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"Madam President, I should like to thank Members for a very interesting and helpful debate. I knew from the beginning that we were on the same side, but it is good to reassure each other whenever possible. I should like to respond to a few specific points very briefly and then make one general comment, which will cover the issue raised. We are aware of the issue of breast cancer in men, raised by Mr Bowis. We have to deal with it as a rare disease, because it is much less common than for women. We are focusing on it and will raise it with experts very soon to see how we can include it in future guidelines, but as a rare disease, in the same way as we deal with other rare diseases. On research, I should like to repeat that environmental causes are part of the plan. The new Seventh Framework Programme will provide an opportunity to open up that area of research. Gene-environment interaction and cancer development will also cover lifestyle and other major risk factors. We will then be able to learn more about the causes of the disease. That is a priority, because prevention is much more important than having to treat the disease afterwards. The question of other cancers was raised by Mr Adamou. We are working on those and not just concentrating on one. Each one is a specific case and needs specific guidelines and a specific approach. We expect to have guidelines for cervical cancer by next year, for prostate cancer by 2008 and for colorectal cancer by 2009. We have to evaluate, we have to have research, we have to put everything together and then come up with guidelines. We are also working on other areas such as the hepatitis B and C viruses, because we know they cause liver cancer, as well as aspects such as tobacco, obesity and other causes of cancer. We have issued guidelines and recommendations on how Member States deal with this and the inequalities. These do not have legal force, so we cannot enforce them on Member States. They represent best practice. With your help, we encourage and put pressure on Member States to comply with the guidelines. I look forward to debating this once we have produced the report. We shall then be able to discuss the outcome and the commitment of the Member States. This is a worrying issue. The numbers are terrifying. If we have to put pressure on Member States to do their job on this, you can imagine what happens with rare diseases which do not affect so many people. Putting it cynically and bluntly, there is not so much political pressure. If we stop to think about it we could panic, but we must not. Our job is to make sure that Member States fulfil their commitments and follow the recommendations they adopt and the guidelines they agree to. We shall be working on that, in relation not just to breast cancer but to all the inequalities that unfortunately still exist in the European Union, within Member States as well as between Member States. This is not the European Union of solidarity that we all aspire to and have all joined. That applies to the use of structural funds. The money is there, but unless spending on health is adopted as a priority by Member States, there is nothing we can do. Again, it is a challenge for us to make Member States adopt the policies. Unless Member States acknowledge that spending on health is not a cost but an investment – and we have to convince them of that – the situation will not improve. That is where we have to work together and cooperate."@en4
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"Madam President, I should like to thank Members for a very interesting and helpful debate. I knew from the beginning that we were on the same side, but it is good to reassure each other whenever possible. I should like to respond to a few specific points very briefly and then make one general comment, which will cover the issue raised. We are aware of the issue of breast cancer in men, raised by Mr Bowis. We have to deal with it as a rare disease, because it is much less common than for women. We are focusing on it and will raise it with experts very soon to see how we can include it in future guidelines, but as a rare disease, in the same way as we deal with other rare diseases. On research, I should like to repeat that environmental causes are part of the plan. The new Seventh Framework Programme will provide an opportunity to open up that area of research. Gene-environment interaction and cancer development will also cover lifestyle and other major risk factors. We will then be able to learn more about the causes of the disease. That is a priority, because prevention is much more important than having to treat the disease afterwards. The question of other cancers was raised by Mr Adamou. We are working on those and not just concentrating on one. Each one is a specific case and needs specific guidelines and a specific approach. We expect to have guidelines for cervical cancer by next year, for prostate cancer by 2008 and for colorectal cancer by 2009. We have to evaluate, we have to have research, we have to put everything together and then come up with guidelines. We are also working on other areas such as the hepatitis B and C viruses, because we know they cause liver cancer, as well as aspects such as tobacco, obesity and other causes of cancer. We have issued guidelines and recommendations on how Member States deal with this and the inequalities. These do not have legal force, so we cannot enforce them on Member States. They represent best practice. With your help, we encourage and put pressure on Member States to comply with the guidelines. I look forward to debating this once we have produced the report. We shall then be able to discuss the outcome and the commitment of the Member States. This is a worrying issue. The numbers are terrifying. If we have to put pressure on Member States to do their job on this, you can imagine what happens with rare diseases which do not affect so many people. Putting it cynically and bluntly, there is not so much political pressure. If we stop to think about it we could panic, but we must not. Our job is to make sure that Member States fulfil their commitments and follow the recommendations they adopt and the guidelines they agree to. We shall be working on that, in relation not just to breast cancer but to all the inequalities that unfortunately still exist in the European Union, within Member States as well as between Member States. This is not the European Union of solidarity that we all aspire to and have all joined. That applies to the use of structural funds. The money is there, but unless spending on health is adopted as a priority by Member States, there is nothing we can do. Again, it is a challenge for us to make Member States adopt the policies. Unless Member States acknowledge that spending on health is not a cost but an investment – and we have to convince them of that – the situation will not improve. That is where we have to work together and cooperate."@cs1
"Fru formand! Jeg vil gerne takke medlemmerne for en meget interessant og nyttig forhandling. Jeg vidste fra begyndelsen, at vi var på samme side, men det er godt at forsikre hinanden herom, når som helst det er muligt. Jeg vil gerne svare ganske kort på et par enkelte ting og så fremsætte en generel kommentar, der vil dække det rejste spørgsmål. Vi er opmærksomme på spørgsmålet om brystkræft hos mænd, som hr. Bowis rejste. Vi må behandle det som en sjælden sygdom, for den er langt mindre almindelig end hos kvinder. Vi fokuserer på den og vil tage den op med eksperterne meget snart for at se, hvordan vi kan få den med i fremtidige retningslinjer, men som en sjælden sygdom, på samme måde som vi behandler andre sjældne sygdomme. Hvad angår forskning, vil jeg gerne gentage, at miljøårsager er en del af planen. Det nye syvende rammeprogram vil give mulighed for at åbne for dette forskningsområde. Interaktion mellem gener og miljø og udviklingen af kræft vil også dække livsstil og andre væsentlige risikofaktorer. Så vil vi kunne lære mere om årsagerne til sygdommen. Det er noget, vi prioriterer, for forebyggelse er langt vigtigere end at skulle behandle sygdommen senere. Spørgsmålet om andre kræftformer blev rejst af hr. Adamou. Vi arbejder på dem og koncentrerer os ikke kun om én. Hver er noget særligt og behøver særlige retningslinjer og en særlig tilgang. Vi forventer at have retningslinjer for livmoderhalskræft næste år, for prostatakræft i 2008 og for tarmkræft i 2009. Vi må evaluere, vi må have forskning, vi må samle det hele og så udarbejde retningslinjer. Vi arbejder også på andre områder såsom hepatitis B- og C-vira, for vi ved, at de forårsager leverkræft, såvel som med aspekter som tobak, fedme og andre årsager til kræft. Vi har udsendt retningslinjer og anbefalinger for, hvordan medlemsstaterne skal håndtere dette og ulighederne. De har ingen juridisk kraft, så vi kan ikke gennemtvinge dem over for medlemsstaterne. De repræsenterer bedste praksis. Med Deres hjælp tilskynder vi medlemsstaterne og lægger pres på dem for at overholde retningslinjerne. Jeg ser frem til at debattere dette, når vi har fremlagt rapporten. Så vil vi kunne drøfte resultatet og medlemsstaternes engagement. Dette er et bekymrende spørgsmål. Tallene er frygtindgydende. Hvis vi må lægge pres på medlemsstaterne for at få dem til at gøre, hvad de skal i denne sag, kan De sikkert forestille Dem, hvordan det forholder sig med sjældne sygdomme, der ikke rammer så mange. For at sige det kynisk og ligeud er der ikke meget politisk pres der. Hvis vi for et øjeblik standser op for at tænke over det, kunne vi gå i panik, men det må vi ikke gøre. Vores opgave er at sikre, at medlemsstaterne opfylder deres forpligtelser og følger de anbefalinger, de vedtager, og de retningslinjer, de enes om. Det må vi arbejde på i relation ikke bare til brystkræft, men også til de uligheder, der desværre stadig eksisterer i EU inden for medlemsstaterne såvel som imellem dem. Det er ikke det solidaritetens EU, som vi alle ønsker, og alle har meldt os ind i. Det gælder anvendelsen af strukturfondene. Pengene er der, men medmindre medlemsstaterne vælger at prioritere brugen af dem til sundhedsudgifter, er der intet, vi kan gøre. Også det er en udfordring til os om at få medlemsstaterne til at vedtage denne politik. Medmindre medlemsstaterne erkender, at sundhedsudgifter ikke er omkostninger, men en investering - og det må vi overbevise dem om - vil situationen ikke blive bedre. Det er derfor, vi må stå sammen og samarbejde."@da2
