Francesco Cosentino: Policy change can only happen when it is driven both at EU and national level

As the European Commission prepares to launch the European Cardiovascular Health Plan, recognizing the strong link between cardiovascular disease and diabetes is more important than ever. However, for real impact, the plan must provide funding that reflects the scale of the CVD burden, says Francesco Cosentino, Vice-President of the European Society of Cardiology (ESC) from 2020 to 2022, and a member of JACARDI’s Stakeholder Advisory Board. JACARDI’s work in optimizing the availability of health data can play a vital role in shaping future policies and ensuring data availability will also be key to improving adherence to guidelines.

What significance does JACARDI hold for you and your organization in terms of its mission and values?

The mission of the European Society of Cardiology (ESC) is to reduce the burden of cardiovascular disease (CVD). Our society is very supportive of the great work being undertaken through JACARDI, which aims to support European countries in reducing the burden of CVD and diabetes and improve quality of care for the individuals affected.

How do you see JACARDI’s role in tackling the increasing prevalence of cardiovascular disease and diabetes in Europe?

I believe that JACARDI, through its numerous science-based pilot projects in 18 EU countries and with its network of 76 partners, has great potential to foster community spirit, knowledge sharing and to create value for tackling the increasing prevalence of CVD and diabetes across Europe. I think that JACARDI’s main strength is the integrated approach addressing both diseases simultaneously with a focus on the entire patient journey.

How do you think JACARDI will influence future collaboration on cardiovascular disease and diabetes prevention in Europe?

JACARDI specifically reflects the realities of patients who live with two comorbidities. We know CVD remains the predominant cause of death and disability in Europe. In the European Union, 62 million people live with CVD and close to 30 million new cases are diagnosed every year. In addition, 1 in 10 adults live with diabetes. What we also know is that people with diabetes have a two to three times higher cardiovascular risk than people without diabetes. They also see their life expectancy reduced by 10-14 years.

It is important to diagnose CVD and diabetes as early as possible to prevent complications and reduce healthcare costs. Recognizing these interlinkages between these two comorbidities is also crucial in the context of the incoming European Cardiovascular Health Plan from the European Commission. I believe that diabetes will be included within this plan.

So, joint health checks based on common risk factors for both diseases, such as high body mass index (BMI), high blood pressure, tobacco and alcohol consumption, high blood glucose and high LDL cholesterol are sensible and cost-effective options for the identification of high cardiovascular risk in individuals.

Based on your experience chairing the ESC Guidelines on Diabetes and Cardiovascular Disease, how can JACARDI’s research contribute to shaping future clinical guidelines in Europe?

Our ESC Guidelines on Diabetes and Cardiovascular Disease are an excellent tool to implement evidence-based, person-centered treatment strategies. This is what we call personalized medicine, which we know is effective in reducing cardiovascular risk in patients with diabetes. I believe that findings from JACARDI may potentially help the implementation of our guidelines in the daily clinical practice.

A critical step is ensuring that the clear target outlined in the ESC guidelines, to achieve better outcomes for people living with diabetes and CVD, is met for all patients. However, we are not there yet.

In this regard, data availability, data sharing and utilization are really crucial to improve patients’ and healthcare professionals’ adherence to the guidelines. One of the Work Packages of JACARDI aims to optimize the way individuals, communities, and organizations access, understand and use health information. These can be very helpful in shaping future guidelines.

With your background in cardiovascular pharmacology, what role do you think pharmacological innovations will play in complementing JACARDI’s efforts to reduce the burden of cardiovascular disease and diabetes?

I believe that a wide range of stakeholders have an important part to play in improving cardiovascular health in our population. This also includes the innovations coming from pharma and device companies. We hope that the innovation pipeline will continue to improve in the coming years as many clinical needs remain unmet.

Collaboration is definitely key and this is why the ESC is also a proud partner of the European Alliance for Cardiovascular Health (EACH), which comprises 21 leading organizations, including medical societies, industries and patients organizations.

Given your leadership experience in the European Society of Cardiology, how can JACARDI help drive policy changes at the European level to improve cardiovascular and diabetes care across diverse healthcare systems?

