JACARDI takes the floor at OECD policy dialogue on Europe’s Cardiovascular Health
On 5 May 2025, the OECD convened a high-level policy dialogue in Brussels to address one of Europe’s most pressing public health challenges: the growing burden of cardiovascular diseases (CVDs). With the participation of the European Commission and key representatives from national governments, civil society, and international organisations, the event marked an important moment in shaping the OECD’s analytical work on CVD trends, prevention, and care across the EU. Represented by its Coordination Team, JACARDI brought forward lessons from its cross-country collaboration, referencing tools, frameworks, and reflections that align with the OECD’s strategic priorities, particularly around equity, data, and cross-sectoral integration.
Cardiovascular diseases (CVDs) remain the leading cause of mortality and morbidity across Europe, placing immense pressure on health systems, economies, and societies. Addressing this burden demands more than incremental change—it requires a shared, data-driven, and equity-focused vision for action.
The OECD’s policy dialogue, “Burden of Cardiovascular Disease in the EU,” held on 5 May 2025 with the participation of the European Commission, convened key stakeholders to discuss forthcoming OECD work that aims to analyse trends in CVD burden, prevention, and management across the EU.
The event gathered representatives from national governments, civil society, and intergovernmental organisations to ensure that the forthcoming report reflects stakeholder priorities and is rooted in collective insight.
JACARDI—the Joint Action on Cardiovascular Diseases and Diabetes—was represented by its Coordination Team: Benedetta Armocida, Graziano Onder and Beatrice Formenti. During both plenary and roundtable sessions, JACARDI shared reflections on the future of CVD response in Europe, highlighting insights from its ongoing collaboration with countries and stakeholders. The Joint Action welcomed this opportunity to align with OECD’s strategic direction and contribute to a common agenda for strengthening CVD prevention and control.
Six key areas of alignment were highlighted:
- A shared framework: the Patient Journey
Echoing the OECD’s analytical framework, JACARDI supports a patient-centred approach that addresses the full continuum of care—from health promotion and early prevention to integrated treatment and long-term management. This patient journey model underpins JACARDI’s operational structure and is currently being implemented through real-world pilots in 18 European countries.
Notably, JACARDI integrates cardiovascular diseases and diabetes within a unified framework, recognising their clinical, biological, and systemic interlinkages. This convergence reflects a growing consensus: that sustainable improvement in population health requires integrated, system-strengthening, and equity-oriented solutions. - Equity as a structural imperative
JACARDI endorses the OECD’s emphasis on reducing health inequities, particularly among migrants, ethnic minorities, and other underserved groups. Equity is not an add-on but a core pillar of JACARDI’s approach—operationalised through the 4C Equity Framework: Critical reflection, Contextualised data, Co-design, and Clear, inclusive communication.
This commitment is made tangible through specific tools like capacity-building masterclasses, a dedicated maturity matrix, and pilot initiatives targeting institutional barriers, including racism and discrimination in healthcare. JACARDI advocates for the standardisation and institutionalisation of such equity-driven models across EU health policies and programmes. - Putting women’s hearts on the Agenda: gender-sensitive CVD responses
Despite notable advances in CVD care, gender disparities persist. Women remain underdiagnosed, undertreated, and underrepresented in research—leading to suboptimal outcomes. JACARDI addresses these challenges through a gender-sensitive approach, following The Lancet Commission on Women and Cardiovascular Disease which underscores the need to embed sex- and gender-specific data into every level of policy and practice.
For example, in Spain, an interactive tool is being developed to map gender-based health disparities regionally. In France, a comprehensive data linkage is underway to examine how gender and social deprivation intersect in influencing disease risk and care pathways. These initiatives represent a shift toward gender-responsive and inclusive health systems. - Data for change: building the evidence base
Fragmented, delayed, and non-comparable data continue to hinder effective CVD policy implementation. There is a pressing need for harmonised, disaggregated, and interoperable health data—especially data disaggregated by sex, ethnicity, and socioeconomic status.
JACARDI is addressing this gap by developing a conceptual data framework for mapping and improving national and regional datasets. The framework spans risk factors, disease conditions, and modifiers of disease or care across population, outpatient, and hospital settings. The information is also structured by domains (care, results, quality indicators), offering a comprehensive and standardised approach to data mapping.
This framework will inform a practical consultation tool to support standardised, comparable, and interoperable data collection across Europe. The aim is to enhance research, promote accountability, and strengthen European health information systems in alignment with OECD, WHO, and EC priorities. - Screening and early detection
A key recommendation from JACARDI reported within the dialogue was the creation of a centralised platform to oversee CVD screening—ensuring quality, transparency, and accountability throughout all stages, from design to evaluation. Such a platform would also house validated risk prediction tools tailored to diverse populations.
JACARDI supports this vision with a suite of tools developed across the Joint Action, including guidance for implementing, monitoring, and evaluating screening programmes; roadmaps for sustainability; and strategies for disease burden surveillance (via WP7). These resources reflect JACARDI’s holistic approach, linking prevention, early detection, and continuous care. - Workplace interventions
CVDs and diabetes significantly impact Europe’s labour market. JACARDI addresses this challenge by promoting workplace interventions that support people living with NCDs in maintaining or returning to employment.
Strategic recommendations include strengthening occupational health services, fostering inclusive workplace cultures, combating stigma, promoting intersectoral collaboration, and increasing awareness and research investment. By aligning employment policy with health priorities, JACARDI aims to reduce economic strain and improve quality of life.
From prevention to rehabilitation: closing the gaps
Effective care for CVD and diabetes requires integrated, person-centred pathways that span the full spectrum of need—from early detection to long-term management and reintegration into society. Reducing fragmentation, ensuring timely access to services, and addressing the needs of chronically ill individuals are essential. JACARDI is actively supporting Member States in designing and implementing more cohesive, sustainable care models—bridging current gaps and promoting resilience in national health systems.
Looking ahead: building Europe’s CVD response together
As the OECD-led analytical report continues to evolve, JACARDI remains committed to contributing to this inclusive, co-creative process. Through piloted innovations, practical tools, and sustained cross-border collaboration, the Joint Action seeks to strengthen Europe’s collective response to CVD and diabetes.
