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Op-ed | President of the Consultative Commission on Industrial Change at the European Economic and Social Committee: Without critical raw materials resilience, there will be no green or digital industrial revolution

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Opinion by  Pietro Francesco De Lotto, President of the Consultative Commission on Industrial Change at the European Economic and Social Committee

Whether we are talking about a fourth, fifth, or even sixth industrial revolution, we often see public debate take place. Despite the different views on the issue, one thing we can say with certainty is that our industry is undergoing a profound revolution, which comprises a twin challenge: becoming greener and more circular, as well as going through a digital transformation. It is a revolution that is driven by several factors: our commitments under the Paris Agreement, the pursuit of global competitiveness, the need to adapt labour markets, consumer sensitivity and, last but not least, public opinion.

The UN Sustainable Development Goals and the fight against climate change are clearly essential pillars of the EU’s action, and we need to ensure that they are perceived and experienced more and more as an opportunity rather than a burden by all parts of society and industry. The European Green Deal, the Circular Economy Action Plan, the recently updated New Industrial Strategy for Europe, the Fit for 55 package presented in July, and the related activities and legislation are essential tools to transform public debates into an everyday reality, everywhere in Europe, leaving no one behind in this collective effort.

Raw materials, and especially critical raw materials, are at the core of this process. Digitalising and greening EU industries and society require technologies that depend on raw materials. Wind power, for instance, comes from turbines that contain, among other materials, rare earth elements. The EU relies almost 100% on China to supply such elements. Similar scenarios exist for many technologies that are essential to the green and digital transition, from batteries to photovoltaics, from robotics to fuel cells. The EU Critical Raw Materials Action Plan and the Updated Industrial Strategy identify 30 materials and 137 products respectively that are essential for our industry and society and on which the EU is highly dependent.

These are worrying figures, but they also provide a necessary reality check. The past few months have brought these dependencies to the public’s attention even more clearly, as the COVID-19 pandemic has exposed the need for EU industry and society overall to become more resilient and strategically autonomous, especially in areas such as vaccines, medicines and medical devices. The time to act on these critical factors is therefore ripe, and we must make use of all instruments to address our dependencies with a strategic vision.

The Commission’s Action Plan on Critical Raw Materials, on which the European Economic and Social Committee (EESC) recently published its opinion CCMI 177, is a good instrument that combines measures to fix current shortcomings with actions to mitigate possible future problems. The EESC believes that the actions envisaged by the European Commission are essential if we are to maintain and strengthen the EU’s industrial base. This is a very important first point: for too long, we have left this issue up to the free market and industry, hoping that it would regulate itself. We must however now acknowledge that, as much as companies should be free to build their supply chains, we need to secure some parts of these chains that we deem of strategic importance to the European Union.

More specifically, the EU needs support instruments for sustainable primary sourcing in Europe. Financial instruments for sustainable projects, as well as streamlined authorisation processes are needed, as is the greater involvement of and public acceptance by citizens and local communities. This is also very much linked to the need to maintain extractive and processing capacities in the EU. We need to support workers and regions through better training and a deeper link with higher and vocational education, including investment in training and retraining workers, and in the teaching of specialist disciplines such as geology, metallurgy and mining, even at undergraduate level.

At the same time, and this is the second point, we need to invest in activities that can foster substitution; something that will only be possible with significant, constant investment in R&D programmes to discover new materials and processes for ensuring justified substitution.

Together with primary sourcing and substitution, the third key element is that of circular reuse and secondary sourcing from waste. To do this, we need to invest in research and development, but we also need to carefully assess the waste we ship outside Europe, while at the same time mapping – as soon as possible – the potential supply of secondary critical raw materials from EU stocks and waste.

As for the external dimension, the EU needs to diversify its trading relations, while supporting developing countries. These two objectives go hand in hand, as our efforts should be aimed at forging strategic partnerships with like-minded nations in a multilateral framework, which can both help avoid supply disruptions for EU industry and contribute to the well-being and development of developing third countries. In this regard, there are three very specific elements to be underlined: the mutual advantages of integrating the Western Balkans countries into the EU supply chain; the urgent need for an increased role for the Euro in critical raw materials trading and the need to take greater account of the ethical dimension when drawing up Europe’s critical raw materials list.

