“I don’t think any cancer patient forgets the day that they are told they have cancer. It’s as if that becomes a new beginning for the rest of your life,” the Commissioner for Health and Food Safety, Stella Kyriakides, said talking to “Τo Vima” about her three times cancer experience, but also what the EU Beating Cancer Plan can offer to patients and their families. She adds that having cancer is part of her and her life’s journey, but does not define her. As a psychologist herself, she stresses the added value the Commission’s recently adopted Comprehensive Approach to Mental Health has for European citizens, indicating that mental health is an issue which societies, but also governments, have focused on more after the COVID 19 pandemic. Her firm belief is that “It’s ok not to be ok”, while she notes that there are no magic solutions to any problem.

 The full interview with Stella Kyriakides for “To Vima”.

 Q: As the Commission nears the end of this term, do you feel it has been successful or that it should perhaps have done things differently? 

A: The Von der Leyen Commission has been in crisis management mode almost constantly since the start of this mandate. We had the unprecedented health crisis with the pandemic right at the beginning of the current term, and following that we had the wars in Ukraine and the Middle East, as well as the energy crisis, food security, inflation and so forth. Nonetheless, I believe that we have managed to put forward proposals that are going to make a difference to the lives of Europe’s citizens in many areas. In both the present and the future. In the area of health, following the pandemic we have made robust proposals that will help build a strong European Health Union for the first time. In this sense, we have turned the pandemic from a crisis into an opportunity for European citizens in the area of health. This is extremely important.

Q: How did you feel when you were offered the health portfolio? Because, health was mainly a competence of the member states prior to COVID. Did you feel that had been given a less attractive and productive portfolio?  Then the pandemic turned you into one of the protagonists of this mandate.

A: No, I didn’t feel that. Health remains a member-state competence. I was given a portfolio for Health and Food Safety, and I always viewed it as a portfolio with which I could do a great deal. That is what I felt from the very first moment, even before the pandemic. It is a portfolio in which you can deliver and have a tangible impact on citizens’ lives, their well-being, their health. So, I was given an opportunity to bring the European Union closer to citizens in the sphere of health, and to ensure that the food they eat is safe. Of course, the pandemic reinforced this effort. It catapulted health to the top of the political agenda. The budget of 5.3 billion that we were allocated in the area of health following the pandemic shows this.  It has also put it very high on the agenda of member states and I believe it will stay there. It allowed us to change what we need to do for the future of Europe. But, it is a portfolio that for myself, even prior to the pandemic, was a portfolio that was dynamic and a portfolio of opportunities.

Q: There were some critics who put the blame on Ursula von der Leyen, on you and on the Commission for delays. What’s your reply to them almost a year before the end of the Commission’s mandate?

A:We had an unprecedented and truly global health crisis.  I look back and I am truly saddened by the multilevel impact it had on people’s lives. Over two million citizens lost their lives. And at that point in time, we said that we were going to make sure we would be prepared globally for the future. Nobody was prepared for this pandemic. Neither Europe nor the world. So, I think that we are going forward in a way, so as to ensure that if we are confronted with a situation like Covid 19 again, we will not be caught unprepared in any way, and that we will be able to protect the lives of our citizens. I always say that I welcome criticism because we learn from it. But, I also believe that we need to look at what we have achieved. And what this Commission achieved in an unprecedented health crisis was unprecedented. Most emblematic, we managed to procure and produce safe and effective vaccines for all EU citizens equally and at the same time. And to make those vaccines available to every single European citizen, no matter where they lived, at the same time. To coordinate and collaborate with all the Member States so they could deal with the economic and social and other consequences of the pandemic and then to turn it into an opportunity. And in the area of health, this has led to the building of a European Health Union.

“Τhe first time Europe has had a robust and holistic plan”

Q: The Commission’s initiatives include the EU Cancer Plan. What does this plan mean for patients, for their relatives, for whoever has to deal with cancer?