JACARDI’s contribution rests on four foundational principles:
- Equity as structure and substance—addressing the needs of women, migrants, and other underserved groups throughout the policy cycle;
- High-quality, harmonised, and disaggregated data—to enable effective monitoring, accountability, and action;
- Cross-sectoral integration—connecting health with education, employment, social protection, and digital transformation;
- Inclusive, multi-stakeholder engagement—ensuring that patients, professionals, policymakers, and civil society shape the future together.
In closing, JACARDI exemplifies what is possible when countries align around a shared vision. Through collaboration, knowledge exchange, and an unwavering commitment to inclusion, we are not only shaping better health outcomes—we are building a lasting legacy of equity, resilience, and solidarity across Europe.
“JACARDI, together with all key stakeholders, is showing what’s possible when Europe comes together with a shared purpose and vision—turning knowledge into action, and collaboration into a legacy of healthier, fairer societies for all, starting with the urgent challenge of cardiovascular diseases.”
— JACARDI Coordination Team, Benedetta Armocida and Beatrice Formenti
Milka Sokolović: JACARDI is a beacon of proactive change in Europe’s healthcare landscape
Promoting healthy eating habits and regular physical activity can greatly reduce the risk of non-communicable diseases, but the responsibility cannot fall solely on individuals. This is the approach championed by Milka Sokolović, Director General of EPHA, the European Public Health Alliance, and a member of JACARDI’s Stakeholder Advisory Board. Strong public health policies are crucial in ensuring access to healthy food options and encouraging physical activity. JACARDI plays a key role in driving these efforts, fostering cross-sector collaboration and advocating for policies that empower individuals to make healthier choices. At the same time, we must harness the power of civil society and advocate for stricter regulations on industries that harm health, including the tobacco, alcohol, and ultra-processed food sectors.
What does JACARDI mean to you and your organization in terms of its mission and values?
For EPHA and myself, JACARDI is a crucial initiative in combating cardiovascular diseases, diabetes, and other non-communicable diseases in Europe. Its focus on prevention, disease management, and cross-sectoral collaboration aligns with EPHA’s values of health equity and evidence-based policy. JACARDI’s comprehensive approach addresses these conditions and considers the broader social and commercial determinants of health, enhancing our joint advocacy for sustainable public health policies in the EU.
Based on your experience in public health, what do you consider the main barriers to reducing the prevalence of cardiovascular disease (CVD) and diabetes in the EU, and how can these challenges be addressed?
Public health, particularly regarding non-communicable diseases like CVDs and diabetes, faces many challenges, including the influence of health-harming industries and varying public health policies across member states. To effectively counter these diseases we advocate for more stringent regulations on industries that negatively impact health, such as the tobacco, alcohol and ultra-processed food sectors. It is also vital to improve the coordination and integration of health policies across the EU for greater efficiency and uniformity.
Bridging the gap between political action and healthcare practice requires early stakeholder input in policy making. Leveraging the collective strength of civil society to advocate for these changes and prioritising public health in the political agenda is essential. JACARDI’s work addresses many of these critical areas.
In your experience, what are the most critical economic and political factors to consider when implementing health initiatives across different global settings?
Effectively addressing cardiovascular disease and diabetes requires understanding both economic and political contexts. Economically, resource availability and stable health financing are crucial for sustaining initiatives. Politically, long-term commitment from governments and stakeholders is necessary to implement robust health policies. Early engagement with policymakers ensures health initiatives align with regional and national priorities, improving their effectiveness.
The JACARDI model, emphasising cross-country and sector cooperation, including other joint actions like the JA PreventNCD, offers a blueprint for addressing these challenges. Through collaboration, JACARDI enhances the implementation of adaptable and resilient health strategies, serving as a framework for other global health initiatives.
What role do lifestyle changes, such as diet and physical activity, play in the prevention and management of CVD and diabetes, and how can public health policies better support these changes?
Lifestyle changes are fundamental in the prevention and management of cardiovascular diseases (CVD) and diabetes. Encouraging healthy eating habits and regular physical activity can significantly reduce the incidence of these conditions, but it cannot rely solely on the individual. Public health policies play a key role by facilitating access to healthy food options and promoting physical activity through the creation of safe and accessible public spaces.
Integrating lifestyle interventions into national health policies can have a positive impact on public health. From JACARDI’s perspective, this is being addressed through initiatives that improve health literacy and encourage active participation from diverse populations. Furthermore, educational campaigns and programmes in schools and workplaces can motivate behavioural changes.
Finally, comprehensive policy approaches are crucial and it is essential that public policies tackle health misinformation and provide citizens with the necessary tools to assess the information that they are exposed to.
How do you see JACARDI’s role in addressing the growing prevalence of cardiovascular disease and diabetes in Europe?
JACARDI is a beacon of proactive change in Europe’s healthcare landscape. Its comprehensive approach to disease management and prevention addresses the rising prevalence of CVD and diabetes, focusing on prevention, early diagnosis, and effective management.
Beyond immediate health interventions, JACARDI integrates diverse healthcare approaches, ensuring inclusivity and adaptability for both urban and underserved populations. This ensures no one is left behind. Through these efforts, JACARDI strengthens European health systems’ ability to manage and prevent these diseases, promoting a healthier and more equitable future for all European citizens.
In a career that spans a quarter of a century and three countries, it was her unceasing quest for more impact and purpose in her work that brought Milka Sokolović to EPHA. As Director General, she instigates alliances and forges partnerships, while advocating for equitable solutions to European public health challenges, insisting on the vital role of civil society in reaching those solutions.
Milka Sokolović holds a degree in Biology from the University of Belgrade, and a PhD in Medicine from the University of Amsterdam. Through her research and academic roles at the Universities of Belgrade and Amsterdam, and her leadership roles at the European Food Information Council (EUFIC) and the European Nutrition Leadership Platform (ENLP), she has developed a remarkable expertise in scientific research, communication, and strategic partnerships.
Milka is skilled at developing and implementing organisational strategies, equipped with robust leadership competencies, and armed with ample enthusiasm, driven by Goethe’s “Knowing is not enough, we must apply. Willing is not enough, we must do.”
Learn more about EPHA here and connect with Milka Sokolović here.
