Supporting kidney care at the European level, discussion with John F. Ryan

On the occasion of World Kidney Day 2022, the year of Kidney Health For All, John F. Ryan, Director of Public Health, at the European Commission, shares what the European Union is doing to support kidney health and World Kidney Day.

What is the EU Commission’s vision for better kidney care?

On non-communicable diseases, we have recently launched a new approach within that context which is called our approach of Healthier Together. The idea is to avoid premature deaths; complementing the work on cancer that we are already doing in the European Cancer Plan. It is a general framework that would cover a variety of non-communicable diseases focusing on prevention and health promotion. This initiative may also support better knowledge analysis and data gathering and sharing. It may support things as well like screening or early detection. It may support issues around diagnosis and better treatment, and of course, there is the issue of quality of life of patients. So we are working with the [European Union] member states’ authorities through a specific expert group and we have also established a process of discussion with our stakeholder community which would include a wide definition of stakeholders organizations such as EKHA [European Kidney Health Alliance] or the International Society of Nephrology and many more. We imagine a sort of horizontal strand which would deal with health determinants in a more general sense because many of the health determinants are of course common to several diseases. Examples would be issues around tobacco, nutrition, alcohol consumption, and physical activity. As you know one of the risk factors for chronic kidney disease is diabetes and high blood pressure and if we focus on the proposed strands including health determinants we hope we will also have a positive effect on kidney disease, in addition to any other conditions which we would be targeting. Moreover, we hope that the implementation of this initiative would encourage member states to devise their actions on all non-communicable diseases, especially those that are particularly relevant for a particular country. We work directly with the member state authorities who wish to replicate best practices to tackle these health challenges including in the area of kidney disease. Indeed the work plan of the EU for Health Program includes a call already for collecting and implementing best practices for a variety of non-communicable diseases and chronic kidney diseases would be included. We encourage colleagues to consult this call and see if they have something that they would wish to see financially supported.

Which current EU programs address kidney health?

Now talking about innovations in treatments, the commission has been supporting research and innovation through for example the Horizon Europe program where we had 40 projects. 40 projects with a total of 64 million euros directly addressing chronic kidney disease and 24 projects for an amount of 47 million euros addressing kidney transplantation. Just to give you a flavor of the type of projects that we have been funding: we had a randomized controlled phase II trial on the personalization of immunosuppression by monitoring viral load post kidney transplantation with a budget of 6 million euros and a consortium for diagnosis and risk stratification in kidney transplant patients with a budget of 6.6 million euros together with a number of others. For example, concerning stem cell therapy for diabetic kidney disease in a clinical trial and a new dialysis system that’s portable and can be used at home and at work. So you can see there’s a whole series of different projects; a rather large number of projects I would say from the research program which directly address the needs for innovation and treatment. We also have possibilities in the Horizon Europe program, a research program which brings additional possibilities on prevention, diagnosis, early detection, treatment, and management. So in addition to all these projects which have already been financed in the past, the current Horizon Europe program is very much open to these types of projects. The European Innovation Council work program for 2021 also included a call on medical technology and devices and mentioned specifically portable dialysis equipment. So from the point of view of the research program, we fully support the need for additional research, pooling of knowledge to increase the quality of life and life expectancy of chronic kidney disease patients.

Now despite the heavy burden of kidney disease globally, kidney disease is not listed in the top five non-communicable diseases [Editor’s note: by the World Health Organization]. For some reason, there is a question mark over whether kidneys are a vital organ but we do think that kidney chronic kidney disease is something which can be addressed at the European Union level. I’ve given the example of the research program where substantial investments have been made in this area. In terms of public health; we will be supporting through the Healthier Together project, which I mentioned,the identification and rollout of best practices, which could quite easily cover aspects relating to to kidney disease. I would really hope that organizations, patient groups, health professionals would feel it possible to engage with the Commission and the member states in a discussion on how to include kidney disease as part of this process

What is your message for World Kidney Day 2022?

I think it is of the utmost importance that this type of event receives as much support as possible and that’s why I’m very happy to be able to speak to you today.
In respect of your efforts to raise the profile of kidney disease as a public health issue, I fully support your initiative. I fully support your work and I really think that there is a lot that we can do together in improving knowledge and action in the area of kidney disease.

How will the COVID 19 pandemic affect kidney care delivery?

In terms of advice on how to deliver better kidney care for everybody, I would say that the impact of COVID-19, which is continuing, of course, will have major implications for our health systems. Particularly in terms of delivery of care to chronic disease patients. We are looking at the moment to see how health systems can be strengthened. The commission has proposed a number of changes to our legislation but we have also proposed a substantially increased budget for the EU for a health program and for the research program taking account of the needs of the health systems in building back after the pandemic.

NB: This blog is a transcript of a personal video message from Mr Ryan which you can watch here