Ministers' Deputies
CM Documents

CM(2000)115 24 August 2000
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722 Meeting, 21 September 2000
6 Social cohesion

6.1 European Health Committee (CDSP)
Abridged report of the 47^th meeting

(Strasbourg, 27-28 June 2000)

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1. The European Health Committee (CDSP) held its 47^th meeting on 27-28 June 2000 in Strasbourg. The list of participants and agenda are set out in Appendix 1 and 2 respectively.

Mr. Kingham (United Kingdom) whose term of office ended at this meeting, was re-elected Chairman for one year.

Mrs T. Mikkola (Finland) was elected member of the Bureau, to succeed Mr. O. Simonen (Finland) who withdrew from the Bureau before the end of his term as member.

Dr A. Poposka ("the former Yugoslav Republic of Macedonia") was elected member of the Bureau to succeed Dr P. Wium whose term of office ended at this meeting.

The Chairman welcomed the experts who were attending a meeting of the CDSP for the first time.

He also welcomed Mr. J. Opazo, Observer from Canada, Dr. S. Zobrist, Observer of the World Health Organisation (WHO), Mrs M. Garcia, Observer of the Federation of Red Cross and Red Crescent Societies, and Dr. O. Quintana (Spain) representing the Steering Committee on Bioethics (CDBI).

2. The CDSP was pleased to note that the tripartite meetings held regularly between the Council of Europe, the WHO (Europe) and the European Commission favoured co-operation between these organisations. It instructed the Secretariat to carry on striving to conclude a tripartite agreement on health between the three organisations.

3. The CDSP reviewed the state of implementation of its work programme for 2000.

It adopted a draft Recommendation on criteria for the development of health promotion policies and transmitted it to the Committee of Ministers for adoption (Appendix 3).

It also adopted terms of reference for the Selected Committee of experts on Quality Assurance in blood transfusion services (SP-R-GS) (Appendix 4) and for the Committee of experts to study organisational aspects of co-operation in organ transplantation (SP-CTO) (Appendix 5).

The CDSP examined Assembly Recommendation 1445 (2000) on the health security for Europe’s populations and agreed to submit to the Committee of Ministers the preliminary reply set out in Appendix 6 to this report.

The CDSP took note of progress in the implementation of the work programme for 2000 and expressed satisfaction at the work done so far in the preparation of:

- the draft Recommendation on the adaptation of health care services to the needs of people in marginal situtations;

- the state of the art report on xenotransplantation and the draft Recommendation on the same subject;

- the guide on quality assurance for organs, tissues and cells;

- the annual update of the Appendix to Recommendation R(95)15 on the preparation, use and quality assurance of blood components (The Guide).

The CDSP underlined the importance of maintaining the activities of the Task Force for the restructuring of blood transfusion services in Central and Eastern Europe and requested that funds be sought, within and outside the Council of Europe, to enable it to respond to the requests of member states.

4. The CDSP discussed its work programme for 2001 and subsequent years and proposed to draw up a programme which responded to major topical issues where the Council of Europe could do pioneering work and agreed to include the following new topics in its work programme for 2001:

- the organisation of palliative care - ethical and health aspects;

- the impact of information technologies on health care;

- health policies supporting health promotion and disease prevention - drawing up a protocol to the European Social Charter (Article 11);

- health and the media - role and impact of the media in health issues;

5. The delegation of Norway confirmed the invitation of their Minister of Health to host the 7^th Conference of Health Ministers in Oslo, on the theme of "Health and Human Rights".

The CDSP requested the Committee of Ministers to set up a Committee of Senior officials to prepare the Conference.

6. The CDSP agreed to hold its next meeting on 13-14 December 2000.

Dr Andrea GUDHA, , Ministère de la Santé, TIRANA

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Mrs Verena GREGORICH-SCHEGA, Federal Ministry of Labour, Health and Social Affairs - VIENNA

Mme A.M. SACRE-BASTIN, Ministère des Affaires sociales, de la Santé publique et de l'Environnement, BRUXELLES

Mme Chantal GUEUR, Direction Générale de la Santé de la Communauté française - BRUXELLES

