Managing Frailty. A comprehensive approach to promote a disability-free advanced age: the ADVANTAGE initiative
ADVANTAGE will build a common understanding on frailty to be used by Member States on which to base a common management approach of older people who are frail or at risk for developing frailty in the European Union.
The identification of the core components of frailty and its management should promote the needed changes in the organization and the implementation of the Health and Social Systems to provide those models of care that, stemming from the particular health profile of each Member State (MS), will allow them to face the challenge of frailty within a common framework.
ADVANTAGE will summarise the current State of the Art for the different components of frailty and its management, both at individual and population level, will collect information on the development of programs to manage frailty in older adults in the EU and will propose, as its main outcome, a common European model to approach frailty. This model will include a road map that, considering the degree of frailty policies� development, will propose interventions for frail and at risk people and will establish tailored milestones for each MS in order to achieve a comprehensive approach to promote a disability-free advanced age. Furthermore, the model will identify gaps of knowledge in the field that would benefit from further research.


Europe have experienced several terror attacks in recent years. Health preparedness and cross sectoral response also involves planning for terror attacks including biological or chemical agents. To be better prepared to handle these types of terror attacks EU have set up a call, as part of the Third Health Programme 2014-2020, to develop a proposal for Joint Action to Strengthen Health Preparedness and Response to Biological and Chemical Terror Attacks. This acronym for the Joint Action is JA BICTRA.

The JA BICTRA is under development, and the main objectives are to (1) to address gaps in health preparedness and (2) the urgent need to strengthen cross-sectoral work with the security, civil protection and health sectors.
The coordinator, has in the development of the proposal, focused on attracting relevant technical expertise from health, law enforcement and civil defense sectors to support delivery on the main objectives.
The work of the Joint Action will be done in eight work packages. Four of which are core work packages: coordination, dissemination, evaluation and integration & sustainability. And four technical work packages that will be addressing the following areas: preparedness and response planning, cross sectorial collaboration, risk and crisis communication and novel threats.
The proposal is supported by 18 applicants, and at the time of submission it includes 34 affiliated entities. If successful, the project will have a running time of 36 months.



Joint Action on Dementia 2015-2018The Joint Action will focus on two phases on work: approximately 12 months on developing a consensus on the best evidence of effective action in 4 key areas (diagnosis and post-diagnostic support; crisis and care coordination; quality of care in residential care settings; and dementia-friendly communities); and approximately 24 months on testing the best evidence of effective action in localities to develop a greater understanding of how change can be taken forward in practice.In addition, there will be 3 additional components: evaluation of the joint action (outputs and quality: dissemination; and overall coordination of this project.The project will be achieved through collaborative effort, with the 4 main work plans having identified leads or co-leads and other countries contributing time to the work.


InfAct (Information for Action) is a JA on health information (HI). HI is essential to build up country specific and cross-country knowledge. HI is the basis to inform national health policies, to steer population health investment decisions, to assess the effectiveness of different approaches to enhance population health through promotion, prevention, treatments and care. Timely, up-to-date HI is also vital in framing EU wide programs and policies.

The major outcome expected of the JA is a sustainable solid infrastructure on EU HI through improving the availability of comparable, robust and policy-relevant health status data and health system performance information. Through country collaboration, the JA streamlines HI activities, reduces the data collection burden and works for a sustainable and robust data collection in Europe that facilitates and supports country knowledge, health research and policy making.

The JA gives attention to:

• develop the business case and roadmap for implementation of the European Research Infrastructure Consortium on Health Information for Research and Evidence-based Policy
o governance structures,
o national HI consortia and domain specific HI research networks
• assess HI systems (HIS) in MS and regions
• develop a roadmap for training in HI with the objective to tackle HI inequality through Europe
• standardize HI instruments, tools and methods
• strengthen the HI efficiency for public health policy through new ways of using health and non-health data sources
• enhance the introduction of the interoperability of health data sources
• enhance the translation of HI into public policy

The JA watches for the sustainability of all actions taken by the JA. Coordination, dialogue and interaction with the Commission Expert Groups on HI and on HSPA, Eurostat, DG Research and other relevant DGs, international organization (WHO, OECD) reinforce further the sustainability of the JAs’ work and outcomes.