". Frau Präsidentin! Ich danke den Damen und Herren Abgeordneten für eine sehr interessante und hilfreiche Debatte. Ich wusste von Anfang an, dass wir auf derselben Seite sind, aber es ist gut, sich gegenseitig zu bestätigen, wann immer es möglich ist. Ich würde gern ganz kurz auf ein paar konkrete Punkte eingehen und mich dann allgemein zu der diskutierten Problematik äußern. Wir wissen um das Problem Brustkrebs bei Männern, das Herr Bowis angesprochen hat. Wir müssen dies als seltene Krankheit behandeln, weil es weit weniger häufig auftritt als bei Frauen. Wir behandeln es gegenwärtig schwerpunktmäßig und werden uns sehr bald mit Fachleuten beraten, um festzustellen, wie wir es in die künftigen Leitlinien einbinden können, aber als seltene Krankheit – so, wie wir mit anderen seltenen Krankheiten verfahren. Zur Forschung möchte ich wiederholen, dass umweltbedingte Ursachen eingeplant sind. Das neue Siebte Rahmenprogramm wird die Chance bieten, in diesen Forschungsbereich vorzustoßen. Bei der Untersuchung der Wechselwirkung von genetischen Faktoren und Umwelteinflüssen und des Auftretens von Krebs werden auch Fragen wie Lebensstil und andere Hochrisikofaktoren eine Rolle spielen. Wir werden dann viel mehr über die Ursachen dieser Krankheit erfahren können. Das ist eine Priorität, denn Vorbeugung ist wesentlich wichtiger als die Krankheit dann behandeln zu müssen. Herr Adamou hat die Frage anderer Krebserkrankungen angesprochen. Wir befassen uns mit diesen und stellen nicht nur eine in den Vordergrund. Jede ist ein spezieller Fall und braucht spezielle Leitlinien und ein spezielles Vorgehen. Wir gehen davon aus, dass wir bis nächstes Jahr Leitlinien zum Gebärmutterhalskrebs haben, bis 2008 für Prostatakrebs und bis 2009 für Darmkrebs. Wir müssen bewerten, wir brauchen Forschung, wir müssen alles zusammenführen und dann Leitlinien aufstellen. Wir arbeiten auch an anderen Bereichen, wie etwa zu den Hepatitis-B- und –C-Viren, weil wir wissen, dass sie Leberkrebs verursachen, und ebenso zu Tabak, Adipositas und anderen Krebsursachen. Wir haben Leitlinien und Empfehlungen darüber herausgebracht, wie die Mitgliedstaaten damit und mit den Unterschieden umgehen. Diese haben keine Rechtskraft, wir können sie also den Mitgliedstaaten nicht aufzwingen. Sie stellen nachahmenswerte Praktiken dar. Mit Ihrer Hilfe können wir die Mitgliedstaaten dazu bewegen und drängen, die Leitlinien zu befolgen. Ich hoffe auf eine Debatte darüber, sobald wir den Bericht verfasst haben. Dann sind wir in der Lage, das Ergebnis und das Engagement der Mitgliedstaaten zu diskutieren. Dies ist ein Besorgnis erregendes Problem. Die Zahlen sind erschreckend. Wenn wir hier schon Druck auf die Mitgliedstaaten ausüben müssen, damit sie ihre Arbeit tun, dann können Sie sich vorstellen, was bei seltenen Krankheiten geschieht, von denen nicht so viele Menschen betroffen sind. Dort ist der politische Druck nicht so groß, um es zynisch und unverblümt zu formulieren. Wenn man genauer darüber nachdenkt, könnte man in Panik verfallen, aber das dürfen wir nicht. Unsere Aufgabe ist es, dafür zu sorgen, dass die Mitgliedstaaten die Verpflichtungen erfüllen, die sie eingehen, und die Leitlinien befolgen, denen sie zustimmen. Wir werden daran arbeiten, nicht nur im Hinblick auf Brustkrebs, sondern bei allen Unterschieden, die leider in der Europäischen Union nach wie vor bestehen, innerhalb von Mitgliedstaaten und zwischen ihnen. Dies ist nicht die solidarische Europäische Union, nach der wir alle streben und der wir alle beigetreten sind. Das gilt für den Einsatz von Strukturfondsmitteln. Das Geld ist da, aber wenn Ausgaben zur Gesundheit von den Mitgliedstaaten nicht als Priorität eingestuft werden, dann können wir nichts machen. Auch hier ist es unsere Aufgabe, dafür zu sorgen, dass die Mitgliedstaaten die Maßnahmen übernehmen. Wenn die Mitgliedstaaten nicht anerkennen, dass Gesundheitsausgaben keine Kosten, sondern Investitionen sind – und davon müssen wir sie überzeugen –, wird sich die Lage nicht verbessern. Daran müssen wir gemeinsam und vereint arbeiten."@de9
"Κυρία Πρόεδρε, θα ήθελα να ευχαριστήσω τους βουλευτές για μια πολύ ενδιαφέρουσα και χρήσιμη συζήτηση. Γνώριζα από την αρχή ότι είμαστε στην ίδια πλευρά, αλλά είναι καλό να διαβεβαιώνουμε ο ένας τον άλλον, όποτε αυτό είναι εφικτό. Θα ήθελα να απαντήσω πολύ σύντομα σε ορισμένα συγκεκριμένα σημεία και, στη συνέχεια, να κάνω ένα γενικό σχόλιο, το οποίο θα καλύψει το ζήτημα που έχει τεθεί. Γνωρίζουμε το ζήτημα του καρκίνου του μαστού στους άνδρες, στο οποίο αναφέρθηκε ο κ. Bowis. Πρέπει να τον αντιμετωπίσουμε ως σπάνια ασθένεια, διότι δεν είναι τόσο συχνός όσο στις γυναίκες. Επικεντρωνόμαστε σε αυτόν και θα τον θέσουμε πολύ σύντομα υπόψη των εμπειρογνωμόνων, για να δούμε με ποιον τρόπο θα τον συμπεριλάβουμε στις μελλοντικές κατευθυντήριες γραμμές, αλλά ως σπάνια ασθένεια, κατά τον ίδιο τρόπο με τον οποίο αντιμετωπίζουμε και άλλες σπάνιες ασθένειες. Όσον αφορά την έρευνα, θα ήθελα να επαναλάβω ότι τα περιβαλλοντικά αίτια αποτελούν μέρος του σχεδίου. Το νέο έβδομο πρόγραμμα πλαίσιο θα παράσχει την ευκαιρία να ανοίξει αυτός ο τομέας της έρευνας. Η αλληλεπίδραση γονιδίων και περιβάλλοντος και η ανάπτυξη καρκίνου θα καλύπτει επίσης τον τρόπο ζωής και άλλους σημαντικούς παράγοντες κινδύνου. Θα είμαστε έτσι σε θέση να διδαχθούμε περισσότερα σχετικά με τα αίτια της ασθένειας. Αυτό αποτελεί προτεραιότητα, διότι η πρόληψη είναι πολύ πιο σημαντική από τη θεραπεία της ασθένειας σε μεταγενέστερο στάδιο. Ο κ. Αδάμου έθεσε το ζήτημα άλλων μορφών καρκίνου. Τις εξετάζουμε χωρίς να εστιάζουμε μόνον σε μία. Καθεμία συνιστά ειδική περίπτωση και απαιτούνται ειδικές κατευθυντήριες γραμμές και ειδική προσέγγιση. Προσδοκούμε ότι θα έχουμε στη διάθεσή μας κατευθυντήριες γραμμές για τον καρκίνο του τραχήλου της μήτρας έως το επόμενο έτος, για τον καρκίνο του προστάτη έως το 2008 και για τον καρκίνο του παχέος εντέρου και του ορθού έως το 2009. Πρέπει να προβούμε σε αξιολόγηση και έρευνα, να συνδυάσουμε όλα τα στοιχεία κα εν συνεχεία να καθορίσουμε κατευθυντήριες γραμμές. Εργαζόμαστε επίσης και σε άλλους τομείς, όπως είναι οι ιοί της ηπατίτιδας Β και Γ, διότι γνωρίζουμε ότι προκαλούν καρκίνο του ήπατος, καθώς και σε πτυχές όπως ο καπνός, η παχυσαρκία και άλλα αίτια καρκίνου. Εκδώσαμε κατευθυντήριες γραμμές και συστάσεις σχετικά με τον τρόπο με τον οποίο τα κράτη μέλη οφείλουν να αντιμετωπίσουν το εν λόγω ζήτημα και τις ανισότητες που αυτό συνεπάγεται. Δεν πρόκειται για νομικά δεσμευτικές πράξεις και, ως εκ τούτου, δεν μπορούμε να τις επιβάλουμε στα κράτη μέλη. Αφορούν βέλτιστες πρακτικές. Με τη συνδρομή σας, ενθαρρύνουμε και ασκούμε πίεση στα κράτη μέλη να συμμορφωθούν προς τις κατευθυντήριες γραμμές. Ανυπομονώ να επαναλάβουμε αυτήν τη συζήτηση, όταν θα έχουμε ολοκληρώσει την έκθεση. Τότε, θα είμαστε σε θέση να συζητήσουμε το αποτέλεσμα και τη δέσμευση των κρατών μελών. Πρόκειται για ανησυχητικό ζήτημα. Τα αριθμητικά στοιχεία είναι τρομακτικά. Εάν πρέπει να ασκήσουμε πίεση στα κράτη μέλη για να επιτελέσουν το έργο τους επ’ αυτού, φαντάζεστε τι συμβαίνει με τις σπάνιες ασθένειες που δεν πλήττουν τόσο πολύ κόσμο. Για να το θέσω κυνικά και ωμά, δεν ασκείται και τόση μεγάλη πολιτική πίεση. Εάν το σκεφτούμε, μπορεί και να τρομοκρατηθούμε, αλλά δεν πρέπει. Έργο μας είναι να διασφαλίσουμε ότι τα κράτη μέλη τηρούν τις δεσμεύσεις τους και ακολουθούν τις συστάσεις που εγκρίνουν και τις κατευθυντήριες γραμμές με τις οποίες συμφωνούν. Θα συνεχίσουμε να εργαζόμαστε επ’ αυτού, όχι μόνον σε σχέση με τον καρκίνο του μαστού αλλά και σε σχέση με όλες τις ανισότητες που εξακολουθούν, δυστυχώς, να υφίστανται στην Ευρωπαϊκή Ένωση, τόσο εντός όσο μεταξύ των κρατών μελών. Αυτή δεν είναι η Ευρωπαϊκή Ένωση της αλληλεγγύης την οποία επιδιώκουμε και στην οποία συμμετέχουμε όλοι μας. Αυτό ισχύει και για τη χρήση των διαρθρωτικών ταμείων. Τα χρήματα υπάρχουν, αλλά εάν η χρηματοδότηση για την υγεία δεν εγκριθεί ως προτεραιότητα από τα κράτη μέλη, δεν μπορούμε να κάνουμε τίποτα. Και πάλι, αποτελεί πρόκληση για εμάς το να πείσουμε τα κράτη μέλη να εγκρίνουν τις πολιτικές αυτές. Εάν τα κράτη μέλη δεν αναγνωρίσουν ότι η χρηματοδότηση για την υγεία δεν αποτελεί δαπάνη αλλά επένδυση –και θα πρέπει να τους πείσουμε επ’ αυτού– η κατάσταση πρόκειται να βελτιωθεί. Εδώ είναι που πρέπει να συνεργασθούμε."@el10
