The HAPPY PATIENT project aims at reducing the inappropriate use and dispensing of antibiotics in the most common community-acquired infections (i.e., respiratory tract infections, urinary tract infections, dental infections) with a multifaceted intervention in health care facilities as suggested in point 4.2 of the EU guidelines for the prudent use of antimicrobials in human health. The multifaceted intervention will be carried out in five countries with a diverse pattern of antibiotic consumption: ES, FR, LT, PL and GR.
We will follow a model which both promotes both stakeholder stewardship and is patient-centred. The critical focus will be on the most important interaction in determining usage of antibiotics: contact between patients and health professionals at different levels of the Health Care System. Hence, activities of HAPPY PATIENT will target patients, primary care professionals (general practitioners, nurses, and dentists), secondary care (out-of-hours services), nursing homes and community pharmacists.
We will follow the Audit Project Odense (APO) methodology developed in FP6 HAPPY AUDIT project. APO consists of an audit-based registration to perform a context analysis before the implementation of the multifaceted intervention, and then to perform an assessment of changes after the implementation of the multifaceted intervention. Based on the Normalization Process Theory for changing behaviour, the multifaceted intervention will include: a) peer feedback with reflexion and discussion, b) enhancement of communication skills in order to improve the communication process between the health professionals and the patients, c) patient information leaflets and posters, d) country-tailored information on antibiotic usage(incl. the “antibiotic foot-print”).
HAPPY PATIENT expects to reduce the inappropriate prescription of antibiotics by 40%. Its key outputs will be both scalable and capable of implementation throughout the diverse health systems in the EU.

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The “Joint Action on integrating prevention, testing and link to care strategies across HIV, Viral Hepatitis, TB & STIs in Europe” (INTEGRATE) has the overall objective to increase Integrated early diagnosis and linkage to prevention and care of HIV, viral hepatitis, TB and STIs in EU Member States by 2020.
A number of tools have been developed to reduce transmission, optimize early diagnosis and linkage to care for one or more of these four diseases. INTEGRATE will map relevant existing tools for cross-linking. A peer-review process will identify which of these tools are complimentary or redundant for other disease(s), and which could be adapted or require further innovation.
HIV, viral hepatitis, TB and STIs are cross-borders public health threats of concern to Europe that affect vulnerable populations disproportionately and require personalised interventions. As multiple dimensional approaches are required to reduce the public health burden, the most optimal profile of approaches that provide additive effects (and that are reasonably cost-effective) should be identified and implemented broadly.
INTEGRATE provides a platform to disseminate and exchange best practice among Member States and facilitate discussions on innovations and emerging issues within the four diseases. In this respect, INTEGRATE is a shared European effort that extends beyond the partners and can create important synergies across European stakeholders, projects and initiatives.
INTEGRATE supports the implementation of the Commission Communication on ‘Combating HIV/AIDS in the European Union and neighboring countries’ and the ‘Action Plan on HIV/AIDS in the EU and neighboring countries’ by ensuring better preparedness across the EU and by identifying innovative evidence-based testing and prevention tools to reduce new cases of HIV, viral hepatitis, TB and STIs in priority groups.
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Over five million patients in the EU annually receive transfusions or transplantations of substances of human origin (SoHO): blood components, plasma derived medicines, tissues & (stem) cells, germ cells for assisted reproductive technologies and organs. These treatments depend heavily on the availability of SoHO obtained from more than 13 million donors. Obviously, donor availability is the most vulnerable link in assuring these treatments.

Procedures to collect SoHO, including donor selection and the actual collection or procurement, are regulated in the EU by several directives. In addition, the European Directorate for the Quality of Medicines & Health Care (EDQM) publishes recommendations (Guides) relating to the preparation, use and quality assurance of SoHO forming a basis for standard operating procedures. From this, one could infer that practice throughout Europe is harmonised. However, implementation of the directives and Guides in Member states has resulted in diverging donor selection and protection policies. Expert opinions, lacking quantitative risk-based selection criteria, and prompting a one-size-fits-all approach, have in fact lead to inflexibility and inconsistency.

TRANSPOSE aims at a structured, alternative approach to construct risk-based Guidelines for the selection and protection of donors. To this end, TRANSPOSE will involve a massive pool of experts and take stock of current practices and scientific insights.

TRANSPOSE may facilitate the process of revising related EU Directives. Moreover, the developed guiding principles and Donor Selection & Protection Guidelines will assist EU member states to implement policies in a consistent and clear-cut way. Finally, a standard Donor Health Questionnaire with carefully guided local/regional/national customization will become available, which can be used widely and will enable comparisons between Member States on the prevalence of certain risks and risky behaviours throughout Europe.

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The Joint Action proposal on “HIV and Co-infection Prevention and Harm Reduction” (HA-REACT) addresses existing gaps in the prevention of HIV and other co-infections (especially tuberculosis and hepatitis) in priority areas of the EU. Despite huge advances in treatment and care and successful implementation of evidence-based preventive interventions in many EU member states, these infections are still not controlled among certain population groups and regions. The HA-REACT Joint action (JA) directly addresses the Communication from the Commission [COM(2009)569] on “Combating HIV/AIDS in the European Union and neighbouring countries, 2009 -2013” and relevant actions laid out in the associated [SWD(2014)106] action plan extension 2014-2016. The project takes a practical rather than a theoretical or purely guiding approach. It will implement concerted, multi-country, and multi-actor actions, strengthening evidence-based practices in the focus countries, where the situation and needs are particularly challenging. Focused action for greater impact is the leading principle of this proposal. The HA-REACT will focus on pragmatic actions targeting the most vulnerable populations, i.e. people who inject drugs (PWID). The focus countries for the JA were selected according to an objective and transparent selection criteria, developed by the ECDC and the EMCDDA in which the countries were ranked according to their epidemic situation and coverage of preventive measures. In addition to work packages of Coordination, Dissemination and Evaluation, HA-REACT actions are organized into five core work packages: Testing and linkage to care, Scaling up harm reduction, Harm reduction and continuity of care in prisons, Integrated care, Sustainability and long-term funding.
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