European Research For A Healthier Future

EUROPEAN
RESEARCH
FOR A HEALTHIER
FUTURE
Re-edition - October 2011
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Acknowledgement
This publication would not have been possible without the support of colleagues from the Health Directorate.
Head of Unit for Horizontal Aspects and Coordination: Stphane Hogan.
Aziza Haas
Editor/Contact
EUROPEAN COMMISSION
Directorate-General for Research and Innovation
Directorate F Health
Unit F1 Horizontal Aspects and Coordination
Office CDMA 2/181
B-1049 Brussels
Tel. (32-2) 29-52893
Fax (32-2) 29-95888
e-mail: Aziza.Haas@ec.europa.eu
Directorate-General for Research and Innovation
FP7 Cooperation / Health
EUROPEAN COMMISSION
EUROPEAN
RESEARCH
FOR A HEALTHIER FUTURE
Re-edition - October 2011
Table of contents
Introduction 6
Chapter I: Genomics and systems biology 8
Chapter II: Medical research 16

Chapter III: Infectious diseases 24

National Contact Points - The Ambassadors of FP7 30
Chapter IV: Public health 32
Chapter V: Health biotechnology 38

Health research focus pages

International scientic cooperation 14

Understanding schizophrenia 20
Ethics 22

Small and medium-sized enterprises 23

National Contact Points - The ambassadors of FP7 30

Promoting health across generations 36

From evaluation to management 44
Hope, excellence and
innovation
We are fast approaching the launch of Horizon 2020, the most ambitious EU research and innovation programme
to date, and so it is timely to take stock of what we have achieved so far under the current research framework pro-
gramme, and look to the future.
There can be no doubt that research is transforming our lives, and Europes citizens see maintaining support for
cutting-edge research on health as a top priority. Through the Seventh Research Framework Programme (FP7), the
EU provides substantial funding for collaborative, cross-disciplinary research involving teams from across Europe and
beyond. This interim overview is presented two years before the end of FP7, when 690 research grants have already
been awarded under the Health theme, amounting to a substantial 3.2 billion euro investment.
Projects funded under the Health theme demonstrate that research really does lead to innovation. New knowledge has
improved patient health and quality of life. Novel drugs and diagnostic tools are also making their way to the market
in fact a recent evaluation found that roughly one quarter of FP7 project participants apply for at least one patent.
Research and innovation are essential drivers of the Europe 2020 strategy for smart, sustainable and inclusive growth,
and in October 2010 the Commission launched the Innovation Union agship initiative as a cornerstone of this strat-
egy. We are determined to create the conditions to ensure that excellent research is turned into products and services
that create growth and jobs in the EU. The Innovation Union explicitly identies health as one of the major challenges
facing us today, alongside demographic change, energy, resource efciency and climate change.
The Innovation Union initiative has also set the scene for the launch of Horizon 2020, which will bring together all EU
research and innovation funding within a common strategic framework when existing programmes come to an end. It
will cover the whole cycle from research, through to innovation and exploitation in the marketplace, and will offer more
effective support to innovative small and medium sized enterprises that are particularly active in the health sector.
This brochure outlines the current key priorities of EU funded health research, as well as the most recent achievements
giving the reader some insight into our policies, programmes and projects. The ambition and drive of our policy and
the wide range of success stories coming from our health research programmes are truly remarkable.
Mire Geoghegan-Quinn
Commissioner for Research,
Innovation and Science
Health needs collaborative research
EU-funded research projects typically include many scientists
from Europe and beyond. They work in universities, research
centres, hospitals, companies and associations, collaborating
towards ambitious objectives, which would be impossible to
achieve by a single group or a single country.
This brochure provides a brief overview of the objectives and
the scope of the health research funded by the EUs Seventh
Framework Programme for research and technological devel-
opment (FP7) in the period 2007 to 2013. Specic chapters are
devoted to the various components of the Health theme under
that programme; genomics and systems biology, medical re-
search, infectious diseases and epidemics, public health and
health biotechnology, as well as to overarching issues.

The research funded is characterised by its excellence. A strict
evaluation process is applied to ensure that only the best research
projects are selected for funding and that ethical standards are
adhered to. By pursuing excellence in education, research and
innovation, we are targeting lifelong health and well-being for all,
both in Europe and beyond. An additional, complementary goal,
is competitiveness within Europes health related industries and
businesses. The EUs commitment is backed by over EUR 6
billion in funding for health research. This represents a signicant
contribution to the prevention, diagnosis, treatment and control
of disease.

Independent evaluations suggest that this investment is paying
off. Now two thirds of the way through FP7, research results
are benetting patients directly. In addition, project participants
believe that much of their research would not have been possible
at least in the scope achieved without EU funding. This
is partly due to its signicant leverage effect on other sources
of nance, ultimately allowing scientists to be more ambitious,
go further with their investigations, and acquire even greater
knowledge.
Small and medium-sized enterprises (SMEs) are just one of
the beneciaries of this leverage effect. In recognition of their
potential within the European research landscape, tailor-made
measures are in place to facilitate participation.
As global health challenges require action at the level of the global
research community, the scope for international cooperation has
been extended in FP7 beyond earlier framework programmes.
Another important change is the greater emphasis on translating
basic knowledge into clinical applications, including the rigorous
scientic validation of results, prior to regulatory approval of new
products. The project Translating Molecular Knowledge into Early
Breast Cancer Management: Building on the Breast International
Group (TRANSBIG) paints a very encouraging picture of what
can happen when science and innovation meet. The 40-partner
venture is using the results of laboratory experiments to develop
tools enabling doctors to treat breast cancer more effectively.
Central to the project are clinical trials to identify which follow-up
treatment is required if any after surgery.
This emphasis on translational research ties in with the Europe
2020 strategy and its focus on innovation, employment,
education and social inclusion, as well as climate and energy, as
key contributors to the construction of a smart, sustainable and
inclusive economy. Health research is an important player within
the strategy, helping to build a more inclusive society, as well as
creating jobs and start-ups, and driving innovation.

Europe 2020 has also seen the launch of a pilot European
Innovation Partnership on Active and Healthy Ageing, which
aims to add two years to the average healthy lifespan in the EU
by 2020. The partnership is designed to help more EU citizens;
remain healthy, active and independent as they age, make social
and health care systems more sustainable and efcient, and
contribute to the emergence of a market for innovative products
and services in Europe and beyond.
A snapshot of the various activities taking place in Europe
is, however, all we can provide in this publication. Further
information on EU-funded health research is available from our
websites, publications and information services.
We hope that you nd the brochure both stimulating and
inspiring.
Introduction 6
7 Introduction
European health research
in FP7: three pillars
Biotechnology, generic tools and medical technologies
for human health
n High-throughput research
n Detection, diagnosis and monitoring
n Prediction of suitability, safety and efcacy of therapies
n Innovative therapeutic approaches and interventions
Translating research for human health
n Integration of biological data and processes
n Research on the brain and related diseases, human development
and ageing
n Research on infectious diseases
n Research on major diseases: cancer, cardiovascular disease,
diabetes/obesity, rare diseases, other chronic diseases
Optimising the delivery of health care to European citizens
n Translation of clinical outcome into clinical practice,
including better use of medicines
n Quality, efciency and solidarity of health care systems
n Enhanced health promotion and disease prevention
In addition, cross-cutting actions include:
n Support for health research
n Responding to EU policy needs
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What are genomics
and systems biology?
Examples of completed genomes
Genomics and systems biology 10