Mr St KOULAKSAZOV, Ministry of Health, SOFIA

Dr Miroslav GLUHINIC, Ministry of Health, ZAGREB

Dr Constantinos MALLIS, Medical and Public Health Services, NICOSIA

Mrs Alexandra KRALOVA, Ministry of Health, PRAHA

Mrs Marianne KRISTENSEN, National Board of Health, COPENHAGEN K

Mrs Helle Hyllehoj MOLZEN, Ministry of Health, COPENHAGEN K

Prof. Raul TALVIK, Tartu University, TARTU

Mrs Taru MIKKOLA, International Affairs , Ministry of Social Affairs and Health, HELSINKI

Mrs Kaija HASUNEN, Ministry of Social Affairs and Health, HELSINKI

Mr Risto POMOELL, Ministry of Social Affairs and Health, HELSINKI

FRANCE / FRANCE

M. André ERNST, Direction générale de la Santé, Ministère de l'Emploi et de la Solidarité PARIS

Mr Artchil KOBALADZE, Ministère de la Santé, TBILISSI

GERMANY / ALLEMAGNE

Mr Helmut VOIGTLAENDER, Director, Federal Ministry for Health, BONN

Mrs Marinetta DROBEK, Federal Ministry for Health, BONN

Mrs Jenni KOUREA KREMASTINOU, National School of Public Health, ATHENS

Mrs Katalin SARKANY, Ministère de la Santé, BUDAPEST

Mr. David A. GUNARSSON, Ministry of Health and Social Security, REYKJAVIK

Dr R. BOOTHMAN, Department of Health, DUBLIN 2

Dr Mary AYLWARD, Department of Health, DUBLIN 2

Mrs Colomba IACONTINO, Ministry of Health, ROME

Dr Silvija PABLAKA, Ministry of Welfare, RIGA

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Dr Romalda BARANAUSKIENE, Ministry of Health, VILNIUS

LUXEMBOURG / LUXEMBOURG

Dr Margot MULLER, Division de la médecine scolaire, LUXEMBOURG

Dr Raymond XERRI, Department of Health Policy and Planning, FLORIANA

Dr Silviu DOMENTEI, Ministry of Health, CHISINAU

Prof. Dr H.D.C. ROSCAM ABBING, Ministry of Health, Welfare and Sports, THE HAGUE

Dr Per WIUM, National Board of Health, OSLO

Dr Jens ESKERUD, Department of Hospital Policy, OSLO

Mr Jacek Stanislaw GRALINSKI, Ministry of Health, WARSAW

Ms Monika PRZYGUCKA, Ministry of Health, WARSAW

Prof. Vasco REIS, Direcçao Geral de Saude, LISBOA

Mrs Luminita POPESCU, Ministry of Health, BUCHAREST

Prof. Felix VARTANIAN, Russian Academy for Advanced medical Studies, Ministry of Health of Russian Federation, MOSCOW

Mrs Silvia GUBOVA M.D. Ministry of Health, BRATISLAVA

Dr Vlasta MOCNIK DRNOVSEK, Ministry of Health, LJUBLJANA

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Mrs Elena MORO, Direction générale de la Santé publique, Ministère de la Santé,

MADRID

Ms Lena BARRBRINK, Ministry of Health and Social Welfare, STOCKHOLM

Dr Lennart RINDER, National Board of Health and Welfare, STOCKHOLM

Mme Delphine SORDAT, Départment fédéral de l’intérieur, BERN

Dr Anastasia POPOSKA, M.D. PhD. Faculty, SKOPJE

Mr. Selçuk METINER, Ministère de la Santé, ANKARA

Mrs Zhanna TSENILOVA, Ministry of Health, KIEV

UNITED KINGDOM / ROYAUME-UNI

Mr. R. A. KINGHAM, Department of Health, International Branch, LONDON

Dr Octavi QUINTANA-TRIAS, Institut national de la Santé, MADRID

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Prof Farman ABDULLAYEV, Minister of Health, BAKU

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Mr. Jaime OPAZO, Health Canada, OTTAWA

Dr Roger LEHMANN, STRASBOURG

Père Dominique CHARLES, STRASBOURG

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Mme S. ZOBRIST, Office at the European Union, BRUSSELS