A:This is a life-changing plan for patients and their families. It is the first time that Europe has had a cancer plan that is robust and holistic, and which covers everything from prevention to surviving and quality of life. It is the first time it has a plan with a €4 billion plus budget. And the plan is already delivering. I feel that over the last four years we have done more at the European level for cancer than in all the years before. For example, we have new screening guidelines. We have championed the rights of cancer patients, so they do not face discrimination when accessing financial services. We have proposed a youth survivors’ network for young people with cancer, which is entirely new. A great deal is happening with the cancer plan. Ultimately, what we need, what we want to do, is to change the realities of every cancer patient and their families. This is a plan which is a central pillar of the European Health Union, which is already having a tangible impact.  It is important that it continues into the future. We need to do a great deal more and we are determined to do so.

Q:Αs a woman who has had cancer in the past, do you feel that the Plan can help in practice? Because some people who are suffering might say all this is well and good at the theoretical level. Meaning that the Commission may present a proposal or take a decision, but the difficulties remain.

A: There are, of course, difficulties and there are no magic solutions. But, to give just one example, the fact that we will be able to offer screening to more European citizens means we will detect cancer earlier. Equally important is the fact that we are setting up a network of comprehensive cancer centers. So citizens will be able to access the best care across all Member States, meaning we will improve the quality of care for cancer patients in Europe. The fact that we have proposed a pharmaceutical reforms as part of the European Health Union, which will give all citizens access to the same medications, no matter where they live, thus creating a single market for medicines, will also benefit cancer patients. So, it is not a plan which that only exists on paper. It includes concrete actions which will mean tangible changes for patients and their families. And that is how it needs to be.

A central priority in all Commission policies is eliminating inequality. You cannot have inequalities in the area of health, because health is a human right. And in all our policies, we seek to reduce inequalities for all our citizens across Europe, whether in relation to their access to medication, to their cancer care, to their access to mental health services. This principle of equity is central to the European Health Union. And that is why, when I look back at the pandemic, although none of us will ever forget what the world went through and the lives lost, we owe it to our citizens to build a Europe which is closer to its citizens in the area of health, and which fights inequalities on all levels. Then I will truly be able to say it is something the Commission can be proud of.

“Having cancer made me more determined to be an even stronger voice in the fight against inequalities in care”

Q: You have been a psychologist and used to work with children with cancer. And then you yourself were diagnosed with cancer. Do you remember that period? Your reactions, your thoughts, your relations with your family?

A: I don’t think you ever forget. I don’t think any cancer patient forgets the day they are told they have cancer. It’s as if it becomes the start of the rest of your life. You become very aware of different needs that people have. But it also made me more determined to be an even stronger voice against inequalities in care. Not only cancer care, all health care.

Q: And you haven’t had to face cancer just the once.

A: No. Three times.

Q:Three times. But you’re so positive. How did you make it through? Because it’s so hard when you go back to your doctor and they say you have a new fight on your hands.

A: I always see the glass half full in everything I do. And I always learn from the difficulties in my life. And having cancer does not define me. It is part of me. It’s part of my journey. But it has also allowed me to really see what we need to do in the area of health in general, not only in terms of cancer, to fight inequalities.

Q:How old were your kids then?

A: The first time I was diagnosed, I was just 40 years old and my sons were 14 and 10. They have always been very aware of it. We made sure they were. We have never hidden anything from them. As I believe that being open, especially with our loved ones, in whatever we face is of paramount importance.  And I can say for sure that families are the strongest supporters of all our cancer-related initiatives. Cancer is part of your family. It’s part of your family’s history. You cannot separate yourself from it. And you have to be open and able to talk about it and say the word ‘cancer’. Because for many, many years and in the country I know best, we would never, ever say it. We would call it many other things, like “that disease.” But when I was diagnosed, I was determined to speak about it openly, because I was already quite well known as a psychologist in the public hospital. And I came out and said it, loud and clear.

Q: Was it breast cancer all three times?

A: Breast cancer twice, plus a sarcoma.

“It’s ok not to be ok.”