". Señora Presidenta, quiero dar las gracias a sus Señorías por este debate útil e interesante. Desde el principio he sabido que estábamos en el mismo bando, pero es bueno apoyarnos mutuamente siempre que sea posible. Me gustaría responder muy brevemente a unos cuantos aspectos específicos y hacer un comentario general en relación con la cuestión planteada. Somos conscientes del problema del cáncer de mama en los hombres, planteado por el señor Bowis. Tenemos que abordarlo como una enfermedad rara, porque es mucho menos frecuente que en el caso de las mujeres. Prestamos atención a esta cuestión y muy pronto la plantearemos a expertos para ver cómo podemos incluirla en futuras directrices, pero en calidad de enfermedad rara, del mismo modo que hacemos con otras enfermedades raras. En cuanto a la investigación, me gustaría repetir que las causas ambientales forman parte del plan. El nuevo Séptimo Programa Marco nos ofrecerá la oportunidad de abrir esa vertiente a la investigación. La interacción entre los genes y el medio ambiente y el desarrollo del cáncer también abarcará el estilo de vida y otros factores de riesgo importantes. Entonces podremos saber más sobre las causas de la enfermedad. Esto es una prioridad, porque la prevención es mucho más importante que tener que tratar la enfermedad una vez contraída. La cuestión de los otros tipos de cáncer ha sido planteada por el señor Adamou. También estamos trabajando sobre estos y no nos limitamos a uno solo. Cada uno es un caso específico y necesita directrices concretas y un enfoque específico. Esperamos tener directrices sobre el cáncer cervical el año que viene, sobre el cáncer de próstata en 2008 y sobre el cáncer colorrectal en 2009. Tenemos que evaluar, tenemos que investigar, tenemos que reunir información y, entonces, elaborar las directrices. También estamos trabajando en otros terrenos, como los virus de la hepatitis B y C, porque sabemos que causan cáncer de hígado, así como en aspectos como el tabaco, la obesidad y otras causas de cáncer. Hemos elaborado directrices y recomendaciones sobre cómo abordan los Estados miembros la enfermedad y sobre las desigualdades. Esas directrices no tienen fuerza jurídica, así que no podemos obligar a los Estados miembros a cumplirlas. Reflejan las mejores prácticas. Señorías, con su ayuda animamos y presionamos a los Estados miembros a que cumplan las directrices. Espero volver a debatir este asunto una vez hayamos presentado el informe. Entonces podremos someter a debate el resultado y el compromiso de los Estados miembros. Es un problema preocupante. Las cifras son espeluznantes. Si tenemos que presionar a los Estados miembros para que hagan sus deberes, sus Señorías pueden imaginarse lo que ocurre con las enfermedades raras que no afectan a tantas personas. Por decirlo francamente y sin rodeos, no hay tanta presión política. Si nos paráramos a pensar en ello nos entraría el pánico, pero no debemos hacerlo. Nuestro trabajo es asegurarnos de que los Estados miembros cumplan sus compromisos y sigan las recomendaciones que adopten y las directrices que acuerden. Tenemos que trabajar en ello, en relación no solo con el cáncer de mama, sino con todas las desigualdades que, lamentablemente, siguen existiendo en la Unión Europea, a escala nacional y entre Estados miembros. Esta no es la Unión Europea de la solidaridad a la que todos aspiramos y a la que todos nos hemos sumado. Esto se aplica al uso de los Fondos Estructurales. Tenemos dinero, pero a menos que los Estados miembros den prioridad al gasto en sanidad, no hay nada que hacer. Repito, nuestro reto es hacer que los Estados miembros adopten las políticas. A menos que los Estados miembros reconozcan que el gasto en sanidad no es un coste, sino una inversión –y tenemos que convencerles de ello–, la situación no mejorará. Por eso tenemos que trabajar juntos y cooperar."@es20
"Madam President, I should like to thank Members for a very interesting and helpful debate. I knew from the beginning that we were on the same side, but it is good to reassure each other whenever possible. I should like to respond to a few specific points very briefly and then make one general comment, which will cover the issue raised. We are aware of the issue of breast cancer in men, raised by Mr Bowis. We have to deal with it as a rare disease, because it is much less common than for women. We are focusing on it and will raise it with experts very soon to see how we can include it in future guidelines, but as a rare disease, in the same way as we deal with other rare diseases. On research, I should like to repeat that environmental causes are part of the plan. The new Seventh Framework Programme will provide an opportunity to open up that area of research. Gene-environment interaction and cancer development will also cover lifestyle and other major risk factors. We will then be able to learn more about the causes of the disease. That is a priority, because prevention is much more important than having to treat the disease afterwards. The question of other cancers was raised by Mr Adamou. We are working on those and not just concentrating on one. Each one is a specific case and needs specific guidelines and a specific approach. We expect to have guidelines for cervical cancer by next year, for prostate cancer by 2008 and for colorectal cancer by 2009. We have to evaluate, we have to have research, we have to put everything together and then come up with guidelines. We are also working on other areas such as the hepatitis B and C viruses, because we know they cause liver cancer, as well as aspects such as tobacco, obesity and other causes of cancer. We have issued guidelines and recommendations on how Member States deal with this and the inequalities. These do not have legal force, so we cannot enforce them on Member States. They represent best practice. With your help, we encourage and put pressure on Member States to comply with the guidelines. I look forward to debating this once we have produced the report. We shall then be able to discuss the outcome and the commitment of the Member States. This is a worrying issue. The numbers are terrifying. If we have to put pressure on Member States to do their job on this, you can imagine what happens with rare diseases which do not affect so many people. Putting it cynically and bluntly, there is not so much political pressure. If we stop to think about it we could panic, but we must not. Our job is to make sure that Member States fulfil their commitments and follow the recommendations they adopt and the guidelines they agree to. We shall be working on that, in relation not just to breast cancer but to all the inequalities that unfortunately still exist in the European Union, within Member States as well as between Member States. This is not the European Union of solidarity that we all aspire to and have all joined. That applies to the use of structural funds. The money is there, but unless spending on health is adopted as a priority by Member States, there is nothing we can do. Again, it is a challenge for us to make Member States adopt the policies. Unless Member States acknowledge that spending on health is not a cost but an investment – and we have to convince them of that – the situation will not improve. That is where we have to work together and cooperate."@et5
"Arvoisa puhemies, kiitän parlamentin jäseniä erittäin mielenkiintoisesta ja hyödyllisestä keskustelusta. Tiesin alusta alkaen meidän olevan samalla puolella, mutta on hyvä rauhoitella toinen toistaan aina mahdollisuuksien mukaan. Haluan vastata muutamiin konkreettisiin kohtiin hyvin lyhyesti ja esittää sen jälkeen yhden yleisen huomautuksen, jossa vastataan esiin tuotuun kysymykseen. Olemme tietoisia jäsen Bowisin esiin tuomasta miesten rintasyövästä. Sitä on käsiteltävä harvinaisena sairautena, sillä se ei ole lainkaan niin yleinen kuin naisilla. Kiinnitämme aiheeseen huomiota ja käsittelemme sitä asiantuntijoiden kanssa hyvin pian selvittääksemme, miten se voidaan sisällyttää tuleviin suuntaviivoihin, tosin harvinaisena sairautena samalla tavoin kuin käsittelemme muitakin harvinaisia sairauksia. Toistan, että ympäristötekijät on otettu tutkimussuunnitelmissa huomioon. Uusi seitsemäs tutkimuksen puiteohjelma antaa mahdollisuuden käynnistää tämän alan tutkimukset. Geenien ja ympäristön yhteisvaikutuksessa sekä syövän kehittymisessä otetaan huomioon myös elintavat ja muut tärkeimmät riskitekijät. Sen jälkeen pystymme selvittämään tarkemmin sairauden syyt. Tämä on ensisijainen tavoite, sillä ennaltaehkäisy on tärkeämpää kuin sairauden hoito jälkikäteen. Jäsen Adamou toi esiin muut syöpätyypit. Käsittelemme niitäkin, emmekä keskity vain yhteen tyyppiin. Jokainen tapaus on erilainen ja edellyttää erityisohjeita ja tarkoin rajattua lähestymistapaa. Tavoitteenamme on laatia kohdunkaulan syöpää koskevat ohjeet ensi vuoteen mennessä, eturauhassyöpää koskevat ohjeet vuoteen 2008 mennessä sekä paksu- ja peräsuolisyöpää koskevat ohjeet