Mrs Marcela GARCIA, Représentant la Fédération des Sociétés de la Croix Rouge

Mr. Matti MIKKOLA, President, European Committee on Social Rights, TALLINN

Mr. Tekin AKILLIOGLU, Member of the European Committee on Social Rights, ANKARA

SECRETARIAT

Mr Constantinos PILAVACHI, Director General

Mrs Gabriella BATTAINI-DRAGONI, Director

Mr Henry SCICLUNA, Head of Health Department

Mr Karl-Friedrich BOPP, Administrator

Mr. Piotr MIERZEWSKI, Administrator

Mrs C. WENDELBO, Administrative Assistant

Mrs C. HILLER, Assistant

1. Opening of the meeting

2. Adoption of the agenda

3. Report of the Bureau

4. Election of Chairman and a new member of the Bureau

5. Decisions of the Committee of Ministers

5.1 Report of the 46^th meeting

5.2 Opinion on Assembly Recommendation 1445 (2000)

6. Co-operation with other International Organisations

6.1 European Commission ,WHO (Europe) and the Federation of Red Cross and Red Crescent Societies

6.2 15^th Quadripartite meeting

6.3 Meeting of the Chief Medical Officers of the Community States

6.4 Tripartite meeting

A. IMPLEMENTATION OF THE CURRENT WORK PROGRAMME

7. Position and role of the individual

7.1 Health Promotion and health education – the ENHPS

8. Quality and safety

8.1 Blood Transfusion

8.1.1 Meeting of the Committee of Experts on Blood Transfusion and Immunohaematology (SP-HM)

8.1.2 Recommendation No R (95) 15 on the Preparation, Use and Quality Assurance of blood components – 2000 revision of the technical appendix (The Guide)

8.1.3 Viral inactivation of labile blood products

8.2 Organ Transplantation

8.2.1 Committee of Experts on the Organisational Aspects of co-operation in organ transplantation (SP-CTO)

8.2.2 Group of Specialists on Quality Assurance for organs, tissues and cells

8.2.3 Committee of Experts on Xenotransplantation

8.2.4 Protocol to the Convention on Human Rights and Biomedicine on organ transplantation

8.3 Methodology for drawing up guidelines on the best medical practices

9. Equity in access

9.1 Vulnerable Groups

Adaptation of health care services to the demand for health care and health care services of people in marginal situations

9.2 Essential services

Committee of experts on criteria for preventive medicine and health promotion

B. FUTURE PROGRAMME OF WORK

10. Programme of activities

10. 1 Implementation of the Programme of activities for 2000

10. 2 Implementation of the Programme of activities for 2001

10.3 ADACS Programme

C. INFORMATION

11. Exchange of views and information

D. MISCELLANEOUS

12. Other business

13. Date and place of next meeting

APPENDIX 3

Draft Recommendation Rec (2000)…

of the Committee of Ministers to member states on criteria

for the development of health promotion policies

The Committee of Ministers, under the terms of Article 15.b of the Statute of the Council of Europe,

Considering that the aim of the Council of Europe is to achieve greater unity between its members and that this aim may be pursued, inter alia, by the adoption of common action in the area of public health;

Bearing in mind Article 11 of the European Social Charter on the right to the protection of health;

Recalling that Article 3 of the Convention on Human Rights and Biomedicine requires that contracting parties provide "equitable access to health care of appropriate quality";

Noting moreover the relevance of the World Health Organization’s Targets for Health for All for the European region and of its recent policy documents on health promotion and prevention policies;

Noting the importance of the Ottawa Charter for Health Promotion (1986), the Djakarta Declaration on Leading Health Promotion into the 21st Century (1997) and the Verona Declaration on the implementation of investment for health as statements on the guiding principles of public health;

Noting that the 5th Global conference on Health Promotion (2000) in Mexico pledged to bridge the equity gap and to monitor progress made in incorporating health promotion strategies into national and local policy and planning;

Noting that the strengthening and maintaining of health is a key priority for all member states, as an investment which helps people to reach their full potential and countries to maintain social cohesion as well as the competitiveness of the economy;

Aware that non-communicable diseases linked to unhealthy lifestyles and environments are overtaking communicable diseases, mental health disturbances and problems related to ageing;

Conscious that health promotion is a process which enables people to increase control over and improve their health, contributes to their individual and collective well-being and helps to reduce inequities in health;

Aware that carefully planned health promotion policy is therefore an investment for all countries, whatever their economic situation, which has the potential to reduce the demand for and cost of some community health and hospital services;

Considering that health promotion is an essential element of a citizen’s right to health care and therefore is a responsibility of the government;

Conscious that health promotion is a dynamic concept which is constantly evolving and which has to be adapted to the culture and situation of each member state;

Considering also that citizens have a responsibility to put into practice the message transmitted by health promotion and prevention activities as a tool for avoiding ill-health;

