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.
Learn more and connect:
JA Prevent NCD
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.
Elisabeth Dupont: A joint approach on CVD and diabetes is more than just the sum of the two!
JACARDI has the potential to be truly transformative according to Elisabeth Dupont, Regional Manager at the International Diabetes Federation Europe (IDF Europe) and member of JACARDI’s Stakeholder Advisory Board. In an enlightening discussion, we explore the powerful synergy of tackling diabetes and cardiovascular diseases through an integrated approach. With years of experience in patient advocacy, Elisabeth shares valuable insights on policy engagement, stressing the importance of early collaboration with policymakers, while harnessing the collective voice of national diabetes associations and people with lived experience. Her expertise particularly shines through when discussing patient involvement in healthcare initiatives.
How do you see JACARDI’s role in tackling the increasing prevalence of diabetes in Europe?
Over 32 million people in the EU live with diabetes, and this figure is expected to rise to 38 million by 2030. Adding to this challenge is the fact that more than one-third of people with diabetes remain undiagnosed, underscoring the urgent need to improve diabetes prevention, management, and care. Diabetes is a highly complex and evolving condition, with various expressions and causes, requiring a life-course approach. Its scientific and policy links to cardiovascular diseases (CVDs) further highlight the importance of initiatives like JACARDI.
The Joint Action on Cardiovascular Diseases and Diabetes, which addresses the entire patient pathway, has the potential to be truly transformative. By bringing together 76 partners across 21 countries, JACARDI will enhance understanding of the diabetes landscape at regional, national, and European levels. Successful pilot projects will serve as proof of concept, demonstrating what truly impacts health outcomes and quality of life for people with diabetes, and how healthcare systems must adapt or transform to improve detection, early diagnosis, access to education, and high-quality treatment and care. A joint approach on CVD and diabetes is more than just the sum of the two!
What advice do you have for JACARDI’s pilots to translate their results into policy?
My first piece of advice would be to engage with policymakers as early as possible, leveraging the support and influence of national diabetes associations and people with lived experience. Translating project results into policy changes requires collaboration with the community and a clear understanding of how the project aligns with regional and national diabetes priorities, such as addressing healthcare workforce shortages, improving access to care in rural areas, or enhancing early diagnosis, integrating care and ensuring equitable access to innovation. It’s also essential to demonstrate the added value for healthcare systems and highlight the pilot’s positive impact on patient outcomes and quality of life.
IDF Europe is one of the key stakeholders of JACARDI. How can we strengthen this cooperation to address the growing challenge of diabetes and bring real and tangible added value to populations and patients?
IDF Europe is an umbrella organization of 72 diabetes associations, active in 45 countries, representing both people living with diabetes and healthcare professionals. IDF Europe strongly believes that the voice of people living with diabetes must remain central at all levels to ensure that interventions, innovations, and policy changes truly address their needs and deliver tangible impact. We welcome the opportunity to advise work package leaders and pilot leaders to ensure patient input and feedback are consistently integrated.
To ensure the long-term sustainability of the Joint Action, it is crucial to establish ongoing communication with the wider diabetes community, keeping them regularly informed of progress and involving diabetes associations in pilot activities where their contributions can enhance the project. Additionally, we suggest leveraging the IDF Europe network to communicate about the Joint Action and co-develop advocacy campaigns that promote policy changes based on successful pilot outcomes.
Elisabeth Dupont has been working for more than 15 years as senior project manager for the International Network for Cancer Treatment and Research, the African Cancer Registry Network and the US National Cancer Institute Center of Global Health. In 2019 she joined IDF Europe as Regional Manager. She is passionate about promoting collaboration and partnerships and putting the voice of people living with chronic conditions, including diabetes, center stage.
Learn more about IDF Europe here and connect on LinkedIn here.
Charles Agyemang: The challenge, especially with minority populations, is building trust
Some communities may seem hard to reach, but the real issue is that we don’t know how to connect with them, says Charles Agyemang, professor of Global Migration, Ethnicity and Health at the University of Amsterdam. As a member of JACARDI’s Scientific Advisory Board and an expert on ethnic inequalities in health and non-communicable diseases, he shares his experiences in working to connect with and empower minority communities. We also discussed the importance of addressing diversity in Europe and how JACARDI is leading the way.