Stefano Del Prato: Advancing precision diabetes medicine – the role of data, technology, and JACARDI’s contribution through pragmatic and practical actions
The collection, analysis, and the insights we gain from data are critical for monitoring improvements in healthcare, and helping us to standardize treatment across Europe. JACARDI is a critical asset in this regard, says Stefano Del Prato, President of the European Diabetes Forum (EUDF) and member of JACARDI’s Stakeholder Advisory Board. With decades of expertise in diabetes research and clinical practice, he offers a deep dive into the four most critical steps – early diagnosis, empowering people, equitable care, and embracing science and technology – for combating the burden of NCDs, the avenues for making innovations of diabetes care more accessible, and how advancements in monitoring technology can support personalized treatment.
What significance does JACARDI hold for you and your organization in terms of its mission and values?
The EUDF brings together all the key stakeholders working and advocating in the field of diabetes across Europe. To me, JACARDI is a natural complement to our efforts to standardize diabetes treatment throughout Europe. Standardizing treatment can reduce diabetes-related complications including cardiovascular disease, and mortality. I believe JACARDI is an outstanding tool for uniting the expertise of more than 20 European countries. We are proud to serve as advisors because, at the European Diabetes Forum, we share a goal similar to that of JACARDI. I see this as a partnership and a significant opportunity to improve outcomes for many people at risk of cardiovascular complications across Europe.
What are the most critical next steps for Europe in addressing the dual burden of cardiovascular disease and diabetes?
I believe there are many actions we can take. At the European Diabetes Forum, which I currently preside over, we have been collaborating to identify key initiatives to propose to the new European Parliament’s political agenda – a process that took place during the election campaign. We developed four main messages, primarily focused on diabetes but applicable to many conditions that increase cardiovascular risk.
The first is early detection. This approach works for identifying individuals at risk of diabetes, those showing signs of obesity or overweight to prevent further progression, and those at cardiovascular risk.
The second is empowering people. In diabetes care, this means educating individuals to manage their condition effectively, while also raising general awareness about how proper health education and a healthy lifestyle can prevent non-communicable diseases and their cardiovascular consequences.
The third is providing equitable care. Although Europe is a powerful and dynamic region, significant differences exist from country to country. We must ensure that effective management strategies, procedures, and the latest medications are implemented as swiftly and fairly as possible across Europe to reach all those who need them.
Finally, the fourth is embracing science and technology. We believe Europe should lead in research and clinical development. We have brilliant minds here, and we need systems that enable collaboration to develop new science and technology, as well as to implement effective innovations in clinical practice. In summary, our four priorities are early diagnosis, empowering people, equitable care, and embracing science and technology – each of which can greatly improve care for more people.
In your recent article for Euractive, you highlighted that European health systems are not ready to fully utilize the emerging innovations in diabetes care. You mentioned local policy barriers across Europe, including bureaucratic hurdles and lengthy approval processes for modern treatments. Given that diabetes cases in the EU are projected to nearly double by 2050, with significant implications for cardiovascular diseases and other complications, how do you see JACARDI contributing to the transformation of national health systems to overcome these barriers and implement more effective diabetes care strategies across Member States?
JACARDI is a complex program with great value because it brings together many European countries. By enhancing networking, discussions, and the sharing of experiences and new ideas, it offers a tremendous opportunity for progress. In addition to these networking benefits, JACARDI includes pragmatic and practical actions. One critical aspect is the proper collection of data through registries. Such registries allow us to monitor improvements in healthcare for reducing the burden of diabetes and cardiovascular risk within each country and compare differences between countries, thereby helping us to standardize treatment approaches.
I hold a simple principle: the free circulation of people in Europe means that individuals who move from one country to another—and who may have diabetes or cardiovascular disease—should receive similar and optimal treatment regardless of where they are. To achieve this, we must harmonize healthcare processes as much as possible. With 21 countries participating, JACARDI unites local expertise and experiences, leading to actions that can be translated into effective clinical processes. I am convinced it is essential to teach our new medical professionals the importance of data—its collection, analysis, and the insights we can gain from it. In my view, JACARDI is a critical asset in this regard.
Professor Del Prato, in your article you discussed how scientific and technological innovations are transforming diabetes care. We are aware of continuous glucose monitoring devices, next-generation insulin pumps, digital applications, and AI-driven solutions. Could you elaborate on the specific technological breakthroughs you believe will have the most significant impact on diabetes care in Europe? Which of these innovations do you see as priorities for implementation across EU healthcare systems?
I believe a key technological advance is improved glucose monitoring. This advancement is significant not only because it helps individuals with diabetes understand how lifestyle modifications or medications affect their blood sugar levels but also because continuous glucose monitoring systems allow for interconnectivity. This connectivity makes telemonitoring possible, which can facilitate both the education and self-empowerment of people with diabetes, as well as the collection of data to alert physicians when a patient is deviating from optimal glycemic control.
It’s not just about measuring glucose continuously; it’s also about processing and transmitting that data. For instance, in my region in Tuscany, Italy, there is a system that sends continuous glucose monitoring data directly to a patient’s electronic health record.
There is also a distinction between technologies for type 1 and type 2 diabetes. You mentioned automatic insulin delivery, which is an incredible and important advancement. I recall when I began my career, we used an early form of an artificial pancreas—a bulky machine that required the patient to remain in bed for a time. Now, after more than 30 years of progress, technology has evolved rapidly to manage glucose control in individuals who lack insulin secretion throughout their daily tasks.
These examples demonstrate how technology can support personalized treatment and foster precision diabetes medicine. By analyzing data from glucose monitoring, a more detailed profile of an individual with diabetes can be generated, which may help determine the optimal treatment at the right time. This concept applies not only to diabetes but also to other conditions, including cardiovascular risk. If we can identify individuals at higher risk, we can focus our efforts and allocate resources more effectively. I believe that technology will significantly advance diabetes care and medicine as a whole.
How do you see the role of GLP-1 receptor agonists in type 2 diabetes management? By 2022, the American Diabetes Association’s standards of care included GLP-1 receptor agonists as a first-line pharmacological therapy for type 2 diabetes in patients with or at high risk for heart failure. How do you see their role in Europe?
I do not see much difference across the pond. I was involved in the consensus on the treatment of type 2 diabetes from the American Diabetes Association and the European Association for the Study of Diabetes, and our recommendations were identical. When managing type 2 diabetes, it is essential to reduce complications in order to improve quality of life. This requires addressing four major aspects in addition to social determinants of health and lifestyle modifications.
First, achieving good glycemic control is crucial in preventing microvascular complications. Many individuals with diabetes still experience eye, kidney, or nerve complications, which also contribute to cardiovascular risk.
