Last week the European Parliament voted on the Commission proposal to revise the existing Tobacco Products directive. Why was the proposal made and what are the prospects for a new directive coming into force?

Our aim in tabling this proposal was to bring the current Directive up to date with market, scientific and international developments and to improve the functioning of the internal market. The proposal further seeks to discourage young people from starting to use tobacco by making tobacco products less attractive. Most people take up smoking when they are very young – 70% of smokers started before 18 and 94% before 25.

Smoking remains the principal preventable cause of death, about 700,000 people die of it each year.  Measures taken over the years to discourage smoking have helped to reduce the proportion of EU citizens who smoke from 40% in the EU15 in 2002 to 28% in the EU 27 in 2012

The Commission also proposes measures against illicit trade, such as a tracking and tracing system and security features, to ensure that tobacco products circulating within the EU comply with the Directive.

The European Parliament vote is not the end of the road but will allow us to take the process of negotiations forward and to engage with the Council in order to come to a meaningful agreement. We have witnessed a lively and thorough debate and I would like to thank the MEPs for their support and to pay a special tribute to the rapporteur, Linda McAvan, for her commitment, determination and important contribution towards securing this favourable vote. The Commission will carefully analyse and define its position on the amendments adopted so that negotiations can continue in trialogue. I am confident that the revised Directive can still be adopted within the mandate of the current Parliament ending next June. All institutional actors have to play their role since EU citizens expect all of us to act on tobacco and to adopt in the near future a new legislation, which will put the EU on the frontline on a global stage.

On 21 June the Council had already approved most of our proposals also endorsing a common approach entitling its Presidency to negotiate with the European Parliament. Compromises were made by Ireland about the size health warnings on cigarette packages. I still propose they should cover 75% of either side with pictorial warnings. I don't want slim cigarette boxes that were retained. Poland, Czech Republic and Romania voted against. The main issues at stake are the size of health warnings, the use of flavours and electronic cigarettes.

The resistance, which has emerged, is because the proposal is effective! It will affect tobacco consumption and some politicians say jobs will be lost. Those involved in the tobacco industry are opposed to the Commission's proposal as they think it will lead to economic loss but the truth is that any possible negative economic effects will be limited.  Our proposal should reduce the number of smokers by 2% in five years, that is, 2 million, discourage people from starting and also persuade them to quit.

Can you explain how the anti-smoking iCoach activity works?

The EU's iCoach is a free Internet based programme supporting the EU-wide campaign, Ex-smokers are unstoppable, focused on encouraging Europeans to stop smoking. The target audience is 25- to 34-year-old smokers (28 million Europeans). It shifts the focus from the dangers of smoking to the positive benefits of quitting, highlighting the inspirational achievements of ex-smokers and offering practical tips on quitting.

In all the 24 EU languages iCoach helps people quit smoking at their own pace and 30% of those who use iCoach actually quit smoking. It works by analysing the smoking habits of its participants and provides tailored advice on a daily basis. At the end of each month, iCoach compiles a report, which provides feedback on the user’s progress as well as advice to facilitate the process and encourage the user to quit smoking for good.

To date, close to half a million Europeans have registered to iCoach through our Ex-smokers are Unstoppable campaign and the Commission's joint initiative with Football Club Barcelona – Quit Smoking with Barça.

What are the key challenges facing Europe's health sector?

With the increase in ageing, there is a huge strain on both health systems and pensions. All EU member states' systems need reform to become sustainable while all finance ministers will probably  cut national health expenditures. Even Germany and Malta, which have sound finances, are getting recommendations from the EC about the cost of health services. What we don't want are arbitrary cuts, lower levels of health care and we do not underestimate impacts of what may happen. Key health determinants are nutrition, activity, consumption of alcohol and tobacco. Chronic diseases are on the increase, diabetes is going up: Germany has the highest prevalence rate at 11.7% (10% in Malta).

So how can the EU help and what are the key activities of your Directorate-General?

In July we set up a panel of experts, which gives free non-binding advice to member states on the sustainability of health systems. The EU Health Programme (2014-2020) with a proposed budget of  €446m aims to support, complement and add value to member states' policies, improve the health of EU citizens and reduce health inequalities. The programme's four objectives are to promote health and prevent disease, protect citizens from cross-border health threats, contribute to innovative and sustainable health systems and facilitate access to better and safer healthcare for EU citizens.

Negotiations on the finalisation of the programme are advancing well and I am confident that the last obstacles can be overcome this autumn. While the programme has changed as a result of the negotiations, as it is always the case, it is good to note that no major changes, neither in the objectives nor in the budget, have been proposed. This shows a great deal of support for the programme as proposed by the Commission.