What significance does JACARDI hold for you and your organisation in terms of its mission and values?
JACARDI is bringing a new dimension and aims to change the way things are done at the European level. The extensive network provides an excellent opportunity to interact with people, re-evaluate existing practices, and learn from other countries. It is quite exciting that JACARDI places inequalities at the center of its focus.
For me and my team, this is an opportunity to learn about what is happening across Europe and to contribute to ensuring that care and services related to cardiovascular disease are delivered equitably across Europe, taking into account people from diverse backgrounds such as migrant and ethnic minority groups.
How do you see JACARDI’s role in tackling the increasing prevalence of CVDs and diabetes in Europe?
Over the years, many countries have been working on cardiovascular diseases, but often in silos. When it comes to diversity and its various aspects, such as ethnicity and gender, many countries have been addressing these issues in their own ways and often with limited attention.
Now JACARDI provides an opportunity to raise awareness, share best practices among countries, and develop excellent ideas that can be implemented locally. It also allows countries to assess how far they have progressed, and engage with others in the process. More importantly, it ensures that countries are not working alone in silos. They have a network of people to rely on and seek input from when needed, fostering a collective responsibility to address this issue at the European level.
What is our role in promoting equity in healthcare?
Diversity cuts across the entire project, which is what makes it unique. In other words, regardless of what you are working on in your country, it is essential to apply a vested lens to it. I believe that adopting diversity as a horizontal approach should be the approach that is taken across the world.
This is the flagship element of the project. Everyone involved is expected to take it seriously and actively work on it. Having a dedicated work package focused on this ensures a constant reminder and provides a source of support for those seeking help. Some countries are more advanced in addressing these themes, and this project creates an opportunity to support countries that are less developed in their approach to diversity.
One important issue is the sustainability of the project’s results. There should be a plan and funding to enable the implementation of the diversity lens across all of Europe and ensure equitable healthcare for everyone regardless of ethnic background, gender, sexual orientation and so forth after JACARDI.
How do you see the significance of considering cultural diversity in the development of treatment for diabetes and cardiovascular disease and what is the most critical aspect of this?
The fact of the matter is that Europe today is very diverse, especially in urban centers. This is a reality, and we must address it. Diversity plays a crucial role in cardiovascular diseases, and understanding it is key to addressing inequalities in health and healthcare.
It also makes economic sense to address these gaps. For example, if we know that a specific group is affected by hypertension and we ignore this, individuals may eventually end up in the hospital with strokes, and society will bear a heavy cost of treating and caring for stroke patients. We should focus on the individuals or groups most affected and implement effective interventions to support them in living healthier lives.
Many of these inequalities are tied to social determinants of health and access to resources. For example, not everyone has the privilege of living a healthy life because of financial constraints, which may prevent them from buying healthy food. No matter how much health information you provide to specific communities, it is not going to be effective if their social and economic circumstances are not right. There must be a plan backed by resources to simultaneously promote healthy life and improve social and economic circumstances among a culturally diverse population.
Do you have any tips or valuable experiences on how to implement research findings in healthcare to benefit both the system and the patients?
It is crucial to involve the communities that matter from the very beginning of the implementation process. Their voices, especially those that are often unheard, must be included. We need to empower these communities, ensuring they are not just recipients but co-creators of the initiatives. By working together with communities from the start, we can ensure that the program is meaningful and sustainable.
Often, there is a tendency to go into communities and tell them what they should do. Instead, we should focus on ensuring that people are actively engaged in decisions, so that they take ownership of the program. When communities take ownership, they are more likely to ensure the program’s continued success after its initial implementation.
It’s crucial to recognize that long-term commitment is necessary for the success of a program. Governments must invest in supporting communities, especially those from lower economic groups and minorities, as it offers long-term benefits.
Do you have advice on how we can reach different communities?
People often say some communities are “hard to reach,” but the real issue is that we don’t know how to connect with or reach them. In fact, these communities are quite accessible if we approach them the right way and through proper channels.
The challenge, especially with minority populations, is building trust. To truly connect with people, we need to focus on establishing trust and building bridges. It’s about making people feel comfortable and valued. We need to invest time, establish relationships, and co-create with them.