Second, we must focus on body weight management. Drugs like GLP-1 receptor agonists—and more recently, dual agonists—have shown great promise in achieving glycemic control and promoting weight loss.
Third, it is important to consider cardiovascular risk from the outset, as many patients with diabetes also have high blood pressure, dyslipidemia, or impaired kidney function.
Finally, for those who already have cardiovascular damage or are at very high cardiovascular risk, we recommend that medications proven to provide cardiovascular benefits are used as early as possible. This includes GLP-1 receptor agonists and SGLT-2 inhibitors. In this respect, our approach is aligned with our colleagues in the United States.
Stefano Del Prato is a retired Professor of Endocrinology and Metabolism at the School of Medicine, University of Pisa and past-Chief of the Section of Diabetes, University Hospital of Pisa, Italy. Currently he is affiliate Professor of Medicine at the Interdisciplinary Research Center “Health Science” of the Sant’Anna School of Advanced Studies in Pisa and affiliate physician at the “Fondazione Toscana Gabriele Monasterio”, Pisa.
Professor Del Prato’s main research interests have always been the physiopathology and therapy of type 2 diabetes and insulin resistance. He acts as referee for numerous journals and has served on the Editorial Boards of major scientific journals in the field of diabetes and metabolism. Professor Del Prato is past Vice-President of the European Association for the Study of Diabetes (EASD), past Chairman of the European Foundation for the Study of Diabetes (EFSD), past President and Honorary President of the Italian Society of Diabetology, and immediate past-President of the EASD.
Currently is the President of the European Diabetes Forum (EUDF). He served as Chairman of the Scientific Committee of the World Diabetes Congress in Dubai, UAE, in 2011. He has authored over 560 articles (PubMed) in peer-reviewed international journals and has been awarded several honors including the Prize of the Italian Society of Diabetology for outstanding scientific activity, the Honorary Professorship at the Universidad Peruana Cayetano Heredya in Lima, the 10th Lifetime Contribution Oration Award from the Madras Diabetes Research Foundation, India. He has been bestowed the honor of Commander of the Order of the Italian Republic for Scientific Merits.
Learn more about Stefano Del Prato and his work here, and connect on LinkedIn here.
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.
Quick buy policies targeting key risk factors | Quick buy policies targeting disease groups |
Tobacco Increase excise taxes Implement graphic health warnings Enforce comprehensive bans on tobacco advertising Pharmacological support for quitting tobacco | Cardiovascular diseases Hypertension treatment Acetylsalicylic acid for heart attacks Thrombolytic therapy for strokes |
Alcohol Increase excise taxes Enact bans on exposure to advertising Restrict availability Provide brief psychosocial intervention | Diabetes Glycaemic control & home glucose monitoring Albuminuria screening & angiotensin-converting enzyme inhibitor treatment Blood pressure control Statin use for people with diabetes over 40 years old |
Unhealthy diet Reformulate policies for healthier food and beverages Front-of-pack labelling Behaviour change communication and mass media campaigns | Chronic respiratory diseases Acute COPD treatment with bronchodilators & steroids |
Physical inactivity Brief counselling intervention in primary health care | Cancers HPV vaccination for 9–14 year old girls HPV DNA screening from the age of 30 years Cervical cancer: early diagnosis programs linked with timely treatment Breast cancer: early diagnosis programs linked with timely treatment |
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
Bart Torbeyns: JACARDI’s unified strategy makes perfect sense
Meet Bart Torbeyns, the Executive Director of the European Diabetes Forum (EUDF) and a pivotal voice in the fight against diabetes and cardiovascular disease. As a member of JACARDI’s Stakeholder Advisory Board, Bart commends JACARDI’s integrated approach to addressing both diseases simultaneously. “For primary care physicians and patients managing multiple chronic conditions, JACARDI’s unified strategy makes perfect sense,” he observes. Bart passionately advocates for the elimination of discrimination against individuals living with diabetes and establishes that the critical step for lowering its burden is establishing clear targets through better data.
What significance does JACARDI hold for you and your organization in terms of its mission and values?
At its core, JACARDI is about improving outcomes for people living with diabetes and cardiovascular disease. While I work for the united diabetes community, we’re acutely aware that many of the people living with diabetes also face cardiovascular risks and, in some cases, complications. What makes JACARDI so valuable is its focus on the entire patient journey, starting with health literacy, labor participation, patient pathways, screening, and better management. These areas are still critically needed across many European countries.
For example, in the area of screening, we know that up to one in three people with diabetes are unaware they have the disease, reaching one in two in certain countries. These individuals, by definition, are not receiving education or proper treatment, leading to severe complications. Addressing these gaps is fundamental to the work we do.
How do you think JACARDI’s work aligns with promoting the overall well-being of patients?
The well-being of people with diabetes is crucial, and JACARDI’s work aligns perfectly with this focus. Health literacy and labor participation are especially vital in this context. Self-management is another key element. When people are well-treated, well-managed, and educated about their condition, they gain confidence in how to handle it, which provides peace of mind.
This is particularly important for families, parents, and teachers who support younger individuals with type 1 or type 2 diabetes. The better they understand the disease, the better the overall well-being of those involved.
Labor participation is another critical area. Unfortunately, discrimination against people with NCDs, including diabetes, still exists. Many individuals hesitate to reveal their condition, for instance, I know people who would never inject insulin publicly and instead hide to do it. It’s crucial to combat this stigma. People with diabetes can make valuable contributions to the economy and society. I’ve encountered many brilliant individuals with diabetes, and ensuring they have opportunities to participate fully is essential for their well-being but also for our economy and society. The work JACARDI is doing on labor participation is a prime example of addressing these challenges.
What are the most critical next steps for Europe in addressing the dual burden of cardiovascular disease and diabetes?
A critical step is establishing clear targets to achieve better outcomes for people living with diabetes and cardiovascular disease. This process begins with better data, improving its availability, sharing, and utilization. For instance, many European countries don’t even know how many people in their population have diabetes. Without this basic information, it’s difficult to make progress.
Once we have reliable data, the next step is setting targets to improve results and prevent complications. What I particularly appreciate about JACARDI is its collaborative approach, bringing together the cardiovascular and diabetes communities. There’s so much we can learn and share from each other.
