Every year, on 28 July, the World Health Organization (WHO) and partners mark World Hepatitis Day to increase awareness and understanding of viral hepatitis and the diseases it causes. It is estimated that around 290 million people worldwide are living with viral hepatitis, and many remain unaware of their status. Failure to identify the undiagnosed, and link them to care, means that millions will continue to suffer and lives will be lost. The focus of this year’s campaign is therefore ‘Find the missing millions.’

Transmitted through the sharing of needles, syringes and other injecting equipment, hepatitis C is the most common infectious disease among people who inject drugs in Europe. If HCV infection in this group is not addressed, there may be considerable costs in the future, both to individuals and to health budgets.

As part of its harm reduction initiative to increase access to hepatitis C testing and improve linkage to care, the EMCDDA is showcasing today its knowledge questionnaire designed for those working in drug treatment settings. The main aim of the questionnaire is to: allow those working in these services to refresh their knowledge on the hepatitis B and C viruses (HBV, HCV), including transmission, testing and care for people who inject drugs. The questionnaire also provides a practical tool for managers of drug treatment facilities to identify staff training needs and increases awareness among drug service staff of the importance of knowing their own HCV status.

The knowledge questionnaire, now available in seven languages (German, English, French, Italian, Dutch, Polish and Portuguese), covers a wide range of issues, including HCV and HBV prevalence, routes of transmission, prevention measures, treatment and testing options and international testing and treatment recommendations. This practical tool, which can be administered on paper or adapted to an online version, consists of a series of true statements which provide factual information on viral hepatitis. The answer format — ‘I knew it already’ or ‘This is new to me’ — allows participants to ‘learn by doing’ and to assess their own level of knowledge and refresh it.

The EMCDDA has created an online version of the survey in English as an example. Click here to test your knowledge.

EMCDDA Director Alexis Goosdeel says: ‘Staff working in drug services play a vital role, both in reaching people who may be at risk of hepatitis infections, and in linking them to care. They are an important source for informing people who inject drugs about infection risks and prevention, about available tests and effective treatment and about the type of medical services they provide on-site. This questionnaire can help ensure that drug service professionals have up-to-date knowledge on viral hepatitis in order to help people who inject drugs access the care they need’.

Over the past 25 years, the EMCDDA has been monitoring the prevalence and incidence of blood-borne virus infections among people who inject drugs. In 1997, it published its first estimate of the burden of hepatitis C among this group, which highlighted the extent of what had, until then, been a ‘hidden epidemic’ in the shadow of HIV/AIDS. This triggered further research into the impact, costs and policy options regarding this disease, leading to an overview on the issue published in 2004. In the following years, the agency focused on identifying effective responses to prevent and reduce injecting-related harms and making this information available to policymakers and practitioners across Europe. Yet, despite the availability of new highly effective treatments for hepatitis C infection, access to testing and care for people who inject drugs still remains limited today. In line with countries’ commitment to eliminate hepatitis C as a public health threat by 2030 (¹), the EMCDDA launched a new harm reduction initiative on hepatitis C in 2018. Through this initiative, the agency now offers a set of practical resources aimed at supporting countries in promoting HCV testing and care for this vulnerable group through drug services.

#WorldHepatitisDay #FindTheMissingMillions #emcdda25

The ‘Civic space ― experiences of organisations in 2019’ paper draws on views from 205 civil society organisations from FRA’s Fundamental Rights Platform. It shows the main obstacles they face in their work:

• Almost half of national and local civil society organisations say that the situation in their country has deteriorated.
• More than half say they faced verbal and online threats and attacks, including hate speech, as well as negative media reports about them.
• One in five say they experienced a physical attack, targeting either one of their employees/volunteers or their office building.
• The majority has difficulties accessing or participating in public consultations, mainly due to short deadlines or lack of feedback from the authorities.
• Many face challenges arising from regulatory frameworks, such as provisions on freedom of expression, assembly and data protection.
• Availability of, and access to funding is a problem for most civil society organisations. The proposed EU Justice, Rights and Values Fund could assist their finances.

Civil society is an essential component of the democratic system. The quantity, quality and intensity of obstacles affecting civil society’s ability to carry out their work provide an indication of a country’s general state of fundamental rights, democracy and rule of law.

This second annual consultation shows that many of the human rights organisations that FRA cooperates with continue to face challenges in their daily work.

FRA started an annual consultation with organisations participating in its Fundamental Rights Platform in 2018, focusing on the challenges they experience in their daily work.

The consultation followed the publication of FRA’s 2018 report on ‘Challenges facing civil society working on human rights in the EU’, which highlighted different areas of concern.

The new findings underline the continued relevance of the opinions FRA formulated in its 2018 report on civil society, which EU institutions and Member States should consider.

Workplace exposure to biological agents is widespread and linked to a large number of health problems, including infectious diseases, allergies and cancer. An estimated 5,000 workers die each year in the EU alone as a result of work-related infectious diseases. EU-OSHA’s new report aims to raise awareness of the topic and provide reliable information that supports efforts to establish effective preventive measures.