vuoteen 2009 mennessä. Arviointi- ja tutkimustulosten yhdistämisen jälkeen on laadittava ohjeet. Tutkimuksemme koskevat myös muita aloja, kuten B- ja C-hepatiittiviruksia, sillä tiedämme niiden aiheuttavan maksasyöpää, sekä tupakkaa, liikalihavuutta ja muita syöpää aiheuttavia tekijöitä. Olemme laatineet jäsenvaltioille ohjeet ja suositukset siitä, miten niiden on käsiteltävä näitä asioita ja eriarvoisuutta. Ohjeilla ei ole oikeusvaikutuksia, joten niiden noudattamista jäsenvaltioissa ei voida valvoa. Ne vastaavat parhaita käytäntöjä. Parlamentin avulla kannustamme ja painostamme jäsenvaltioita noudattamaan ohjeita. Odotan kertomuksen laatimisen jälkeen tästä aiheesta käytävää keskustelua. Silloin pystymme keskustelemaan tuloksista ja jäsenvaltioiden sitoutumisesta. Tämä on huolestuttava ongelma. Määrät ovat kauhistuttavia. Jos joudumme painostamaan jäsenvaltioita huolehtimaan tästä asiasta kunnolla, voitte vain kuvitella, miten on harvinaisten sairauksien laita, sillä ne eivät kosketa niin monia. Totean kyynisesti ja aivan suoraan, ettei tähän asiaan kohdistu riittävästi poliittista painetta. Jos pysähdymme miettimään asiaa saatamme hätääntyä, mutta niin ei saa käydä. Tehtävämme on varmistaa, että jäsenvaltiot pitävät lupauksensa ja noudattavat hyväksymiään ohjeita ja suosituksia. Käsitellessämme tätä asiaa otamme huomioon sekä rintasyövän että Euroopan unionissa ja sen jäsenvaltioissa ja niiden välillä vallitsevan valitettavan eriarvoisuuden. Tämä ei ole se solidaarinen Euroopan unioni, jota yhdessä tavoittelemme ja johon olemme liittyneet. Tämä koskee rakennerahastojen käyttöä. Määrärahoja on, mutta elleivät jäsenvaltiot aseta terveydenhuoltomenoja etusijalle, mitään ei ole tehtävissä. Totean vielä, että haasteenamme on saada jäsenvaltiot toteuttamaan nämä toimet. Jäsenvaltiot on saatava vakuuttuneiksi siitä, että terveydenhuoltomenot ovat pikemminkin investointi kuin kustannus, sillä muuten tilanne ei parane. Tähän tarvitaan meidän yhteistyötämme ja yhteisiä toimia."@fi7
"Madame la Présidente, je voudrais remercier les députés pour ce débat très intéressant et utile. Je savais dès le départ que nous étions du même côté, mais il est bon de se rassurer mutuellement chaque fois que c’est possible. Je voudrais répondre à quelques questions spécifiques très brièvement et faire ensuite un commentaire général. Nous sommes conscients du problème que pose le cancer du sein chez les hommes, qu’a soulevé M. Bowis. Nous devons le considérer comme une maladie rare, car il est bien moins fréquent que chez les femmes. Nous nous penchons sérieusement sur la question, et nous la soulèverons auprès d’experts très prochainement afin d’examiner comment nous pouvons l’intégrer dans des lignes directrices futures, en tant que maladie rare, de la même manière que nous traitons d’autres maladies rares. Concernant la recherche, je voudrais réitérer que le plan couvre les causes environnementales. Le septième programme-cadre permettra d’ouvrir ce domaine de la recherche. L’interaction gène-environnement et le développement du cancer engloberont également le style de vie et d’autres grands facteurs de risque. Nous pourrons alors en savoir plus sur les causes de la maladie. Il s’agit d’une priorité, car mieux vaut prévenir que guérir. M. Adamou a soulevé la question des autres cancers. Nous y travaillons, nous ne nous concentrons pas uniquement sur l’un d’entre eux. Chaque cancer est particulier et requiert une approche et des lignes directrices spécifiques. Nous pensons disposer de lignes directrices sur le cancer du col de l’utérus l’année prochaine, sur le cancer de la prostate en 2008 et sur le cancer colorectal en 2009. Nous devons procéder à des évaluations, faire des recherches, rassembler le tout, et présenter des directives. Nous travaillons également à d’autres questions, comme les virus des hépatites B et C, car nous savons qu’ils provoquent le cancer du foie, ainsi qu’à d’autres facteurs, comme le tabac, l’obésité et d’autres causes du cancer. Nous avons publié des lignes directrices et des recommandations sur la manière dont les États membres abordent ce problème et les disparités, mais comme elles n’ont pas de valeur juridique, nous ne pouvons pas obliger les États membres à les appliquer. Il s’agit de meilleures pratiques. Avec votre aide, nous encourageons et pressons les États membres à appliquer les lignes directrices. J’attends avec impatience de débattre à nouveau cette question lorsque nous aurons présenté le rapport. Nous serons alors en mesure de parler des résultats et de l’engagement des États membres. Ce problème est inquiétant, à l’instar des chiffres qui s’y rapportent. Si nous devons insister auprès des États membres afin qu’ils remplissent leurs obligations dans ce domaine, vous pouvez imaginer ce qui se passe avec des maladies rares qui n’affectent pas autant de monde. Pour parler franchement et avec cynisme, il n’y a pas tant de pression politique. Si nous cessions de réfléchir au problème, nous pourrions nous affoler, mais nous ne devons pas. Notre travail consiste à veiller à ce que les États membres tiennent leurs engagements et suivent les recommandations et les lignes directrices qu’ils ont acceptées. Nous y travaillerons, non seulement concernant le cancer du sein, mais également concernant toutes les disparités qui existent malheureusement encore au sein de l’Union européenne, dans les États membres et entre ces derniers. Ce n’est pas l’Europe de la solidarité à laquelle nous aspirons tous et à laquelle nous avons tous adhéré. Cela vaut pour l’utilisation des Fonds structurels. L’argent est là, mais si les États membres ne décident pas d’investir en priorité dans la santé, nous ne pouvons rien faire. Ici encore, notre défi consiste à faire adopter les politiques par les États membres. Tant que les États membres ne reconnaissent pas que les dépenses en matière de santé ne sont pas un coût mais un investissement - et nous devons les en convaincre -, la situation ne s’améliorera pas. C’est dans ce domaine que nous devons collaborer et travailler de concert."@fr8
"Madam President, I should like to thank Members for a very interesting and helpful debate. I knew from the beginning that we were on the same side, but it is good to reassure each other whenever possible. I should like to respond to a few specific points very briefly and then make one general comment, which will cover the issue raised. We are aware of the issue of breast cancer in men, raised by Mr Bowis. We have to deal with it as a rare disease, because it is much less common than for women. We are focusing on it and will raise it with experts very soon to see how we can include it in future guidelines, but as a rare disease, in the same way as we deal with other rare diseases. On research, I should like to repeat that environmental causes are part of the plan. The new Seventh Framework Programme will provide an opportunity to open up that area of research. Gene-environment interaction and cancer development will also cover lifestyle and other major risk factors. We will then be able to learn more about the causes of the disease. That is a priority, because prevention is much more important than having to treat the disease afterwards. The question of other cancers was raised by Mr Adamou. We are working on those and not just concentrating on one. Each one is a specific case and needs specific guidelines and a specific approach. We expect to have guidelines for cervical cancer by next year, for prostate cancer by 2008 and for colorectal cancer by 2009. We have to evaluate, we have to have research, we have to put everything together and then come up with guidelines. We are also working on other areas such as the hepatitis B and C viruses, because we know they cause liver cancer, as well as aspects such as tobacco, obesity and other causes of cancer. We have issued guidelines and recommendations on how Member States deal with this and the inequalities. These do not have legal force, so we cannot enforce them on Member States. They represent best practice. With your help, we encourage and put pressure on Member States to comply with the guidelines. I look forward to debating this once we have produced the report. We shall then be able to discuss the outcome and the commitment of the Member States. This is a worrying issue. The numbers are terrifying. If we have to put pressure on Member States to do their job on this, you can imagine what happens with rare diseases which do not affect so many people. Putting it cynically and bluntly, there is not so much political pressure. If we stop to think about it we could panic, but we must not. Our job is to make sure that Member States fulfil their commitments and follow the recommendations they adopt and the guidelines they agree to. We shall be working on that, in relation not just to breast cancer but to all the inequalities that unfortunately still exist in the European Union, within Member States as well as between Member States. This is not the European Union of solidarity that we all aspire to and have all joined. That applies to the use of structural funds. The money is there, but unless spending on health is adopted as a priority by Member States, there is nothing we can do. Again, it is a challenge for us to make Member States adopt the policies. Unless Member States acknowledge that spending on health is not a cost but an investment – and we have to convince them of that – the situation will not improve. That is where we have to work together and cooperate."@hu11