By adopting a patient-centric perspective, it’s clear that many people with diabetes are at high risk of developing cardiovascular disease, and the reverse is also true. Often, we think in silos, creating separate plans for diabetes, obesity, or cardiovascular disease, but for primary care physicians and patients managing multiple chronic conditions, JACARDI’s unified strategy makes perfect sense, and that’s an approach I fully support.
Recently the new Commissioner for Health and Animal Welfare, Mr. Várhelyi, announced he will propose a comprehensive cardiovascular health plan that will also address diabetes and obesity. We very much welcome such a comprehensive approach and we are confident that JACARDI’s deliverables will be consolidated in this new plan.
Bart Torbeyns is a dedicated leader in public health policy and advocacy, with a focus on improving healthcare systems and addressing chronic diseases. With master’s degrees in Pharmacy and Business Economics from the University of Louvain, he has contributed to initiatives like the SUGAR and the DYSIS studies, generating vital local data for diabetes and atherosclerosis care in Belgium. He has worked as Head of Public Affairs in Belgium and Europe at MSD and Sanofi, and analyzed healthcare systems and developed strategies to promote equitable access to care. Now serving since 2020 as the Executive Director of the European Diabetes Forum (EUDF), he works to advance collaborative, patient-centered policies addressing diabetes and cardiovascular health across Europe.
Learn more about the European Diabetes Forum (EUDF) here and connect with Bart Torbeyns on LinkedIn here.
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.
Janne Sørensen: Being aware of one’s own biases is part of a patient-centered approach
The diversity of JACARDI’s experts is a tremendous asset to the project, as it brings many different perspectives to the table, according to Janne Sørensen, diversity expert at the University of Copenhagen in the Department of Public Health. As a member of JACARDI’s Scientific Advisory Board, she shines a light on how vulnerable groups are impacted by diabetes and cardiovascular disease, and how healthcare professionals can better answer their needs. Her message to people working in healthcare is to see the whole person in front of them and to consider implementing equity as a lifelong learning process.
What significance does JACARDI hold for you and your organisation in terms of its mission and values?
As a public health expert, one of the core elements of my work is addressing health inequalities and striving for greater health equity for all. JACARDI’s focus on combating these inequalities, particularly in the context of cardiovascular diseases and diabetes, resonates deeply with both my personal mission and the goals of my organization.
How do you see JACARDI’s role in tackling the increasing prevalence of cardiovascular diseases and diabetes in Europe?
Well, this is a big question and a significant challenge, as diabetes is on the rise. We need to stop its progression and bring the situation under control. JACARDI is a large initiative and, I believe, a serious attempt to address this challenge. You are confronting the problem head-on with innovative approaches. JACARDI positions itself at the heart of the EU’s efforts to tackle this issue. It is an impressive project, and I am very happy to be part of it.
How do you see our role in promoting equity in healthcare?
JACARDI plays a significant role here because it aims to address inequalities. In other words, we see disparities affecting many vulnerable groups who are significantly impacted by these health issues. For example, people with lower socio-economic status, migrants, ethnic minorities, and LGBT groups all have a higher prevalence of diabetes and cardiovascular diseases.
I must say this is an ambitious objective for such a large project, and it might be quite challenging to mainstream diversity, reach everyone, and ensure that everyone adopts principles of equity and diversity.
How do you see the significance of cultural diversity in the development of diabetes and CVD treatment? And what is the most important or critical aspect of this?
This is significant because you are addressing these particularly vulnerable groups. It is therefore crucial to ensure that you consider meeting people with their diverse identities, vulnerabilities, and characteristics in order to effectively tackle the issues of diabetes and cardiovascular disease.
Implementing diversity can be challenging, but you’ve brought it to the forefront. Ideally, the insights gained from this project will inspire experts to incorporate them into their own work and organizations long after it concludes. JACARDI brings together a diverse group of experts, representing a wide range of educational backgrounds, nationalities, ethnicities, and experiences. This diversity is a tremendous asset to the project, as it brings many different perspectives to the table.
You are providing training for healthcare professionals on cultural diversity. Are there questions that professionals often ask?
Some people ask why it is necessary to discuss diversity, especially if they are already working with a patient-centered approach. My answer is always that while you might have a patient-centered approach, it doesn’t necessarily require that you, as a health professional, reflect on your own background, biases, and stereotypes. Understanding these is crucial when interacting with patients.
Additionally, we discuss health inequalities: that many people are worse off in terms of health because they have fewer opportunities from the beginning of their lives, simply because they belong to specific groups and face discrimination within the healthcare system. These differences also exist among various groups, such as people with disabilities or those from the LGBT community, and so on.
What is your message to healthcare professionals then?
My message is that you need to see the whole person in front of you, in addition to knowing the prevalence of diseases and risk factors and being able to diagnose. This is not easy, because as a healthcare professional, you have to consider many things during a short appointment.
I believe we are trying to improve communication and interaction between healthcare professionals and patients by raising awareness of the disadvantages the patient may face, as well as the risk factors. At the same time, it’s important to recognize what professionals bring into the meetings.
This is a lifelong learning process, not something that can be mastered through a short course. Applying these lessons in practice after completing a course is an entirely different challenge.
Janne Sørensen is a specialist in diversity and diversity competence, based at the Department of Public Health at the University of Copenhagen. Her work focuses on integrating diversity competence into medical education through training programs for students and healthcare professionals. Alongside her teaching, Janne conducts research on various aspects of diversity and addresses issues of discrimination within medical student communities.
Learn more about Janne Sørensen and her work and connect on LinkedIn.
Silvia Ussai: JACARDI aims to fill the gaps in the management of NCDs
“This initiative is remarkable because, while many projects focus on non-communicable diseases, JACARDI prioritises policy integration”, says Silvia Ussai, a member of JACARDI’s Scientific Advisory Board. Drawing on over a decade of experience in shaping health policies across local, national, and international levels, and managing major programs like H2020, and NextGenEU, she underscores how JACARDI tackles critical gaps towards the reduction of major risk factors leading to cardiovascular diseases and diabetes.
What significance does JACARDI hold for you and your organization in terms of its mission and values?
JACARDI truly goes beyond the state of the art in non-communicable diseases (NCDs). It is a transformative initiative in the fight against NCDs. For the first time, JACARDI seeks to standardise approaches within and beyond the EU to ensure a coherent strategy for NCDs, and cardiovascular diseases in particular.