Human Mouse Fruit y Round worm
nematode

Estimated number of genes
25 000 25 000 13 600 19 100
Number of chromosomes
46 40 8 6
The three billion letters that make up our genetic code or genome contain all the
information needed to turn a fertilised egg into an adult human being. Thanks to the
human genome project, we now know the sequence of the letters. The next challenge
lies in discovering the function of all our 25 000 genes and understanding how the
human genome works.
Genomics researchers are drawing on new scientic tools to investigate in minute
detail the function of every single stretch of our DNA. For example, if a stretch of DNA
is identied as a gene which codes for a certain protein, researchers will investigate
the structure of the protein and its function in the body. As a result of these advances,
research is entering a new era with proteomics, a discipline aiming at the detailed
study of our proteins, the building blocks of our cells.
Early results from these exciting new elds of research have already challenged estab-
lished views about the nature of the genome. For example, it was once thought that a
large proportion of our genome was inactive junk DNA. However, we now know that
many regions once thought of as junk are in fact regulatory sequences, which are respon-
sible for telling genes whether or not to be active. This is important for health research as
mutations in regulatory sequences have been implicated in a number of diseases.
The rise of genomics has also played a role in moving biological research towards
a more systems-based approach as large amounts of data began to be available.
Researchers are increasingly realising that our bodies cannot easily be subdivided
into individual, independent components. Rather, genes, proteins, cells and organs
interact with each other and the environment in numerous, complex ways.
Systems biology aims to shed new light on these interactions, which are vital for the
holistic understanding of many major diseases, such as cancer and diabetes. In this
new era of biology, scientists combine data from different disciplines into biological
models with the power of computer science, mathematics or engineering to under-
stand the phenomena of life.
Systems biology studies the phenomena of life in a holistic way.
A surprising result of the human genome sequencing experiments is that only a
very small proportion (less than 2 %) of the entire genome encodes for proteins.
What may be hiding behind the remaining 98 % of the human genome?
Genomics and
systems biology
Organism
46 40 8 6
New tools new data
for new elds of research
When researchers rst started investigating the human genome,
analysing the sequence of a stretch of DNA and working out its role
was a long, slow process. Now, new tools and technologies for high-
throughput research are helping researchers speed up this process and,
crucially, handle the vast amounts of data created.
The microarray
One important tool of the genomics technologies is the microarray, which
is also known as a nucleic acid array or a DNA chip. In a microarray, thou-
sands of DNA molecules are distributed as spots on the surface of a piece
of glass or plastic. A solution containing uorescently labelled DNA from
specic cells, such as malignant tumours, is then poured over the array.
If a DNA molecule in a solution nds a matching partner on the surface,
they pair up and the activity level of that gene can be measured by the
intensity of the uorescent marker on that spot. In this way, researchers are
able to identify the activity of many genes involved in diseases. A similar
array can be used to study the proteins present in a healthy or diseased
cell. The applications of these new high-throughput technologies are es-
sential for the identication of potential novel genes involved in diseases.
Bioinformatics
The research tools outlined above are capable of generating vast amounts
of data, very quickly, ranging from gene sequences and protein structures
to experimental results and patient statistics. Bioinformatics involves de-
veloping the computing tools necessary to manage and analyse this sea
of information.
Biobanks
Biobanks consist of tissue samples from a broad cross section of people
coupled with information on their lifestyle and medical history. With
biobanks, scientists can identify the small differences in our genetic make-
up which are linked not only to our physical characteristics, but also to our
chances of developing certain diseases or reacting to certain drugs.
Biobanks
Biobanks consist of tissue samples from a broad cross section of pe
coupled with information on their lifestyle and medical history.
biobanks, scientists can identify the small differences in our genetic m
up which are linked not only to our physical characteristics, but also to
chances of developing certain diseases or reacting to certain drugs.
11 Genomics and systems biology
Model organisms
Despite outward appearances, mice,
zebra sh and nematode worms have
many genes with a human equivalent.
By studying these genes in these
animal models, scientists can learn
a great deal about human health. A
common technique involves knock-
ing out and hence inactivating a spe-
cic gene to determine the impact
this has on the organism.
Structural genomics
The way in which molecules such as
proteins and ribonucleic acids (DNA,
RNA) interact with one another and
with other molecules such as drugs is
determined by their three-dimensional
(3D) structure. Structural genomics
researchers use a range of imaging
techniques to study the 3D structure
of these molecules. These include
ring high-intensity X-ray beams at
crystallised proteins and studying the
structure and dynamics of proteins
with nuclear magnetic resonance
(NMR) methods. Meanwhile,
advances in electron microscopy are
now enabling researchers to view
proteins in their working environment
in unprecedented detail.
APO-SYS
Using a systems biology approach to study cancer and AIDS
When our cells age or become damaged, our bodies destroy them in a process called apoptosis, or
programmed cell death. This is a perfectly normal process, and in a healthy adult, millions of cells may
undergo apoptosis every second. However, in certain diseases, the apoptotic process breaks down, with
disastrous results. In cancer, it is the suppression of apoptosis that allows malignant cells to thrive. In
AIDS, in contrast, the apoptosis speeds up, killing off our immune cells faster than they can be replaced.

The Apoptosis systems biology applied to cancer and AIDS (APO-SYS) project is using the latest re-
search tools to study cell death both in the lab and in animal models such as fruit ies and mice. The proj-
ect is also analysing clinical samples from patients with cancer and AIDS. The results of these experiments
are being fed into computer models, which will be able to predict the likelihood of apoptosis in different
situations. The project results will boost doctors understanding of clinical data and hopefully lead to the
development of new diagnostic tools and drugs to treat these serious diseases.
For further information, see http://www.apo-sys.eu
EDICT Picturing membrane proteins
Membrane proteins are our cells gatekeepers; they decide what is allowed in and out, and some of
them are capable of converting light energy into chemical energy. They play a key role in every process
in the body. Faulty membrane proteins have been implicated in diseases as diverse as diabetes, heart
disease, epilepsy, depression, osteoporosis, stomach ulcers and cataracts. In addition to this, patho-
gens such as bacteria and parasites also rely on interactions with membrane proteins for their survival.
However, our current understanding of membrane proteins is poor.
The European drug initiative for channels and transporters (EDICT) project is using advanced imaging
techniques to investigate the structure of some 80 membrane proteins involved in a range of diseases.
High-resolution images coupled with sophisticated computational methods are helping the researchers
to identify new drug targets.
EU-funded projects
on genomics and systems biology
EUCOMM Studying human health through mice
Over 90 % of mouse genes have a human equivalent, making mice ideal model organ-
isms for the study of human health and diseases. Using knock-out techniques, the
European conditional mouse mutagenesis program (EUCOMM) is creating a library
of mouse stem cells, each of which contains a mutation in one of the mouses 20 000
genes. With these cells, any laboratory can make mouse mutants in a standardised,
cost-effective way. Crucially, the system is set up in such a way that researchers can
switch the genes off in individual organs or at a given phase of development. This is
important because certain genes have different functions in different tissues at differ-
ent times.
For further information, see http://www.eucomm.org
By providing support to scientists using innovative genomics
techniques and multidisciplinary approaches in systems biology, the
framework programme promises breakthroughs in the ght against
devastating diseases and contributes to developing the medicines
of the future.
HYPERGENES Using population genetics
to study blood pressure
High blood pressure (hypertension) is a serious condition which affects a
large proportion of the population, and is a major factor in heart disease
and stroke. The HYPERGENES project is applying the latest genomics
tools to 4 000 people to identify the genes responsible for hypertension
and tease out their complicated interactions with each other and the
environment.
The data gathered is being used to develop a simple, inexpensive diag-
nostic chip which will help to identify those most at risk of developing high
blood pressure. Furthermore, as hypertension is recognised as a common
complex disorder, the ndings of the HYPERGENES project will be of use
to researchers trying to disentangle the factors involved in other diseases.
For further information, see http://www.hypergenes.eu
GEHA Using genomics tools
to understand the ageing process
With the ageing of Europes population, there is growing interest in research
which will help us reach advanced age in good physical and cognitive
health. The Genetics of healthy ageing (GEHA) project is analysing over
2 500 pairs of brothers and sisters from around Europe who have reached
the grand old age of 90, along with a group of younger control subjects.
The scientists are using genomics tools to hunt down genes and gene
variants linked to age-related diseases and disabilities.
For further information, see http://www.geha.unibo.it
Health research focus:
International scientic cooperation
Improving public health and the delivery of health care, tackling
disease, coping with epidemics all countries, everywhere in the
world, are confronted with health challenges. And, as disease knows
no borders, all countries potentially stand to benet when major
breakthroughs are made.
As one of the world leaders in health research, the EU has been en-
couraging international cooperation to achieve such breakthroughs
for decades. Successive framework programmes have increasingly
emphasised the need to bring together complementary competencies
from around the world and foster constructive collaborations across
borders to optimise the results of R&D efforts.
Since 2002, the EUs research framework programmes have
provided opportunities for international cooperation with countries
that are neither EU Member States nor associated to the framework
programmes. All health research topics are now open to such
cooperation, which in fact is mandatory in some cases. The Health
theme under FP7 has the objective to support research aimed at
improving peoples health and boosting the competitiveness of health-
related industries. Furthermore, it addresses global health issues.
Project consortia are invited to include research partners from
around the world, including International Cooperation Partner
Countries (ICPCs) and countries with scientic and technological
(S&T) cooperation agreements with the EU. International cooperation
under FP7 is unique in that its focus, besides combining global S&T
activities, is to bring thematic and geographical goals to fruition. A
number of third countries have already taken a step forward and
created contact points which develop and strengthen knowledge
transfer and networks with the scientic communities within the EU.
The EU is also using its good standing in international organisa-
tions such as the World Health Organization to raise awareness,
promote common interests, foster scientic excellence and con-
tribute to shared global commitments such as the Millennium De-
velopment Goals (MDGs). These efforts in science diplomacy are
other vital contributions to creating partnerships and intensifying
collaborations with researchers around the world. Thus, interna-
tional cooperation has the objectives of supporting European sci-
entic and economic development through strategic partnerships
with third countries and also addressing specic problems that
third countries face or that have a global character.
Connecting the research community, worldwide
For further information, see http://ec.europa.eu/research/health/policy-issues-international-cooperation_en.html
Health research focus: International scientic cooperation 14
AsiaFluCap:
Building the capacity to deal
with pandemic inuenza
Avian u and the highly pathogenic H5N1
virus have been headline news for several
years with good reason, considering the
dire consequences of successive outbreaks
in Asia and around the world. And, in the
wake of sporadic cases of human infection,
concerns about the emergence of a human
form of the virus have also been growing.
This latest challenge is a new battle in
mankinds ongoing war against an age-
old enemy. Seasonal inuenza epidemics
are estimated to claim more than a quarter
of a million lives worldwide every year, and
they also translate into substantial nancial
losses for national economies.
The EU has been supporting inuenza
research since 2001 and has shortlisted
an initial round of 11 collaborative projects
to pursue this effort under the current
framework programme. Health system
analysis to support capacity development
to respond to pandemic inuenza
in Asia (AsiaFluCap) is one of these
projects. Funded for a period of three
years, it brings together partners from
Germany, Indonesia, the Netherlands,
Taiwan, Thailand, the United Kingdom
and Vietnam. The partners will develop
a framework enabling them to evaluate
a health systems operational capacity
to contain and mitigate a hypothetical
outbreak of pandemic inuenza. This
framework will then be used to identify
capacity gaps and areas for action in
Indonesia, Taiwan, Thailand and Vietnam.
15 Health research focus: International scientic cooperation
International cooperation in FP7: three avenues
1) A general opening of all topics to any country
Research entities from third countries have been encouraged to participate in EU-
funded health research projects since the beginning of the previous framework
programme. FP7 aims to intensify this particular strand of cooperation. Research
entities from any country are potentially eligible under any health research topic.
2) Specic International Cooperation Actions (SICAs)
SICAs explicitly address health issues requiring cooperation with particular re-
gions or countries. Topics are chosen in view of the characteristics, priorities and
needs of these regions or countries. SICA projects are based on the principles of
partnership and dialogue; the involvement of at least two participants from ICPCs
is mandatory. Key research areas for health-related SICAs include MDG-related
research topics such as maternal and child health, reproductive health, neglected
infectious diseases, and health systems and health policy.
3) Programme-level cooperation
This type of cooperation involves coordination and co-nancing between the
European Commission and funding authorities in other countries. Topics are
dened jointly with research and funding agencies in the target countries. The
cooperation starts with a selection of an area and the planning of independent
calls. It aims to support individually funded projects working towards a common
goal. This option is useful both for smaller initiatives between the EU and a single
third country or for very large projects which no individual region or country could
reasonably be expected to take on single-handedly. The unity of such projects is
secured through purpose built management and reporting procedures, but in fact
such projects essentially involve separate grants.
European & developing countries
clinical trials partnership EDCTP
The EDCTP, as an innovative model for product development public-private partner-
ship, co-nances projects in vaccine and drug development, where African and Euro-
pean academia and pharmaceutical industry are equal partners. While supported by
the European Union and its Member States to the tune of EUR 400 million, it operates
as an autonomous body and publishes its own calls.