Many times, researchers only engage when they need something, but we should connect even when we don’t need anything. By forming relationships and spending time with communities, it becomes easier to reach out when the need arises.
Charles Agyemang is a professor of Global Migration, Ethnicity and Health at Amsterdam University Medical Centres, University of Amsterdam. He is currently the Vice President of the EUPHA Migrant health section, Secretary of EUPHA’s Governing Board and Scientific Chair of the Global Society of Migration, Ethnicity, Race and Health. He is also a member of the prestigious US National Academy of Medicine and The European Academy. His work focuses on migration and health, particularly in relation to cardiovascular diseases. One of his most notable projects is the RODAM study, which investigates obesity and type 2 diabetes among African migrants.
Learn more about Charles Agyemang and his work here and connect on Linkedin here
Experts from WHO Europe, JA Prevent and JACARDI gathered for a joint event
Data has the power to save lives
Many passionate voices came together on September 10th in Brussels to address the pressing challenges of preventing and controlling noncommunicable diseases (NCDs). The event, Strengthening NCD Monitoring Systems in the EU: A Collaborative Approach, brought together representatives from WHO Europe, JA Prevent, JACARDI, and several Member States. Their shared insights and best practices sparked crucial discussions, setting the stage for a more coordinated and impactful approach to NCD monitoring.
“Iremember the excitement of the political cadre before the 2011 high-level UN meeting on NCDs” – reflected Dr. Galea Gauden, strategic advisor to the WHO Regional Director for Europe just one year before the next UN high-level meeting 2025. At that time, momentum had been building, but new data show that COVID-19 pandemic derailed Europe’s progress toward achieving NCD targets, as Dr. Ivo Rakovac, WHO’s regional advisor on NCD surveillance highlighted. This setback has had a profound impact on societies, families, and communities and EU countries are still lagging behind in target setting and health examination surveys. Despite the available science and research, demonstrating the success of NCD prevention programs and gaining political support remains a significant challenge.
The way we can fight this challenge, is to bring together and share all recent data on NCD prevention and intervention and turn them into a tool for advocacy. Data-driven policies are essential for combating noncommunicable diseases, the biggest health threat in our region. This event marked an essential first step in coordinating efforts across participating organisations, each showcasing their objectives and achievements. For JACARDI, partnerships with WHO Europe and JA Prevent are vital, as collaboration is key to amplifying our collective impact. As of 2023, only 48% of countries in the WHO European region have fully implemented recommended NCD policies and capacities in key areas such as surveillance and governance, tobacco control, alcohol control, unhealthy diet reduction, physical activity promotion and NCD management in health systems. At the event, frontrunners like Norway, Spain, Estonia and Denmark shared success stories, while Germany, Finland, and Italy offered best practices in NCD monitoring. One of the event’s highlights was an innovative closing session led by Dr. Gauden, where participants contributed to drafting a joint political declaration. Using an AI tool, he summarised the most frequently cited ideas, leading to the following key takeaways:
Data and Monitoring
We should harmonise data collection methods, ensuring the availability and usability of health data. By interconnecting monitoring systems for NCDs, risk factors, and determinants, we will enable more effective decision-making, policy advocacy, and targeted interventions for NCD prevention.
Political Commitment and Accountability
We recognise the need for enhanced political will to address NCDs with evidence-based interventions and clear accountability. Governments must take ownership, set clear targets, and resist industry pressures, prioritising public health over economic interests.
Prevention and Health Promotion
Preventive measures and health promotion are central to reducing the NCD burden. This includes integrating health literacy into education, launching national awareness programs, and creating environments where healthy choices are normalised and accessible. Using a common methodology for implementing and assessing pilot projects can reduce the risk of failure and enable a thorough analysis of the results.
For this reason, all 142 JACARDI pilot projects follow a common structure and timeline, with working methods based on the concepts of ‘grassroots innovation’ and implementation science.
Creation of a Different Landscape for Cardiovascular Diseases and Diabetes in Europe Through JACARDI Joint Action
Scientific publications by JACARDI
In this post series we share the scientific publications directly linked to the JACARDI project. All publications featured in this series are authored or co-authored by JACARDI partners and reflect research and findings developed within the project framework.