". Signora Presidente, desidero ringraziare i deputati di questo dibattito molto interessante e utile. Sapevo sin dall’inizio che eravamo dalla stessa parte, ma fa bene rassicurarsi a vicenda ogniqualvolta sia possibile farlo. Desidero rispondere molto brevemente ad alcune osservazioni specifiche e poi esprimere un commento generale relativamente alla tematica discussa. Siamo consapevoli del problema degli uomini colpiti da carcinoma mammario, che è stato sollevato dall’onorevole Bowis. Dobbiamo affrontare questa patologia come una malattia rara, perché è molto meno comune di quanto non lo sia tra le donne. Ci stiamo dedicando a questo problema e ne discuteremo molto presto con esperti del settore per trovare il modo di includerlo nelle linee guida future, ma come malattia rara, così come facciamo per altre malattie rare. Per quanto riguarda la ricerca, desidero ribadire che le cause ambientali rientrano nel nostro piano. Il settimo programma quadro ci fornirà l’occasione di esplorare questo campo della ricerca. L’interazione tra fattori genetici e ambientali e lo sviluppo dei tumori deve tenere conto anche dello stile di vita e di altri importanti fattori di rischio. Potremo così approfondire la nostra conoscenza delle cause della malattia. E’ una priorità, perché è molto più importante prevenire che dover poi curare la malattia. Il problema delle altre patologie tumorali è stato sollevato dall’onorevole Adamou. Confermo che non ci stiamo concentrando solo su una malattia, ma stiamo lavorando in modo più generale sulle patologie tumorali. Ogni caso è specifico e richiede linee guida specifiche e un approccio specifico. Prevediamo di elaborare linee guida per il tumore del collo dell’utero entro il prossimo anno, per il tumore alla prostata entro il 2008 e per il cancro colorettale entro il 2009. Dobbiamo eseguire valutazioni, dobbiamo fare ricerca, dobbiamo riunire tutte le conoscenze e poi elaborare le linee guida. Stiamo lavorando anche in altri settori, come i virus dell’epatite B e C, perché sappiamo che possono essere all’origine del tumore epatico, e inoltre su aspetti come il fumo, l’obesità e altre cause di tumori. Abbiamo pubblicato linee guida e raccomandazioni che illustrano come gli Stati membri affrontano il problema ed evidenziano le disuguaglianze. Non hanno forza di legge, quindi non possiamo obbligare gli Stati membri ad attuarle. Rappresentano le migliori pratiche. Con il vostro aiuto, incoraggiamo gli Stati membri ed esercitiamo su di loro pressione, perché si conformino alle linee guida. Guardo con interesse all’opportunità di riparlarne, quando avremo elaborato la relazione. Allora potremo discutere del risultato e dell’impegno degli Stati membri. E’ un problema allarmante. Le cifre sono spaventose. Se, rispetto a questa patologia, dobbiamo esercitare pressione sugli Stati membri, perché facciano il loro dovere, potete immaginarvi come stanno le cose per quanto riguarda le malattie rare che non colpiscono così tante persone. A voler essere cinici e anche estremamente franchi, possiamo dire che non c’è molta pressione politica. Se ci fermiamo per un attimo a pensare, potremmo davvero essere presi dal panico, ma non dobbiamo farlo. Il nostro compito è quello di fare in modo che gli Stati membri ottemperino ai loro impegni e seguano le raccomandazioni che adottano e le linee guida che accettano. Lavoreremo in quest’ottica, non solo rispetto al tumore della mammella, ma anche rispetto a tutte le disuguaglianze che purtroppo ancora esistono nell’Unione europea, negli Stati membri e tra gli Stati membri. Questa non è l’Unione europea solidale alla quale aspiriamo tutti e alla quale tutti abbiamo aderito. Per quanto riguarda l’utilizzo dei Fondi strutturali, vorrei dire che i fondi ci sono, ma a meno che la spesa per la sanità non venga adottata come priorità dagli Stati membri, non possiamo fare nulla. Ancora una volta, la nostra sfida è fare in modo che gli Stati membri adottino le politiche. A meno che gli Stati membri non riconoscano che la spesa per la sanità non è un costo ma un investimento – e dobbiamo convincerli di questo – la situazione non migliorerà. Proprio su questo aspetto, dobbiamo lavorare insieme e cooperare."@it12
"Madam President, I should like to thank Members for a very interesting and helpful debate. I knew from the beginning that we were on the same side, but it is good to reassure each other whenever possible. I should like to respond to a few specific points very briefly and then make one general comment, which will cover the issue raised. We are aware of the issue of breast cancer in men, raised by Mr Bowis. We have to deal with it as a rare disease, because it is much less common than for women. We are focusing on it and will raise it with experts very soon to see how we can include it in future guidelines, but as a rare disease, in the same way as we deal with other rare diseases. On research, I should like to repeat that environmental causes are part of the plan. The new Seventh Framework Programme will provide an opportunity to open up that area of research. Gene-environment interaction and cancer development will also cover lifestyle and other major risk factors. We will then be able to learn more about the causes of the disease. That is a priority, because prevention is much more important than having to treat the disease afterwards. The question of other cancers was raised by Mr Adamou. We are working on those and not just concentrating on one. Each one is a specific case and needs specific guidelines and a specific approach. We expect to have guidelines for cervical cancer by next year, for prostate cancer by 2008 and for colorectal cancer by 2009. We have to evaluate, we have to have research, we have to put everything together and then come up with guidelines. We are also working on other areas such as the hepatitis B and C viruses, because we know they cause liver cancer, as well as aspects such as tobacco, obesity and other causes of cancer. We have issued guidelines and recommendations on how Member States deal with this and the inequalities. These do not have legal force, so we cannot enforce them on Member States. They represent best practice. With your help, we encourage and put pressure on Member States to comply with the guidelines. I look forward to debating this once we have produced the report. We shall then be able to discuss the outcome and the commitment of the Member States. This is a worrying issue. The numbers are terrifying. If we have to put pressure on Member States to do their job on this, you can imagine what happens with rare diseases which do not affect so many people. Putting it cynically and bluntly, there is not so much political pressure. If we stop to think about it we could panic, but we must not. Our job is to make sure that Member States fulfil their commitments and follow the recommendations they adopt and the guidelines they agree to. We shall be working on that, in relation not just to breast cancer but to all the inequalities that unfortunately still exist in the European Union, within Member States as well as between Member States. This is not the European Union of solidarity that we all aspire to and have all joined. That applies to the use of structural funds. The money is there, but unless spending on health is adopted as a priority by Member States, there is nothing we can do. Again, it is a challenge for us to make Member States adopt the policies. Unless Member States acknowledge that spending on health is not a cost but an investment – and we have to convince them of that – the situation will not improve. That is where we have to work together and cooperate."@lt14
