Akram Ashyani, Ph. D.(Life Science Platform)
Cardiovascular Disease and EU approach
TEUICP Column
Akram Ashyani, Ph. D.(Life science Platform)
2022/04/27
Non-Communicable diseases (NCDs) such as cardiovascular diseases (CVDs) impacted EU nations by causing 80 percent illnesses and resulting in early deaths. NCDs have significant financial and human consequences, which are likely to rise as the EU’s population ages [1]. There are two forthcoming calls relevant to CVDs containing “Cardiogenomics” and “Towards the Healthcare Continuum: technologies to support a radical shift from episodic to continuous healthcare” which will be open at June 16th, 2022 and will be closed at October 19th, 2022 at 17:00:00 Brussels time.
About 70 percent of all deaths around the world is because of NCDs [2]. CVDs, which is one of the NCDs, are a collection of heart and blood vessel disorders that include heart, brain vascular, and blood vessel diseases [3]. Every year, CVDs cause approximately 17.9 million mortalities worldwide. Strokes and heart attacks are the reason of more than four out of every five CVD death, and one-third of them happen for adults under 70 years old [4].
In 2019 more than half of worldwide deaths because of CVD happened in Asia, increasing from 23 percent to 25 percent in 29 years. Ischemic heart disease or stroke were the leading causes of them. CVD will become a greater burden in the future, resulting in more hospitalizations and fatalities [6].
Since the outbreak of COVID-19, research into other diseases has been put on hold. A delay in treatment and diagnosis occurred, particularly for NCDs. People’s lifestyles have altered, and quarantines and isolation have lowered their exercise, increasing their chance of contracting an NCDs. It indicates that a serious situation has deteriorated.
Heart disease is the second reason of mortality in Taiwan [7] [8]. As CVD should be given more consideration, Taiwan became an affiliated member of the European Society of Cardiology(ESC), “Taiwan Society of Cardiology (TSOC)”, and aims to promote cardiology research, education, prevention, and treatment. They support cardiology research, fund academic talks and seminars, educate cardiology professionals, and assist the government in reviewing policies and recommendations for heart disease care [9].
COVID-19 demonstrates that patients with NCDs are more vulnerable to other illnesses. As reducing the NCDs’ burden necessitates a comprehensive strategy to address health inequalities, the EU’s approach towards NCDs demands an integrated response focusing on prevention acrosssectors and policy domains, along with attempts to enhance health systems. Therefore, European Commission is developing “Healthier Together – EU Non-communicable diseases initiative” in order to assist EU countries to reduce the troubles made by NCDs, with a concentration on five areas which CVD is one of them [1].
To do so, the European Commission will assist EU countries in achieving the “United Nations and World Health Organization’s nine voluntary targets” by 2025 and support “Sustainable Development Goal 3.4”, targeting to decrease one-third of early deaths caused by NCDs and improve mental health and well-being by 2030 [1].
The European Commission under the “Horizon 2020 research and innovation action” has funded the SPICES project about “Scaling-up Packages of Interventions for Cardiovascular disease prevention in selected sites in Europe and Sub-Saharan Africa”. Their findings show that in order to prevent CVD, engaging with communities is essential. They looked at the way of implementing a CVD prevention program in basic care and community settings, with a focus on vulnerable groups, as well as bridge the gap between research and practice. They utilized a collaborative approach and collaborated with local partners. Their implementation was carried out in five settings including Uganda as a rural and semi-urban community with a low-income, South Africa as a middle-income country, and Belgium, France, and the United Kingdom as high-income nations [10].
They discover that healthcare is frequently more organized which leads to better teamwork. It is difficult to provide medicine and equipment. In higher-income nations organizations do not collaborate with each other which makes reduction in the prevention of CVD among society as collaboration with many local health and welfare actors is essential. Also attaining the trust of target group of sensitive persons is critical prerequisite for working on CVD prevention. Due to a COVID-19-related delay, this project will be completed in June 2022, and they expect that their programs will continue in the future [10].
Moreover, the European Commission formed a “Steering Group on Health Promotion, Disease Prevention and Management of Non-Communicable Disease” (“the Steering Group”) for assisting in the achievement of the health objectives of the “Sustainable Development Goals”[11]. The Commission is advised by the “Steering Group” to advance coordination in order to solve “public health, prevention and NCDs concerns” [1].