Aware that measures aimed at reducing the incidence of health problems depend to a large extent on situations and factors beyond the immediate control of health and social services activities;

Recommends that the Governments of member states:

- develop comprehensive and coherent strategies for the promotion of health at a countrywide level;

- monitor health and its determinants with a view to identifying priority needs and improving the health of the population and reducing inequalities;

- adopt, where necessary, policies, legislative and other measures necessary for:

- integrating health promotion into the activities and decision-making processes of government, public sector, private sector and non-governmental organisations;

- ensuring that the impact on health of the relevant major policies in decision making are foreseen, measured and taken into account in planning;

- facilitating the participation of all those involved;

- improving health education and the dissemination of information;

- implement all aspects of health promotion, including preventative action, for the benefit of the whole population and particularly of vulnerable groups, who would be underprivileged even further if health promotion were not developed;

- take into account the concept of quality of life in health promotion.

In pursuit of these goals governments should take into account the criteria set out in the appendix to this recommendation.

I. Establishing an evidence-based health promotion policy and plan of action

1. When developing health promotion programmes for the population in general and/or specific target groups, member states should:

- establish with a high degree of certainty which are the determinants of health, and, in particular, of inequalities of health within the community;

- have clear and feasible goals and objectives supported by available evidence;

- define the measures likely to be taken;

- have reliable evidence that the proposed policies and interventions are efficient and sustainable;

- ensure that the programme is cost/effective;

- undertake an assessment of alternative actions.

2. Providers should be trained to adopt evidence-based health promotion practices and the public should be educated and encouraged to demand and accept evidence-based medicine and health policy.

II. Impact of other policies on health

1. All government sectors should acknowledge the influence of the socio-economic determinants on health and recognise the real cost of the absence of a planned health promotion.

The role and impact on health of other policies, systems and services (transport, food production, housing, employment, education, environment, communication) should be taken into account in developing health promotion policies and the systems and services should be organised and adapted accordingly.

2. Priority needs to be given to reducing or eliminating the major avoidable causes of disability and death in countries and to the most significant pre-determinants of health (sufficient and healthy food, pure water, clean air, a guaranteed basic minimum income for families, housing, maternal and child care, good general education, labour protection and health at work).

III . Integrated approach to health promotion

1. Health promotion should be an integral part of all public policies. The status of

health as a goal should be boosted and health promotion used as a mechanism for its delivery in all sectors of society. It should be based on an integrated approach towards the better health of both whole populations and individual citizens, in partnership with a wide range of agencies and social actors.

2. At the same time the responsibility of individuals for their own health should be emphasised, and adequate skills and conditions enabling healthy choices assured.

3. Member states should ensure that health promotion strategies are implemented at all levels, from the individual citizen in specific settings (schools, workplace and health care) to local and national government.

4. All government departments and regional and local authorities should co-ordinate between them to ensure that health becomes an integral aspect of policy in all sectors of activity. Integration of health into all sectors of society is successful only if management at the highest level takes responsibility for health promotion.

5. The impact of other major policies on health and vice versa should be evaluated and monitored regularly. The necessary organisational structures therefore need to be created at the national, regional and local levels to enable real partnership to develop across all sectors.

6. Health promotion, as a major activity of health care services, should be given proper recognition at all levels from the most senior level of management to the community level.

7. The role of the health care services as a vehicle for health promotion should be recognised. Structures and processes need to be in place supporting communication between practitioners involved in prevention, treatment and care.

1. Member states should:

- encourage political and social dialogue between the public, the providers and buyers of health promotion;

- involve all the major agencies in health promotion planning;

- ensure the participation and consultation of the public in such planning.

This process should not however hamper the implementation of public health measures in the event of a crisis such as a serious epidemic of infectious disease.

2. The most disadvantaged groups of the population should play an important role in the assessment of their own health needs and in the success of implementing policies.

3. Tools should be made available to individualise health promotion at the primary health care level (for example: developing personalised self-care programmes by using computer-assisted health promotion diagnosis).

1. In order to make informed choices about health promotion programmes, the public, which is the major provider of health and social care, through self-care and care of family and friends, should have free access to information about the range of treatments or policy interventions available, their outcomes and variations in outcomes.

Where possible, the existing knowledge and evidence basis should be explained in plain language.

2. The public should be properly informed about the benefits of health promotion especially and about health protection and disease prevention programmes. They should also be informed about any accompanying risks and harmful effects. The quality criteria should also be made known.