Overall, we want to see EU industry flourish in a green and digital way, but we do not want to see our industry and society shift from one dependency (for instance on certain fossil fuels) to another full reliance on certain critical raw materials. To avoid this, and to ensure that the green and digital transitions increase resilience, competitiveness and social justice, we need to invest in research and development, sustainable domestic mining exploration, recovering valuable materials from waste, training and retraining a skilled workforce and creating a multilateral level playing field. This is essential in order to ensure that the green and digital revolutions are successful and benefit EU industry and society as a whole, and do not leave any worker, region and country of the world behind.

Pietro Francesco De Lotto

President of the Consultative Commission on Industrial Change at the European Economic and Social Committee

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MEP Vasile Blaga: Firm decisions are needed to boost vaccination in Romania. We cannot afford new pressure on the health system

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MEP Vasile Blaga (PNL, EPP) believes that “firm decisions are needed to stimulate vaccination in Romania”, stressing that “we cannot afford a new pressure on the health system like in wave 4”.

“The year 2021 ends primarily under the sign of the pandemic generated by COVID 19. We all know the effects of wave 4 in Romania. Even if at the moment the figures are in reasonable ranges, what is happening in countries with high vaccination rates is a warning signal for the new wave of the pandemic. Authorities in Bucharest need to take firm decisions to increase vaccination rates. There is no time for hesitation. Sceptics should take a closer look at the fact that despite high infection figures, the number of deaths and serious cases is low in countries with high vaccination rates. This is where the effectiveness of vaccines can be seen,” said Blaga.

He said that the Romanian health system can no longer afford an over-supply such as in wave 4, which had a major and totally unfair impact on all sick people in Romania.

“We must activate the community spirit in Romania and realise that the fact that we vaccinate helps our neighbours, including the fact that a potential infection with Covid 19 does not deny access to hospital to a patient with a chronic disease,” the MEP added.

“The decision of each of us on vaccination has knock-on effects”, concluded Vasile Blaga.

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MEP Vasile Blaga: Eliminating gender gaps in the European labour market – a priority for the European Parliament

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Closing the gender gap in the European labour market was at the top of last week’s plenary agenda, said MEP Vasile Blaga (PNL, EPP) on Monday.

The European Parliament’s last plenary session this year put gender inequality in the European labour market on the agenda. Statistics show that at EU level there is still a pay gap of more than 14 percentage points (14.1%) between men and women and a wider pension gap of almost 30 percentage points, both to the disadvantage of women. Moreover, the report voted on at the last plenary session of the European Parliament also notes that women face a precarious situation in the labour market.

“Together with the EPP Group in the European Parliament, I voted in favour of the report on gender equality to draw attention once again to the fact that Member States must come up with concrete proposals to minimise gender inequalities and to strongly support women’s rights in the European Union”, said the EPP MEP for CaleaEuropeană.ro.

The report adopted in the European Parliament also focuses on eradicating violence against women, a phenomenon which has increased significantly during the pandemic.

“Abuse against women must be vigorously prosecuted and the perpetrators must be investigated and punished without hesitation. Moreover, monitoring and protection programmes for victims of domestic violence need to be improved in order to minimise this phenomenon”, added Vasile Blaga.

In a non-legislative report adopted last Wednesday by 500 votes to 105 with 87 abstentions, MEPs reiterated that equal pay and equal treatment are an essential prerequisite for women to enjoy equal rights, economic independence and professional fulfilment.

They call on Member States to take practical measures to ensure that women have equal access to the labour market and jobs and that they enjoy equal pay and equal rights as workers. For example, to achieve this, sanctions should be imposed on companies that do not comply with labour law. In this respect, MEPs welcome the Commission’s proposal for mandatory pay transparency measures. However, they stress that pay transparency alone will not be enough to address deep-rooted gender inequalities.

