10.H. Round table: Access, equity and the relevance of the Pandemic Treaty: lessons from the COVID-19 response

Abstract   Access to medicines, equity and fair pricing have been intensely debated in the context of EU policies and global health priorities for many years prior to the COVID-19 pandemic. To this effect, there have been efforts to develop mechanisms to jointly assess health technologies (HTA Regulation) and to establish cross-border partnerships for price negotiation and procurement. Although TFEU (art.168) is limiting the scope of activities and decisions to be taken at the EU level for public health matters, the Commission has also played an active part in global health discussions in the G20 and in the G7 since 2010, and there is explicit commitment to SDGs, and in particular UHC (SDG3.8) ‘leaving no one behind’ (2019). Indeed, according to its commitments “the EU advocates equitable, universal and high-quality healthcare coverage and promotes fair, effective financing of research to benefit the health of all [and] it is working to ensure that new products are safe, effective, accessible and affordable.” In the context of the COVID-19 pandemic, the EU came together in solidarity within and beyond its borders, including through joint procurement of countermeasures. At the same time, different instruments were developed to combat the pandemic globally, such ACT-Accelerator deploying the diagnostic and medicinal products, including, vaccines, and its COVAX Global Vaccines Facility to scale up production and establish consensus on the international allocation of these products. In this transitional phase, issues that arise are: What is the role of the EU in shaping European public health and global health? What are the fundamental principles enshrined in legislative and non-legislative instruments determining EU policies and actions of global health impact? Is such EU policymaking informed by evidence? Are the necessary interdisciplinary and intersectoral partnerships in place to generate the necessary evidence? Which instruments and mechanisms have been the most efficient and effective in combating the COVID-19 pandemic? Are they relevant for future pandemics and for increasing preparedness and resilience? What has been the role and contribution of the EU in these initiatives? What are the values and fundamental principles determining EU action and policy, and to what degree are EU policies evidence-informed? Will the EU's efforts be determined by G20 decision-making, interests and priorities? Each panel member will briefly (5 min) present work conducted to inform European public health and global health policies. The panel will then discuss EU public health and global health policies, assessing the extent to which they are evidence-informed and the degree to which they reflect the fundamental principles of the Union. There will be two rounds of questions/statements, the first elucidating the role of the EU, the second examining it in the context of the COVID-19 pandemic and future pandemics, incl. in the context of the development of the Pandemic Treaty. Key messages • Sound governance, transparency and implementation monitoring is required for all instruments and mechanisms to combat the COVID-19 pandemic and ones, with due consideration to sustainability and UHC. • The EU’s role in global health needs to be strengthened via interdisciplinary and intersectoral collaboration for evidence-informed policies, and in a manner consistent with EU fundamental principles. Speakers/Panellists Dimitra Lingri National Organization for Health Care Services Provision, Athens, Greece Rosa Castro European Public Health Alliance, Brussels, Belgium Tom Buis Wemos, Amsterdam, Netherlands Aurelie Mahalatchimy UMR DICE CERIC & EAHL Interest Group on Supranational Biolaw, Aix-en-Provence, France


Background:
In the Netherlands, since 2015, a paradigm shift towards client-centred 'care for youth' initiated a focus on client autonomy, enabling clients to make informed decisions in their care process.Client autonomy is assumed to positively correlate with mental and physical health and can be strengthened by autonomy-supportive behaviour from professionals.Aiming for client autonomy, three organizations developed an electronic health record (EPR-Youth), accessible for parents and adolescents.Although research shows that patient-accessible records contribute to patient autonomy, limited research is available about use of such records among adolescents.We investigated whether use of EPR-Youth in 'care for youth' contributed to experienced autonomy among adolescents and parents, and what role professional autonomysupportive behaviour played.

Methods:
A mixed methods design combined baseline and follow-up questionnaires with focus group interviews, over a two-year period.Clients completed a questionnaire about experienced autonomy and portal use at baseline (1202 parents, 202 adolescents) and after one year (914 parents, 89 adolescents).Professionals completed questionnaires about autonomysupportive behaviour at baseline (N = 100), after 5 months (N = 57) and 24 months (N = 110).After 14 months, focus group interviews were held with a purposive sample of parents (N = 8), adolescents (N = 4) and professionals (N = 12).

Conclusions:
The use of EPR-Youth was associated with increased autonomy among parents and adolescents.Autonomy-supportive professional behaviour enhanced this effect.

Key messages:
The possible contribution of EPR-Youth to client autonomy is promising, but follow-up research is needed to strengthen evidence.Implementation of client-accessible records with the aim to enhance client/patient autonomy needs to address autonomy-supportive professional behaviour to increase impact.
Access to medicines, equity and fair pricing have been intensely debated in the context of EU policies and global health priorities for many years prior to the COVID-19 pandemic.To this effect, there have been efforts to develop mechanisms to jointly assess health technologies (HTA Regulation) and to establish cross-border partnerships for price negotiation and procurement.Although TFEU (art.168) is limiting the scope of activities and decisions to be taken at the EU level for public health matters, the Commission has also played an active part in global health discussions in the G20 and in the G7 since 2010, and there is explicit commitment to SDGs, and in particular UHC (SDG3.8)'leaving no one behind' (2019).Indeed, according to its commitments ''the EU advocates equitable, universal and high-quality healthcare coverage and promotes fair, effective financing of research to benefit the The cumulative incidence ranged from 7. 0%[4.5-10.3] in Wolisso to 30.8% [14.3-51.8] in Ameya, the most distant district.The relative probability of insulin treatment was higher with increasing time to SLCH ] p = 0.027).The hospitalization rate for DKA was significantly correlated with the travel time to the hospital.Access to care is therefore a key factor for health that should be taken into account by improvement programs and the spatial analysis of travel time could help focus on priority areas.Key messages: Spatial analysis can be a robust tool to tailor population healthcare needs on its own topography.Health policies must consider that accessibility can influence the severity of clinical presentation.
15th European Public Health Conference 2022 health of all[and]it is working to ensure that new products are safe, effective, accessible and affordable.''In the context of the COVID-19 pandemic, the EU came together in solidarity within and beyond its borders, including through joint procurement of countermeasures.At the same time, different instruments were developed to combat the pandemic globally, such ACT-Accelerator deploying the diagnostic and medicinal products, including, vaccines, and its COVAX Global Vaccines Facility to scale up production and establish consensus on the international allocation of these products.The panel will then discuss EU public health and global health policies, assessing the extent to which they are evidence-informed and the degree to which they reflect the fundamental principles of the Union.There will be two rounds of questions/statements, the first elucidating the role of the EU, the second examining it in the context of the COVID-19 pandemic and future pandemics, incl. in the context of the development of the Pandemic Treaty.