"Madam President, I should like to thank Members for a very interesting and helpful debate. I knew from the beginning that we were on the same side, but it is good to reassure each other whenever possible. I should like to respond to a few specific points very briefly and then make one general comment, which will cover the issue raised. We are aware of the issue of breast cancer in men, raised by Mr Bowis. We have to deal with it as a rare disease, because it is much less common than for women. We are focusing on it and will raise it with experts very soon to see how we can include it in future guidelines, but as a rare disease, in the same way as we deal with other rare diseases. On research, I should like to repeat that environmental causes are part of the plan. The new Seventh Framework Programme will provide an opportunity to open up that area of research. Gene-environment interaction and cancer development will also cover lifestyle and other major risk factors. We will then be able to learn more about the causes of the disease. That is a priority, because prevention is much more important than having to treat the disease afterwards. The question of other cancers was raised by Mr Adamou. We are working on those and not just concentrating on one. Each one is a specific case and needs specific guidelines and a specific approach. We expect to have guidelines for cervical cancer by next year, for prostate cancer by 2008 and for colorectal cancer by 2009. We have to evaluate, we have to have research, we have to put everything together and then come up with guidelines. We are also working on other areas such as the hepatitis B and C viruses, because we know they cause liver cancer, as well as aspects such as tobacco, obesity and other causes of cancer. We have issued guidelines and recommendations on how Member States deal with this and the inequalities. These do not have legal force, so we cannot enforce them on Member States. They represent best practice. With your help, we encourage and put pressure on Member States to comply with the guidelines. I look forward to debating this once we have produced the report. We shall then be able to discuss the outcome and the commitment of the Member States. This is a worrying issue. The numbers are terrifying. If we have to put pressure on Member States to do their job on this, you can imagine what happens with rare diseases which do not affect so many people. Putting it cynically and bluntly, there is not so much political pressure. If we stop to think about it we could panic, but we must not. Our job is to make sure that Member States fulfil their commitments and follow the recommendations they adopt and the guidelines they agree to. We shall be working on that, in relation not just to breast cancer but to all the inequalities that unfortunately still exist in the European Union, within Member States as well as between Member States. This is not the European Union of solidarity that we all aspire to and have all joined. That applies to the use of structural funds. The money is there, but unless spending on health is adopted as a priority by Member States, there is nothing we can do. Again, it is a challenge for us to make Member States adopt the policies. Unless Member States acknowledge that spending on health is not a cost but an investment – and we have to convince them of that – the situation will not improve. That is where we have to work together and cooperate."@lv13
"Madam President, I should like to thank Members for a very interesting and helpful debate. I knew from the beginning that we were on the same side, but it is good to reassure each other whenever possible. I should like to respond to a few specific points very briefly and then make one general comment, which will cover the issue raised. We are aware of the issue of breast cancer in men, raised by Mr Bowis. We have to deal with it as a rare disease, because it is much less common than for women. We are focusing on it and will raise it with experts very soon to see how we can include it in future guidelines, but as a rare disease, in the same way as we deal with other rare diseases. On research, I should like to repeat that environmental causes are part of the plan. The new Seventh Framework Programme will provide an opportunity to open up that area of research. Gene-environment interaction and cancer development will also cover lifestyle and other major risk factors. We will then be able to learn more about the causes of the disease. That is a priority, because prevention is much more important than having to treat the disease afterwards. The question of other cancers was raised by Mr Adamou. We are working on those and not just concentrating on one. Each one is a specific case and needs specific guidelines and a specific approach. We expect to have guidelines for cervical cancer by next year, for prostate cancer by 2008 and for colorectal cancer by 2009. We have to evaluate, we have to have research, we have to put everything together and then come up with guidelines. We are also working on other areas such as the hepatitis B and C viruses, because we know they cause liver cancer, as well as aspects such as tobacco, obesity and other causes of cancer. We have issued guidelines and recommendations on how Member States deal with this and the inequalities. These do not have legal force, so we cannot enforce them on Member States. They represent best practice. With your help, we encourage and put pressure on Member States to comply with the guidelines. I look forward to debating this once we have produced the report. We shall then be able to discuss the outcome and the commitment of the Member States. This is a worrying issue. The numbers are terrifying. If we have to put pressure on Member States to do their job on this, you can imagine what happens with rare diseases which do not affect so many people. Putting it cynically and bluntly, there is not so much political pressure. If we stop to think about it we could panic, but we must not. Our job is to make sure that Member States fulfil their commitments and follow the recommendations they adopt and the guidelines they agree to. We shall be working on that, in relation not just to breast cancer but to all the inequalities that unfortunately still exist in the European Union, within Member States as well as between Member States. This is not the European Union of solidarity that we all aspire to and have all joined. That applies to the use of structural funds. The money is there, but unless spending on health is adopted as a priority by Member States, there is nothing we can do. Again, it is a challenge for us to make Member States adopt the policies. Unless Member States acknowledge that spending on health is not a cost but an investment – and we have to convince them of that – the situation will not improve. That is where we have to work together and cooperate."@mt15
". Mevrouw de Voorzitter, ik wil de afgevaardigden graag bedanken voor dit zeer boeiende en nuttige debat. Ik wist vanaf het begin dat we aan dezelfde kant stonden, maar het is goed om elkaar daarin te bevestigen wanneer het maar mogelijk is. Ik wil heel kort reageren op enkele specifieke punten en vervolgens een alomvattende, algemene opmerking maken. We zijn ons bewust van het feit dat borstkanker ook bij mannen voorkomt, zoals de heer Bowis opmerkte. We moeten het bij hen als een zeldzame ziekte beschouwen, aangezien borstkanker veel minder voorkomt bij mannen dan bij vrouwen. We kijken ernaar en zullen het spoedig bespreken met deskundigen om te zien hoe we dit kunnen opnemen in toekomstige richtsnoeren, maar dan wel als een zeldzame ziekte en op de manier waarop we ook met andere zeldzame ziekten omgaan. Ik herhaal graag nog eens dat er op het gebied van onderzoek ook aandacht is voor milieuoorzaken. Het nieuwe zevende kaderprogramma biedt daarvoor ruimte. Wat betreft de wisselwerking tussen genetische factoren en het milieu en de ontwikkeling van kanker wordt gekeken naar levenswijze en andere belangrijke risicofactoren. Daardoor krijgen we meer inzicht in de oorzaken van de ziekte. Dat heeft prioriteit, omdat voorkomen veel belangrijker is dan genezen. De heer Adamou stelde andere vormen van kanker aan de orde. Daar zijn we mee bezig; we concentreren ons niet op één verschijningsvorm. Elke vorm van kanker staat op zich en heeft zijn eigen specifieke richtsnoeren en specifieke aanpak nodig. We verwachten volgend jaar richtsnoeren te hebben voor baarmoederhalskanker, in 2008 voor prostaatkanker en in 2009 voor dikkedarmkanker. We moeten evalueren, we moeten onderzoeksresultaten vergaren, we moeten de zaken op een rijtje zetten en dan met richtsnoeren komen. We houden ons ook bezig met andere verschijnselen, zoals het hepatitis B- en het hepatitis C-virus, omdat we weten dat deze virussen tot leverkanker kunnen leiden, en met aspecten zoals tabak, zwaarlijvigheid en andere oorzaken van kanker. We hebben richtsnoeren en aanbevelingen doen uitgaan over de wijze waarop lidstaten het beste hiermee en met de ongelijkheden kunnen omgaan. Deze hebben geen juridische geldigheid, dus we kunnen ze niet bij de lidstaten afdwingen. Het gaat om beste praktijken. Met uw hulp kunnen we de lidstaten stimuleren en druk op hen uitoefenen om zich aan de richtsnoeren te houden. Ik kijk uit naar het debat dat naar aanleiding van het verslag hierover zal plaatsvinden. Dan kunnen we bespreken wat ervan is geworden en in hoeverre de lidstaten zich eraan hebben gehouden. Dit is een verontrustende zaak. De cijfers zijn schrikbarend. Als we al druk moeten uitoefenen op de lidstaten om zich op het gebied van borstkanker van hun taak te kwijten, kunt u zich voorstellen hoe het gaat met zeldzame ziekten waaraan veel minder mensen lijden. Om het cynisch en bot te zeggen: er is geen grote politieke druk. Het is beter om daar maar niet al te lang bij stil te staan, want dan kan het zijn dat de paniek toeslaat. Het is onze taak om ervoor te zorgen dat de lidstaten hun verplichtingen nakomen en de aanbevelingen en richtsnoeren opvolgen die zij aanvaarden. Wij zullen ons niet alleen richten op de aanpak van borstkanker, maar ook op de ongelijkheden die helaas nog steeds binnen de Europese Unie bestaan, zowel binnen de lidstaten zelf als tussen de lidstaten onderling. Dit is niet de Europese Unie van solidariteit waarnaar we als leden allemaal streven. Hiermee kom ik op het gebruik van de structuurfondsen. Het geld is er, maar zolang de lidstaten het niet als een prioriteit zien om het geld aan de volksgezondheid te besteden, kunnen we niets doen. Nogmaals: het is een uitdaging voor ons om ervoor te zorgen dat de lidstaten het beleid overnemen. Zolang de lidstaten niet inzien dat uitgaven voor de volksgezondheid geen kosten zijn, maar een investering – en daarvan moeten we hen overtuigen – zal de situatie niet verbeteren. Waar het hier op aankomt, is samenwerking."@nl3