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A government project to digitise healthcare is needed. More calls from Romanian experts at national and European level

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© European Union, 2020

The COVID-19 pandemic has highlighted the need for a health system that can cope with paradigm shifts in remote healthcare, and telemedicine has been a great help to patients as well as doctors over the past two years. Thus, the digitalisation of the health system and health services is a topic of interest at European and national level. However, there is an uneven development of digitisation and e-Health solutions in EU countries in Central and Eastern Europe, according to a report by PricewaterhouseCoopers, for the European Federation of Pharmaceutical Industries and Associations (EFPIA).

National authorities, European decision-makers, representatives of the pharmaceutical industry responded to the initiative launched by www.CaleaEuropeana.ro and the Romanian Association of International Pharmaceutical Manufacturers (ARPIM) and held an open dialogue on the European opportunities for digitisation of the healthcare system in Romania, but also on the steps that our country needs to go through in the digital transition so that Romanian patients can benefit in the coming years from easy access to healthcare and telemedicine.

The main lessons learned by the European Union since the beginning of the pandemic and until now were discussed, as well as the need to accelerate the digital transition in the European Union’s health systems, but especially the importance for the Romanian authorities, regardless of political colour, to establish a unitary strategy for the digitisation of health, a strategy that coordinates the institutions in the field and is connected to European directives.

The digitisation of the Romanian health system must allow transparent access to reliable data which must be published in formats suitable for secondary use, for epidemiological or health policy analysis.

Topics of interest for Romania in the field of digitisation of health can be (non-exhaustive list): European Cancer Knowledge Database; European Cancer Imaging Initiative; Cancer Management Inequalities Registry in Member States; Connecting e-prescribing and electronic patient record systems between Member States; Connecting and exchanging information between reference centres for rare diseases; Participation in transnational registries in the field of chronic diseases; National/transnational remote medical consultations and second opinion in imaging or pathology; Evaluation of health apps for reimbursement, etc.

Develop a government project covering the key issues for digitisation in health, needed

Prof. Dr. Adrian Streinu-Cercel, President of the Health Committee of the Romanian Senate, calls for a government project covering the key aspects of digitisation in health: “To be an integrated system it has to start from one head, i.e. the Romanian Government. If we don’t decide what we want this digitisation to look like, it will be everyone with their own database, everyone with their own application.”

  • We have the opportunity to do a very good job from the beginning and for that we all have to sit around the same table, regardless of political colours, and discuss how we want this national digitisation programme to look like and how to integrate with other countries, if we want that.

Romania needs to establish a National Contact Point to align our country with European directives

Ștefan Busnatu, advisor for digitisation to the Minister of Health, set up a digitisation strategy for the health system a year ago, which unfortunately has not been integrated into the NRDP.

  • We need to establish a National Contact Point, which will deal with the whole digitisation component in order to be aligned with the Brussels directives and all the European reforms. The National Contact Point is a three million euro project, which theoretically has to be taken on by someone. At the moment the CNAS have sent the assumption from a coordination point of view. It is important to decide where it would be most coherent to create the National Contact Point in Romania for digitisation and digital transformation.

The time has come for telemedicine to offer patients a better quality of life, while giving doctors new tools

Adela Cojan, President of the National Health Insurance House, reviewed the latest national milestones for the digital transformation of Romania’s healthcare system. A Memorandum has been signed at governmental level for tripartite participation to access European funds for the development of the project “IT systems for connecting to the electronic health record the providers of paraclinical services, specialist outpatient, rehabilitation, home care, providers of clinical services, palliative, medical devices or emergency consultations at home”, being basically an extension of the electronic health record, which was initially designed only on family medicine and hospitals.

  • The societal and economic benefits of the widespread use of telemedicine are practically enormous. At the moment we are far from being fully in the middle of their use, but I believe the time has come for telemedicine to offer patients a better quality of life, while giving doctors new tools. It is a challenge, there have been reservations, but now in the areas where we have introduced remote consultations they have been widely accepted, which is why we have also extended them in the regulations for next year.

