EU Health Research Articles

Qualitative research for improving Access to Vaccination for Newly Arrived Migrants (AcToVx4NAM)

Abstract Background Increasing vaccination uptake among vulnerable groups constitutes a high priority across Europe. Access to Vaccination for Newly Arrived Migrants (AcToVx4NAM) is a 3-year project (Grant n 101018349, 3rd EU Health Programme) with a mission to increase vaccination uptake in Newly Arrived Migrants (NAM) regardless of legal status. AcToVx4NAM will improve health system Vaccination Literacy (VL) and vaccination access, by making access conditions more equitable and guaranteed. Methods Across 8 countries research took place to identify barriers, enablers and solutions to system level problems. Qualitative analysis through focus groups and interviews took place with professionals who work with NAMs including administrative personnel, cultural mediators, policy officers as well as physicians, nurses, social and mental health care professionals. Research examined barriers across the different dimensions that constitute the ActoVax4NAM General Conceptual Framework namely Entitlement, Reachability - Adherence (vs. hesitancy), Achievement of vaccination (execution and completion) and Evaluation. Results A number of common system level barriers were identified related to gaps in the registration process and problems in reaching people eligible for vaccinations. Not all NAMs face the same problems in terms of accessing the health system (i.e asylum seekers vs economic migrants). Communication breaks exist between the various services involved with delivering care and vaccination to NAMs while the lack of appropriate culturally sensitive and appropriate informative material still remains. The role of non-medical personnel in promoting vaccinations was emphasized as well as the importance of evaluating and disseminating best practice. Conclusions Findings direct to specific evidence based solutions with an emphasis on tailored made to specific needs activities. Key messages • Shift focus from individual level barriers to system level barriers considering all hubs of the vaccination process. • Address vaccination needs of NAM early to stress the importance of prevention in the health integration process.

8.J. Workshop: Transfer and adoption of digitally enabled integrated care good practices: the JADECARE Joint Action

Abstract The ageing population and the burden of chronic conditions is increasing the demand for more comprehensive, efficient and smarter healthcare. The EU funded Joint Action JADECARE (Joint Action on implementation of Digitally Enabled integrated person-centred CARE) intends to reinforce the capacity of health authorities to successfully address the health system transition to digitally enabled integrated person-centred care. JADECARE involves 45 organisations from 16 different EU countries covering different funding systems (both Bismarck, Beveridge and mixed) holding different levels of penetration, adoption and maturity of integrated care. It focuses on the transfer and adoption of four original Good Practices (oGPs) to the contexts of 21 Next Adopters (NA). The project started on October 1 2020 and ends on September 30 2023. The oGPs that are being transferred in JADECARE concern integrated care, chronic conditions, self-care, prevention and population health. They are: The Basque Health strategy in ageing and chronicity: integrated care (Spain), the Catalan open innovation hub on ICT-supported integrated care services for chronic patients (Spain), the OptiMedis Model-Population-based integrated care (Germany) and the Digital roadmap towards an integrated health care sector (Denmark). Due to the heterogeneity of the NA, the transfer strategy of JADECARE enables them to customize the parts of the oGPs that will be transferred and adapted to its local context, considering its needs, local strategies and implementation goals. The JADECARE three-step implementation strategy has been designed to be appropriate from the scientific point of view, applicable considering data availability and feasible according to project's timeline and resources: • Pre-implementation: definition of Local interventions and action plans. • Implementation: roll-out and operation, based on two Plan-Do-Study-Act cycles. • Post-implementation: result analysis, impact assessment and reporting on learnings. By the end of 2022, the implementation phase will be completed, and all NA will start analyzing their results and reporting on learnings. Currently, NAs have defined their interventions and action plans for implementation and are finalizing the first of the two PDSA cycles that they will be performing within JADECARE. 3 of the NAs are implementing interventions at national level, 14 at regional level and 4 at local level. Most of the NAs implement interventions related to digitally enabled integrated care (36), 11 are related to risk stratification and 9 to patient empowerment. This workshop explores the key elements and challenges to be addressed when transferring Good Practices (GP) to heterogeneous health systems with different needs, aims and scopes. It will also highlight the experience of two NA: Marche region, in Italy and Olomouc, in Czech Republic and promote the discussion among speakers and attendees to highlight the challenges and key elements to enable the transfer of GPs. Key messages • JADECARE will impact on EU health systems by implementing innovative solutions and helping to change the model of care provision. It will also settle the basis to implement them at large scale. • The long-term effect of JADECARE is supported by involving stakeholders at regional and national levels to provide political support and commitment to sustained integrated care.

