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.
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.