We have met with Euro-Commissioner Tonio Borg http://ec.europa.eu/commission_2010-2014/borg/ twice this year, once in the European Parliament (CAM Interest Group meeting) and once at his cabinet. We are keen to follow up on these meetings by presenting him with data which he requested. Further details below. We will continue our advocacy work with EUROCAM, who have invited more guests to their table.
We will provide ETCMA members with a paper that sums up the current evidence base for acupuncture. Rather than being a dry overview, it has been written specifically with political lobbying purposes in mind. As such it contextualizes scientific research into acupuncture, discusses EBM principles' applicability, and sums up the acupuncture evidence that we have from systematic reviews and meta-analyses regarding efficacy, comparative effectiveness, safety and cost-effectiveness. ETCMA members will also receive a powerpoint presentation that we hope will be useful for lobbying purposes in your own countries.
We wish to announce that the ETCMA Executive Committee has decided to leave EFCAM as of 23 July 2013. We felt that our interests were no longer represented by the umbrella organization that EFCAM is. More about that later on in the report.
An overview and summary of the meetings that we have attended:-
EFCAM board meeting 13/02/13
EFCAM wishes to expand its scope of activity beyond DG Sanco http://ec.europa.eu/dgs/health_consumer/index_en.htm and is looking at DG Internal Market Services http://ec.europa.eu/dgs/internal_market/index_en.htm
to help with registration and legislation for CAM. A feud between EUROCAM and EFCAM is developing, resulting in a ban on the President of EFCAM attending future EUROCAM meetings.
EUROCAM board meeting 03/04/13
Governance principles within EUROCAM: the agreement is to work on a consensus basis.
Since the group is only a stakeholder collaboration and not a regulated body with statutes and membership fees, the goal is to strive for consensus. The governing
principles were discussed Governing Principles( please click on this)
When a consensus is not reached, talks will go on until consensus is reached. If
not, then by majority vote.
We took note of an EPHA CAM working group.
The EC decided that the ETCMA should become a member of EPHA and we have since applied for membership, which ought to be approved soon.
WHO meeting in Rothenburg 09/05/13
Dr Zhang Qi of the WHO first met with the President and CEO of ETCMA in private, followed by a meeting with all ETCMA delegates.
(See notes from that meeting below).
EFCAM board meeting 29/05/13
We discussed DG Sanco policy: 'Investing in Health' � Horizon 2020 http://ec.europa.eu/dgs/health_consumer/dyna/enews/enews.cfm?al_id=1348
This policy is a reaction to the economic crisis in the EU. This lists priorities in
health policy: prevention, chronic diseases, healthy ageing, cost-effectiveness,
... to improve productivity in the EU.
Commissioner Borg himself addressed the Health Policy forum on April 9 (quite exceptionally)
see http://ec.europa.eu/commission_2010-2014/borg/docs/speech_eu_health_policy_forum_09042013_en.pdf because it seems he really wants to push his 'Investing in Health' policy.
ETCMA might have an opening here and will try to present the evidence base for acupuncture for chronic pain, cost-efficiency etc to Mr Borg as soon as we can.
EFCAM had decided to no longer go to the EUROCAM meetings. The ETCMA decided that they felt they wanted to continue meetings with EUROCAM, which forced EFCAM to reconsider its position. EUROCAM had sent out invitations to seven organizations (including the ETCMA), and EFCAM decided to send two representatives to the EUROCAM meetings.
KrY decided to leave EFCAM from this meeting onwards because of poor finances.
EUROCAM meeting with Stefano Soro, Head Medicinal Products DG SANCO 05/06/13
Ton Nicolai (ECH) started the meeting by saying that he wanted to expand on the
points from the CAMbrella Roadmap (as summarized here: http://www.echamp.eu/news/newsletter/newsletter-archive/2012/december/the-roadmap-for-european-cam-research.html
Stefano Soro (SR) responded by saying that he was well aware of CAMbrella, and the main points from the CAM Conference, and he immediately added that his agency had no new initiatives regarding CAM, nor did his colleagues from DG SANCO.
EUROCAM hoped that our concerns would be made known to all decision makers involved and SR assured us that he would present all the main points from the meeting upwards and laterally:-
1. Unequal access to CAM health care (mainly accessed by people from higher social classes).
SR: no new initiatives planned, also not for homeopathic medicines.
Herbert Schwabl (HS) did a short speech on the ineffectiveness of the existing legislation of herbal products. SR wants to make the existing legislation work and feels no need to add on new legislation. He was unimpressed by the comment that different countries have different rules. He later said that if certain medicinals (not food supplements) are unavailable in a certain country but forbidden in another country, we should notify that country and could notify him to let that member state know that they are restricting access to a medicinal available in other EU countries = infringement of consumer law.
HS mentioned the HMPC http://www.ema.europa.eu/ema/index.jsp?curl=pages/about_us/general/general_content_000264.jsp
several times and Walburg Marić-Oehler (ICMART) repeatedly asked for a response from SR to become more active on the regulation of herbal medicinals. SR was a bit reluctant but when he was informed that his predecessors sometimes went to the HMPC meetings he said he would look into it. Reports of their meetings can be found here
ema
2. To tie in with specific Health Projects, Stephen Gordon (ECCH) talked about addressing anti-microbial resistance with homeopathic medicinals, and SR said that any serious data of efficacy to reduce use of antibiotics would be looked at seriously by all involved. See
http://www.epha.org/a/5501
and http://www.euro.who.int/en/who-we-are/governance/regional-committee-for-europe/past-sessions/sixty-first-session/documentation/working-documents/wd14-european-strategic-action-plan-on-antibiotic-resistance
and http://ecdc.europa.eu/en/healthtopics/antimicrobial_resistance/Pages/index.aspx
And if any ETCMA member knows of data that Chinese Herbal Medicine reduces use of antibiotics, please do send along the info as we can contact SR directly
with this.
