separate article)
  • EUDONORGAN project aiming not only to train health professionals but also to organize awareness raising events with the support of the trained professionals and to propose and implement dissemination actions as well as monitoring and evaluation strategies.

Going forward, the Commission wants to make sure to define selected, clearly defined objectives going forward to favour tangible outcomes and hence ensure a stronger impact. The EC insists on the importance of:

  • Bottom-up agenda-setting, engaging professionals, administrations, politicians, public opinion
  • Bringing together groups of countries with similar issues and situations.
  • Learning from/collaborating with adjacent areas of expertise (e.g., tissues & cells, devices)
  • Focusing more on MS with less developed transplant programmes
  • Reflecting on implementation and sustainability, including IT.

Download Stefaan Van der Spiegel ‘s presentation slides here.

CKD and transplantation in the UK : a patient’s viewpoint

For Kidney Care UK representative Fiona Loud – transplantation is “the gold standard treatment” – as she put it at the European Kidney Forum 2018 in Brussels. Affected by a rare disease causing pre-eclampsia and having to face two episodes of kidney cancer, Fiona Loud said she was fortunate enough to benefit from a transplant after 5 years on dialysis thanks to her husband.

In the UK, in 2017/2018, there were 1,575 deceased donors – a record, but 4,700 have died waiting for a transplant in the last 5 years – that is 3 per day! Likewise, in the UK, 250,000 people a year die, but only 5,000-7,000 will become donors: 4 in 10 families who could approve a donation when their loved one had passed away, say no; this can be as high as 7 in 10 from a black or Asian background.

Establishing an “opt-out” system based on presumed consent is being considered in England based on the promising results of Wales where an opt-out system was introduced in 2015. Results are promising, with higher consent at 24.3 donors pmp https://bit.ly/2qRPyyP. However, in such opt-out systems, the family retains the right to over-ride that presumed decision of consent if desired.

National conversations are slowly increasing donation numbers BUT for success to increase, there needs to be more education for the public and in schools, adequate resources such as hospital transplant facilities and surgeons, and donors and their families need to be better supported.

Download Fiona Loud’s presentation slides here.

EKHA launches Gift of Life campaign and Call to Action

EKHA has launched the Gift Of Life campaign to boost organ donation and foster increased access to transplantation across EU Member States.

An advocacy initiative, EKHA’s Gift of Life campaign aims to raise awareness on the need for:

  • a coordinated approach at EU level as regards kidney donation
  • appropriate legal, structural and cultural frameworks in EU member states to boost donation rates and hence reduce the numbers of deaths resulting from kidney failure while waiting for a transplant.

 

The “Gift of life” campaign aims to provide:

  • A platform to channel EKHA’s key messages on transplantation to the European Commission, the European Parliament and other relevant EU stakeholders in the field
  • A framework for EU Member States to develop national awareness raising activities on transplantation in a coordinated manner.

As part of the “Gift Of Life” campaign, EKHA has produced a “Call to Action”, urging for:

  • Education programmes for healthcare professionals, patients and the general public to boost living donor transplantation at EU and national levels.
  • Establishment of appropriate legal and structural frameworks to make EU Member States’ transplantation programmes successful
  • Opting-out systems for deceased organ donation in EU member states
  • A coordinated approach towards kidney transplantation at EU level

Read here EKHA’s concrete recommendations. We encourage you  to join the Call to Action and to formally express support to EKHA’s awareness raising campaign “Gift Of Life”

Learn more about EKHA’s Gift of Life campaign.