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3rd European Union Osteoporosis Consultation Panel Meeting
Wednesday, November 10, 2004

EU consultation panelThe third meeting of the EU consultation panel took place in Brussels on November 10, 2004 in conjunction with a lunch meeting for the European Parliament Osteoporosis Interest Group members. The panel meeting, chaired by Maev-Ann Wren, Irish journalist and health economist with a special interest in health care systems, brought together for the first time representatives from the new member states. The Consultation Panel thanks IOF for organising the meeting and Weber Shandwick Brussels, who assisted with logistics, media support and pro bono meeting facilities.

Meeting report and speaker presentations

Prior to the meeting, members each submitted a brief report to outline the main achievements and challenges in each of the 25 member states measured against the European Commission's eight recommendations during 2004. The report was discussed and a question and answer period allowed for interaction and clarification among panel members. Below is a brief summary of the meeting, picture gallery, presentations made by speakers, and a final report issued in February 2005 resulting from the meeting.

Osteoporosis in Europe: Indicators of Progress (PDF, 249 KB)

See press release issued on the occasion of the meeting.
See photo gallery
View member states progress reports (PDF, 188 KB)

Welcome address by the Chairs of the EP Osteoporosis Interest Group

Angelika Niebler, MEP Ms Honeyball (right) and Ms Niebler (left), European Parliament Osteoporosis Interest Group co-chairs

Mary Honeyball MEP (UK) and Angelika Niebler MEP (Germany), the European Parliament Osteoporosis Interest Group co-chairs, welcomed the panel participants. stating that "between us we can take the debate forward". Ms. Honeyball recalled the important role of the European Parliament Interest Group in raising awareness of osteoporosis both in the parliament and in the member states so that osteoporosis "does not get lost among other issues". She stressed the importance of getting a Council Conclusion finalized as quickly as possible so that osteoporosis action could be taken to the next stage. In her closing remarks, Ms. Honeyball paid tribute to the founding chair of the EP Osteoporosis Interest Group, Ms. Mel Read, whose role was so influential in establishing and expanding the EP Interest Group.

In her welcome speech, Angelika Niebler emphasized that the task of the Interest Group is to create awareness among MEPs, to motivate political interest in osteoporosis and to do its best to obtain a Council Conclusion by 2005. Personally, Ms Niebler has taken action in various ways, including in her home state of Bavaria where a resolution on osteoporosis was adopted by the women's group of her political party. As regards activities in the European Parliament, an initiative report on women and health in the Women's Rights & Equal Opportunity Committee will include the issue of osteoporosis and, in her preparations for the 7th Research framework programme, Ms. Niebler will try to put emphasis on osteoporosis as a disease for which further research is necessary and for which financial support will be needed on the EU level. In her conclusion Ms. Niebler said, "it is crucial for us to ensure that osteoporosis is included in relevant EU strategies, programmes and activities such as health and research strategies and their related programmes - the public health action programme and the research framework."

Prof. Juliet CompstonIntroduction (PDF, 387 KB): Prof. Juliet Compston, Chair EU Osteoporosis Consultation Panel & International Osteoporosis Foundation (IOF) board member gave an overview of the policy action taken to date at the European level and stressed the need for a Council Conclusion on Osteoporosis to assist member states with the ongoing implementation of the recommendations of the 1998 European Commission report and the key steps of the Consultation Panel's action plan.

Mariann Skar, European CommissionNews from the European Commission (PDF, 30 KB): Mariann Skar, European Commission, directorate general public health. Ms. Skar stated the Commission's support, especially in preventing osteoporosis through the promotion of healthy lifestyles and possibly assisting with fracture data collection. The Commission services will continue to look for the best way forward to keep osteoporosis on the agenda. In conclusion, Ms. Skar said "We need to work together to ensure that those most at risk are identified and advised before the first fracture happens, and that known ways of reducing the risk for this disease are widely promoted."

Progress towards implementing the EU Osteoporosis Consultation Panel's Action Plan to make osteoporosis a health care priority:

Awareness-raising campaigns (PDF, 288 KB): Mary Anderson, EU Osteoporosis Consultation Panel co-ordinator & IOF board member. Many excellent initiatives have been implemented over the last year to educate people at high risk of osteoporosis and health care professionals in a position to diagnose osteoporosis-related fractures. Non-profit organisations have been very active, however more government support is needed in many member states.

Preventive strategies (PDF, 260 KB): Prof. Liana Euller-Ziegler, Bone & Joint Decade French Network co-ordinator and Prof. Christel Lamberg-Allardt, Finnish Bone Society and Finnish Osteoporosis Association. Widespread insufficiency in calcium and vitamin D intake as well as lack of exercise throughout Europe will have an impact on bone health and on the number of people with osteoporosis in the future. Preventive strategies implemented by the governments in France and Finland were presented to encourage action in less active member states.