The ESC together with the European Alliance for Cardiovascular Health, has been advocating for a European Cardiovascular Health Plan for many years. Now finally, the policy context is extremely positive. The President of the EU Commission put CVD on the agenda and the Commissioner for Health has committed to developing a European Cardiovascular Health Plan, similar in ambition to Europe’s Beating Cancer Plan.

This was announced on the 3rd of December 2024, on the same day the Ministers of Health from the 27 Member States of the European Union approved the Council Conclusions on the Improvement of Cardiovascular Health in the EU.

It is clear that the plan is coming. What we need to ensure is that there is significant funding attached to the plan, proportionate to the burden of CVD. I believe the magnitude of work and effort from JACARDI also shows the interest at Member State level of this being a priority topic.

Policy change can only happen when it is driven at both the EU and national levels. And JACARDI showcases this important complementary nature with 80% of the close to €60 million in funding coming from the EU and the remaining 20% from the 21 participating European countries. I think collaboration is key and the driving force behind making real progress.

Prof. Francesco Cosentino is a Professor of Cardiology at the Karolinska Institute and University Hospital in Stockholm, Vice-President of the European Society of Cardiology (ESC) from 2020 to 2022 and co-Chair of the ESC Advocacy Committee from 2022 to 2024. He chaired the 2019 ESC Guidelines on Diabetes and Cardiovascular Disease and serves as Deputy Editor of the European Heart Journal and Consulting Editor of Cardiovascular Research Journal.

As a leading researcher, he has received grants and awards from national and international research councils and private foundations and has authored over 200 original articles in top-ranking, peer-reviewed journals. As a member of JACARDI’s Stakeholder Advisory Board, he contributes to work packages focused on data insights (WP7), screening (WP8), patient pathways (WP9), and patient self-management (WP10).

Learn more about Francesco Cosentino and his work here, and about ESC here.

From promising ideas to real impact: WHO’s Quick Buys for combating NCDs

What if targeted actions could transform public health across Europe in just five years? This was the question posed at an event organized by the WHO European Region, where experts gathered to unveil and discuss the groundbreaking paper ‘Quick buys for prevention and control of noncommunicable diseases’. The study, conducted by experts in noncommunicable diseases (NCDs) at WHO/Europe, has for the first time analysed exactly how 25 specific public health measures, so-called quick buys, can have a positive impact on population health across Europe and central Asia in as little as 5 years.

NCDs are the leading cause of death and disability worldwide. In Europe, they account for 90% of all deaths and 85% of disability, including mental ill health. A significant proportion of NCD deaths are premature, before the age of 70 and an estimated 60% of all avoidable NCD deaths are due to preventable causes. These could be addressed by reducing alcohol and tobacco use, unhealthy diets and physical inactivity.

However, progress on NCD prevention has stalled, as highlighted by the WHO Europe’s European Health Report 2024 and the UN’s 2025 NCD progress report. These publications show a rise in obesity and diabetes and insufficient progress toward meeting global NCD targets by 2030. With just 25 weeks remaining until the 4th UN High-Level Meeting on NCDs, the clock is ticking to accelerate progress toward reducing premature mortality from NCDs. In line with this objective, JACARDI supports countries in reducing the burden of cardiovascular diseases and diabetes at the individual and health system levels.

From best buys to quick buys: a roadmap for action

Dr Benedetta Armocida, coordinator of JACARDI, emphasized during the event the transformative potential of these interventions. “Advancing cost-effective policies is a global health priority. This paper makes a critical contribution by introducing structured timeframes, an essential component for strategic planning, implementation and impact assessment”.

WHO has previously identified a set of best buys, proven, cost-effective measures to address NCDs. Now, it can show which of those measures deliver the fastest results. The 25 quick buys, published in The Lancet Regional Health – Europe [1], include policies targeting key risk factors and disease groups.

The 25 quick buys with proven impact within 5 years

These measures are designed to yield high-impact results in record time, making them indispensable in the current public health landscape. Professor David Stuckler, from the University of Bocconi and co-author of the paper, echoed the urgency: “This paper is a roadmap for action. There are no more excuses not to implement it”.