"Madam President, I should like to thank Members for a very interesting and helpful debate. I knew from the beginning that we were on the same side, but it is good to reassure each other whenever possible. I should like to respond to a few specific points very briefly and then make one general comment, which will cover the issue raised. We are aware of the issue of breast cancer in men, raised by Mr Bowis. We have to deal with it as a rare disease, because it is much less common than for women. We are focusing on it and will raise it with experts very soon to see how we can include it in future guidelines, but as a rare disease, in the same way as we deal with other rare diseases. On research, I should like to repeat that environmental causes are part of the plan. The new Seventh Framework Programme will provide an opportunity to open up that area of research. Gene-environment interaction and cancer development will also cover lifestyle and other major risk factors. We will then be able to learn more about the causes of the disease. That is a priority, because prevention is much more important than having to treat the disease afterwards. The question of other cancers was raised by Mr Adamou. We are working on those and not just concentrating on one. Each one is a specific case and needs specific guidelines and a specific approach. We expect to have guidelines for cervical cancer by next year, for prostate cancer by 2008 and for colorectal cancer by 2009. We have to evaluate, we have to have research, we have to put everything together and then come up with guidelines. We are also working on other areas such as the hepatitis B and C viruses, because we know they cause liver cancer, as well as aspects such as tobacco, obesity and other causes of cancer. We have issued guidelines and recommendations on how Member States deal with this and the inequalities. These do not have legal force, so we cannot enforce them on Member States. They represent best practice. With your help, we encourage and put pressure on Member States to comply with the guidelines. I look forward to debating this once we have produced the report. We shall then be able to discuss the outcome and the commitment of the Member States. This is a worrying issue. The numbers are terrifying. If we have to put pressure on Member States to do their job on this, you can imagine what happens with rare diseases which do not affect so many people. Putting it cynically and bluntly, there is not so much political pressure. If we stop to think about it we could panic, but we must not. Our job is to make sure that Member States fulfil their commitments and follow the recommendations they adopt and the guidelines they agree to. We shall be working on that, in relation not just to breast cancer but to all the inequalities that unfortunately still exist in the European Union, within Member States as well as between Member States. This is not the European Union of solidarity that we all aspire to and have all joined. That applies to the use of structural funds. The money is there, but unless spending on health is adopted as a priority by Member States, there is nothing we can do. Again, it is a challenge for us to make Member States adopt the policies. Unless Member States acknowledge that spending on health is not a cost but an investment – and we have to convince them of that – the situation will not improve. That is where we have to work together and cooperate."@pl16
"Senhora Presidente, gostaria de agradecer às Senhoras e aos Senhores Deputados o interessantíssimo e útil debate. Sabia desde o início que estávamos do mesmo lado, mas é bom tranquilizarmo-nos uns aos outros, sempre que possível. Gostaria de responder brevemente a alguns pontos muito específicos, apresentando seguidamente um comentário de carácter geral, abarcando o tema tratado. Temos consciência do problema do cancro da mama nos homens, abordado pelo senhor deputado Bowis. Temos de o encarar como uma doença rara, dado ser muito menos comum do que nas mulheres. Estamos a consagra-lhe toda a atenção e vamos brevemente tratá-lo com especialistas para avaliar a forma como o podemos incluir em futuras directrizes, mas como doença rara, do mesmo modo que tratamos outras doenças raras. Relativamente à investigação, gostaria de repetir que a abordagem das causas ambientais faz parte do plano. O novo Sétimo Programa-Quadro vai dar oportunidade a que se alargue essa área da investigação. A interacção dos factores genéticos e ambientais e o desenvolvimento de cancro incluirão igualmente o estilo de vida e outros importantes factores de risco. Poderemos assim aprender mais sobre as causas da doença. Trata-se de uma prioridade, pois preveni é muito mais importante do que ter de tratar a doença posteriormente. A questão dos restantes tipos de cancro foi levantada pelo senhor deputado Adamou. Estamos a trabalhar nesse sentido, não nos concentrando apenas num tipo. Cada um é um caso específico e necessita de directrizes específicas e de uma abordagem também específica. Contamos ter, no próximo ano, directrizes para o cancro cervical, em 2008, para o cancro da próstata e, em 2009, para o cancro colorrectal. Temos de avaliar, temos de investigar, temos de organizar todos os elementos e depois apresentaremos as directrizes. Estamos igualmente a trabalhar em áreas como a dos vírus da hepatite B e C, pois sabemos que causam cancro do fígado. Trabalhamos também aspectos relacionados com o tabagismo, a obesidade e outras causas do cancro. Produzimos directrizes e recomendações sobre a forma como os Estados-Membros devem gerir estas situações, bem como a questão das desigualdades. Estes textos não têm validade jurídica, portanto não podemos impor a sua aplicação aos Estados-Membros. Estes textos constituem boas práticas. Com a vossa ajuda, vamos encorajar e pressionar os Estados-Membros a darem seguimento a estas directrizes. Aguardo com expectativa o debate que teremos logo que o relatório esteja pronto. Nessa altura, poderemos discutir os resultados e o envolvimento demonstrado pelos Estados-Membros. Esta questão é preocupante e os números são aterradores. Se é preciso pressionar os Estados-Membros para fazerem o que devem num tema como este, podem V. Exas. imaginar o que acontece com as doenças raras que não afectam tantas pessoas. Falando de modo cínico e sem rodeios, a pressão política é muito menor. Se parássemos para pensar neste problema, poderíamos até entrar em pânico, mas não podemos deixar que isso aconteça. A nossa missão é assegurar que os Estados-Membros honram os seus compromissos e seguem as recomendações que decidem adoptar e as directrizes a que dão o seu acordo. Vamos trabalhar nesse domínio, não apenas em relação ao cancro da mama, mas em relação a todas as desigualdades que infelizmente ainda existem na União Europeia, no seio dos Estados-Membros e entre os Estados-Membros. Não é esta a União Europeia da solidariedade a que todos aspiramos e que todos aderimos. Este ponto aplica-se à utilização dos fundos estruturais. O dinheiro existe, está lá, mas nada poderemos fazer, se os gastos na saúde não forem adoptados como prioridade pelos Estados-Membros. Mais uma vez, estamos perante o desafio de fazer com que os Estados-Membros adoptem tais políticas. Enquanto os Estados-Membros não reconhecerem que os gastos na saúde não constituem uma despesa, mas sim um investimento – é disso que temos de os convencer –, a situação não irá melhorar. É neste ponto que temos de trabalhar em conjunto e cooperar."@pt17
"Madam President, I should like to thank Members for a very interesting and helpful debate. I knew from the beginning that we were on the same side, but it is good to reassure each other whenever possible. I should like to respond to a few specific points very briefly and then make one general comment, which will cover the issue raised. We are aware of the issue of breast cancer in men, raised by Mr Bowis. We have to deal with it as a rare disease, because it is much less common than for women. We are focusing on it and will raise it with experts very soon to see how we can include it in future guidelines, but as a rare disease, in the same way as we deal with other rare diseases. On research, I should like to repeat that environmental causes are part of the plan. The new Seventh Framework Programme will provide an opportunity to open up that area of research. Gene-environment interaction and cancer development will also cover lifestyle and other major risk factors. We will then be able to learn more about the causes of the disease. That is a priority, because prevention is much more important than having to treat the disease afterwards. The question of other cancers was raised by Mr Adamou. We are working on those and not just concentrating on one. Each one is a specific case and needs specific guidelines and a specific approach. We expect to have guidelines for cervical cancer by next year, for prostate cancer by 