Guidelines (PDF, 41 KB): Prof. Juliet Compston.
The importance of guidelines for good clinical practice was emphasized. In addition to posting links to all available evidence-based guidelines in the EU on the IOF website, Prof. Compston proposed setting up a resource database - a type of template- as an assistance to countries who don't yet have evidence-based guidelines.

Fracture care, rehabilitation and prevention of falls (PDF, 296 KB): Prof. David Marsh, president, International Society for Fracture Repair . Prof. Marsh warned that "although most governments are developing plans to bring down waiting times for surgery, the expected epidemic of osteoporotic fractures will swamp facilities in the future".

Economic data (PDF, 169 KB): Requirements for DXA for the management of osteoporosis in Europe. Prof. John Kanis, WHO Collaborating Centre for Metabolic Bone Diseases.
Prof. Kanis stressed that the projections are reliable - with all certainty the cost of fragility fractures will more than double to over euro 70 billion per year by 2050. Diagnostic equipment is under-resourced given that the burden of fractures for women over the age of 50 is already greater than breast cancer and equivalent to cardiovascular diseases.

Evaluation of actions and planning of future healthcare resources (PDF, 278 KB): The European fracture database: Prof. Olof Johnell, WHO working group & vice-chair, IOF Committee of Scientific Advisors. Prof Johnell stressed the importance of obtaining accurate data on the burden of osteoporotic fractures on each country. He reminded participants that hip fracture data could be obtained relatively easily through in-patient hospital records and that the burden of all osteoporotic fractures could then be estimated from the hip fracture rate.

Lunch with European Parliament Osteoporosis Interest Group members in the European Parliament, members' salon.

Some 20 MEPs, Commission officials including representation from the Commissioner of Public Health and permanent representatives of member states to the EU, took part in the lunch with the consultation panel – it was a valuable opportunity for interaction between policy makers and osteoporosis experts. Following a short speech of welcome by Mary Honeyball MEP, Osteoporosis Interest Group co-chair, Prof. Juliet Compston reminded participants that "fractures cause enormous suffering and costs - costs which will double in the next 40 to 50 years". After reviewing the history of osteoporosis policy action in Europe, Prof. Compston reiterated the goal for 2005 – an EU Council Conclusion – which will be essential to maintain a high profile for osteoporosis.

Prof. Cannata Andia, panel member from Spain, spoke briefly, saying that "I would like to thank the panel and Interest Group for your support - the concrete plans outlined in the Action Plan have helped push forward our government plans in Spain". A similar message was given by Prof. Ortolani, panel member from Italy, who said, "The role of this panel was relevant to what we could achieve in Italy...credibility was provided by being part of this important panel".

John Austin MP, England, emphasized the importance of dialogue between countries. He recalled that "osteoporosis is a disease which is not only costly, but escalating, also in terms of human misery". The agenda has moved forward in England however he stressed that we all need to be insuring that what governments say they will do is effectively implemented.

Dr. Istvan Marton, panel member from Hungary and osteoporosis expert, expressed his gratitude to the IOF for the support which was helpful in his society's 14-year history. Dr.Marton stated, "this initiative will be valuable for new member states as well as old".

Ms. Angelika Niebler MEPMs. Angelika Niebler MEP, Osteoporosis Interest Group co-chair, thanked everyone for their active participation. She pointed out that much has been done in a number of countries, but that there is still much to be accomplished to achieve the eight recommendations outlined in the 1998 European Commission report. Ms. Niebler underlined that it is essential that as many MEPs as possible get involved in the Interest Group and use their position and influence to help obtain a Council Conclusion on Osteoporosis by the end of 2005.

Closing remarks: Prof. Socrates Papapoulos, EU Osteoporosis Consultation Panel senior advisor & IOF board member.

Prof. Socrates PapapoulosAfter a lively question and answer discussion, Prof. Papapoulos underlined the fact that, from the beginning in 1996, quite a lot has been achieved, through a step-by-step approach and by following clear aims and targets. Saying "We must continue to focus on these targets", Prof. Papapoulos reminded participants that, since the European Commission is not prepared to do more than advise on general health issues (such as helping to promote healthy lifestyles), the emphasis has to be on action by local government. The main concrete action to be expected from the European Commission is a Council Conclusion. The Council Conclusion can then be used as a link to influence local governments.

Additionally two specific issues should be seen as priorities for 2005: Clinical guidelines and the fracture registry. The guidelines are an important tool, and by creating a template that all countries can use, we can help ensure that every country has guidelines.
The fracture registry will provide the hard evidence of the burden of osteoporotic fractures which will encourage governments to focus on osteoporosis.

Finally, although preventative education is important, the short-term targets must be the patients, those that need to be cared for. Education should focus on raising awareness among administrators and policy makers so that they understand how serious osteoporotic fractures are: the link between bone mineral density (BMD) and fracture risk should become as obvious as is the link between high blood pressure and cardiovascular disease.

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