for further information, see http://www.edctp.org
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Medical research 18
Medical research
Many families in Europe, indeed many families around the world, will have rst-hand ex-
perience of the tragic consequences of major diseases such as cancer, cardiovascular
disease, neurological conditions or diabetes at some point in their lives. Cancer, to take
one example, claimed about 1.7 million lives in 2006 in Europe alone. Other diseases,
both infectious and non-infectious, compound the heavy burden on societies and health
care systems around the world.
Medical research is unceasing in its efforts to identify means of prevention, improve
diagnostics, explore promising avenues for new medicines and therapies, and assess
their efcacy. Signicantly increased patient survival rates for many types of cancer bear
testimony to the potential of this particular area of research, and work on other major
diseases has delivered similar success stories. However, many signicant leads remain
to be investigated, and research, powered by technological and medical progress, is
regularly uncovering new clues. Once discoveries are made, further effort is needed to
translate them into marketable products and introduce them to clinical practice.
EU funding is supporting many of the worlds leading projects determined to tackle this
challenge. This nancial backing enables research entities to pool their expertise and
resources, across borders and across competencies, to pursue lines of research that
individual entities could not reasonably be expected to address on their own.
Diabetes and obesity
In Europe, about 30 million are estimated to suffer from diabetes. Precise gures are,
however, difcult to ascertain, as many cases remain undiagnosed. A serious disease
in itself, which can reduce a patients life expectancy, diabetes also raises the risk of
developing cardiovascular disease. Despite signicant progress in the management of
the disease, diabetes has been gaining ground over the past two decades. This fact is
largely attributed to a similarly sharp rise in the prevalence of obesity, which is known
to be linked to the more common form of diabetes.
The EUs research efforts in this area are twofold, with one strand studying the aetiology,
prevention and treatment of the different types of diabetes and another investigating the
genetic, lifestyle and epidemiological aspects of obesity.
Upgrading clinical practice in the ght
against cancer
Aetiology, prevention, diagnosis, therapy: every new insight gained on the origins and pro-
gression of a disease like cancer is potentially life-changing for millions. Collaborative projects
across the EU are working to deliver updates on disease aetiology, new medicines and thera-
pies, better methods of prevention, early diagnosis and treatment, and a clearer view of the
effectiveness of therapeutic interventions.
Breast cancer, a disease which one in eight women in the developed world will face in their
lifetime, is one of the areas where health research is expected to make a spectacular differ-
ence. If detected early and treated in quality-assured, specialist breast cancer units, 90 % of
these cancers could be treated successfully. Breakthroughs in our understanding of the best
ways to prevent, diagnose and treat this disease will help to save more lives.
The TRANSBIG project assessed ways of determining the need for a patient with breast
cancer to receive follow-on treatment. The proposed approach involves developing a detailed
molecular knowledge of the patients tumour. The ability to assess if the cancer of a specic
patient is likely to recur will not only improve the effectiveness of the therapy, but also reduce
the burden of over-treatment as currently experienced by an estimated 12 % to 20 % of
patients on the patient herself and on the health care system. TRANSBIG is a European
Network of Excellence dedicated to Translating molecular knowledge into early breast
cancer management building on the Breast International Group (BIG) network for improved
treatment tailoring.
The RATHER project (Rational Therapy for Breast Cancer: Individualized Treatment for Dif-
cult-to-Treat Breast Cancer Subtypes) is expected to deliver proof-of-concept for novel thera-
peutic interventions, together with matched personalised diagnostic approaches for patients
for whom there are no targeted therapies available. The project will focus on protein kinases
and their signalling pathways in two difcult-to-treat subtypes of the breast cancer - triple
negative (TN) breast tumours (15% of all breast cancer cases) and invasive lobular carcinomas
(ILC) of the breast (10% of all breast cancer cases). If successful RATHER will initiate a phase
I/II clinical trial to examine patient responses to drugs in a clinical setting.
For further information, see
http://www.breastinternationalgroup.org
http://www.ratherproject.com
Medical research 19
Understanding schizophrenia
Schizophrenia is still one of the most mysterious mental disorders. Cost-of-illness indications uni-
formly point to disquieting human and nancial costs. Symptoms typically emerge in adolescence
and early adulthood. Vulnerability for schizophrenia is partly genetic, but is also due to environmental
effects.
The diagnosis of the disease is associated with demonstrable alterations in brain structure and
changes in dopamine neurotransmission. Pharmacological treatments blocking the dopamine sys-
tem provide control rather than cure. A hundred years after being so named, researchers are begin-
ning to understand the biological mechanisms underlying the symptoms of schizophrenia and the
psychosocial factors that moderate their expression.
Two new projects on schizophrenia funded by the European Commission started in 2010.
The aim of the European Network of National Schizophrenia Networks Studying Gene-Environment
Interactions (EU-GEI) is to identify the interactive genetic, clinical and environmental determinants in-
volved in the development, severity and outcome of schizophrenia. EU-GEI will employ family-based,
multidisciplinary research paradigms, which allow for the efcient assessment of gene-environment
interactions. In order to go beyond old ndings from historical convenience cohorts with crude mea-
sures of environmental factors and clinical outcomes, the focus in EU-GEI will be on recruitment of
new, family-based clinical samples with state-of-the-art assessments of environmental, clinical and
genetic determinants as well as their underlying neural and behavioural mechanisms.
The partners in EU-GEI represent the nationally funded schizophrenia/mental health networks of the
UK, Netherlands, France, Spain, Turkey and Germany as well as other partners, with a total of 26
institutions involved.
The second project, named OPTiMiSE (OPtimization of Treatment and Management of Schizo-
phrenia in Europe) focus on two goals: optimising current treatment and explore novel therapeutic
options. Indeed, despite nearly fty years of pharmacological and psychosocial research, the overall
prognosis of schizophrenia has improved only marginally. While the antipsychotic efcacy of most
antipsychotics is generally uncontested, their overall functional impact has been modest. The OPTi-
MiSE project therefore intends to address both basic, but so far unanswered, questions in the treat-
ment of schizophrenia and the development of new and experimental interventions. It is expected
that the project will lead to evidence directly applicable to treatment guidelines, will explore the devel-
opment of novel treatments and will identify potential mechanisms for new drug development.
The OPTiMiSE project builds on the combined expertise of 18 partners from 12 countries. The
majority of the partners share a history of joint research endeavours in schizophrenia and are active
members of the National Mental Health Schizophrenia Research Networks in Europe.
http://www.eu-gei.eu/
http://www.optimisetrial.eu/
Medical research 20
Rare diseases
In Europe, rare diseases are dened as diseases affecting less than one person in
2000. Rare diseases tend to be very serious, but due to their low prevalence in any
given population, they are particularly challenging areas of research.
This is a context where the multidisciplinary, collaborative, cross-border approach en-
couraged by the EU is proving particularly valuable. Substantial funding, coupled with
the opportunity to pool expertise, resources, patient data and biological material is
giving research into rare diseases a much-needed boost.
Other chronic diseases
Functional and sensorial impairments and chronic diseases such as arthritis, rheuma-
tism, musculo-skeletal conditions, respiratory problems or allergies are another priority
area of EU-funded health research. Many of these conditions may not, in themselves,
be life-threatening, but all are potentially disabling and seriously affect the patients
quality of life.
EU projects are devising improved diagnostics and intervention strategies in order to
delay the onset of such diseases, treat them or alleviate their symptoms. New projects
launched in 2010 notably explore the following areas:
n Genetic factors of osteoporosis;
n Hearing or visual impairment and degeneration;
n Innovative concepts in chronic obstructive pulmonary disease;
n Intervertebral disk degeneration: prevention and repair;
n Osteoarthritis;
n Osteoporosis: signalling pathways in bone formation and homeostasis,
genetic factors of osteoporosis;
n Understanding and combating age-related muscle weakness;
n Treatment of urinary incontinence;
n Non-alcoholic fatty liver disease;
n Chronic kidney disease;
n Mechanisms of development of allergy and asthma;
n Role of infection and dysbiosis in development of allergies and
autoimmune diseases.
Cardiovascular disease
Diseases of the heart and circulatory system (cardiovascular disease or CVD) remain the main causes
of death in the EU, killing over 2 million people per year. Of all deaths in the EU-27, mortality from
CVD reaches 42 % (45 % of deaths in women and 38 % of deaths in men). Despite the progress of
medical science of the past 30 years, many disorders of the cardiovascular system remain unsolved.
Even though some forms of CVD are becoming less frequent causes of death, continued research
is needed to produce further improvements.
EU-funded health research strives to improve the prevention, diagnosis, treatment and monitoring
of these diseases, including the vascular aspects of stroke. Emphasis is placed on translational
CVD research, where basic research discoveries are moved into clinical applications using broad
multidisciplinary approaches. The latest wave of EU-funded CVD research is investigating the
following areas:
n heart failure;
n arrhythmias;
n cardiomyopathies;
n cardioprotection etc.
Medical research 21
Ethics
Health research focus: Ethics 22
Ethics at the centre of research
Public attitudes towards science and technology are overwhelmingly positive. The condence gen-
erated by messages such as scientically tested or scientically proven is testament to societys
support of scientic endeavour. It also highlights the social responsibility that accompanies research.
As science advances and the relationship between science and society evolves, new challenges are
created for the scientic community.
Today, there are more scientists than ever before. Every day, exciting research opportunities spring
into existence. Projects are larger, more complex, and more expensive. The role that science plays
in our lives continues to gain in importance, and society, in turn, has a stake in science. Conse-
quently, the relationship between science and society continues to change and intensify in the
pursuit of progress.
Excellence in science means addressing ethical concerns to improve the quality of the science
itself, but also to highlight the importance of its outcomes to the wider community. The EUs commit-
ment to ethics in research is reected in explicit requirements, and more specically in the evaluation
of project proposals. Ethics may be context-dependent, but any research teams approach to ethical
matters is taken as an indication of the honesty and the clarity of its proposal.
While there are rarely clear-cut answers when it comes to ethics, some areas are excluded from EU
funding by denition. These are human cloning for reproductive purposes, altering the genetic heri-
tage of human beings, and creating human embryos only to conduct research or obtain stem cells.
For further information, see http://cordis.europa.eu/fp7/ethics_en.html