3. Health promotion should be based on a positive approach to life, through the creation of environments (social, physical and economic environments) which do not only enhance individual responsibility but structurally promote healthy and pleasurable choices as well.

4. When health promotion and health education programmes are drawn up they should take into account the culture, the traditional beliefs and values of the communities for which they are intended.

5. Information on the effectiveness of health promotion programmes such as the WHO CINDI programme and the European Network of Health Promoting Schools (ENHPS) project (a joint WHO/Council of Europe/European Commission project) should be made more widely available. Local demonstration projects should build on knowledge gained from such projects and demonstrate the real effectiveness and transferability of knowledge to different countries and cultures.

6. The role of different professional and occupational groups (doctors, nurses, teachers, pharmacists, police, social workers) should be defined (at a countrywide level) and their training adapted and developed as appropriate. Where necessary management and incentive arrangements should be changed to support the provision of health promotion.

7. The specific roles of policy makers in many sectors including that of politicians and the media need to be recognised and supported through information, education and other approaches.

1. Specific indicators should be introduced to monitor the impact of the outcomes of health promotion activities including preventive policies (changes in risk factors, preventable complications of disease, improvement in functional capacity, premature mortality and morbidity, percentage of total health expenditure).

2. Minimum databases should be constructed to monitor the promotion of health including prevention of disease as part of the normal reporting systems, vital statistics, surveys, regulatory surveillance, etc.

3. The effectiveness of health promotion measures should be supported by scientific evidence on the basis of repeatability of the results in real every day practice.

1. Health promotion policies should be planned in detail, taking into account the cost of delivering the intervention to the population as a whole or groups of the population at risk.

2. Where health promotion resources are the responsibility of health ministers, appropriate management and accountability structures should be available to protect health promotion services from the ever-rising cost pressures of providing curative services.

3. Where there is sufficient evidence, a shift of resources from curative to preventive policies should be considered, within a unified approach towards strengthening the health of the population. In the allocation of resources, the basket of essential health promotion and preventive services should be defined. Such an approach should help ensure that health promotion is affordable and sustainable.

Select Committee of Experts on quality assurance in blood transfusion services (SP-R-GS)

Select Committee of Experts

European Health Committee (CDSP)

i. Quality Assurance

- to promote quality assurance with the latest developments including the up-dating of the technical Appendix to Recommendation R (95) 15 on the preparation, use and quality assurance of blood components.

ii. Transfusion transmitted diseases

- review of their incidence and preventive measures, including the selection of donors.

iii. Microbiological safety

- in blood and blood components

- in the laboratory

- new methods, in particular, molecular biology

iv. Exchange of sera

- to improve proficiency testing

The Select Committee will submit its report to the Committee of Experts on blood transfusion and immunohaematology (SP-HM).

a. States whose governments are entitled to appoint members: Belgium, Denmark, Finland (1), France, Germany, Hungary, Italy, Poland, Spain, Sweden, United Kingdom, Austria (1), Ireland (1), Netherlands (1), Norway (1), Switzerland (1).

b. Qualifications desirable in members: specialists in the fields covered by the terms of reference, working within the framework of a national and/or regional transfusion centre.

Terms in office should not exceed three years, unless otherwise decided by the National Health Authorities.

The Council of Europe's budget bears travelling and subsistence expenses for one expert per State, except for the States marked (1) which participate at their own expense.

c. The European Commission may send a representative without the right to vote or defrayal of expenses, to meetings of the Select Committee.

d. The following observers with the Council of Europe may send a representative without the right to vote or defrayal of expenses to meetings of the Select Committee: Canada, Holy See, Japan, Mexico, United States of America.

e. The following States or organisations may send representatives, without the right to vote or defrayal of expenses, to the meeting of the Committee: New Zealand, WHO, International Federation of Red Cross and Red Crescent Societies, International Society of Blood Transfusion (ISBT).

One meeting of 4 days every year.

These terms of reference expire on 31 December 2002.

Committee of Experts to study organisational aspects of co-operation in organ transplantation (SP-CTO)

Committee of Experts

European Health Committee

The Council of Europe first made proposals on organ transplantation in 1978 in Recommendation R (78) 29 on the Harmonisation of legislation of member States relating to removal, grafting and transplantation of human substances.

This recommendation was followed by a 3^rd Conference of European Health Ministers in 1987 on the ethical, organisational and legislative aspects of organ transplantation. The Conference considered that the organisational aspects of organ transplantation were particularly important in meeting the organ shortage and that European co-operation was needed to ensure an efficient organisation.