How does better regulation shape EU health policy? A case study of unhealthy advertising regulation

Abstract Introduction Better Regulation is a meta-regulatory tool designed to improve regulatory quality and reduce regulatory burden in the development of EU policy. Despite concerns by civil society that its operation may have a chilling effect on regulatory protections, its impact on health policy has not been researched systematically. Using provisions on high fat, sugar and salt (HFSS) food and alcohol advertising to children within the revision of the audiovisual media services directive (AVMSD) as a case study, we explore how the operation of Better Regulation affects EU health policy processes. Methods We employ a qualitative process tracing approach based on policy documents, Freedom of Information requests, media reporting, and expert interview data. Results After an evaluation in 2016, the revised AVMSD maintained a reliance on self- and co-regulation of alcohol and HFSS food advertising to children, despite significant evidence supportive of statutory measures and pressure from the public health community to strengthen provisions. This result aligns with calls from commercial actors to retain the status quo. Preliminary results indicate that pathways via which Better Regulation guidelines may have contributed to this outcome include, for instance, the structure and approach used in the impact assessment and the related scrutiny process, the design of the consultation strategy, and the evaluation criteria of the AVMSD proposal. Conclusions Considering how policymaking infrastructure - as a key political determinant of health - may shape the processes and dynamics underlying decision-making can support those working towards a policy environment which protects human and environmental health. In examining EU alcohol and HFSS food advertising provisions within the AVMSD revision through a focus on Better Regulation processes, we contribute a novel perspective towards explaining how measures to improve regulatory quality interact with actors’ agency to shape policy outputs. Key messages • The Better Regulation agenda should be understood as a key political determinant of health at the EU level. • Understanding the ways in which governance tools such as Better Regulation can shape health policy is important for those engaged in promoting effective and evidence-informed public health action.

Five-hub General Conceptual Framework to improve the vaccination coverage for newly arrived migrants

Abstract Background Within the Project “Increased Access for Newly Arrived Migrants-AcToVax4NAM” (Grant n 101018349, 3rd EU Health Programme), a General Conceptual Framework (GCF) was developed for understanding how to improve vaccination coverage for Newly Arrived Migrants (NAM), by characterizing and critically analysing system barriers and possible solutions to increase vaccination Methods A logical pathway was hypothesized based on conceptual hubs in the immunization process. The identification of barriers and solutions was carried on by: a) non-systematic revision of scientific and grey literature, institutions and relevant websites, and documents suggested by Consortium Partners; b) qualitative research conducted in each Consortium Country. The GCF was used as a guide for the above mentioned activities and organize results into the GCF itself to enrich it with content Results 5 conceptual hubs were identified: ENTITLEMENT to vaccination, REACHABILITY of people to be vaccinated, ADHERENCE to vaccination, ACHIEVEMENT of vaccination, EVALUATION of the intervention. All hubs are linked sequentially, starting with Entitlement without which the process cannot take place. Hubs are connected: if vaccination does not take place, it’s important to go back to the previous hubs to understand the barriers. Reachability-Adherence-Achievement are closely related because some approaches are cross-cutting, such as proximity interventions which, in addition to allowing the system to approach NAM, promote adherence and thus possibility of completing the process. Other strategies may be implemented with different purposes: training aims to foster a culturally competent approach to facilitate adherence and avoid vaccination hesitancy, but also to improve competence in the entire process and lead to vaccination completion Conclusions The proposed GCF facilitates identification of barriers and possible solutions to the effective achievement of immunization, at all stages of the process Key messages • The GCF can be the basis for the creation of country-specific flow-charts through which to test strategies aimed at increasing immunization coverage in NAM. • The GCF will be useful at EU level, to facilitate both the harmonisation of approaches and interventions and the evaluation of comparable approaches.