The quick buys focus on practical measures. For example, pharmacological treatment of hypertension in adults, treatment of myocardial infarctions with acetylsalicylic acid, and treating strokes with intravenous thrombolytic therapy have all an impact of less than a year.

The role of Joint Actions: JACARDI and JA PreventNCD

As a Joint Action initiative, JACARDI exemplifies how research and policy can align to drive meaningful change.

1. Provide evidence on feasibility, scalability and sustainability

The study on quick buys underscores the need for more natural experiments to assess the real-world impact of interventions. “This is precisely where Joint Actions like JACARDI can play a crucial role. By generating robust implementation research, Joint Actions provide essential evidence on feasibility, scalability and sustainability of interventions. JACARDI serves as a bridge between research and policy, facilitating the translation of evidence into concrete, actionable strategies at national and regional level”, explained Dr Armocida.

2. Creating a platform for knowledge exchange

Stakeholder cooperation and a multi-sectoral approach is another aspect highlighted by the JACARDI coordinator. “By fostering cooperation among Member States and key EU stakeholders and diverse sectors, Joint Actions can create a platform for knowledge exchange, capacity building and coordinated policy responses. This collaborative approach extends beyond national boundaries, contributing to a more integrated and effective NCDs prevention and control framework at European level”, concluded Dr Armocida.

3. Ensuring the effectiveness and equity of monitoring systems

In line with this, Dr Hanna Tolonen, representing JACARDI’s sister project called JA PreventNCD, emphasized the vital importance of monitoring systems in ensuring the effectiveness and equity of public health interventions: “Within JA PreventNCD, we are working on the monitoring aspects to see how countries are currently tracking progress and how we can support them in improving their surveillance activities”.

By leveraging collaborative initiatives like these and integrating evidence-based strategies, the path forward becomes clearer and more achievable. The message from the WHO/Europe event is clear: the time for action is now. This is the way to turn promising ideas into tangible health outcomes for all.

Source:
[1] Gauden Galea, Allison Ekberg, Angela Ciobanu, Marilys Corbex, Jill Farrington, Carina Ferreira-Bores, Daša Kokole, María Lasierra Losada, Maria Neufeld, Ivo Rakovac, Elena Tsoy, Kremlin Wickramasinghe, Julianne Williams, Martin McKee, David Stuckler, Quick buys for prevention and control of noncommunicable diseases

The Lancet Regional Health – Europe, 2025, 101281, ISSN 2666-7762

David Beran: What has impressed me most is the collaboration between outstanding scientists across Europe

David Beran, a member of JACARDI’s Scientific Advisory Board, highlights the value of the network being built through JACARDI, fostering exchanges that will have a positive impact on science beyond the project. He is a Swiss citizen and Assistant Professor at University of Geneva specialized in health management and diabetes. In his view JACARDI exemplifies the strength of the European ideal of uniting individuals from different member states to collectively improve lives. David Beran is currently involved in leading a new initiative that aims to bridge science and policy, the NCD Policy Lab at University of Geneva. In this interview, he shares his insights on the connection between evidence-based outcomes and policy making, the anticipated local and global impacts of the JACARDI pilot projects and the importance of collaboration and mutual learning in research.

What significance does JACARDI hold for you and your organization in terms of its mission and values?

I think there’s three ways to answer this question. As a university researcher specialized in diabetes, I believe we need more research to document and develop a wide range of tailored solutions. JACARDI does this with the diversity of pilot projects across different countries and contexts.

I would say another important element is that one of the missions of the division I’m in focuses on partnerships and learning from others. One of the key values I’ve observed in JACARDI is the interactions, discussions and presentations among colleagues from different countries, exchanging their experience, their knowledge and working together.

Finally, I’m leading a new initiative at the University of Geneva, the NCD Policy Lab, which aims to bridge science and policy. This goal is in line with the objectives of JACARDI. This Joint Action also recognises the need to engage a wide range of policymakers, including the EU, the World Health Organisation, ministries of Health, local authorities and even mayors or lower level officials. I think these three areas are crucial for JACARDI: research, partnership and knowledge sharing, and the link between science and policy.

