Policymakers and patient groups have warned that chronic underinvestment in disease prevention is pushing EU healthcare towards a financial breaking point. Health systems are facing mounting pressure to shift resources away from treating illness towards preventing it – policymakers are seriously concerned that the current model is no longer financially sustainable.

Speaking at the Euractiv Health Policy Conference, senior figures from public health organisations, patient groups and the pharmaceutical industry converged on a shared diagnosis: Europe spends too much managing disease and too little stopping it from occurring.

“We are spending 80 per cent on care, we are spending 3 to 6 per cent on prevention,” said Olivér Várhelyi, the EU’s health commissioner. “If we do a rebalance and we focus more on prevention, it means we can save more on care.”

Cardiovascular disease was cited as the most striking illustration of the gap between medical knowledge and political action. Birgit Beger, executive officer of the European Heart Network, noted that CVD remains the leading cause of death across the EU, accounting for 1.7 million fatalities each year and an estimated economic burden of €282bn annually. She said experts broadly agree that four-fifths of cases could be prevented through existing interventions. “We have good ideas, but they are not implemented,” she said.

Beger called for a more fundamental reorientation of European health policy – encompassing tighter tobacco controls, healthier food environments and broader early detection programmes — rather than incremental adjustments to systems still designed around acute treatment.

Fraser Goodwin, policy coordinator at the European Federation of Allergy and Airways Diseases Patients’ Associations, argued that health systems are contending not with discrete pressures but with overlapping crises: ageing demographics, rising chronic disease, climate change and antimicrobial resistance. He described the situation as a “polycrisis” that demands structural reform rather than targeted fixes.

Goodwin said primary care – GPs and pharmacies – should be repositioned as the front line of prevention and early diagnosis, rather than remaining largely reactive. While acknowledging the EU budget’s limited scale relative to national healthcare spending, he argued that Brussels could act as a significant “multiplier” by coordinating action across member states and pressing governments to honour their obligations to the World Health Organisation.

Industry representatives sought to expand the frame of the debate. Alexander Natz, secretary general of EUCOPE, the European Confederation of Pharmaceutical Entrepreneurs, said prevention was essential but warned that Europe could not take continued pharmaceutical innovation for granted. Geopolitical uncertainty, transatlantic pricing disputes and the complexity of EU regulation all risk diverting investment elsewhere, he said. “We have to make sure that we are working on our competitiveness,” Natz argued, calling on policymakers to treat industry as a partner in solving systemic healthcare challenges rather than simply a supplier.

Speakers broadly agreed that the fiscal logic of continuing to underfund prevention is becoming untenable. As Várhelyi put it, the question for European governments is no longer simply whether they can afford their health systems, but whether they can afford to keep structuring them around illness.

[VA, BM]