The project recognises that there are significant differences in the way countries address NCDs due to differences in government investment and health care frameworks, resulting in different patient pathways. By adopting a standardised approach based on the highest scientific standards, JACARDI brings an innovative dimension to healthcare.
This initiative is remarkable because, while many projects focus on non-communicable diseases, JACARDI prioritises policy integration. Its commitment to high standards of care throughout the patient journey is closely aligned with the mission and values of our organisation.
In your experience, what are the most critical economic and policy considerations when implementing health initiatives in diverse global settings?
When I was a medical student, my professor of internal medicine used to say: “the two most challenging things to achieve with patients are convincing them to stop smoking and losing weight”. These are the main drivers of non-communicable diseases. It’s important to focus on behavioural science and provide patients with evidence to effectively support these changes.
Let me give you an example. Pregnancy is often accompanied by advice to stay physically active, but the consequences of insufficient activity — such as what it means in real life to depend everyday on insulin injections to keep your baby safe — are not clearly communicated. Many patients do not fully understand how their habits affect their lives, with consequences such as gestational diabetes, which is highly disruptive. And that is where JACARDI comes in, to fill that gap, to give patients the information to understand what they can do, what their power is, and the consequences of not following certain guidelines.
Policymakers also need to recognise the importance of investing in the prevention of NCDs. The effectiveness of preventive programs remains largely overlooked, despite all the evidence highlighted during the COVID pandemic. Budget constraints make it difficult to prioritise among multiple health threats, including infectious diseases and cancer. Patients need to be actively involved in prevention, rather than relying on drugs alone. Without their engagement and empowerment, financial resources will always be insufficient to address these pressing health challenges.
How do you see JACARDI’s role in tackling the increasing prevalence of cardiovascular disease and diabetes in Europe?
JACARDI addresses key gaps in the management of cardiovascular disease and diabetes, such as health literacy and patient behaviour. If you look at the JACARDI work plan, work packages reflect this in a crystal clear manner, relying on the highest standard of scientific evidence to date to improve outcomes of NCDs. So JACARDI is leading the healthcare transformation toward the prevention of NCDs at the EU level and beyond.
What role do you believe JACARDI can play in shaping future healthcare policies and practices, especially in low-resource settings?
I believe the most important role it can play is to scale up and transfer lessons learned in developed countries to low-resource settings. By acting as a pioneer, it can help to replicate successful policies and practices and guide other regions in addressing these health challenges.
Silvia Ussai is an International Public Health Manager with a unique skill set obtained through a double degree as Doctor of Pharmacy and Medical Doctor. She holds a specialization in International Healthcare Management from SDA Bocconi and, in 2019, she successfully completed the Program on Negotiation (PON), the executive-level negotiation training offered by Harvard University. With over a decade of experience, Dr. Ussai has made significant contributions to health policies and pharmaceutical systems at local, regional, national, and international levels.
Learn more about Silvia Ussai and her work and connect on LinkedIn.
Birgit Beger: An EU Cardiovascular Health Plan is the best way forward
Birgit Beger, CEO of the European Heart Network (EHN) and member of JACARDI’s Stakeholder Advisory Board, strongly believes that investment in health is a win-win for society overall. With the EU stepping up with the European Commission’s recent announcement of an EU Cardiovascular Health Plan, Birgit Beger shares her hope for an ambitious proposal by the European Commission in line with the work undertaken for the European Beating Cancer Plan. She sees JACARDI’s importance in leveraging knowledge and best practices across Europe and underscores the need to involve stakeholders early on, because they can help bridge the gap between policy and practice.
What significance does JACARDI hold for you and your organization in terms of its mission and values?
In line with EHN Strategy, JACARDI, with its joint action of European pilot projects to reduce the burden of cardiovascular diseases and diabetes, mirrors one of EHN’s core pillars: prevention. Furthermore, EHN supports JACARDI’s overarching goal of improving CVDs and diabetes in terms of disease management.
In your experience, what are the most pressing challenges in implementing effective healthcare policy at both the EU and national levels in the area of cardiovascular disease prevention?
There is a disconnect between the political and healthcare practice levels. For example, the pressing societal burden of cardiovascular diseases has only recently come to the attention of policy makers at national and European levels. The recognition of the urgency for action is growing and yet, given that we are speaking these days about a permacrisis, many politicians are dealing with a myriad of urgent priorities simultaneously. However, as has always been argued, investment in health is a win-win for society overall, financially, for social inclusion and cohesion. This is particularly relevant for cardiovascular disease (CVD), which is the number one cause of mortality and morbidity in Europe and globally.
EHN’s vision is that “every person in Europe should grow up and live in a sustainable environment which promotes cardiovascular health. Premature and preventable deaths due to cardiovascular diseases should be reduced by 30% in 2030. State of the art, personalised care and quality of life should be accessible and attainable for those born or living with CVD”. In this context, taking legislative action to reduce the impact of major risk factors for CVD (unhealthy nutrition, smoking, physical inactivity, air pollution and climate change, but also hypertension, obesity and high cholesterol levels) are of the utmost importance in reducing the burden of CVD.
This being said, not all CVDs are preventable. Therefore, it is equally important to invest in early detection and management of cardiovascular diseases, thereby enabling people who are at high risk of developing CVD, or who have already contracted a CVD, to actively manage their condition, so that they can live to a mature age, with a good quality of life.
What do you see as the key success factors for achieving long-term impact in reducing the prevalence and burden of CVD? How is the EU CVH plan coming along?
Indeed, EHN believes that an EU Cardiovascular Health Plan is the best way forward since it represents a structured and financed approach to combat the cardiovascular burden on society and the increasing CVD numbers, which are already emerging for 2023 and 2024 following the Covid-19 pandemic. We see that many Member States are taking action for national CVH plans, that the European Parliament is supporting a European CVH plan and we are pleased to hear that the European Commission President Ursula von der Leyen identified CVD as a new health priority for her renewed mandate. It is important that the European Commission comes forward with an ambitious proposal in line with the work undertaken for the European Beating Cancer Plan.
Therefore, we applaud wholeheartedly the recent adoption of Council Conclusions on the Improvement of Cardiovascular Health in the EU on 3 December 2024, as well as the commitment from the new Health Commissioner, Olivér Várhelyi, to develop a European Cardiovascular Health Plan. EHN particularly welcomes references made to prevention, women’s health and research. A strong focus on the patients’ voice will be a decisive quality element of such a future European plan. It will hopefully trigger efforts at national level to improve or develop national cardiovascular health plans.