How do you see JACARDI’s role in tackling the increasing prevalence of diabetes in Europe?

I think JACARDI has an important role to play in the fight against diabetes. The different work packages address concrete challenges that exist and the approach is to document the challenges and to also find innovative solutions. The approach of having different pilot projects and how these can address local specific challenges, as well as how these lessons from a small context can then be transferred to the whole country or even to the whole of Europe is really innovative. I really think that the strength of this project is to look at those local specificities and then to take that mutual learning and spread the lessons learned beyond that small pilot either to the whole country or to other countries.

From your extensive experience as a diabetes researcher, how do you think JACARDI will influence future collaboration on diabetes prevention in Europe?

Beyond the scientific aspects, what has impressed me most is the collaboration between the outstanding scientists across Europe in this Joint Action. A valuable outcome of this project is the network that is being created, fostering exchanges that will have a positive impact on science beyond JACARDI.

As a Swiss citizen living outside “Europe”, I’m also a proud European. I think this project exemplifies the strength of the European ideal of uniting individuals from different member states to collectively improve lives. To really tackle diabetes, which is a global challenge and a European challenge. And again, JACARDI is bringing together the best scientists to tackle it.

Moreover, diabetes is not only a health problem, it is also a social and economic problem. I firmly believe that research has the power to document, to provide solutions and to guide governments in their responses to this challenge.

What impact do you hope JACARDI will have on future research and policy-making?

The pilot projects have the potential to move from pilots to full-blown projects. So, what does it take to scale up a pilot? Scaling up can mean different things: does it involve expanding to one more region, to an entire country, or even to other European nations? Will these larger initiatives within a specific country drive progress? Could they also be regarded as multi-country studies based on the initial pilot fostered by JACARDI?

As I mentioned earlier, I believe that the networks created are the greatest impact that JACARDI can have on future research. Research thrives on collaboration and the exchange of ideas, and this project has excelled in fostering these connections. For example, I was involved in the work package tackling patient pathways, where colleagues from different countries, such as Spain, Italy or Finland, all worked together on important data issues.

There are so many ideas floating around that you can clearly see this could lead to future research and have a clear impact on diabetes policy. One potential impact is on policies that continue to support research in this area, while another is on policies to adopt the outcomes of JACARDI. I think we need more research and this Joint Action has a role to play in highlighting the importance of research and continued funding for research. Both of those will take investment, time and engagement with policy makers and I think JACARDI has already started to do that. It will take persistence and patience to really be able to keep this on the policy makers’ agenda both by emphasizing the need for further research and by highlighting what JACARDI’s results mean for the future of diabetes.

I also see an opportunity to demonstrate the value of JACARDI’s work for people with diabetes and non-communicable diseases. By involving advocates and patient organizations and sharing JACARDI’s successes with the media, we can remind everyone that people with diabetes are citizens with rights and a voice. With one in ten people in Europe affected by diabetes, they represent a significant political bloc. Building on this momentum, JACARDI can continue to show policymakers the return on their investment, while also highlighting the need for ongoing support for this unique and exciting initiative.

David Beran is an Assistant Professor at the Geneva University Hospitals and University of Geneva within the Division of Tropical and Humanitarian Medicine. Previously, he has worked as Project Coordinator of the International Insulin Foundation based at University College London (UCL) where he developed and implemented a health systems tool to assess access to diabetes care. This work was carried out in Kyrgyzstan, Mali, Mozambique, Nicaragua, Vietnam and Zambia and led to the development of specific policies and projects to address the barriers identified.

His research interests include health systems and health systems research, management of chronic diseases, diabetes, access to insulin and the issue of multi-morbidity. Current projects include the NCD Policy Lab at University of Geneva, a global survey of barriers to access to insulin, and he has worked closely with the WHO on the issues of diabetes and access to medicines for noncommunicable diseases.

Learn more about David Beran’s work, the NCD Policy Lab, and connect on LinkedIn.