Key concepts of European research ethics
All research activities supported by FP7 should respect fundamental ethical principles, includ-
ing those reected in the Charter of Fundamental Rights of the European Union.
Research on human stem cells (both adult and embryonic) may be nanced, depending on the
scientic proposal and the legal framework of the Member State(s) involved.
The principle of precaution requires projects to conduct a careful assessment of predictable
risks and potential benets at the outset, establish proportionality between these, and imple-
ment appropriate safety measures.
23 Health research focus: Small & medium-sized enterprises
SMEs for a healthy future
Small and medium-sized enterprises (SMEs) are the backbone of the economic future of the EU,
and main drivers of innovation in medicine. Dynamic, exible and keen to identify promising niches,
SMEs are usually among the rst to respond to emerging challenges and seize new market op-
portunities. Many engage in cutting-edge research.
Recognising this crucial contribution to the EUs economy and to the excellence of research, the frame-
work programmes have increasingly aimed to involve high-tech, research-intensive SMEs in collabora-
tive research projects. Therefore a number of topics targeted to SMEs are included in the calls for pro-
posals. The Commission has adopted measures to change the legal and nancial regulations, aligning
them explicitly on the needs of smaller enterprises.
The rules regarding intellectual property rights have been revised to offer more clarity and to account for
the particular requirements of SMEs. Furthermore, a special guarantee fund covers the nancial risk of
defaulting project participants, thereby reducing the need for nancial checks and bank guarantees.
In addition to the network of National Contact Points, the main structure providing information and
assistance on all aspects of participation in FP7, the European Commission has also set up the
dedicated support scheme Fit for Health to facilitate SME participation (www.tforhealth.eu). Experts
in 22 countries are on hand to offer tailor-made assistance, in particular through a project-matching
database enabling SMEs and other participants to locate partners for FP7 Health proposals. A new
support action, SM-BIO-POWER, specically targets SMEs working in the medical technology and
biomedical engineering sectors.
Helping SMEs to make a success of their framework programme participation is a priority of the
Health theme. Several initiatives are in place to support SMEs with the valorisation of funded project
results. For example, the KAPPA-Health project (www.kappa-health.org) assesses the success
factors which lead healthcare companies to generate value from their participation in EU-funded
research projects, and what elements to take into account when to applying for cooperative
research grants.
A recent study nanced by the European Commission (project KAPPA-Health) indicated that over
90% of research-intensive SMEs having participated in a FP6 co-nanced research project considered
their participation as a success and 50% of these have already generated commercial return.
The increased emphasis on SMEs in FP7 will open up new avenues, enabling them to expand their
research activities. In forming collaborative partnerships with other SMEs, larger companies and
academia from Europe and beyond, SMEs can drastically reduce their nancial exposure, boost
their expertise and maximise the outcome of their R&D efforts.
http://ec.europa.eu/research/health/policy-issues-sme_en.html
Small & medium-sized
enterprises
3
INFECTIOUS DISEASES
Infectious diseases
For some of us, the threat of infectious diseases conjures up images of a bygone era centuries ago when the
menace of disease swept through cities, destroying livelihoods and ravaging lives. Nevertheless, infectious
diseases remain a major threat to this day. They still account for more than two-thirds of disease afiction
in poorer parts of the world, and recent threats to public health on a global scale, such as avian inuenza
and severe acute respiratory syndrome (SARS), have also reminded us of human susceptibility to emerging
threats, and the danger of resting on our laurels.
Infectious diseases, diseases transmitted from one living being to another, are responsible for around 15
million human deaths worldwide every year. These diseases are largely preventable and are a major cause
of disability, death and economic upheaval. Unprecedented strides in science have brought forward new
technologies and applications, resulting in breakthroughs that offer renewed hope in combating infectious
diseases. Many of these scientic advances, unfortunately, have yet to be translated into drugs, microbicides
and vaccines.
While it is true that scientic progress in this area is unparalleled, there is still much to be done, as for
example with neglected infectious diseases, such as sleeping sickness and leishmaniasis. Furthermore,
ongoing research is required into new and (re-)emerging epidemics that have the potential to affect human
populations in the future.
Europes seven-year
priority plan
The EU encourages research into infectious diseases by pursuing four major
lines of enquiry:
n poverty-related diseases,
n potentially new and (re-)emerging epidemics,
n antimicrobial drug resistance,
n neglected infectious diseases infectious diseases.
The European research environment for infectious diseases has focused on the provision
of resources, whereby highly innovative ideas may be conceived, and new approaches
may be developed for the prevention, treatment and management of these diseases. The
approach is a pragmatic one, facilitating the means of driving basic knowledge through
to clinical application. This has meant integrating European expertise from a range of
disciplines, forming partnerships between public and private organisations, and collabo-
rating with international research groups on other continents.
The European Commission has committed signicant resources in support of translation-
al research and intervention activities to combat infectious diseases under the Seventh
Framework Programme (FP7). The commitment builds on a body of rigorous European
research efforts established through previous framework programmes.
http://ec.europa.eu/research/health/infectious-diseases
Infectious diseases 26
Is poverty a trigger
for disease?
Unsurprisingly, yes it is. Circumstances such as overcrowded living
conditions, insufcient access to proper health care and poor nutrition
make those affected by poverty more vulnerable to infectious diseases.
However, the reverse is also true. While poverty can be attributed to
the rampant spread of communicable diseases in developing countries,
the crisis of disease in turn brings with it a socioeconomic toll that is
debilitating to a countrys growth and prosperity.
Infectious diseases such as HIV/AIDS, malaria and tuberculosis, known
as poverty-related diseases (PRDs), account for over 5 million deaths
every year, mainly in developing countries. This global emergency unites
European and international research efforts in a stronghold for the
development of therapies as well as diagnostic and preventive tools.
New approaches are required to confront these infectious diseases, and
the European Commission provides wide-reaching support to a range
of policy areas, including trade, development and research. Since 2002,
the Commission has almost quadrupled its overall annual support to
research activities for PRDs. Under the Sixth Framework Programme
(FP6), this support amounted to more than EUR 400 million specically
for discovery and translational research activities as well as the European
and developing countries clinical trials partnership (EDCTP).
This commitment continues under FP6s successor, with research efforts
focused on combating PRDs at global level, as well as on Europe-specic
aspects of the three major diseases and hepatitis. European resources
under FP7 are used to support the integration of expertise from different
disciplines, the formation of partnerships and the involvement of research
groups from developing countries.
International commitment
to address a global crisis
Established by the European Union in
2003, the European and developing
countries clinical trials partnership
(EDCTP) was the largest single
initiative introduced under the Sixth
Framework Programme (FP6).
Its aim is to accelerate the availability
of new or improved drugs, vaccines
and microbicides against the three
major PRDs (HIV/AIDS, malaria and
tuberculosis) by focusing on phase
II and III clinical trials in sub-Saharan
Africa, the worlds worst-affected
region. Besides a devastating loss of
lives, the diseases are responsible for
impeding development and contri-
buting to a crippling cycle of poverty
in these countries.
The EDCTP is a collaboration be-
tween 16 European and 47 African
countries in sub-Saharan Africa.
It is the rst initiative based on Art 185
of the EU treaty (ex-Article 169),
which allows the EUs participation in
research programmes undertaken by
several EU Member States. It is fund-
ed with EUR 200 million by the EU
and co-funded with EUR 200 million
from the 16 European partner coun-
tries. Additional co-funding comes
from third parties. Since 2003,
EDCTP supported 163 projects
with a total value of approximately
EUR 311 million.
for further information, see
http://www.edctp.org
How does this research
affect me?
Research funding for newly emerging
epidemics is critical. In the mid-1990s, the
European Commission issued a special call
for proposals that confronted the bovine
spongiform encephalopathy (BSE) crisis,
otherwise known as mad cow disease.
In addition to contributing to successful
products, such as the development of
tests for the disease, this action led to
the founding of solid European research
capacity in this area.
Similarly, the Commission responded to
the outbreak of severe acute respiratory
syndrome (SARS) in 2003 with funding
support that generated a number of
scientic advances. Between 2000 and
2007, funding support of over EUR 90 mil-
lion was allocated specically to inuenza
research and has contributed to a number
of successful results, such as vaccines for
both humans and poultry, new diagnostic
tests and the early discovery of the emer-
gence of drug-resistant viruses. Support
for scientic research into these and other
zoonoses continues, an indication of the
very real health threat that emerging dis-
eases pose to the world.
The pandemic threat:
the emergence
of new disease
While the European Commission has a long tradition of funding research into emerging
epidemics, a dedicated activity for this area was established for the rst time under FP7.
The decision to support a specic strategy for potentially new and (re-)emerging epidem-
ics is a response to the threat of emerging zoonoses, such as SARS and the recent
spread of the highly pathogenic avian inuenza virus H5N1, and other pathogens with
pandemic potential.
The programme is designed to respond to research needs in two ways:
n a long-term planning and consistent funding stream for researchers;
n a exible approach to respond to new threats in the rapidly changing eld of emerging
epidemics.
Resources aimed at accelerating the development of new diagnostics, drugs and
vaccines will continue to be made available for large and obvious threats, such as
pandemic inuenza. At the same time, support has also been committed to target
pathogens that pose a less imminent threat, with the aim of developing a more
methodical approach to integrating European scientic excellence. This strategy also
means that early identication of new pathogens will afford European scientists and
authorities precious time to prepare emergency measures.
In both instances, the call topics for EU funding support will cover the entire range of
health research, from innovative basic research and early-stage clinical trials to implemen-
tation research that supports public health responses.
Determining
priorities,
addressing gaps
Neglected infectious diseases (NIDs) result in chronic
disability or premature death for millions of sufferers.
The diseases, 90% of which originate in low-income
countries, are also shrouded in social stigma that af-
fects human potential and quality of life. Lymphatic -
lariasis, for example, is endemic in over 80 countries.
A classic late-stage sign of this disease is elephantia-
sis, a painful, disguring swelling of the limbs.
Research into NIDs has been identied as one of
the four priority pillars under the infectious diseases
strategy of FP7. In addressing this research gap,
the European Commission aims to improve current
methods and develop new approaches for the pre-
vention, diagnosis, treatment and control of NIDs.
European involvement in this area is critical to ad-
dressing needs and redirecting attention to a chal-
lenge requiring international participation. The Com-
missions aim is to fund gaps in research, specically
targeting neglected tropical diseases, including NIDs
within parasitic (e.g. trypanosomiasis, leishmaniasis
and Chagas disease), bacterial (e.g. Buruli ulcer and
leprosy), and helminths (schistosomiasis and lari-
asis) disease groups.
For each of these disease groups, research gaps
such as diagnostics, drugs to overcome drug resis-
tance and vaccine development may be addressed.
Funding support for prevention and control strate-
gies for these and other NIDs has also been identi-
ed as a priority in European research.
The genomic age: confronting
the problem of drug resistance
Once easily mastered through the administration of antibiotics, severe
bacterial infections are again sharply increasing in Europe due to increasing
resistance against available antibiotics. Hospitalised patients today run
a signicant risk of becoming infected by multi- or even pan-resistant
infections against which virtually no drugs are effective. Lately, community-
acquired infections are also becoming a serious concern. At the same time,
the drug development pipeline for new antibiotics is virtually empty due to
a lack of incentives for the pharmaceutical industry to invest in this eld. In
the longer term, difculties in effectively treating bacterial infections pose a
threat to many modern diagnostic and treatment modalities.
Research on antimicrobial drug resistance has been a high priority on
the agenda of the EU Framework Programmes, with more than EUR 300
million of EU support provided to the eld in the last 10 years. A profound
knowledge of the basic molecular mechanisms of resistance forms the
basis for more translational research approaches. These address key
pathogens causing major drug resistance problems, bringing forward
basic research either through clinical research into improved patient
management or product-oriented research on new diagnostic tests and
novel antimicrobial drugs.