The SHARP Joint Action will strengthen implementation of Decision 1082/2013/EU, supporting the EU level preparedness and responses to health threats and the implementation of the International Health Regulations (2005). The Joint Action implements actions mentioned in Annex 1 of the Annual Work plan 2018 of the EU Health Programme 2014-2020.
Through the Joint Action, the member and partner states and the Unions common ability to prevent, detect and respond to biological outbreaks, chemical contamination and environmental and unknown threats to human health will be strengthened. Special efforts will be employed to fill gaps that have been or will be identified in priority countries (countries that have biggest gaps in the capacity required for full IHR capability). The Joint action consists of 10 Work Packages, covering core public health capacities according to the IHR (2005). In addition to a coordination function, these will cover areas such as Communication, Evaluation, Sustainability, IHR core capacity, Preparedness, Laboratories, Training and exercises, Chemical threats and Clinical management.
SHARP will also collaborate with several other Joint Actions, specifically the “Healthy Gateways” that addresses Points of Entry, the Joint Action on Vaccination (EU-JAV) and the Joint Action on Antimicrobial Resistance (EU-JAMRAI).
The partnership of the joint action consists of 26 Associated Partners and 33 Affiliated Entities, which all will receive Commission co-funding. In addition there are 9 Collaborating Partners that will self-fund all activities that they participate in. Totally 30 countries (24 EU members, 3 EEA/EFTA members and 3 European neighborhood countries) participate in the Joint Action. The SHARP JA will liaise with and collaborate with the ECDC, the WHO EURO regional office and the WHO Health Emergency and IHR unit in Lyon, and IANPHI in relevant activities. Special emphasis will be made to avoid duplication of work for the member states.



Topic: Joint Action to strengthen preparedness including laboratories in the EU against serious cross-border threats to health and support the implementation of International Health Regulations (IHR)


The overall ambition from EU Member States (MS) is to better include eHealth into health policy and better align eHealth investments to health needs. A central aspect is the transferability of health data across borders of MS and therefore the organizational, technical, semantic and legal interoperability. In order to ensure progress and to bridge the gaps between the governance, strategy and operational levels, a dedicated mechanism for eHealth at EU level has been established: The eHealth Network was formally established in 2011 through the Commission’s Implementing Decision 2011/890/EU based on Art. 14.3 Directive 2011/24/EU and represents the highest decision-making body at EU political level. At a European level there is a strong need to maintain this mechanism and to ensure further common political leadership and ongoing integration of eHealth into health policy in order to continue developing eHealth services responding to health systems‘ needs and health objectives. This is the framework for the Joint Action to support the eHealth Network which is led by the MS and co-financed by the European Commission through a Joint Action.

Hence, the main objective of the Joint Action is to act as the main preparatory body for the eHealth Network. By doing so, the Joint Action aims to develop political recommendations and instruments for cooperation in the four specific priority areas that are specified in the eHealth Network's multi-annual work plan 2015-2018 and that were adopted by the eHealth Network in May 2014:
(1) Interoperability and standardisation,
(2) monitoring and assessment of implementation,
(3) exchange of knowledge and
(4) global cooperation and positioning.

Thereby, the Joint Action functions also as a platform for operational and strategic cooperation between MS on eHealth including their relationship with eHealth Stakeholder Groups and Standardization Organizations.


Rare diseases (RD) have been identified as one of the paradigmatic fields in which actions conducted at the European level constitute the adequate response to their specific problems: poor recognition leading to diagnostic delay and inappropriate management including adapted social services, poor health outcomes, social burden, limited knowledge on natural history and pathophysiology leading to an insufficient development of new therapies. The low prevalence and the specificity of RD make that a global, multi-stakeholder approach, intended to gather specific expertise and to build shared strategies is necessary to address these issues.
The general objectives of RD-Action are to:
▪ Support the further development and sustainability of the Orphanet database, the biggest global repository of information on RD
▪ Contribute to solutions to ensure an appropriate codification of RD in health information systems
▪ Continue implementation of the priorities identified in Council Recommendation 2009/C151/02 and the Commission Communication (COM 2008 679) on RD, with a view to ensuring the sustainability of the recommended priority actions and to support the work of the Commission Expert Group on Rare Diseases (CEGRD).
This JA will expand and consolidate the achievements of the former JAs on RD supported by the European Commission: the Orphanet JA and the EUCERD JA. More precisely, this proposal has the ambition to help member states to implement the recommended measures adopted or to be adopted by the CEGRD and to produce the data necessary for countries to do so. Interactions between the production of data at the Orphanet database level and the implementation of policy priorities including codification will be strengthened during this JA.RD-Action large geographical coverage is key to success as it will promote the transfer of European recommendations into national policies and the collection of information and concerns from MS to the CEGRD, thus to the European Commission.