European Regional and Local Health Authorities (EUREGHA)

Abstract EUREGHA's vision is to ensure that the local and regional perspective is represented in EU health policy because local and regional authorities are the natural interface between citizens and European institutions, being the bridging bodies between policies and practices and the closest organizations to the concept of communities. We are the only European network prioritizing the representation of local and regional health authorities at EU level, as they fulfil a key role in improving efficiency, quality, and accessibility of healthcare systems and services. EUREGHA understands their specific needs and works tirelessly to represent regional and local health authorities in EU health policy, to amplify their voices as a means to improve European public health and healthcare. Through advocacy, policy monitoring, profile promotion, partnerships, and project development, EUREGHA facilitates and promotes collaboration between its members, EU institutions, pan-European health networks and other healthcare stakeholders. Network activities and projects are implemented upon a strategic background of “ways to make things happen” such as value based healthcare, smart specialization strategies and skills for innovation and digital transformation - on one side - and along thematic and field objectives such as cross-border healthcare, cancer, obesity, mental health and ageing - on the other side. Lower Austria is a long-standing member and Vice-Chair of EUREGHA.

The UK National Health Service's migration infrastructure in times of Brexit and COVID-19: Disjunctures, continuities and innovations.

The COVID‐19 pandemic and Brexit were separate yet inter‐related developments which affected the British National Health Service (NHS). The UK's state‐funded health sector had historically relied on migrant labour and depended on a migration infrastructure designed to solve its nursing labour shortages. The analysis of primary qualitative and secondary quantitative data shows that the NHS migration infrastructure increased its orientation towards Asia to compensate for the effects of Brexit. The paper reveals how the persistent use of temporary visas along with conditional contractual arrangements has led to various exclusions for migrant nurses and midwives. These data also demonstrate how international travel restrictions associated with COVID‐19 created temporary obstacles for nurses' inflows. Alongside Brexit, this has also resulted in an increase in outflows amongst EU health workers. The article identifies the development of migrant support infrastructure amongst Filipino and Indian nurses as a major COVID‐19 linked innovation.

Health burden of road traffic noise in the EU in 2020–2035

The negative health effects of road traffic noise in the EU are analyzed over the period 2020–2035. For a baseline scenario, with autonomous traffic growth and fleet development, we find that there will be 31 million highly annoyed persons and 15 million highly sleep-disturbed persons in the EU in 2030. The corresponding EU health burden in 2030 is equivalent to the loss of 1.7 million “healthy life years”. Various noise abatement scenarios are analyzed, with noise solutions such as quiet road surfaces, quiet tires, and electric vehicles. The health benefits of the scenarios are calculated as health-burden differences from the baseline scenario. The calculation methodology is based on the noise exposure distributions reported in 2017 by EU member states, for urban agglomerations and for major roads. Changes in noise exposure are calculated with EU model Cnossos for vehicle emission, considering different types of roads (residential streets, main roads, motorways,...), and taking into account the separate contributions of rolling noise and propulsion noise to the vehicle emission. Two different noise valuation methods are used to express the health benefits in Euros. The monetized health benefits are used as input for a cost-benefit analysis of the scenarios over the period 2020–2035. For quiet tires, for example, high health benefits and low costs are found, resulting in a high benefit-cost ratio. This work was part of a study for the European Commission, exploring different options for reducing the EU health burden caused by noise from road, rail, and air traffic.

Adaptation of Brucella melitensis Antimicrobial Susceptibility Testing to the ISO 20776 Standard and Validation of the Method.