The research sought to identify and describe the most relevant exposures, and the report provides in-depth analyses for five sectors/types of occupation that are particularly at risk of exposure:

• health care
• animal-related occupations
• waste and wastewater treatment
• arable farming
• occupations that involve travelling or contact with travellers.

The project also focused on emerging risks, including multi-resistant bacteria and the wider spread of infectious agents. The occurrence of the severe acute respiratory syndrome (SARS) and COVID-19 epidemics in Europe, for example, have been linked to the phenomenon of globalisation. EU-OSHA’s Executive Director, Christa Sedlatschek, emphasises the effect that such pandemics have on the healthcare sector: ‘Global health problems are putting healthcare systems under intense pressure, and urgent measures are needed to protect workers from infectious diseases beyond the provision of protective equipment. Healthcare workers’ safety and health has to be a priority in an emergency situation such as the COVID-19 pandemic, which has shown how important it is that the existing legal protections are implemented.’

The experts interviewed for the project spoke of the need for emergency plans that allocate financial resources to tackling future outbreaks of disease. They also mentioned that information collected through compulsory reporting could help in identifying early signs of the spread of a disease.

A legal framework exists to protect people from workplace exposure to harmful biological agents, but awareness of it needs to be raised. If the risks are to be tackled in a better organised way, exposure to biological agents and the health problems resulting from them have to be assessed and recorded. With this in mind, the research looked at and analysed systems for monitoring diseases and exposures. Providing more training and guidance to employers and workers will also help to ensure more systematic prevention.

The research highlights that there is lack of awareness of exposure to biological agents in all sectors with the exception of healthcare and laboratories. In addition, groups such as young people, cleaners and maintenance workers, migrant workers and pregnant women are at particular risk. Improving access to information and implementing specific measures to protect such groups are therefore essential.

Case study examples demonstrate the importance of recognising the risks and taking collective action to manage them. For example, in Finland, the occupational health services have made effective use of health surveillance data for targeted interventions to tackle farmer’s lung. The measures introduced were successful in reducing the number of cases and in helping agricultural workers who had already experienced health problems.

The report also concludes that sectors affected by unintended exposures need general guidance and that providing workers with relevant information is key. Respecting the hierarchy of control measures set out in legislation and prioritising collective over personal protective measures are vital.

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The Council today appointed the European prosecutors of the European Public Prosecutor’s Office:

• Frédéric Baab
• Cătălin-Laurențiu Borcoman
• Jaka Brezigar
• Danilo Ceccarelli
• Gatis Doniks
• Yvonne Farrugia
• Teodora Georgieva
• Daniëlle Goudriaan
• Petr Klement
• Tomas Krušna
• Tamara Laptoš
• Katerina Loizou
• Ingrid Maschl-Clausen
• José Eduardo Moreira Alves d’Oliveira Guerra
• Juraj Novocký
• Andrés Ritter
• Maria Concepción Sabadell Carnicero
• Gabriel Seixas
• Kristel Siitam-Nyiri
• Harri Tiesmaa
• Yves Van Den Berge
• Dimitrios Zimianitis

The prosecutors will supervise investigations and prosecutions and will constitute the EPPO College, together with the European Chief Prosecutor.

European prosecutors are appointed for a non-renewable term of six years. The Council may decide to extend the mandate for a maximum of three years at the end of this period. As part of the transitional rules for the first mandate following the creation of the EPPO, the European prosecutors from one third of the member states, determined by drawing lots, will hold a three year non-renewable mandate. This is the case for the prosecutors from Greece, Spain, Italy, Cyprus, Lithuania, Netherlands, Austria and Portugal.

Each member state nominated the candidates for the position of European prosecutor. These must be candidates who are active members of the public prosecution service or judiciary of the member state, whose independence is beyond doubt and who possess the qualifications required for appointment to high prosecutorial or judicial office in their respective member states. They must have relevant practical experience of national legal systems, of financial investigations and of international judicial cooperation in criminal matters. The selection panel then drew up the reasoned opinions and the ranking for each of the nominated candidates who fulfilled the conditions. After having received the reasoned opinions, the Council selected and appointed one of the candidates to be the European Prosecutor for each of the participating member states.

Background

The European Public Prosecutor’s Office will be an independent body of the EU responsible for investigating, prosecuting and bringing to judgment crimes against the financial interests of the Union (e.g. fraud, corruption, cross-border VAT fraud above 10 million euros). In that respect the EPPO shall undertake investigations, and carry out acts of prosecution and exercise the functions of prosecutor in the competent courts of the member states.

In 2019 the Council and the European Parliament appointed Laura Codruţa Kövesi to be the first European chief prosecutor.

There are currently 22 member states participating in the EPPO (Austria, Belgium, Bulgaria, Croatia, Cyprus, Czech Republic, Estonia, Finland, France, Germany, Greece, Italy, Latvia, Lithuania, Luxembourg, Malta, the Netherlands, Portugal, Romania, Slovenia, Slovakia, Spain).

The EPPO is expected to start its operation at the end of 2020. It will be based in Luxembourg.

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