Off the record he seemed to understand that CAM has a place in the health field.
He asked very specific questions and seemed to focus on efficacy of medicinals.
Cost-effectiveness was less of a concern for him, but all the more to the EU politicians.
He was very interested to find out that several countries have EBM guidelines on
CAM as he did not know this.
EUROCAM board meeting 18/06/13
Tour de table. New members at the table are EFO http://www.efo.eu/portal/
looking for promotion of osteopathy; EURAMA http://www.ayurveda-association.eu/
: few hundred members, all MDs practising Ayurvedic medicine; ANME http://www.anme.info/en/
: wants to see if there can be a common understanding of CAM, including non-doctors practising CAM. Regular members IVAA: mainly interested in CAMDOC alliance, wants to see if there can be cooperation with patient organizations and other trained CAM practitioners; ECPM: does not want to focus on quarrels; EFCAM wants to see the President of EFCAM present at the table and acknowledges that there have been tensions but that cooperation should be possible; EHTPA: preferably no egos, only here for the doing; ECH: Ton Nicolai is coordinating EUROCAM until a structure is approved. Since the whole group wants to find a common ground for everyone to participate it is suggested that everyone takes home the EUROCAM booklet please
click on this), and insert and submit changes to the whole group. Deadline
for submitting: 1st Sept.
If any of you have any suggestions regarding the contents of the booklet, send us
an email.
Vinjar F�nneb�http://en.uit.no/ansatte/organisasjon/hjem?p_menu=42374&p_dimension_id=88112
http://nutritionandhealthconf.org/formalbio_vfonnebo.html
did a presentation on a post-CAMbrella research group: European CAM research and competence centre. This research group is interested in closer cooperation with EUROCAM, as they represent the largest politically active CAM group in Europe.
Research on specific modalities of CAM and on its working mechanisms is not included in the CAMbrella research report, and this is one of the reasons Vinjar came to this meeting. He would like to connect more with producers etc. that can help fund research. And contribute to our practice, evidence base etc. He made the remark that they would like to produce evidence that has external validity. They have experienced statisticians that should try to accommodate the needs of the interest groups (and e.g. allow for individualized treatments). This group applied twice for EU funding in 2012, and failed on both occasions. Getting even one project funded with EU money could install regular 'calls' for CAM research projects. In Norway they have started a project called 'clinical quality registry' for CAM, and have sent out questionnaires to the Norwegian acupuncture society, among others. Details on this are to follow.
Purpose is to build 'systematic experience'.
There was a proposal to write a joint letter to DG Research and ask for a meeting
with them in September.
European Parliament Interest Group Meeting on CAM 27/06/13
The EU Parliament CAM Interest group met on the topic of "CAM: an Investment in Health". It was co-chaired by MEP Alojz Peterle and MEP Sirpa Pietikainen. Approximately 60 people were present. The Keynote speaker was Health Commissioner Mr. Tonio Borg.
It was the first time that a Health Commissioner has attended a CAM Interest Group meeting in the Parliament. Mr Borg declared himself a believer in CAM and said that he regularly used Chinese Medicine. He said that the prejudices about CAM should be removed, that people should be allowed to choose their own healthcare and that providers should have free movement to practise anywhere in the EU. He spoke of the financial pressures of health systems to do more with fewer resources and that in this context sustainable and thus cost-effective treatments and anything that can produce better outcomes at lower cost was welcome. Mrs Pietikainen and Mr Peterle made a number of suggestions for future actions: perhaps a unified umbrella for professional training, to get more data about cost-benefits, to look for possibilities in existing legislation for regulation but to also push for own regulation, and perhaps a new and bigger conference next April/May than the one organized last October.
A report on this event can be read in the Parliament Magazine, page 43 http://www.theparliament.com/digimag/issue373
or click over the pdf file just here CAM
Commissioner Borg's full speech can be read here: http://ec.europa.eu/dgs/health_consumer/dyna/borg/speeches_en.cfm
EFCAM meeting with Commissioner Borg 12/07/13
We met with Comm. Borg at his own cabinet. The full EFCAM report from that meetingis attached here EFCAM
We had prepared an overview of evidence for acupuncture, including cost-effectiveness, to present to the Health Commissioner. EFCAM however denied us that opportunity as they wanted this meeting to be of a general, introductory nature.
The Commissioner mentioned again that he is an ally and that he receives regular treatments in the Chinese medicine clinic in Malta. He also repeated his stance on cost-effectiveness being a major focus point for the (European) healthcare of the future. When asked who we should send our data to, the Commissioner stated that we are welcome to send the data to his cabinet, because they know best whom to forward it to.
We are preparing a dossier that serves the political needs of both Mr. Borg and
the ETCMA.
We hope to soon be able to present it to his cabinet.
EFCAM board meeting 23/07/13
At the beginning of this meeting the ETCMA announced that we would leave EFCAM as of this meeting. Following recent events, we felt that EFCAM was no longer a forum where our interests could best be represented. We bear no ill feeling towards EFCAM and hope to be working with them in the future, maybe through EUROCAM.
Although we acknowledge the work that EFCAM has done over the year, we felt there were moments of undemocratic decision-taking; and since EUROCAM now has many more members than EFCAM we have decided to focus our efforts on strengthening our own political advocacy work whilst continuing in EUROCAM.