Brucellosis, mainly caused by Brucella (B.) melitensis, is associated with a risk of chronification and relapses. Antimicrobial susceptibility testing (AST) standards for B. melitensis are not available, and the agent is not yet listed in the EUCAST breakpoint tables. CLSI recommendations for B. melitensis exist, but they do not fulfill the requirements of the ISO 20776 standard regarding the culture medium and the incubation conditions. Under the third EU Health Programme, laboratories specializing in the diagnostics of highly pathogenic bacteria in their respective countries formed a working group within a Joint Action aiming to develop a suitable method for the AST of B. melitensis. Under the supervision of EUCAST representatives, this working group adapted the CLSI M45 document to the ISO 20776 standard after testing and validation. These adaptations included the comparison of various culture media, culture conditions and AST methods. A Standard Operation Procedure was derived and an interlaboratory validation was performed in order to evaluate the method. The results showed pros and cons for both of the two methods but also indicate that it is not necessary to abandon Mueller–Hinton without additives for the AST of B. melitensis.

European Union health policy after the pandemic: an opportunity to tackle health inequalities?

COVID-19 has exposed and exacerbated the health inequalities across and between European Union member states. It has also raised the profile of EU health policy and the highlighted the value of European cooperation in health. Early failures to respond adequately, coupled with this increased salience, have given rise to a series of initiatives designed to strengthen and expand the EU’s role in health. This presents an opportunity to address the imbalances in the EU’s institutional and legal structure which prevent it from addressing health inequalities more effectively. Drawing on changes underway in the public health, internal market and fiscal governance elements of EU health policy, this paper explores the potential for the post-pandemic EU health policy framework to better support the reduction of health inequalities.

EU health co-design policies to counteract the COVID-19 pandemic effect promoting physical activity.

The research is placed in the context of interdisciplinary medical-legal studies on the importance of promoting physical activity as a public health tool. The aim was to highlight the tools that can be used by EU members for planning interventions aimed at overcoming the consequences of the COVID-19 pandemic and for responding to a future crisis. First, the medical resources relating to the indirect and direct effects of the COVID-19 pandemic are analysed. Then, the results are compared with the measures of the EU bodies to verify the correspondence of the scientific arrests, with the political-regulatory interventions. It was found that the prolonged closure of sports centres and the contagion from COVID-19 produce affects the body in a way that can only be recovered by motor activity. However, in the EU, there does not exist a regulatory harmonization about health issues that can directly impose the Members to implement their legislation to promote motor activity. The signing of the Rome Declaration at the Global Health Summit on 21 May 2021 constitutes an important and concrete commitment for the exchange in the medical-scientific field, and for an effective co-design of intervention strategies for the relaunch of physical activity within projects such as EU4Health and the two-year HealthyLifestyle4All campaign.

Recommendations for developing a lifecycle, multidimensional assessment framework for mobile medical apps.

Digital health and mobile medical apps (MMAs) have shown great promise in transforming health care, but their adoption in clinical care has been unsatisfactory, and regulatory guidance and coverage decisions have been lacking or incomplete. A multidimensional assessment framework for regulatory, policymaking, health technology assessment, and coverage purposes based on the MMA lifecycle is needed. A targeted review of relevant policy documents from international sources was conducted to map current MMA assessment frameworks, to formulate 10 recommendations, subsequently shared amongst an expert panel of key stakeholders. Recommendations go beyond economic dimensions such as cost and economic evaluation and also include MMA development and update, classification and evidentiary requirements, performance and maintenance monitoring, usability testing, clinical evidence requirements, safety and security, equity considerations, organizational assessment, and additional outcome domains (patient empowerment and environmental impact). The COVID‐19 pandemic greatly expanded the use of MMAs, but temporary policies governing their use and oversight need consolidation through well‐developed frameworks to support decision‐makers, producers and introduction into clinical care processes, especially in light of the strong international, cross‐border character of MMAs, the new EU medical device and health technology assessment regulations, and the Next Generation EU funding earmarked for health digitalization.