The only disease for which there is a specific EU strategy is cancer, but we are toying with the idea of joint action on diabetes since the age at which it is contracted is becoming lower and lower.

E-health with health checks and treatments at home monitored in hospitals via internet has great potential. Some countries like the UK (Northern Ireland), Greece and Portugal have launched this. We have also drafted a directive on how to harmonise electronic data, which should be ready for adoption in November.

How is EU tackling cancer?

The European Code Against Cancer was drawn up in 1987 and updated in 2003 aiming to provide evidence based advice to citizens on how to prevent cancer around the two key messages of adopting healthier lifestyles and early detection. Under an agreement with the International Agency for Research on Cancer, the new version should emerge next year, keeping these two key messages and adapting some others in line with new scientific evidence.

The European Partnership for Action Against Cancer launched in 2009 aimed to reduce new cancer cases by 15% by 2020. This goal could in principle be increased but first we need to review how successful the Partnership has been so far in meeting its 2020 target. Then we can consider whether to set more ambitious targets. Work under the Partnership has brought most member states within reach of achieving the goal of having an integrated cancer plan by 2013 since by the end of the year, there will be cancer plans in 24 of the 28 member states. National programmes are quite diverse, but most countries include basic prevention and control activities, patient empowerment and social support for families as well as specific provisions to address inequalities.

The 2003 Council Recommendation on cancer screening called on all member states to implement high quality screening programmes for breast, cervical and colorectal cancer. The Commission produced European Guidelines for quality assurance in the screening of these three types of cancer. Improvements are expected when the Commission puts forward an implementation report next year. In 2008 member states fell short of the target set for the minimum number of screenings by more than 50%; only 22 member states had breast cancer screening programmes in place. For cervical cancer it was only 15 member states and for colorectal cancer only 12.

The new Joint Action on the development of the European Guide on Quality Improvement in Comprehensive Cancer Control (CANCON) will run from 2014 to 2016. The main deliverable will be the Guide itself as well as a member states platform, which will provide space for discussions on cancer topics.

Malta's Mater Dei hospital has provided very valuable input on screening issues and I am confident it will continue to be very active.

Is there an EU approach to HIV/Aids?

Protective legal and social environments for people affected by HIV are sadly not yet fully established across the whole of Europe. Promoting the rights of people affected by HIV/Aids must therefore remain at the centre of European HIV policy, and a priority of the EU Health Programme. I have committed myself to putting forward a renewed Action Plan on HIV/Aids by the end of the year to include issues of discrimination and stigma. Evaluation of the current HIV strategy will help to identify areas where we need to intensify our efforts: to "reach the unreached", to establish access to treatment, to promote prevention, to strengthen the role of civil society and involve people living with HIV/Aids in policy development. In taking this strategy forward, we will make full use of the instruments of EU health policy, other EU instruments and through our external relation policies with the European neighbourhood.

How can EU address the problem of the increased ageing of its population?

The European Innovation Partnership for Active and Healthy Ageing aims to increase the average healthy lifespan by two years by 2020. Poor health is the primary reason why people exit the job market, often before actual retirement age. The important issue is not necessarily to raise the retirement age, but to ensure that Europeans are living longer in good health so that they can remain active as long as they wish to.

The Partnership is based on Action Groups, Reference Sites and Innovative ideas. An Action Group is an assembly of partners with a common objective and committing to run actions within the framework of the Partnership. Reference sites are coalitions of regions, cities, integrated hospitals or care organisations that aim to provide innovative services with proven added value to citizens and care systems in EU regions. They have all committed to share their experiences across the Union. Some have contributed to growth and job creation and many have extended best practice from local to regional or national level.

The Digital Market Place for Innovative Ideas aims to engage wider stakeholders in the Partnership's innovation process, to help disseminate and share results, ideas and initiatives. This July, 32 sites from cities and regions across Europe were rewarded for putting innovative ideas into practice to help older people by implementing innovative technological, social or organisational solutions to enhance the efficiency of health and social care systems, foster innovation and economic growth. For example, the region of Madrid has a clinic for falls and fractures that offers integrated care for older people at risk while in Scotland, the National Telecare Development Programme  helps people to live at home safely for longer.

In 2010 only 4% of the EU population was aged 80+. By 2050 this will rise to at least 10%. An increasingly ageing population is certainly a challenge to Europe's health systems. The current economic crisis has brought this into sharper focus, as health systems in Europe are under resource constraints. We need to spend better rather than more on cost-effective disease prevention and health promotion, sound innovation, such as the use of Health Technology Assessment and eHealth (many of the Reference Sites recognised have demonstrated effective use of eHealth solution).