European Antibiotic Awareness Day
Use and misuse of antibiotics generates antimicrobial resistance, which re-
duces the effectiveness of the drugs in the treatment of disease. Antibiotics
must, therefore, be valued as a lifesaving, but scarce resource and should,
thus, be used cautiously. The lack of adequate diagnostic tests in combina-
tion with patients expectations of receiving antibiotics are strong drivers of
overuse. Considering that only 40% of Europeans know that antibiotics are not
effective against viral infections (Eurobarometer), the general awareness of the
increasing drug resistance problem needs to be raised. An annual European
Antibiotic Awareness Day has, therefore, been organised on 18 November
since 2008 to highlight key aspects of the problem and addressing different
target populations.
HEALTH-NCP-NET
National Contact Points -
The ambassadors of FP7
The main objective of the EU funded Health-NCP-Net is to maximise the quality of the proposals that
are submitted to the framework programmes, including international cooperation at all levels. Many re-
searchers applying for FP7 funding appreciate personalised guidance. They can rely on the support of
an extensive network of ofcially nominated National Contact Points (NCPs) which informs prospective
applicants of suitable opportunities and helps them to nd partners, prepare documentation and deal with
contractual matters.
Contact points operate as part of wider NCP networks for individual countries or particular themes.
Health-NCP-Net, an EU-funded network launched in 2008, aims to take this approach to the next level
for European health research.
Like all NCPs, the partners of Health-NCP-Net support research entities submitting proposals for EU-
funded projects. But this is just one of the projects goals. Another is reinforcing the network itself, by pro-
moting the nomination of new NCPs around the world and mentoring them throughout the early stages,
but also by identifying good practice and disseminating it through recommendations, meetings and train-
ing sessions.
Health-NCP-Net started out with 19 partners in the core consortium, including NCPs in Egypt, Israel and
South Africa. But the network is much bigger in practice, as all Health NCPs are associated to the project
and the network is growing steadily. New NCPs have, for example, just been created in Taiwan, and re-
gional contact points are being established in Africa.
It is not necessary for all countries to have NCPs for all themes, but information regarding the FP7 Health
theme is important to most. Countries that did not nominate ofcial Health contact points, do participate
with the national NCP coordinators in the networks activities.
Coordination action for reinforcing the network of National Contact Points for FP7 HEALTH
http://www.healthncpnet.eu
http://cordis.europa.eu/fp7/health/get-support_en.html
Health research focus: Network of National Contact Points for FP7 Health 30
Beneciary Countries
Austria, Belgium, the Czech Republic,
Egypt, Estonia, France, Germany,
Greece, Israel, Italy, Latvia, Malta,
the Netherlands, Poland, Portugal,
Romania, South Africa, Spain
Partner countries associated
to the projet
Albania, Algeria, Argentina, Armenia,
Australia, Azerbaijan, Belarus, Bolivia,
Brazil, Bulgaria, Cambodia, Canada,
Chile, Costa Rica, Croatia, Cyprus,
Denmark, Faroe Islands, Finland,
Georgia, Hungary, Iceland, Indonesia,
Ireland, Jamaica, Jordania, Kazakhstan,
Kyrgyz Republic, Lesotho, Lithuania,
Luxembourg, Macedonia, Mexico,
Moldavia, Montenegro, Morocco,
Myanmar, New Zealand, Norway,
Philippines, Republic of Korea, Russian
Federation, Serbia, Slovakia, Slovenia,
Sweden, Switzerland, Taiwan, Thailland,
Tunisia, Turkey, Uganda, Ukraine, United
Kingdom, Uruguay, Uzbekistan
Other Countries
31 Health research focus: Innovative Medicines Initiative 31 Health research focus: Network of National Contact Points for FP7 Health
Instituto de Salud Carlos III
(ISCIII - ES)
Agence Bruxelloise pour LEnterprise (ABE - BE)
Instytut Podstawowych Problemow
Techniki Polskiej Akademii Nauk
(IPPT PAN - PL)
Deutsches Zentrum fr Luft
und Raumfahrt E.V. (DLR - DE)
Agenzia per la Promozione della
Ricerca Europea (APRE - IT)
Centro para el Desarrollo
Tecnolgico Industrial (CDTI - ES)
Autoritatea Nationala Pentru Cercetare (ANCS - RO)
Latvian Council of Science (LCS - LV)
SenterNovem (SN - NL)
Technologick centrum Akademie ved
Cesk Republiky (TCAV - CS)
Archimedes Foundation (ARCH- EE)
sterreichische
Forschungsfrderungsgesellschaft
MBH (FFG - AT)
Matimop, Israeli Industry Center for
Research & Development (ISERD - IL)
Malta Council for Science
and Technology (MCST - IT)
Academy of Scientic Research
and Technology (ASRT - EG)
International Centre for Genetic Engineering
and Biotechnology (ICGEB - ZA)
Institut National de la Sant et de la
Recherche Mdicale (INSERM - FR)
Agencia dInovaao - Inovaao Empresarial
e Transferncia de Tecnologia (ADI - PT)
Bionova (EL)
4
PUBLIC HEALTH
Public health
Helping decision-makers
to optimise Europes
delivery of health care