Future Ready Regulatory Frameworks & Real World Data: A Review of EU Digital Health Policy

Can EU initiatives inform US policy makers? The German Digital Healthcare Act is one of the first countries to reimburse digital healthcare solutions for patients. Doctors prescribe selected apps covered by public insurance, covering about 73 million citizens. What’s the selection process and cost? Learn more about EU health data governance, data quality, fair use, interoperability, infrastructure & technology.

Rare Disease Registries Are Key to Evidence-Based Personalized Medicine: Highlighting the European Experience.

Rare diseases, such as inherited metabolic diseases, have been identified as a health priority within the European Union more than 20 years ago and have become an integral part of EU health programs and European Reference Networks. Having the potential to pool data, to achieve sufficient sample size, to overcome the knowledge gap on rare diseases and to foster epidemiological and clinical research, patient registries are recognized as key instruments to evidence-based medicine for individuals with rare diseases. Patient registries can be used for multiple purposes, such as (1) describing the natural history and phenotypic diversity of rare diseases, (2) improving case definition and indication to treat, (3) identifying strategies for risk stratification and early prediction of disease severity (4), evaluating the impact of preventive, diagnostic, and therapeutic strategies on individual health, health economics, and the society, and (5) informing guideline development and policy makers. In contrast to clinical trials, patient registries aim to gather real-world evidence and to achieve generalizable results based on patient cohorts with a broad phenotypic spectrum. In order to develop a consistent and sustained framework for rare disease registries, uniform core principles have been formulated and have been formalized through the European Rare Disease Registration Infrastructure. Adherence to these core principles and compliance with the European general data protection regulations ensures that data collected and stored in patient registries can be exchanged and pooled in a protected environment. To illustrate the benefits and limitations of patient registries on rare disease research this review focuses on inherited metabolic diseases.

EU health information progress: the harvest of policy supporting projects and networks

BackgroundThe European Commission supports the initiation of health information related projects and networks serving comparative population health monitoring and health system performance assessment. Many of these projects and networks have produced relevant data, standards, methods, indicators and knowledge that may be lost as these networks become inactive.The aim of this project retrieval and review was to identify health information projects and networks and their produced output; and subsequently facilitate systematic access to this information for policy makers, researchers and interested others via a web-based repository.MethodsThe scope of this article covers 1. population health oriented topics and 2. health system/health services oriented topics. Out of scope are specific infectious diseases; individual rare diseases; and the occurrence and effects of specific medical treatments, interventions and diagnostics; cohort studies; or studies focusing on research methods.We searched bibliographic databases and EU project databases for policy supporting projects and networks and selected those fulfilling our inclusion criteria after more in-depth inspection. We searched for their outputs. In addition, we reviewed country participation in these projects and networks.ResultsWe identified 36 projects and networks, 16 of which are population health oriented, 6 are health systems and services oriented and 14 cover both. Their total volume of output is not easily retrievable, as many project websites have been discontinued. Some networks and/or their outputs have found continuance within European agencies and/or national institutions. Others are struggling or have gone lost, despite their policy relevance. Participation in the projects was not evenly distributed across Europe. Project information was made available through the Health Information Portal.ConclusionsEU funded projects and networks have contributed greatly to the evidence-base for policy by providing comparative health information. However, more action is needed to evaluate and conserve their outputs and facilitate continued contribution to the field after project funding stops. The realization of a sustainable infrastructure for these projects and networks is urgent. The Health Information Portal can play an important role in conserving and reusing health information. Information inequalities may exist across Europe but need further investigating.