The general objective for EUnetHTA JA3 is to increase the use, quality and efficiency of joint HTA work at European level to support evidence-based, sustainable and equitable choices in healthcare and health technologies and ensure re-use in regional and national HTA reports and activities, in order notably to avoid duplication of assessments. An overarching objective is to develop a general strategy, principles and proposal for a scientific and technical mechanism of permanent sustainable European Collaboration on HTA in the light of the Directive on CBHC. During the JA3 the collaborative production of structured HTA core information, including rapid HTAs will be structurally implemented and the methodologies and production related information and communication technology infrastructure will be finalised as to stand alone from 2020 onwards. EUnetHTA JA3 will also aim to increase the alignment between HTA reports used for reimbursement decisions and clinical practice guidelines that are used by physicians in daily practice. Additionally, EUnetHTA JA3 will also support more alignment of different processes in the lifecycle of health technologies. For instance, processes on market authorization and HTA of pharmaceuticals could be organised in a more closely aligned fashion which may lead to a timelier and more efficient process promoting earlier patient access to products that have a real added value. EUnetHTA JA3 will also contribute to the discussion on the assessment of the effectiveness and safety of new medical devices as is currently taken place as part of the debate on new European legislation for medical devices. Finally, all these outcomes will contribute to the dissemination of health information and knowledge, thus improving policy-and decision-making in the health systems, which turns into protection of citizens against unsafe or ineffective technologies and improves access to high value health technologies. Ultimately this contributes to imTo be developed


In all EU Member states (MS), the high level of overweight and obesity in children and adolescents is of particular concern. In the EU, around 1 in 3 children 6-9 years old were overweight or obese in 2010, a sharp rise in prevalence despite numerous MS or EU initiatives.Physical inactivity and poor diet from birth (and even in utero) are important determinants of adiposity leading to overweight and obesity. They are also independently associated with various non-communicable disease risk factors leading to the main pathologies European populations are suffering from, including detrimental psychosocial outcomes. Overweight and obesity represent an economic burden with up to 7% of EU health budgets spent each year directly on diseases linked to obesity, with more indirect costs resulting from lost productivity. Nutritional problems and physical inactivity need to be addressed in an integrated way so as to promote healthier environments, to make the healthy option the easiest option and to inform and empower families.Within the general frame of the EU Action plan on childhood obesity 2014-2020, the JA’s general objective is to contribute to halting the rise in overweight and obesity in children and adolescents by 2020. Through the, identification, selection and sharing of best data and practices within the 25 countries involved, the JA will allow for : to advocate based on an estimation and forecast of economic cost of overweight and obesity; to improve the implementation of integrated interventions to promote nutrition and physical activity for pregnant women, families with young children; to improve actions within school settings; and to increase the use of nutritional information on foods by public health authorities, stakeholders and families for nutrition policy purposes. The JA will reinforce the links between national nutrition and physical activity policies initiated by the EU Strategy on nutrition, overweight and obesity-related health issues.


Antimicrobial resistance (AMR) is a serious public health threat that is gaining swift ground. The increase of multi-resistant bacteria associated to the lack of new antibiotics represents a threat to global health. Some patients are faced with no therapeutic solutions as some bacteria resist to all antibiotics. Moreover, “old” antibiotics and to some extent more “recent” ones are gradually removed from the market because they are not economically sustainable, albeit being still possibly efficient. The issue of antimicrobial resistance is a real challenge that decision-makers are well aware of and has gained a high priority among public health challenges.
A closely related challenge is the issue of Healthcare Associated Infections that shall not be considered separately. In fact, infection prevention and control strategies should go hand in hand with i) prudent use of antibiotics ii) appropriate tools for monitoring and surveillance and iii) accurate diagnostic tests to decide on the right therapy.
The various national, European and international initiatives that have emerged over the last decade have shown a great commitment to actively tackle these issues.It is essential that all actors in the field of AMR join forces so as to avoid duplication of efforts and ensure greater coherence. Moreover, it is essential that the strategies adopted extend beyond the sole human health domain and bring a global One Health response.
The overall objective of the AMR-HCAI JA is to ensure that policies for control of AMR and HCAI are adopted and implemented across EU MS in a coordinated way, ensuring national specificities are accounted for, in line with the ECDC and WHO guidelines and recommendations, and in conjunction with other European initiatives.This will be made possible by bringing together different networks of policy makers, experts and organizations on AMR and HCAI working in different European and International initiatives and projects relevant for policy decision.