Public health 34
The EUs health care systems are an integral part of the robust social protection for
which Europe is well known, reecting the values of universality, access to high-quality
health care, equity and solidarity. But ensuring that a health care system delivers out-
standing services to all is a complex challenge.
This is reected in FP7s Health theme by the third pillar Optimising the delivery of
health care to European citizens. Research selected for funding will assist decision
makers and stakeholders by providing them with the information that they need to make
informed choices. The projects will contribute to the design of effective strategies for
health promotion, disease prevention, diagnosis and therapy. At the same time, health
system issues such as accessibility, quality and efciency will be focused on, while striv-
ing to ensure that health care is patient-centred and responsive to individual needs.
Turning clinical research into clinical practice
Here the aim is to determine how clinical research ndings can be used best in clinical
diagnosis and treatment, and to improve understanding of decision-making procedures
in health care settings. There is a special emphasis on patient safety, a topic close to
European citizens hearts, on the benchmarking of strategies, and on investigating the
effects of interventions, including continuity of care, patient self-management of dis-
eases and better use of medicines.
Ensuring our health systems are effective and open to all
Research in this area aims to provide tools that will help stakeholders and decision
makers to learn from other health systems, with the goal of ensuring quality, efciency,
solidarity and sustainability. Particularities of national health systems and differences in
population health will be taken into account. This research will have a particular focus
on organisational, nancial and regulatory aspects to establish their impact on effective-
ness and equity of access, important for systems in transition.
Addressing the determinants of health
Research in this area cannot be undertaken without an approach that also addresses
health promotion and disease prevention. Here the intention is to support research that
will deliver evidence for effective public health interventions addressing the wider deter-
minants of health, including mental health and healthy behaviour, and aspects such as
stress, diet or environmental factors as well as health inequalities. While most people
know that lifestyle changes such as quitting smoking or taking up regular physical ac-
tivity could improve their health, many struggle to make and sustain these changes.
Research can provide the scientic basis to design measures which will empower indi-
viduals to lead healthier lives.
Public health 35
Working with
international partners
to strengthen global
public health
Research under this heading is de-
signed to assist low- and middle-
income partner countries to improve
the accessibility, effectiveness, qual-
ity of care and user-friendliness of
their health systems. It will contribute
to initiatives such as the Millennium
Development Goals and the 2004
Mexico Ministerial Summit Statement
on Health Research.
Based on the principles of fair part-
nership and dialogue, joint research in
the form of Specic International Co-
operation Action (SICA) projects will
address key problems such as high
maternal, perinatal and child mortality
as well as lifestyle-induced diseases.
For more information, see
http: //ec. europa. eu/research/
heal t h/ publ i c- heal t h/ publ i c-
health-and-health-systems/index_
en.html
EQUITABLE
Does your health system provide the same standard and quality of care for all? Does it
strive to be equally accessible to all its users? Is it able to address the specic needs of
particularly vulnerable user groups? Answer yes to all three and you may be looking at a
system that has truly mastered the principle of equity in healthcare. But the answers are
unlikely to be straightforward.
The EQUITABLE project, a consortium of partners in the EU and Africa, is putting the
healthcare systems of Malawi, Namibia, South Africa and Sudan to the test in order
to identify the barriers they may need to overcome on the road to genuine equity. The
example of these developing systems is yielding valuable insights for emerging and es-
tablished healthcare systems everywhere.
There is a lot of rhetoric around the idea that healthcare should be equitable, but thats
really not possible unless health services are equally accessible to everyone. And there
are many reasons why that may not be the case. The barriers may be physical, psycho-
logical, administrative, nancial or cultural, to name but a few. They may be linked to the
distance patients must travel to receive treatment, or to the fact that they are displaced,
minority or otherwise vulnerable groups that often struggle to obtain the services they
need. These challenges affect different systems to varying degrees, but there is one in-
dicator that can be applied to all: their ability to address the needs of system users with
disabilities. All health system users should have equal access to crucial services such
as immunisation, dentistry or antenatal care, but only a system specically designed for
equity will be able to offer this level of inclusiveness.
A mud road to an immunisation clinic, for instance, can become an insurmountable ob-
stacle to a wheelchair user. If health provision for people with disabilities can secured and
they are able to access services, then it will be secured for the rest of the population,
because the concern is to maximise the inter-sectoral relationships between education,
transport, healthcare and so on, on which peoples health depends. EQUITABLE is as-
sessing health systems and the policies on which they build. To do so, it has developed
its very own methodology: EquiFrame, an analytic tool for evaluating and developing
inclusiveness in healthcare policies. The project is also proling system users and con-
ducting a survey of 8000 households to analyse their uptake of healthcare services. One
of the aims is to identify people who do not use such services at all, and to establish why.
Due to be published by the end of 2012, these case studies will give non-users of the
healthcare system a voice, and should give policymakers ample food for thought.
http://www.equitableproject.org
Growing up
The loss of a child is a tragedy without equal. The World Health Orga-
nization estimates that almost 10 million children under the age of 5 die
each year, most of them in the developing world and due to preventable or
treatable conditions such as malnutrition, pneumonia, diarrhoea, malaria,
measles and HIV/AIDS.
Protecting children from illness is a priority underpinning human existence
itself, one of mankinds guiding principles. This imperative cuts across all
aspects of EU-funded health research. The EU is committed to the promo-
tion of child health through research into appropriate treatment, protection
and prevention measures.
Developing medicines and standards that are specically suited to children
is one of the main priorities. The EU supports research into paediatric me-
dicinal formulations, including suitable vaccines and drugs to ght some of
the worlds most fatal infectious diseases. In this regard, legislative efforts
are bolstering the work of researchers.
Under FP7, research funding will continue to encourage transnational
partnerships. Childhood cancer, for instance, requires the cooperation
of researchers from across the EU. Other, more common diseases, such
as childhood diabetes, will also benet from European cooperation. Of
course, prevention is better than cure, which is why special emphasis is
also being placed on the promotion of healthy behaviour among children.
Actions targeting immunisation and screening will have another major
role to play.
Examples of specic topics targeted under FP7 include:
n innovative approaches for the development of vaccines;
n paediatric formulations of drugs against HIV/AIDS, malaria and tu-
berculosis;
n type 1 diabetes, a life-threatening chronic disease which usually starts
during childhood;
n adapting off-patent medicines to the specic needs of children;
n childhood and adolescent mental disorders;
n promoting healthy behaviour;
n improving prenatal and maternal care.

