EU Health Strategy: back to gender-blindness?

Ludovic Lacaine, who is in charge of European Affairs at the EMHF, reports on a frustrating and fruitless search through the EU commission's latest health proposals.

I have to say I was quite stupefied and then rather frustrated to discover that the Commission’s proposal for a new health programme turns out to be gender-blind.

Everything began on 6 April 2005, the day the Commission released its new health strategy for the period 2007-2013¹. After opening with excitement the PDF document, I clicked on the search binocular-shaped icon of the Acrobat Reader, franticly typed "gender" and launched the search. Total instances found: 0, the programme replied! Impossible I thought. Then I tried, very hard, with other entries such as "men", "women", "male" or "female", but the machine kept giving me the same despairing answer.

Surprisingly enough, DG SANCO, the EU health administration which has previously shown support for gender matters, seemed to have become suddenly indifferent to men and women’s respective issues.

The ambitious €1.2 billion proposal will aim to promote actions in the field of public health and consumer protection in potentially 25 countries over 7 years. In order to simplify the heavy-weight administrative processes that go with the strategy, the proposal regroups current programmes in the field of health and consumer protection.

This proposal results from a broad consultation process launched by former Health Commissioner, David Byrne. For the promoters of the integration of gender into EU health policies, this consultation was very promising. Indeed 39 contributions out of a wide range of 192 European, national governmental and non-governmental organisations’ replies mentioned gender-sensitive policies as a factor of better health. The Swedish government, for example, pointed out that gender is an issue as important as poverty, social exclusion or access to health care in the improvement of population health². The Europe Older People’s Platform (AGE Platform) recommended that "the strong gender dimension of health should be adequately addressed"³. The European Public Health Alliance (EPHA), a major European public health NGO, also underlined that gender is among "key routes to improving the (…) fundamentals of health"⁴.

But, although gender-related health differences were among the preoccupations of more than 20% of the respondents to the consultation, it is not in the proposal!

The explanation that first comes to mind is that this absence is probably due to the fact that, at EU level, the inclusion of gender into health policies is a fairly recent issue. Well! If that’s the main reason, then how could we explain that "gender" textually appears 5 times in the EU Action programme currently in force since 2003?

A very negative consequence of regrouping two existing programmes is that some "secondary" issues such as gender tend to be lost in the mix. The reference to gendered health strategies introduced in the 2003-2008 programme to tackle the health determinants so cherished by the Commission has literally disappeared. Such determinants include smoking, alcohol consumption, eating habits, and health information among others. Regarding health information for example, the current health programme could not have made it clearer: "All relevant statistics should be broken down and analysed by g ender"⁵ (indent 12) thus recognising the necessity to integrate a gender angle to health data provided to citizens and to policy makers. There is no echo of these commitments in the new proposal.

Gender, as environment, is suffering from administrative simplification and its inclusion into Community health policies is experiencing a dramatic step backwards. Not only in health policies but also in social affairs, gender issues are losing visibility and the opportunities to transpose them into legal texts, that commit Member States to actions, are becoming increasingly rare. This shortfall across the EU agenda could logically lead to organisations active in the field not being eligible for Community financial support. It would jeopardize their ability to develop national and local networks, or gender-focused projects that could effectively contribute to improving both men’s and women’s health across Europe.

At a time when 17% of citizens are still not satisfied with their health status⁶ and the democratic gap is growing with EU institutions, it may be unwise to ignore the respective needs of men and women, who make up 99% of EU population after all!

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