How important are EU-funded projects like JACARDI in addressing NCDs, and what role do they play in complementing the work of other organizations like EHN?
JACARDI has a real potential to implement policy at national level and to make tangible inroads at the European level. It is very promising that so many health institutions are involved in leveraging knowledge and best practices across Europe. EHN is there to support and advise on the work, but also help to disseminate results across its membership.
As CEO of the European Heart Network, you have a unique perspective on the dynamics of cardiovascular health advocacy across Europe. What lessons from your experience there could be applied to projects like JACARDI to maximize their effectiveness?
It is most important to involve stakeholders early on because they can help bridge the gap between policy and practice. As EHN, we can bring expertise to the table from our members at national level, namely, the patient experience, but we also speak to national and European policy makers. In this way, projects such as JACARDI can be fast-tracked further to develop results, through our consolidated support, which will work in practice through the informed connections these layers will bring.
About Birgit Beger
With 22 years of EU public policy experience focusing on leading European Associations like Medical Doctors, Lawyers, Health NGOs, Birgit Beger is a well-respected senior executive. Birgit is a qualified lawyer and skilled communicator with senior management experience and diplomatic outreach to all political levels, both at the national and European level. She has brought considerable added value to the leadership roles she has held during her tenures as CEO of the European Cancer Organisation (ECCO), and as Secretary General of the Standing Committee of European Doctors (CPME). She is a member of WHO-Europe Regional Director’s Advisory Council on Innovation for Noncommunicable Diseases (the NCD Advisory Council) and is the CEO of the European Heart Network, a leading advocate and key partner in shaping and advancing the European Cardiovascular Health Plan.
Learn more about the European Heart Network here & connect on LinkedIn here.
Alessandro Gallina: JACARDI’s strength is in its approach
Actions targeting cardiovascular disease and diabetes are explicitly mentioned in President von der Leyen’s mission letter to the nominated Commissioner for Health, who has already committed to developing a European Cardiovascular Health Plan on his second day in office. Alessandro Gallina, Senior Policy Manager for Non-Communicable Disease Prevention at the European Public Health Alliance (EPHA) and member of JACARDI’s Stakeholder Advisory Board, sees this as an encouraging sign for building on JACARDI’s achievements in the future. He emphasises the importance of co-creating policies with vulnerable and marginalized populations to ensure sustainability and equity, and ensuring that policies are free from conflicts of interest, particularly from health-harming industries. Gallina believes JACARDI’s work can significantly advance health equity in Europe by identifying high-burden regions and driving targeted interventions.
How do you see JACARDI’s role in tackling cardiovascular disease and diabetes, and how is its mission aligned with EPHA’s?
JACARDI plays a critical role in addressing cardiovascular disease (CVD) and diabetes by emphasizing prevention strategies and coordinating cross-sectoral efforts. While these issues are high on the political agenda and impact everyone in Europe either directly or indirectly, JACARDI’s strength lies in its approach. Rather than addressing these two major non-communicable diseases (NCDs) in isolation, JACARDI operates within a broader framework that tackles all NCDs (both preventable and non-preventable). This approach is evident in JACARDI’s strong collaboration with other Joint Actions, such as PreventNCD, and other European initiatives that aim to combat NCDs and improve overall health outcomes.
As a member of the Stakeholder Advisory Board, EPHA brings the expertise and perspectives of our diverse membership, which includes health NGOs, research institutions, and civil society organizations dedicated to enhancing public health through effective, sustainable, and evidence-driven policies. Through our involvement, we aim to provide valuable insights that all participants can leverage to advocate for robust EU policies focused on prevention and the root causes of these diseases, including the commercial and social determinants of health, areas where EPHA is particularly active.
How can JACARDI help in reducing health inequities across European regions?
JACARDI is committed to a sustainability-oriented approach that includes a strong co-creation process and a focus on understanding the disparities between European communities and healthcare systems, allowing for tailored, effective measures. Additionally, JACARDI holds significant potential to address health inequities. By emphasizing data collection and the sharing of best practices, JACARDI can help identify the most affected societal and geographical regions and promote targeted interventions. EPHA, through its advocacy and policy work, supports these efforts by pushing for EU resources to be allocated to high-burden areas, ultimately reducing these disparities. Together, we can make substantial strides towards health equity across Europe.
What are the critical next steps for Europe in addressing the dual burden of cardiovascular disease and diabetes and what role can civil society play in this?
Europe must prioritize structured public health policies that focus on both prevention and equity. Comprehensive EU-wide initiatives are needed to address lifestyle and environmental factors, with a particular emphasis on regulating products from health-harming industries, including tobacco, alcohol, unhealthy foods, and the drivers of climate change. A key action of this is Europe’s Beating Cancer Plan, a groundbreaking initiative that has achieved much while setting the stage for further action. In the mission letter from President von der Leyen to the nominated Commissioner for Health, actions targeting cardiovascular disease and diabetes are explicitly mentioned. We hope and expect these actions to build on what the Beating Cancer Plan has initiated, and the outputs of JACARDI represent a significant step in this direction.
Civil society plays a crucial role in advocating for these changes and mobilizing communities to inform policymakers. EPHA, for example, is actively engaged in the EU policy process, as co-coordinator of the EU4Health Civil Society Alliance, providing evidence-based recommendations and facilitating civil society participation to keep public health at the forefront of the EU agenda.
What are the key outcomes for EPHA from JACARDI’s General Assembly in Paris?
For EPHA, the primary takeaway from this meeting would be a strengthened alignment with JACARDI on goals related to prevention and the reduction of health inequities. I learned a lot in these three days and I hope to gain even deeper insights on how we can further support JACARDI’s work while ensuring our members are actively involved in providing feedback on JACARDI’s pilot initiatives. Additionally, we aim to use these successful cases to shape improved EU policies. This alignment will not only enhance JACARDI’s impact but also reinforce EPHA’s commitment to building a healthier, more equitable Europe.
Alessandro Gallina is focused on promoting effective and equitable policies to tackle non-communicable diseases (NCDs) through a science-based approach. With a background in biology and a doctorate in medical science from the Karolinska Institute in Sweden, Alessandro has devoted his time in academia to understanding NCDs, their causes and treatments, as underlined by his published articles. As a firm believer in the axiom that prevention is key, Alessandro moved to the public health sector and joined the Directorate General for Health (DG SANTE) of the European Commission in Luxembourg. He currently serves as a Senior Policy Manager for non-communicable disease (NCD) prevention at the European Public Health Alliance (EPHA).