TEDDY
Task-force in Europe
for drug development
for the young
Medical research powers the develop-
ment of increasingly effective and so-
phisticated drugs which are often
formulated for adults, and cannot be
assumed to be safe or even effective
in paediatric use. Suitability for chil-
dren has only been established for
some 30 % of the products currently
marketed in the EU.
The TEDDY project, a network of ex-
cellence involving 17 partners from 9
Member States, Romania and Israel,
was launched in 2005. It aims to op-
timise the paediatric use of existing
medicines and stimulate the develop-
ment of new ones, a process in which
it is involving a broad range of stake-
holders active in drug development
and in paediatric clinical practice,
alongside regulatory authorities and
patients associations.
http://www.teddynoe.org
Promoting health
across generations
Health research focus: Promoting health across generations 36
and growing older
Current trends indicate that by the year 2050 the number of people aged 60 and
over will have more than doubled worldwide to 2 billion people. Remarkable ad-
vances in science and knowledge have meant that we are now living longer and
more fruitful lives than ever before. This achievement is not without its challenges,
however, as longer life expectancy impacts on all aspects of 21st century society.
Governments across the globe must manage the economic and social implications
of an ageing population. They must also prepare for increasing demands on health
care, as a rapidly ageing society signals large populations with chronic diseases,
disabilities, and heightened health needs.
Among developed countries, Europe is expected to bear one of the most pro-
nounced shares of this ageing demographic 37 % of Europes citizens will be
over 60 years of age by 2050. The EU recognises that confronting this change is
essential. The goal is to support healthy, active and productive lifestyles for Europes
older people, and the challenge is one that requires comprehensive and integrated
activities.
The health of the ageing population is a consideration emphasised across FP7s
entire Health theme. Research into the process of healthy ageing and age-related
illnesses, biomedical advances as well as prevention and disease management
strategies are examples of the activities supported.
Where FP7 research into the health of the ageing population is concerned, activities
will relate to unravelling the basic mechanisms of human development and ageing,
as well as to prevention, diagnostics and treatment of most common age-related
conditions, and the impact on the quality of life of older people, including:
n biomarkers of normal and diseased ageing;
n clinical trials for elderly patients with multiple diseases;
n systems biology of most common human diseases;
n -omics technologies applied to ageing and most common age-related diseases;
n impairment of touch and proprioception at old age;
n improving the organisation of health service delivery;
n new methodologies for health technology assessment.
Research into these topics will contribute to the efforts of the pilot European Partner-
ship on Active and Healthy Ageing.
37 Health research focus: Promoting health across generations
MARK-AGE
Unravelling the mysteries
of ageing
Why do some of us age faster than
others? Any reply to this question
will have to consider a vast set of
complex, interrelated factors ranging
from genetic heritage to environmental
inuences.
Of course, these factors have been
the focus of intense research for
many years. Candidate biomarkers of
biological age have been proposed,
notably as a means of detecting
vulnerability to age-related disease.
However, a single biomarker taken
in isolation is unlikely to provide
all the answers. The European
study to establish biomarkers of
human ageing (MARK-AGE), an
integrated project supported by FP7,
is assessing existing biomarkers,
identifying new ones and determining
their relative importance in order to
propose a weighted system which
will determine biological age with a
high degree of accuracy.
http://www.mark-age.eu
5
HEALTH BIOTECHNOLOGY
Health biotechnology 40
New tools for new therapies
Advances in biotechnology research have led to the development of tools and tech-
niques which enable us to manipulate genes, cells and tissues in a variety of ways. In
the health eld, doctors and researchers are using these tools to create new therapies
for a wide range of diseases and conditions, many of which are currently untreatable.
The EU is supporting a broad range of projects exploring their potential.
These exciting new therapies are already being used in hospitals and clinics to treat
patients with a variety of diseases. Meanwhile, researchers from many disciplines are
working to improve their effectiveness and see how they can be exploited to treat other
diseases. The safety of these new therapies is another key focus of research.
Regenerative medicine
As the name implies, the eld of regenerative medicine is focused on developing treat-
ments which replace and repair damaged cells, tissues or organs. An important tool in
regenerative medicine is the stem cell. What makes it special is its ability to produce
many different kinds of cell. For example, in adults, haematopoietic stem cells are able to
produce all the different kinds of blood cell. Scientists are also extremely interested in em-
bryonic stem cells, as these have the potential to produce any kind of cell in the body.
In cell therapy, patients receive new cells to replace diseased or damaged ones; a good
example is the use of adult stem cells from bone marrow to treat leukaemia. It is also being
used to develop treatments for Crohns disease, a condition which affects the bowels.
Meanwhile tissue engineering involves using stem cells to regenerate tissues such as
skin, bone, cartilage and blood vessels. Burn victims are already beneting from these
techniques to repair or replace burnt skin, and cell therapy products can be used to
replace knee cartilage which has been damaged by disease or injury. By using the
patients own cells to create new cells and organs, regenerative medicine also helps to
avoid the rejection problems associated with traditional transplants.
Ultimately, scientists hope to be able to harness these techniques to develop treat-
ments that will repair the heart after a heart attack, and even treat spinal cord injuries
and brain damage.
Health
biotechnology
Gene therapy
Many diseases and conditions are caused, at
least in part, by mistakes in our genes which
prevent the affected tissue, organ or system
from working properly. Gene therapy involves
the addition of a healthy working copy of the
faulty gene into the appropriate cells of the
body. Instead of treating the symptoms of the
disease, gene therapy has the potential to
correct the underlying cause.
The objective of gene therapy is to deliver
therapeutic DNA molecules to the inside of
cell nuclei in an efcient, specic and safe
way. One approach uses a virus to trans-
port the gene. However, while this method
is effective at transferring the genes, there is
concern that the virus may trigger immune or
inammatory responses or, once inside the
patient, may recover its ability to cause dis-
ease. Non-viral methods present certain ad-
vantages with simple large-scale production
and low host immunogenicity, but the main
disadvantage is low levels of transfection and
expression of the therapeutic gene.
Gene therapy has already been used to treat
conditions such as severe combined immu-
nodeciency (SCID) and rare eye diseases.
Researchers are now working to improve
the efcacy of these therapies and also ap-
ply them to new conditions, including cystic
brosis and cancer.
Stem Cell Therapy in Neurodegenerative
Diseases - NeuroStemcell
Parkinsons disease (PD) and Huntingtons disease (HD) are
two devastating neurodegenerative brain diseases for which
there is currently only limited or no treatment available, respec-
tively. The NeuroStemcell project is investigating the potential
to take stem cell based therapies for both diseases to the
clinic. PD and HD are ideal candidate diseases for restorative
stem cell-based therapies. Both diseases are characterized by
a slow and progressive loss of one specic type of neuron in
the brain.
The cell replacement strategy aims at substituting the lost
neurons by implantation of new functional cells. Experimental
evidence obtained in animal models, as well as the experience
gained from clinical trials using grafts of foetal cells, indicates
that effective restorative therapies may be possible to achieve
by neural transplantation in these two diseases. Further devel-
opment of this approach, however, will critically depend on the
development of alternative sources of therapeutically effective
cells derived from stem cells.
NeuroStemcell is focused on the identication and systematic
comparison of cell lines with the most favourable character-
istics, generated either directly from human embryonic stem
cells or form other stem cells, such as for example the recently
discovered induced Pluripotent Stem (iPS) cells.
The consortium will engage in parallel into a number of educa-
tional activities and promote the development of resources for
patient groups, regulators and lay public. The regulatory, ethi-
cal and societal issues associated with the use of stem cells
for therapy will be carefully considered as science progresses
from bench to bedside.
http://www.neurostemcell.org
41 Health biotechnology
Diagnostics and imaging
For many diseases, such as cancer, early diagnosis greatly improves the patients
chances of making a full recovery. With this in mind, a good deal of research is focused
on developing diagnostic tools and imaging techniques which will help doctors pick up
on diseases while they are still in the early stages. The same tools can also help doctors
to track their patients progress and choose the most appropriate treatments.
New imaging systems are being developed which combine two different systems, such as
magnetic resonance imaging (MRI) and ultrasound, or ultrasound and optical techniques.