Q:Another issue that you have had to deal with during this mandate is mental health, because people didn’t even want to talk about mental issues in the past. As a psychologist, you know that. You also made a proposal about this. Do you feel that our societies, especially in Greece and Cyprus, which is to say smaller societies, are more open to mental health?

A: People are gradually becoming more open on this issue as well. We cannot have health without mental health.  And I have always believed that the stigma and prejudice around mental health prevents people from asking for help. It prevents parents from openly admitting that they see mental health issues in their children. It prevents adults saying “I am depressed.” We will admit to each other that we have a physical disease more easily than we will a mental health challenge. I am determined to fight the stigma, this prejudice and discrimination. It’s time to speak openly about it. Once again, Covid gave us a strong signal, because we saw how many people were facing mental health challenges during and after the pandemic. That provided the impetus for the Commission’s first ever comprehensive approach to mental health. One of the most important things we need to do is raise awareness, break the stigma, and teach people to tell others it’s okay not to be okay. It’s okay to ask for help.

In terms of health policy, mental health cuts across everything we do. Whether we’re dealing with rare diseases, or cancer, or any other any part of our portfolio, mental health is always part of it. It’s part of our work and our personal life. It’s part of the way we live. It’s part of schooling and education.

Q: Can the Commission’s Mental Health Plan help people facing mental health issues?

A:Yes, because it sets out to support and add value to the work the Member States are doing in this area. There are twenty specific flagship actions with over 1.2 billion in funding, and Member States that employ good practices to deal with, say, depression and suicide prevention are already sharing them with other Member States. And we now have joint actions for training mental health professionals. Anything we do has to be practical, citizen-friendly and applicable across our Union, so member states can use it and  citizens can see tangible benefits. We cannot put policies forward that are going to remain ‘on paper’, as you said before. Citizens need to feel how our plans affect and change their lives. This has been what we wanted to do from the very beginning. Have we succeeded? I cannot be the judge of that. The future will tell. But what I know is that health has moved in a new direction and that there’s no turning back.

Q: Another issue you have had to deal with, especially over the last year, was pharmaceutical shortages. The problem doesn’t seem to have gone away. The Commission had made some efforts. Where is the Commission at regarding current shortages and how is the future looking?

A:There is no magic solution, because there are many long-standing reasons why we have medicine shortages. I want to go back to the issue of equity and equality. In the European Union, you cannot have citizens who do not have access to  medicines they need, no matter where they live. You cannot have citizens and patients who live in one country and have access to a specific medicine and then other patients in another  country with the same disease who won’t have proper access to it for 2 or even 3 years. This is fundamental. During the early days of the pandemic, we managed to produce and procure vaccines and deliver them equally to every citizen on the same day in every member state. So why can’t we do the same when we’re not facing a crisis? So we put forward our pharmaceutical reform, which is very ambitious, as well as balanced. It protects industrial innovation, which is important, but it safeguards patients at the same time by ensuring all European citizens have access to  affordable medicines. The proposals are with the Council and Parliament now, to negotiate as co-legislators, before they come into force.

In the meantime, and in order to tackle shortages, we presented an operational plan to tackle shortages last October, which is now at the implementation stage. This week, we announced the first ever EU list of critical medicines along with a solidarity mechanism, so member states can exchange medicines when they face shortages. And a Critical Medicines Alliance to work with industry and Member States on the more structural aspects of pharmaceutical production. It’s about putting things in motion for the short and medium term and using all the means at our disposal.

We are still experiencing problems, but I believe that we have put the right building blocks in place to make sure we are solving them in both the short term and–through our pharmaceutical reform–in the long term, too. We need to address this. It is not okay for patients to feel that they live in one country and don’t have access to medicine they need, while they do in another country. This is Europe in 2023, and this is about equity.

Q: Since we are approaching the end of the mandate. I have to ask you, what’s up next for you?

A: Good try with the question. I have a great deal of work ahead of me over the coming year, and I never lose focus on the priorities. What comes next? We’ll see.