The Committee of Experts will:

- examine the organisational structures concerning organ transplantation in the member States with a view to detecting the causes of organ shortage;

- study ways of promoting the availability of organs and of improving the organisational infrastructure;

- propose standards for quality assurance of organs and tissues and draw up legal instruments for this purpose;

- develop links between the exchange organisations;

- follow developments in organ transplantation, particularly with regard to their ethical and organisational implications;

- encourage training in organ transplantation, through the organisation of courses and other measures;

- follow the social and ethical implications of the application of new technologies such as xenotransplantation;

The governments of all member states are entitled to appoint an expert.

a. The Council of Europe's budget will cover travelling and subsistence expenses of one expert from each of the following member States: Croatia, Georgia, Finland, France, Greece, Hungary, Italy, Latvia, Netherlands, Romania, Spain, Sweden, Switzerland, United Kingdom. (1)

b. The European Commission may send a representative, without the right to vote or defrayal of expenses, to meetings of the Committee.

c. The following States having observer status with the Council of Europe, may send a representative, without the right to vote or defrayal of expenses, to meetings of the Committee: Canada, Holy See, Japan, Mexico and the United States of America.

d. The following States and Organisations may send a representative, without the right to vote or defrayal of expenses, to meetings of the Committee: Israel, World Health Organisation (WHO), Eurotransplant, and Scandiatransplant.

In view of the technical nature of the subject, the appointment of a consultant might prove necessary in the study of specific themes.

7. Duration

These terms of reference expire on 31 December 2002.

1. The biennial rotating system of membership reflects a wider geographical distribution but also – and most of all – ensures the necessary experience and expertise in the organisational aspects of organ transplantation. This can only be achieved if the major transplant centres are represented and if continuity is ensured.

2. Council of Europe member states can be roughly divided into four groups, according to the following criteria:

Geographical proximity (with a balance of East/West)

Necessary expertise (participation of major transplant centres)

The Committee of Ministers agreed the following distribution into 4 groups for the selection of independent experts of the European Social Charter. Rotating systems of membership exist in a number of committees of experts and are intended to ensure a more democratic participation.

First group

Austria, Czech Republic, Croatia, Germany, Hungary, Liechtenstein, Slovakia, "the former Yugoslav Republic of Macedonia", Switzerland.

Second group

Albania, Belgium, Bulgaria, France, Georgia, Luxembourg, Netherlands, Romania, Slovenia, Russian Federation.

Third group

Denmark, Estonia, Finland, Iceland, Ireland, Latvia, Lithuania, Norway, Poland, Sweden, Turkey, Ukraine, United Kingdom.

Fourth group

Andorra, Cyprus, Greece, Italy, Malta, Moldavia, Portugal, San-Marino, Spain.

3. On the basis of these four groups, the following selection is proposed. It ensures representation of the major transplant centres as well as continuity.

1^st group – Croatia, Switzerland, Hungary

2^nd group – Georgia, France, Netherlands, Romania

3^rd group – Finland, Latvia, Sweden, United Kingdom

4^th group – Greece, Italy, Spain

1^st group – Austria, Czech Republic, "the former Yugoslav Republic of Macedonia", Germany

2^nd group – France, Netherlands, Russian Federation

3^rd group – Estonia, Ireland, Poland, United Kingdom

4^th group – Italy, Portugal, Spain

All other member states will be entitled to be represented, but at their own expenses.

At its 698th meeting in February 2000, the Committee of Ministers asked the European Health Committee (CDSP) to give an opinion on Parliamentary Assembly Recommendation 1445 (2000) on health security for Europe’s population.

The CDSP has examined Assembly Recommendation 1445 (2000) and particularly its request contained in para. 8, to "extend the role of the steering committee responsible for public health by setting up within it a public health unit to offer advice to member states in the various fields connected with this subject".

The CDSP agrees that every possible effort should be made to ensure the health security of Europe’s population.

It is aware that several organisations – the European Community, OECD, WHO – are already very active in this field. It has therefore instructed the Secretariat to draw up a report on the activities of other organisations working in this field in order to allow it to decide whether the Council of Europe could usefully make a contribution in this area.

1    The Committee of Experts is open to all member states but participants will be covered by the council of Europe budget on a rotating system.  For 2001 and 2002 the Council of Europe budget will cover expenses for one expert from each of the listed member states.