These hybrid systems allow doctors to take advantage of the strengths of both systems.
For example, X-rays are very good at revealing details of bones or showing up surgical
implements, notably during an operation, while MRIs are good for producing images
of softer tissues. Combining different imaging technologies into one machine poses
signicant technical challenges; in the example of the combined X-ray/MRI machine,
scientists had to get round the way the magnetic elds produced by the MRI part of the
machine interfered with the X-rays.
For patients, the main advantage of these hybrid systems comes from reducing the
number of imaging appointments.
Biomarkers
Biomarkers are dened as indicators of a particular biological state, and they are widely
used to detect diseases and track the progress of an illness. They can be analysed
through imaging techniques or laboratory tests. An example of a biomarker is prostate
specic antigen (PSA), which is detected in high levels in men with prostate cancer.
Researchers are busy identifying the physiological and molecular changes associated
with a wide range of disorders, with the goal of developing highly sensitive, accurate and
cost-effective diagnostic tests.
Medical research
and animal experiments
following the three Rs
Growing awareness of animal welfare issues means that researchers are
increasingly under pressure to reduce the use of animals in their ex-
periments. Nevertheless, the safety of new treatments, particularly those
based on experimental or innovative concepts, must be ensured before
they are tested on patients.
The EU is a strong supporter of research based around the so-called
3 Rs, which encourage scientists to reduce, rene and replace the use
of laboratory animals. Recent years have seen the development and
regulatory approval of non-animal tests for skin irritancy, phototoxicity
and skin and eye corrosion and irritation. Further alternative tests are
awaiting approval from legislators and yet more are under development.
While most of these new tests take place in the test tube (in vitro), an
increasing number of tests are being developed which are based on
computer modelling (in silico). Between them, these new approaches
promise to substantially reduce the number of animals used in experi-
ments in Europe.
Children and patient safety
The vast majority of medicines in use today were developed for use in
and tested on adults, and just a third of the medicines currently marketed
in Europe are known to be suitable for children. The EU provides support
to a range of projects designed to remedy this situation.
For more information on child health, please go to page 36.
The MolDiag-PaCa
project picking up
on pancreatic cancer
Although it is relatively rare, pancreatic
cancer is one of the deadliest forms
of the disease, killing around 40 000
people per year in Europe alone. One
of the reasons for the low survival rate
is the fact that most people are not
diagnosed until the tumour is too large
to treat. This problem is exacerbated
by the inability of standard imaging
techniques to reliably detect the
cancerous lesions.
The Novel molecular diagnostic tools
for the prevention and diagnosis of
pancreatic cancer (MolDiag-PaCa)
project is working to develop new
tools which will ensure that pancre-
atic cancer patients are diagnosed as
soon as possible.
These tools include methods to identify
those most at risk of developing can-
cer, and screening techniques which
could identify pre-cancerous lesions or
early stage tumours. Novel diagnostic
tests will enable doctors to detect ge-
netic and molecular changes linked to
pancreatic changes in samples of pan-
creatic juice, serum and urine.
http://www.moldiagpaca.eu
From evaluation to management
Funding excellence in research
The European Commission implements a thorough and transparent evaluation process to identify
proposals worthy of funding. The process is rmly grounded in the principle of access for all and the
codes of fairness, impartiality, condentiality, efciency and ethics.
Only excellent research is to be funded. Independent experts from all over the world assist the Com-
mission in the selection of proposals in a rigorously monitored peer-review process. The proposals
are analysed and ranked by the experts according to several selection criteria, of which the most
important is their scientic and technical excellence. The reviewers also identify potential issues and
make recommendations to rene the proposals.
After a negotiation phase with the selected candidates, a grant agreement detailing the nancial
and scientic aspects of the project will be signed. The projects will then run typically from three to
ve years, and their development will be monitored by the Commission services from a nancial and
administrative point of view to ensure good management and good value-for-money use of public
funds. Independent reviewers may assist the scientic ofcers from the Commission in the assess-
ment of the scientic results that will dene the success of the project.
For more information on the European Commissions proposal evaluation process, consult Rules on
submission of proposals, and the related evaluation, selection and award procedures. The publica-
tion is available from http://cordis.europa.eu/fp7/nd-doc_en.html
During the first half of FP7, 2800 proposals competed for funding.
Only the 557 best projects were funded, for a total amount of more than
EUR 2.5 billion.
Who evaluates research proposals?
Most of the evaluators are leading gures in their elds. They are typically experienced researchers,
university professors, clinicians, company managers, etc. from Europe and abroad. Evaluators work
under condentiality and in a personal capacity, not representing their organisation.
A careful selection is made to avoid direct or indirect conicts of interests, in order to ensure the
impartial evaluation of every proposal. Each one is analysed by 3 to 10 experts, selected by the Com-
mission services according to the expertise required and the complexity of the project. After a remote
phase of individual evaluation, consensus meetings are held in Brussels to discuss each group of
proposals for a given domain.
Public funds devoted to research must be adequately spent. The principles
of sound financial and administrative management must be guaranteed in
all EU-funded projects.
Health research focus: From evaluation to management 44
Independent Observers Report
A group of high-level independent observers is appointed every year to ensure transparency in the
evaluation process. They assess the conduct and fairness of the process, verify that the correct
procedures are followed, and provide their feedback in the form of public reports that can be found
at: http://cordis.europa.eu/fp7/health/library_en.html#01
These reports provide input and advice for the European Commission to support the further devel-
opment of project evaluation and selection procedures for FP7.
How do I apply for funding?
A number of strategic areas to be funded are identied every year by the Commission services,
taking into account the main priority lines of the Framework Programme, the input from an advisory
group of experts, the scientic community and representatives from EU Member States and FP7
associated countries.
Applications are invited through calls for proposals published online on the European Commissions
FP7 website: http://cordis.europa.eu/fp7/dc/index.cfm
Proposals are submitted electronically via the Participant Portal, which is the entry point for elec-
tronic administration of EU-funded research and innovation projects. It is hosting the services for
managing the proposals and projects throughout their lifecycle:
http://ec.europa.eu/research/participants/portal/appmanager/participants/portal
For general or specic FP7 queries in any of the ofcial EU languages, call toll free, e-mail or visit a
Europe Direct Contact Centre: http://ec.europa.eu/research/enquiries
National Contact Points (NCPs) also provide assistance and advice to potential applicants in their
own language: http://cordis.europa.eu/fp7/health/support_en.html
The new interactive platform Health competence currently includes 3370
EU-funded health research projects which have been carried out by 5166
partners from the EU and other parts of the world since 2004. It aims to
present the projects latest results in terms of technology offers, patents
and publications.
For further information, see http://www.healthcompetence.eu
45 Health research focus: From evaluation to management
All the experts that have been interviewed unanimously emphasised
and acknowledged that the approach taken by the European Com-
mission for evaluating proposals is of the highest standard ... It can
be taken as an example of best practice that could act as a model for
many national research funding organisations.
Wolf-Michael Catenhusen, Jean-Alexis Grimaud and Manfred Horvat,
Independent Observers Report, Evaluation FP7HEALTH-2007-A , May-June 2007.
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Cataloguing data can be found at the end of this publication.

Luxembourg: Publications Office of the European Union, 2011
ISBN 978-92-79-18551-9
10.2777/71967
European Union, 2011
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doi
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European research for a healthier future
Luxembourg: Publications Office of the European Union
2011 48 pp. 29.7 x 21.0 cm
ISBN 978-92-79-18551-9
doi 10.2777/71967
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I am proud to say that the research funded to date under FP7 is widely
recognised as being of exceptional quality. It is not only improving
health, wellbeing and quality of life in Europe and around the world,
but our research is helping to ensure that Europes health-related
businesses are some of the most competitive on the global stage.

Commissioner for Research, Innovation and Science
http://ec.europa.eu/research/health/index_en.html
http://ec.europa.eu/research/innovation-union/index_en.cfm
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