Prioritizing health information for national health reporting - a Delphi study of the Joint Action on Health Information (InfAct)

BackgroundHealth information (HI) strategies exist in several EU Member States, however, they mainly focus on technical issues and improving governance rather than on content-related priority setting. There is also little research available about national prioritization processes underlying HI development for policy support in the EU. The aim of this study was to broaden the knowledge base on HI prioritization strategies and to encourage expert exchange towards good practice models. A specific focus was put on HI produced for national health reporting, this being a crucial tool for policy advice.MethodsWe conducted a literature search to identify published and grey literature on national HI prioritization. This was followed by a two-round Policy Delphi study, where we explored which processes and methods exist in EU Member States and associated countries for the prioritization of HI collection. In the first round, information about these processes was gathered in semi-structured questions; in the second round, participants were asked to rank the identified approaches for desirability and feasibility. The survey was conducted online; participants were recruited from the membership of the Joint Action on Health Information (InfAct – Information for Action).Results119 experts were contacted, representing 40 InfAct partner institutions in 28 EU Member States and associated countries. Of these, 28 experts responded fully or partially to the first round, and six to the second round. In the first round, more than half of the respondents reported the existence of structured HI prioritization processes in their countries. To prioritize HI, a clear preference was given in the second round for a formal, horizontal process which includes different experts and stakeholders. National public health institutes were named desirable key stakeholders in this process, and also desirable and feasible coordinators for stakeholder coordination.ConclusionHealth information prioritization methods and procedures reflect the heterogeneity of national public health systems in European countries. Mapping, sharing and ranking prioritization methods and procedures for “good practices” provides a meaningful basis for expert knowledge exchange on HI development. We recommend to make this process part of a future sustainable EU health information system and to use the information gathered in this project to initiate the development of a guidance “Good Practice HI Prioritization” among EU Member States and associated countries.

Early Dialogues for Pharmaceutical Products in European Network for Health Technology Assessment Joint Action 3: What Was Done and Where to Go in the Future.

The aim of this article is to describe the process, results, and experiences of European Network for Health Technology Assessment (EUnetHTA) Joint Action 3's (JA3) Early Dialogue (ED) activities and to highlight opportunities for improving the processes. A descriptive analysis of the steps of the EUnetHTA ED process and evaluation of the data from the EDs conducted by EU health technology assessment (HTA) bodies, published guidelines, and documents, as well as internal statistics. In JA3, an Early Dialogues Working Party (EDWP) was established, responsible for developing and improving processes and providing advice to pharmaceutical companies, supported by the ED Secretariat. From June 2017 to May 2021, 113 requests for pharmaceutical EDs were received and 38 conducted. The process was continuously optimized, and different approaches for involving patients were tested. Finally, a centralized procedure was chosen with the key documents produced by two responsible agencies and reviewed by the EDWP. Patient involvement was primarily done by interviewing a national patient representative to obtain general feedback on the disease and the planned study design. During JA3, EDs were established as an efficient, successful product. Pharmaceutical companies benefited not only from the positions of the individual agencies for the national HTA, but also from the recommendations that were common to all HTA authorities. In addition, regarding the European HTA Regulation, it will be important to conduct Joint Scientific Consultations with a view toward future Joint Clinical Assessments and to further develop processes aligned with the high demand for consultation.

The role of the European Union in health policies of member states – an example of the rare diseases policy in Croatia

AimTo assess the European Union's (EU) impact on the Croatian health policy, and identify which mechanisms and processes were used to shape a particular health policy on the EU and national levels. The study focused on the rare diseases policy to obtain a better insight into the process of policy shaping, starting at the EU level and moving down to the Croatian national level.MethodsWe conducted actor analysis, policy networks, and semi-structured qualitative interviews with key policy actors at the EU and domestic level. The analysis of actors included actor mapping, the analysis of their relationships, and of their interdependence. Policy networks involved identifying key actors and analyzing them separately to create both policy networks to explain their hierarchy and relationships. Semi-structured interviews included ten key experts at the EU and national health policy levels.ResultsThe implementation of the EU health policy is complex. Hard and soft law were complementary in the way they affected the translation of EU rare diseases policy into Croatian law. Strong and interconnected EU and domestic actors were significant in this process, which resulted in the creation of Croatia’s rare diseases policy.ConclusionGiven that the rare diseases policy area is a developing policy area, this study contributes to a better understanding of the implementation of the EU health policy, clarifying a mechanism that can enable national governments to adopt specific health policies.