We aim to showcase how evidence supports our joint mission to tackle cardiovascular diseases and diabetes across Europe.
Stay informed on how JACARDI turns evidence into action.
Authors: Jelka Zalatel, Farkaš Lainščak, Jerneja
Keywords: Diabetes mellitus, Cardiovascular disease, Europe, Interventions, Collaboration, Sustainability
Abstract:
The Joint Action on CARdiovascular diseases and DIabetes (JACARDI) aims to reduce the burden of cardiovascular disease and diabetes in European countries, both at the individual and societal levels. The initiative covers the entire patient journey, from improving health literacy and awareness of cardiovascular diseases and diabetes, travelling through primary prevention among high-risk populations and screenings, reaching people living with cardiovascular diseases and diabetes, improving service pathways, self-management, and labour participation. The project involves 21 European countries, 76 partners and plans to implement 142 pilot interventions, ensuring diversity in terms of cultural backgrounds, public health priorities, and healthcare systems.
In Slovenia, interventions will be developed and tested to improve screening for diabetes through community involvement, the involvement of people with diabetes in education programmes in health centres, and the involvement of people with diabetes in a screening programme for diabetic retinopathy. A set of unified, comprehensive and integrated health education materials and approaches will be developed for both healthcare providers and patients referred to the outpatient cardiovascular rehabilitation programme. The effectiveness of the upgraded health education intervention will be tested in a randomized trial. Furthermore, Slovenian experts are involved in developing a harmonized implementation methodology across all 142 pilot interventions, including contextual analysis at the country and pilot levels, multidimensional assessment and evaluation.
JACARDI will enhance cross-national collaboration, maximizing the exploitation of lessons learned through a clear strategy, promoting the integration and sustainability of approaches to achieve high-level impact, including the implementation of effective interaction, cooperation and co-creation between science and policy.
Published in: Slovenian Journal of Public Health, Volume 63 (2024): Issue 3 (September 2024)
Tackling the challenge of cardiovascular diseases and diabetes across Europe: a joint action by more than 300 public health professionals
Scientific publications by JACARDI
In this post series we share the scientific publications directly linked to the JACARDI project. All publications featured in this series are authored or co-authored by JACARDI partners and reflect research and findings developed within the project framework.
We aim to showcase how evidence supports our joint mission to tackle cardiovascular diseases and diabetes across Europe.
Stay informed on how JACARDI turns evidence into action.
Authors: Benedetta Armocida, Beatrice Formenti, Marco Silano, Albert Aszalos, Hector Bueno, Mounia Elyamani, Ane Fullaondo Zabala, Matilde Leonardi, Jaana Lindstrom, Karolina Michalak, Bernardino Morillo, Michal Nowicki, Denis Opresnik, Luigi Palmieri, Roberta Papa, Markku Peltonen, Helena Safadi, Hanna Shchetynina, Natalia Skogberg, Hanna Tolonen, Edwin Wouters, Jelka Zaletel, Graziano Onder, on behalf of the JACARDI Consortium
Keywords: cardiovascular disease, diabetes, public health, EU4health
Abstract:
Cardiovascular diseases (CVD) and diabetes pose significant health challenges in Europe, affecting millions and burdening healthcare systems. The recent EU4Health Programme places reducing the burden of non-communicable diseases (NCD) at the forefront, through a Joint Action focused on CVD and diabetes (JACARDI, Joint Action on CARdiovascular diseases and DIabetes). This initiative unites 21 European countries, including Ukraine, and over 300 experts. Employing an innovative approach and standardised methodology, JACARDI implements 142 pilot projects covering the entire
“patient” journey. Particular focus will be given to improvement of data availability and quality. Additionally, JACARDI will emphasise transversal and intersectional aspects, such as health equity, determinants of health, and social, cultural, and ethnic diversity, while pioneering gender-transformative leadership. Committed to evidence-based interventions, JACARDI aims to harmonise strategies and disseminate knowledge for enhanced CVD and diabetes prevention and management. The goal is to identify effective strategies for wider implementation, fostering cross-national collaboration and fortifying Europe’s health resilience.