On April 8th, 2022, DG SANTE conducted a virtual meeting of the Sub-group on “Healthier Together, the EU Non-communicable Diseases Initiative” under the “Steering Group”. DG SANTE noted that preparatory work on the “Joint Action on diabetes and cardiovascular diseases” had already begun, allowing the EU NCD Initiative to be turned into action under the “2022 EU4Health Work Programme” [12].
EH4Health will aid in the promotion of health and illness prevention. It has a broad scope, including promoting equality in access to healthcare as well as concentrating on research and treatment of NCDs and promoting healthy lifestyles [13]. It contains several calls with deadline of May 25th, 2022, at 17:00:00 Brussels time such as “Call for proposals on prevention of NCDs – other NCDs (different from cardiovascular diseases and diabetes)”, “Call for proposals to monitor and strengthen the implementation of innovative approaches to prostate, lung and gastric cancer screening at Union level”, “Call for proposals to support Member States and other relevant actors to implement relevant results of innovative public health research in relation to vaccination against COVID-19”, “Call for proposals to provide training for health workforce, including digital skills”, and “Call for proposals on promoting mental health” [14].
One of the European Innovation Council Work Programme is EIC Pathfinder which is part of Horizon Europe. The Pathfinder programme funds the “early stage development of high-risk / high gain technologies” leading new scientific discovers, and make people’s lives significantly different [15]. Forthcoming Pathfinder Challenges relevant to CVD are “Cardiogenomics” and “Towards the Healthcare Continuum: technologies to support a radical shift from episodic to continuous healthcare”. They will be open at June 16th, 2022.
Cardiogenomics can help bridge the gap between the diagnosis and treatment in the CVD. The aim of the Cardiogenomics challenge is to help for new treatment for significant CVD disorderssuch as “hemorrhagic and ischemic stroke, aneurysm, cardiomyopathy and certain forms of arrhythmias and other conditions”, that currently they do not have an effective therapy [16].
Their specific aim is to classify “single or multiple gene variants of high biological significance or other key molecules” related to CVD, recognize new goals focused on the variants of special CVD indication to lead to the construction of first-in-class treatment for the same sign, and searching innovative solutions [16].
This challenge is intended to have influenced on cardiology practice and speed up the deployment of personalized care in CVD, as well as collect sufficient data for CVD disease modeling [16].
The most popular method of dealing with disease is still symptom-triggered healthcare. However, for some disease, sech as CVD, where early detection has a direct influence on life or death, the lack of a continues screening programme is obvious. The “EIC pathfinder Challenge, Towards the Healthcare Continuum” seek to create technologies and systems with very low Technology Readiness Levels (TRL) for monitoring of people’s health using novel continuous and individual imaging and sensing modalities, as well as continuous data assessment, procedureand analysis to detect premature symptoms of sickness [17].
They specifically aim to invent a new technology for “unobtrusive proactive healthcare”, resulting to create a foundation to convert the current healthcare system that is symptom-triggered and episodic in to the continuous healthcare [17].
References
[1] “Public Health,” Eropean Commision, [Online]. Available: https://ec.europa.eu/health/non- communicable-diseases/overview_en. [Accessed 2022 05 10].
[2] WHO, “Noncommunicable diseases,” World Health Organization, [Online]. Available: https://www.who.int/health-topics/noncommunicable-diseases#tab=tab_1. [Accessed 11 05 2022].
[3] “Health Promotion and Disease Prevention Knowledge Gateway,” Eropean Commission, [Online]. Available: https://knowledge4policy.ec.europa.eu/health-promotion-knowledge- gateway/cardiovascular-diseases-prevention_en. [Accessed 11 05 2022].
[4] WHO, “Cardiovascular diseases,” World Health Organization, [Online]. Available: https://www.who.int/health-topics/cardiovascular-diseases#tab=tab_1. [Accessed 2022 05 11].
[5] N. Youngson, “Creative Commons Medical Heart Disease Image,” The Blue Diamond Gallery, [Online]. Available: https://www.thebluediamondgallery.com/medical/h/heart- disease.html. [Accessed 11 05 2022].