Coping with interoperability in the development of a federated research infrastructure: achievements, challenges and recommendations from the JA-InfAct

BackgroundInformation for Action! is a Joint Action (JA-InfAct) on Health Information promoted by the EU Member States and funded by the European Commission within the Third EU Health Programme (2014–2020) to create and develop solid sustainable infrastructure on EU health information. The main objective of this the JA-InfAct is to build an EU health information system infrastructure and strengthen its core elements by a) establishing a sustainable research infrastructure to support population health and health system performance assessment, b) enhancing the European health information and knowledge bases, as well as health information research capacities to reduce health information inequalities, and c) supporting health information interoperability and innovative health information tools and data sources.MethodsFollowing a federated analysis approach, JA-InfAct developed an ad hoc federated infrastructure based on distributing a well-defined process-mining analysis methodology to be deployed at each participating partners’ systems to reproduce the analysis and pool the aggregated results from the analyses. To overcome the legal interoperability issues on international data sharing, data linkage and management, partners (EU regions) participating in the case studies worked coordinately to query their real-world healthcare data sources complying with a common data model, executed the process-mining analysis pipeline on their premises, and shared the results enabling international comparison and the identification of best practices on stroke care.ResultsThe ad hoc federated infrastructure was designed and built upon open source technologies, providing partners with the capacity to exploit their data and generate dashboards exploring the stroke care pathways. These dashboards can be shared among the participating partners or to a coordination hub without legal issues, enabling the comparative evaluation of the caregiving activities for acute stroke across regions.Nonetheless, the approach is not free of a number of challenges that have been solved, and new challenges that should be addressed in the eventual case of scaling up. For that eventual case, 12 recommendations considering the different layers of interoperability have been provided.ConclusionThe proposed approach, when successfully deployed as a federated analysis infrastructure, such as the one developed within the JA-InfAct, can concisely tackle all levels of the interoperability requirements from organisational to technical interoperability, supported by the close collaboration of the partners participating in the study. Any proposal for extension, should require further thinking on how to deal with new challenges on interoperability.

Quality Soil as a Pathway to Healthy Food in the EU – Project Information

Abstract Globalization and the pressure to increased industrial agriculture result in deterioration of the environment, climate change and a serious threat to human and animal health. Soil contamination affected by the environmental pollution is one of the most pressing issues in the political and expert debate on food safety within the related EU policies as Common Agricultural Policy, EU agri-environmental, EU food policy and EU health policy.

The Impact of the COVID-19 Pandemic on the Macroeconomic Aggregates of the European Union

Abstract Economic experts’ predictions of a slowdown in the EU’s global economy and economic growth in the year 2020 were based on various risks and uncertainties existing on a world scale, ranging from the US-China trade war, traditionally strained relations of the EU and the US on the one hand and the Russian Federation on the other, all the way to BREXIT and economic migration to developed EU countries. However, the COVID-19 pandemic has further aggravated those forecasts, so that the entire EU is recording a historic decline in all macroeconomic aggregates. The beginning of the pandemic in the EU was accompanied by the complete border lockdown of the entire Union, which greatly affected the economies of the member states. The EU is experiencing a decline of both real and nominal GDP, declining incomes, employment decline and unemployment increase. This paper will investigate the impact of COVID-19 onto GDP, unemployment, and EU public debt. Correlation-regression analysis confirms the positive correlation between these variables and the economic crisis caused by the COVID-19 pandemic. In addition to the economic crisis, a crisis of EU health systems, which requires huge economic investments. A more prominent economic recovery is hard to expect until the global pandemic ends. One thing is for certain, this economic crisis will continue in 2021, whereby a more significant recovery is expected only in the year 2022. Certainly, it will take years to make up for the economic losses caused by the pandemic.