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.
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The Joint Action Towards the European Health Data Space (TEHDAS) is a consortium of 26 EU MS and other countries that work to improve cross-border use of health data for the benefit of citizens’ health, for public health, research and innovation.TEHDAS builds on earlier EU actions fostering the digital transformation of European health systems. It contributes to responding to the Member States’ call at the October 2020 European Council to set up a European Health Data Space and proposed by the von der Leyen Commission.The Joint Action helps Members States and the Commission in developing and promoting concepts for sharing of data so that in the future Europe, citizens, communities and companies benefit from a protected and seamless access to health data regardless where it is stored.TEHDAS will suggest options for an operational framework and governance in order to overcome legal and technical differences between countries. TEHDAS is grounded on the principles of transparency, trust and citizen empowerment. It will work on technical and semantic challenges, propose services, architectural and infrastructural elements required in the European Health Data Space.Citizens increasingly manage their data which requires a better understanding and a European perspective. To maintain trust in fair and secure data sharing, TEHDAS will suggest strengthened governance mechanisms for cross-sector use of health data in common data spaces at the EU and Member State levels.TEHDAS will reach out and engage with many types of stakeholders to reflect their needs and expectations, explore views on economic issues, and suggest concrete ways to integrate results into the future the European Health Data Space.
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Topic: • Addressing differences in national General Data Protection Regulation (GDPR) implementation in the health sector, including the European Health Data Space and the health data use
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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.

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The general objective of the Joint Action – Innovative Partnership for Action Against Cancer (iPAAC JA) is to develop innovative approaches to advances in cancer control. The innovation that will be covered within the JA consists of further development of cancer prevention, comprehensive approaches to the use of genomics in cancer control, cancer information and registries, improvements and challenges in cancer care, mapping of innovative cancer treatments and governance of integrated cancer control, including a new analysis of National Cancer Control Plans. The development of innovative approaches to cancer control will be supplemented by a Roadmap on Implementation and Sustainability of Cancer Control Actions, which will support Member States in implementation of iPAAC and CANCON recommendations. The Roadmap will act as the central pillar of the JA, integrating the diverse topic areas, providing synergies between the topics, ensuring consideration of transversal issues for all topics and acting as the central comprehensive deliverable, integrating all the JA outputs. A variety of methods will be used to fulfil the general and specific objectives including pilot studies, working groups, expert panels, literature review and surveys. A governmental board will be in place to ensure that implementation and sustainability in national contexts are duly considered for each topic area. The proposal for the iPAAC JA proposes actions to address objective 1 of the 2017 annual work programme, that is promoting health, preventing diseases and fostering supportive environments for healthy lifestyles taking into account the ‘health in all policies’ principle. The work to be developed by the iPAAC JA is complementary to the outcomes of the EPAAC and CANCON Joint Actions, funded by the Second and Third Health Programmes and will build on their outputs, using the stakeholder networks as an optimal base for the development of innovative cancer control actions.
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GAPP Joint Action (facilitatinG the Authorisation of Preparation Process for blood and tissues and cells) is a 36 months JA aiming at facilitating the development of a common and optimal approach to assess and authorise preparation processes in blood and tissues establishments (BEs and TEs). Particular attention will be devoted to innovative processes that might come up taking advantage of the work developed in previous EU funded projects/actions. This Joint Action will clearly contribute to the implementation of Union legislation in the fields of human tissues and cells, blood, providing tools and training to increase harmonisation of those MS activities that regulate the areas of blood transfusion, transplantation of tissues and cells and assisted reproduction, in strong abidance with art 4.5 of Annex I of Regulation 282/2014. These are fields of healthcare that involve a considerable amount of movement of donated substances of human origin between MS and also movement of citizens between MS for treatment, particularly in the field of assisted reproduction. The aim of the action is to prepare a “Good Practice Guidelines to authorisation and preparation process in blood, tissues and cells” and its three technical annexes respectively on i) authorisation changes in donation, procurement and collection, processing, preservation, storage and distribution (divided in three part blood, tissues and cells, and reproductive tissues and cells); ii) assessing the quality and safety of donor testing, microbial inactivation and sterilisation steps as part of PPA; iii) assessing clinical data as part of PPA. In addition to this it will be built a model and a tool to facilitate sharing of information among European Union Competent Authorities and a number of CA inspectors will be trained specifically to assess and authorise preparation processes of tissues, cells, reproductive cells and blood products.
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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
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The effects of health inequalities within and between EU MS are widely recognized,and reducing health inequalities is on the agenda of many MS. Moreover new challenges like the huge migration flows and the economic crisis and austerity policies that affect EU citizen’s everyday life are worsening the scenario. Despite an increasing concern and awareness on health inequalities, a wide gap exists in Europe in terms of political response.
The Joint Action Health Equity Europe will represent an important opportunity for MS to work jointly to address health inequalities and underlying social determinants of health.
The general objective of the project is to improve health and well-being of the EU citizens and achieve greater equity in health outcomes across all groups in society by a focus on socio-economic determinants of health and lifestyle related health inequalities. A particular priority will be given to migrants, since poor health and lack of access to health services can be an obstacle to integration.
This Joint Action aims to: deliver a policy framework with a menu of actions and recommendations for national, regional and local uptake and implementation; develop better policies improve monitoring, governance, implementation and evaluation; implement good practices and facilitate exchange and learning; identify factors of success, barriers and challenges and how to overcome them.
The Joint Action will contribute meeting two objectives of the Third health Program by introducing the equity lens in “Objective1: Promoting health, preventing diseases and fostering supportive environments for healthy lifestyles taking into account the ‘health in all policies” and in “Objective4: Facilitating access to better and safer healthcare for Union citizens”.
This Joint Action will follow a three-step approach that will facilitate: identification of policy options to tackle health inequalities; implementation of feasible and effective actions in all MS involved; elaboration and dissemination of further recommendations and guidelines.
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Ageing population and increased prevalence of chronic conditions combined with limited human and financial resources are putting health systems under increasing strain. Digital tools, however, bring an opportunity to improve health care sector. Integrating eHealth into health policy and aligning eHealth investments with health requirements is of high importance, especially when recommendations and practices can be transferred across countries. Targeting Members Sates and Countries of the EU and eHealth stakeholders, as well as the general public, this project aims to improve health care with the use of ICT. eHAction is the Joint Action supporting the eHealth Network, which, in its Multiannual Work Programme 2018-2021, sets targets for exploring eHealth to facilitate the management of chronic diseases and multi-morbidity, by increasing sustainability and efficiency of health systems, and by facilitating personalized care and empowering the citizen. Specifically, it will work to find ways to empower people by giving them an active role in managing their health care data and processes, to use health data in an innovative way and to enhance continuity of care through the use of interoperable and cross-border solutions. The eHAction is in line with the Third Programme of EU actions in the field of health contributing to foster health in Europe by promoting the use of eHealth in a structured policy framework.
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This Joint Action on Rare Cancers (JARC) will be aimed at:

1. prioritising rare cancers (RCs) in the agenda of the Europe (EU) and Member States;
2. developing innovative and shared solutions for European Reference Networks (ERNs) on RCs, in the areas of quality of care, innovation, education and state of the art definition on prevention, diagnosis and treatment.
The objectives of JARC will be achieved by creating a platform for competent national authorities as well as institutions, scientific and professional societies and patient organisations, to produce consensus-based recommendations, with a special view to the new ERNs, seen as a great opportunity for improvement of RC patient outcomes in the EU.
Following the results of the RARECARE project, all the 12 families of RCs will be considered. Consensus-based recommendations about RCs will be provided to improve: 1) epidemiological surveillance of RCs; 2) quality of healthcare, primarily through the new ERNs; 3) the availability of clinical practice guidelines on RCs; 4) innovation, also by optimizing clinical research regulations as well as practices and semantics regarding patient data and tissues; 5) medical and patient education; 6) health policy measures on RCs at the EU and national level; 7) patient empowerment (which will be pursued across all items dealt with by JARC). All EU stakeholders in the field of RCs and rare diseases will be involved.
JARC will carry forward the aims of the Third Health Programme by improving chances of EU RC patients to have access to appropriate healthcare, primarily through optimal shaping of ERNs. Thus, all this should result in reduced healthcare inequalities, increased innovation in health, increased sustainability of health systems, decreased health migration and reduction of gaps in rare cancers survival across EU countries.

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The main focus of the Best-ReMaP Joint Action will be on adapting, replicating and implementing effective health interventions, based on practices that have been proven to work in the areas of food reformulation, framing of food marketing and public procurement of healthy food in public settings, thus contributing to increased offer of healthier options of processed foods (by reducing salt, sugar and fat from the processed foods) available in EU (super)markets. The JA will implement a European Standardised Monitoring system for the reformulation of processed foods. The JA aims to deliver a harmonised EU approach to reducing unhealthy (digital) food marketing to children and adolescents and to use already developed tools for harmonised monitoring of (digital) marketing. A prototype catalogue of food will be tested in the public procurement procedure to contribute to the higher quality of menus by assuring transparent quality of the procured foods within public institutions. Building on this work, the JA will support implementation, transfer and integration of the results, outcomes and recommendations of the Best-ReMaP JA into national and EU-level policies. Throughout the JA processes, the participatory engagement of EU and national stakeholders in the field will be prioritised.
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