[6] “Over half of global cardiovascular deaths happen in Asia,” Open Access Government, 16 06 2021. [Online]. Available: https://www.openaccessgovernment.org/global- cardiovascular-deaths/113113/. [Accessed 11 05 2022].
[7] W. Zhang, “Statistica, Mortality rate of heart diseases in Taiwan from 2007 to 2020,” 23 03 2022. [Online]. Available: https://www.statista.com/statistics/860629/taiwan-heart-disease- death- rate/#:~:text=Heart%20diseases%20were%20the%20second,higher%20death%20rate%20th an%20females.. [Accessed 08 05 2022].
[8] M. Fulco, “Taiwan Business TOPICS, Heart Disease Second Leading Cause of Death in Taiwan,” 21 03 2018. [Online]. Available: https://topics.amcham.com.tw/2018/03/heart- disease-second-leading-cause-death-taiwan/. [Accessed 07 05 2022].
[9] “Taiwan Society of Cardiology,” European Society of Cardiology, [Online]. Available: https://www.escardio.org/The-ESC/Affiliated-Cardiac-Societies/taiwan-society-of- cardiology. [Accessed 07 05 2022].
[10] “Preventing cardiovascular disease through implementation and participatory research, © 2019. This work is licensed under CC-BY-NC-ND.,” Open Access Government, 2022 03 2022. [Online]. Available: https://www.openaccessgovernment.org/preventing- cardiovascular-disease-implementation-participatory-research/133001/. [Accessed 07 05 2022].
[11] “Steering Group on Health Promotion, Disease Prevention and Management of Non- Communicable Diseases,” European Commission, [Online]. Available: https://ec.europa.eu/health/non-communicable-diseases/steering-group_en. [Accessed 12 05 2022].
[12] “Minutes, Meeting, Sub-group on the “Healthier together, the EU Non-communicable Diseases Initiative”, under the Steering Group on Health Promotion, Disease Prevention and Management of Non-Communicable Diseases,” 8 4 2022. [Online]. Available: https://ec.europa.eu/health/system/files/2022-05/ncd_20220408_mi_en.pdf. [Accessed 10 5 2022].
[13] “What, Why, How? Everything You Need to Know About EU4Health,” Multimedia Centre, European Parliament, 09 03 2021. [Online]. Available: https://multimedia.europarl.europa.eu/en/video/what-why-how-everything-you-need-to- know-about-eu4health_N01-AFPS-210308-EU4H. [Accessed 10 05 2022].
[14] “European Commission, Funding & tender opportunities,” [Online]. Available: https://ec.europa.eu/info/funding-tenders/opportunities/portal/screen/opportunities/topic- search;callCode=null;freeTextSearchKeyword=EU4H;matchWholeText=true;typeCodes=0, 1,2,8;statusCodes=31094501,31094502,31094503;programmePeriod=null;programCcm2Id =null;. [Accessed 09 05 2022].
[15] “EIC Pathfinder,” Catalyze, [Online]. Available: https://www.catalyze-group.com/fund/eic- pathfinder/. [Accessed 11 05 2022].
[16] “EIC Pathfinder Challenge: Cardiogenomics,” European Commission, Funding and tender opportunities, [Online]. Available: https://ec.europa.eu/info/funding- tenders/opportunities/portal/screen/opportunities/topic-details/horizon-eic-2022- pathfinderchallenges-01- 03;callCode=null;freeTextSearchKeyword=;matchWholeText=true;typeCodes=0,1,2,8;statu sCodes=31094501;programmePeriod=n. [Accessed 07 05 2022].
[17] “EIC Pathfinder Challenge: Towards the Healthcare Continuum: technologies to support a radical shift from episodic to continuous healthcare,” European Commission, Funding and tender opportunities, [Online]. Available: https://ec.europa.eu/info/funding- tenders/opportunities/portal/screen/opportunities/topic-details/horizon-eic-2022- pathfinderchallenges-01- 04;callCode=null;freeTextSearchKeyword=health;matchWholeText=false;typeCodes=1,2,8; statusCodes=31094501,31094502;pro. [Accessed 08 05 2022].