Learn more about EPHA here and connect on LinkedIn here.
Knut Inge Klepp and Linda Granlund: It’s important to find ways to build a community
With more than 1,600 health care professionals, scientists and public health experts involved, both JACARDI and JA PreventNCD recognize the necessity of fostering and building a strong sense of community and collaboration. According to the coordinators of JA PreventNCD, Knut Inge Klepp and Linda Granlund, building that sense of unity is no small feat, but is essential to make the most of the extraordinary investment and collective effort to tackle non-communicable diseases across Europe. In this conversation, the two coordinators explore the opportunities presented by this unprecedented joint commitment to prevention and the challenges of coordinating such large-scale projects.
What does JACARDI mean to you personally and to JA PreventNCD?
Knut Inge Klepp: There are so many synergies and so many opportunities for collaboration. It’s really useful to be able to work closely with the coordination team at JACARDI. Having colleagues you can share your victories and challenges with strengthens us as a team.
Linda Granlund: I agree with Knut Inge. Working closely with JACARDI is incredibly valuable for us, both as coordinators and as collaborators. It allows us to discuss details, but also to make sure that we avoid any overlap. On a personal note, I have lived with type 1 diabetes for 42 years, so staying informed about the developments in this field is not only professionally important but also deeply relevant to me.
Thank you for sharing! As Dr. Gauden Galea of WHO Europe explained at the Synergy meeting in Brussels this autumn (Strengthening NCD Monitoring Systems in the EU: A Collaborative Approach), after the COVID pandemic, the momentum for prevention and treatment of noncommunicable diseases was lost and the focus shifted to other areas of public health. How do you see the situation now?
Knut Inge Klepp: Well, we have these two joint actions, where the European Commission and the Member States have combined their efforts together, along with the smaller action grants. In total, almost 200 million euros are on the table. I think that reflects a significant turning point. Moving forward, our focus will be on making the best use of the substantial financial support, human capital and political commitment behind these projects.
Linda Granlund: When the Commissioner emphasized this focus, it signaled a significant shift, underscored by strong engagement and active involvement from Member States. With 21 countries participating in JACARDI and 25 in JA Prevent, it’s clear that these nations are committing substantial effort and resources to support our work.
How do you maintain focus while providing flexibility for task leaders and experts?
Linda Granlund: It’s important, to refer back to the background documents, Europe’s Beating Cancer Plan and the Healthier Together initiative. These provide essential guidance amid the many details of the project, work packages, tasks and subtasks. Without anchoring our efforts to these overarching goals, it’s easy to lose focus.
Knut Inge Klepp: First and foremost, it’s important to recognize that this is a significant challenge and we are fully committed to addressing it. Building on what Linda mentioned, our main objective is to ensure that our work aligns with the background documents. We regularly review these objectives and ask work package leaders, task leaders, subtask leaders and even pilot leaders to reflect on how their efforts contribute to the overall objectives. This ongoing process ensures that we are constantly reminded of what we are working towards and what we want to achieve.
Coordinating a project of this scale requires resilience, flexibility, bulletproof management and scientific rigor. What has been the most unexpected challenge you have faced so far in your first year, requiring you to think outside of the box?
Knut Inge Klepp: There are many challenges. One thing we’ve focused on recently is realizing that while we have frequent contact with a smaller group of work package leaders and maybe the task leaders and so on, there are probably between 500 and 1,000 people involved in this project – many of whom we haven’t met personally. We’ve interacted with a lot of them on screen, but it’s also important to find ways to build community, ownership of the project and a common culture. And that is also something that you are very consciously working on within JACARDI.
Linda Granlund: We have talked a lot about the different cultures involved when you have 25 countries working together. Finding a common tone is very important. How do we talk about the project? What do we emphasize? This process takes time, especially as the people involved come from different backgrounds, even if some share similar expertise.
Your dedication to creating a more health-promoting environment in Europe is well reflected in your work with a Youth Advisory Group. In your vision, what’s the NCD issue you envision for them to have to solve when you hand over the future?
Knut Inge Klepp: I started working on my first international non-communicable disease (NCD) prevention project in 1979. That was 45 years ago. Looking back, 30 years seems like a pretty short time. The scale and the context are different, but it’s striking that some of the issues we’re dealing with are quite similar. I think one of the values of this youth panel is their ability to bring a perspective that is grounded in their reality. In terms of health issues, we are seeing the convergence of NCDs with mental health and infectious diseases. The pandemic highlighted the vulnerability of people with underlying NCDs to infectious diseases. Addressing these interconnected challenges is something that today’s young people will have to deal with, even as we continue to work towards solutions in the present.
Linda Granlund: I think when we hand over the results in four or five years, we’ll have an understanding of that. Collaboration across sectors is essential, as we now focus on addressing the underlying factors that contribute to preventing NCDs. These are primarily related to the health care system, but we need to involve the other sectors more, such as the school sector, the transport sector, and create a mutual understanding of why they need to be involved and in what capacity. With the support of the EU Commission, this approach will benefit all the countries involved.
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Linda Granlund is the Division Director for Public Health at the Norwegian Directorate of Health, a role she has held since 2015. With over 20 years of experience, she has led initiatives to improve public health and nutrition. Previously, Linda worked in roles including Director of Health and Nutrition at a Norwegian food company that produces and markets some of the country’s most well-known and beloved food products, where she advanced projects to promote healthier eating. Linda also served as Vice Chair of Diabetesforbundet, the Norwegian Diabetes Association, advocating for better diabetes care. Her expertise spans health policy, nutrition, and public health advocacy.
Knut Inge Klepp is the Executive Director of the Division of Mental and Physical Health at the Norwegian Institute of Public Health. He has had an extensive career in public health, previously serving as the Director General of Public Health at the Norwegian Directorate of Health. Klepp is also an adjunct professor at the University of Oslo. His academic focus includes adolescent nutrition, obesity prevention, and nutrition policy. He has led numerous EU research projects, has published over 250 papers in peer reviewed journals and contributed significantly to international health initiatives, including WHO’s efforts to reduce non-communicable diseases.
Learn more about Knut Inge Klepp and his work here and connect on LinkedIn here.