Lack of interoperability of databases in the healthcare system, one of the critical issues

Adrian Hatos, Chairman of the Committee for Science, Innovation and Technology in the Romanian Senate, says that one of the critical problems facing the entire public system in Romania, not only the medical system, but also the administration and education, is the interoperability of databases or the interoperability of data in general in the medical system, which makes it impossible to access and use data: “We have the possibility of datafication, big data techniques and remote communication in education or medicine. The problem in Romania is primarily institutional and human rather than technical.”

  • So far there have been public and European financial resources for digitisation. We need to look at the problem of working with so many database systems that cannot communicate with each other. We have the opportunity of RRF funding, but also the implementation of a governmental Cloud to force the creation or implementation of a data infrastructure that is unitary, standardised at national level, so that we can communicate in the various structures and take advantage of the opportunities that telemedicine offers.
  • The digital transition must also include changing the attitude of doctors and patients towards technology.
  • The Committee on Science, Innovation and Technology of the Romanian Senate can initiate legislation and support legislation in this area. It can initiate debates in the Senate on digitisation in health.

Patient registers, the most important thing today when it comes to digitising health

Felicia Ciulu Costinescu, Director, Medical Technologies Evaluation Directorate, National Agency for Medicines and Medical Devices of Romania (ANMDMR), says that digitisation of healthcare has become a necessity for facilitating the patient pathway in the healthcare system and has become more important in the context of the pandemic.

  • ANMDMR experts are active and present in Brussels working groups of the European Medicines Agency (EMA) or the European Commission, including in task forces dedicated to digital transformation: “This concern comes from the need to provide EU patients with innovative solutions and emerging technologies. All this can only be achieved by transforming and optimising regulatory processes, improving centres of expertise, providing digital solutions and building an e-learning ecosystem. All of this requires investment over time, but the process has been started and will bring the benefits it was designed to deliver.
  • The digitisation paradigm is a complex one. Patient registries are the most important thing at the moment when we talk about digitising health. The need for these registries is even greater as very high-cost personalised therapies are knocking at the door. These registries will be useful when we want to have access to some data. Interconnecting them with both national and existing European health platforms. The main aim is to develop a common dataset to support the reimbursement decision as well as to support technicians to have easy access to medical data.
  • Digital technologies, intelligent data collection and integration are the present and the future for patient access to personalised, effective and safe treatments.

The leadership of the Romanian Digitisation Authority (ADR) gave details of the objectives of the RegInterMed project in its message to the expert meeting on 14 December. According to the ADR, in October the Ministry of Health put the specifications of the RegInterMed project out to public consultation.

  • The project will implement 100 disease registers for 18 specialities. These will be established separately during the implementation period. In addition, 4 specific registers will be implemented for the INSP (Register “reporting biocidal substances”, Drinking water quality register (RECAP), National operational computerised register of occupational diseases, Register on the management of waste resulting from medical activity).
  • It will have a working meeting on Wednesday 15 December with the new management delegated by the Ministry of Health for this project.

The European Commission is exploring the possibility of European patient registers, but the condition is that national registers exist in all EU countries

Cristian Bușoi MEP, Chair of the Industry and Research Committee of the European Parliament’s ITRE Committee, as the European Parliament’s rapporteur for the EU health programme, EU4Health, insisted that one of the priorities of this programme is digitisation in health at European level and the creation of the EU Health Data Space, which is an initiative of the European Commission that he supports.

  • We also advocated that money from this programme should fund interoperability between different e-health systems at national level, such as electronic patient registers to be interconnected and prescription, which is an e-health solution found in most European countries and this needs to be interconnected.
  • The European Commission is looking at the possibility of European patient registries, but the condition is that there should be national registries in all EU countries, at least for cancer and rare diseases where the number of patients is not so large, it would be easier to manage these patients. At European level, digitisation in health is an essential component. EU4Health can only give a general outline, just as the EU Health Data Space will create some rules for governance, for interoperability.
  • Romania needs to prioritise these projects in order to be able to use European funding.

Romania has all the necessary tools to digitise its health system and to offer Romanian patients European and quality conditions in terms of health and telemedicine. It is essential that decision-makers and politicians have forward-looking projects adapted to European requirements so that Romanian patients can benefit from the opportunities of the digital transition.

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