2008 and for colorectal cancer by 2009. We have to evaluate, we have to have research, we have to put everything together and then come up with guidelines. We are also working on other areas such as the hepatitis B and C viruses, because we know they cause liver cancer, as well as aspects such as tobacco, obesity and other causes of cancer. We have issued guidelines and recommendations on how Member States deal with this and the inequalities. These do not have legal force, so we cannot enforce them on Member States. They represent best practice. With your help, we encourage and put pressure on Member States to comply with the guidelines. I look forward to debating this once we have produced the report. We shall then be able to discuss the outcome and the commitment of the Member States. This is a worrying issue. The numbers are terrifying. If we have to put pressure on Member States to do their job on this, you can imagine what happens with rare diseases which do not affect so many people. Putting it cynically and bluntly, there is not so much political pressure. If we stop to think about it we could panic, but we must not. Our job is to make sure that Member States fulfil their commitments and follow the recommendations they adopt and the guidelines they agree to. We shall be working on that, in relation not just to breast cancer but to all the inequalities that unfortunately still exist in the European Union, within Member States as well as between Member States. This is not the European Union of solidarity that we all aspire to and have all joined. That applies to the use of structural funds. The money is there, but unless spending on health is adopted as a priority by Member States, there is nothing we can do. Again, it is a challenge for us to make Member States adopt the policies. Unless Member States acknowledge that spending on health is not a cost but an investment – and we have to convince them of that – the situation will not improve. That is where we have to work together and cooperate."@sk18
"Madam President, I should like to thank Members for a very interesting and helpful debate. I knew from the beginning that we were on the same side, but it is good to reassure each other whenever possible. I should like to respond to a few specific points very briefly and then make one general comment, which will cover the issue raised. We are aware of the issue of breast cancer in men, raised by Mr Bowis. We have to deal with it as a rare disease, because it is much less common than for women. We are focusing on it and will raise it with experts very soon to see how we can include it in future guidelines, but as a rare disease, in the same way as we deal with other rare diseases. On research, I should like to repeat that environmental causes are part of the plan. The new Seventh Framework Programme will provide an opportunity to open up that area of research. Gene-environment interaction and cancer development will also cover lifestyle and other major risk factors. We will then be able to learn more about the causes of the disease. That is a priority, because prevention is much more important than having to treat the disease afterwards. The question of other cancers was raised by Mr Adamou. We are working on those and not just concentrating on one. Each one is a specific case and needs specific guidelines and a specific approach. We expect to have guidelines for cervical cancer by next year, for prostate cancer by 2008 and for colorectal cancer by 2009. We have to evaluate, we have to have research, we have to put everything together and then come up with guidelines. We are also working on other areas such as the hepatitis B and C viruses, because we know they cause liver cancer, as well as aspects such as tobacco, obesity and other causes of cancer. We have issued guidelines and recommendations on how Member States deal with this and the inequalities. These do not have legal force, so we cannot enforce them on Member States. They represent best practice. With your help, we encourage and put pressure on Member States to comply with the guidelines. I look forward to debating this once we have produced the report. We shall then be able to discuss the outcome and the commitment of the Member States. This is a worrying issue. The numbers are terrifying. If we have to put pressure on Member States to do their job on this, you can imagine what happens with rare diseases which do not affect so many people. Putting it cynically and bluntly, there is not so much political pressure. If we stop to think about it we could panic, but we must not. Our job is to make sure that Member States fulfil their commitments and follow the recommendations they adopt and the guidelines they agree to. We shall be working on that, in relation not just to breast cancer but to all the inequalities that unfortunately still exist in the European Union, within Member States as well as between Member States. This is not the European Union of solidarity that we all aspire to and have all joined. That applies to the use of structural funds. The money is there, but unless spending on health is adopted as a priority by Member States, there is nothing we can do. Again, it is a challenge for us to make Member States adopt the policies. Unless Member States acknowledge that spending on health is not a cost but an investment – and we have to convince them of that – the situation will not improve. That is where we have to work together and cooperate."@sl19
"Fru talman! Jag skulle vilja tacka ledamöterna för en mycket intressant och användbar debatt. Jag kände från början till att vi stod på samma sida, men det är bra att inge varandra ny tillförsikt, närhelst det är möjligt. Jag skulle mycket kort vilja svara på några särskilda punkter och sedan göra några allmänna kommentarer, som kommer att handla om den fråga som tagits upp. Vi känner till frågan om bröstcancer hos män, som John Bowis tog upp. Vi måste ta itu med den som en sällsynt sjukdom, eftersom det är mycket mindre förekommande än hos kvinnor. Vi inriktar oss på det, och kommer att ta upp det med experter mycket snart för att se hur vi kan inbegripa det i framtida riktlinjer, men som en sällsynt sjukdom, på samma sätt som vi har tagit itu med andra sällsynta sjukdomar. När det gäller forskning skulle jag vilja upprepa att miljöorsaker är en del av planen. Det nya sjunde ramprogrammet kommer att ge möjlighet att öppna forskningsområdet. Växelverkan mellan gener och miljö och utveckling av cancer kommer också att omfatta livsstil och andra stora riskfaktorer. Vi kommer sedan att lära oss mer om sjukdomens orsaker. Detta är en prioritet, eftersom förebyggande är mycket viktigare än att efterbehandla sjukdomen. Frågan om andra typer av cancer togs upp av Adamos Adamou. Vi arbetar med dessa och inriktar oss inte bara på en typ. Varje typ är ett särfall och kräver särskilda riktlinjer och ett särskilt tillvägagångssätt. Vi väntar oss ha riktlinjer för livmodershalscancer till nästa år, för prostatacancer 2008, och för kolorektal cancer 2009. Vi måste utvärdera, vi behöver forskning, vi måste sammanställa allt och sedan utarbeta riktlinjer. Vi arbetar också på andra områden, som hepatit B och C-virus, eftersom vi vet att de orsakar levercancer, liksom sådana aspekter som tobak, fetma och andra orsaker till cancer. Vi har lagt fram riktlinjer och rekommendationer om hur medlemsstaterna ska ta itu med detta och med ojämlikheterna. Dessa har inte någon rättsverkan, så vi kan inte påtvinga medlemsstaterna dem. De representerar bästa praxis. Med er hjälp uppmuntrar vi medlemsstaterna och utövar påtryckningar på dem för att efterleva riktlinjerna. Jag ser fram emot att diskutera detta när vi har utarbetat rapporten. Vi kommer då att kunna diskutera medlemsstaternas resultat och åtaganden. Detta är en oroande fråga. Antalet drabbade är skrämmande. Om vi måste utöva påtryckningar på medlemsstaterna för att få dem att göra sitt arbete i denna fråga, så kan ni föreställa er vad som händer med sällsynta sjukdomar som inte påverkar så många människor. Om jag ska uttrycka det cyniskt och rakt på sak, finns det inte så mycket politisk påtryckning. Om vi slutar att tänka på det skulle vi kunna få panik, men det går inte. Vårt arbete är att se till att medlemsstaterna uppfyller sina åtaganden och följer de rekommendationer som de antar och de riktlinjer som de går med på. Vi ska arbeta på detta, inte bara i förhållande till bröstcancer utan när det gäller alla de ojämlikheter som tyvärr fortfarande existerar inom Europeiska unionen, inom medlemsstater och mellan medlemsstater. Detta är inte den europeiska union av solidaritet som vi alla eftersträvar och som vi alla har gått med i. Detta gäller för användningen av strukturfonder. Pengarna finns där, men om inte medlemsstaterna går med på att prioritera användningen av dem för hälsovård finns det inget som vi kan göra. Det är en utmaning för oss att få medlemsstaterna att anta denna politik. Om inte medlemsstaterna erkänner att det inte är en kostnad utan en investering att använda pengarna till hälsovård – och vi måste övertyga dem om detta – kommer inte situationen att förbättras. Det är där som vi måste samarbeta och samverka."@sv21
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