Health information is a fundamental and necessary part of healthcare. However, the development of direct to consumer advertising, of disease awareness (or "disease mongering") campaigns, "compliance programs", and direct and indirect pharmaceutical industry support of patient's organizations have blurred the boundaries between drug promotion and health information.

Relevant health information should be:
• reliable: evidence based (listing data sources), unbiased, and up-to-date, with full transparency on authorship and financing (enabling rejection of information influenced by conflicts of interests);
• comparative: presenting benefits and harms of the full range of available treatment options (including, where appropriate, the option not to treat), together with an explanation of the natural history of the disease,or condition; and
• adapted to users: understandable, accessible, and culturally sensitive.

Currently, there are many sources of relevant health information for the public both in Europe and internationally. There is room for improvement but to state that a "patient information deprivation syndrome"exists in Europe is not true.Specific tools have been developed to assess and rate the quality of health information. The aim of these tools is to help both information providers and users to ensure accuracy, quality and relevance to health care choices. This declaration includes many examples of quality assessment tools and information sources provided by health authorities, medical product agencies, healthcare assessment agencies, health care providers, health professionals, consumers'organizations and independent patient groups.

The role of pharmaceutical companies is strictly limited because of their inherent conflicts of interest. Recommendations on treatment choice must be independent both of individual companies that have a product for sale, and the industry as a whole.The statement by industry lobbyists that "Consumers and patients are effectively excluded from receiving information about their medicine and its comparative effects [because of the] ban [for] drug developers from informing patients […] even on the developers own web sites", makes no sense. Pharmaceutical companies, and all "partners" financed by pharmaceutical companies, cannot provide unbiased comparative information on available drug and non-drug treatment alternatives.

Pharmaceutical companies do have a specific role to play: by law, they must provide well labelled drugs, including patient information leaflets. Directive 2004/27/CE requires package leaflet evaluation by patients.This
is an important and much-needed step. Informative packaging and patient information leaflets are likely to contribute to better medication use and prevention of errors.

Proposals for improvement of European citizens access to relevant information include:
• ensuring transparency of medical products agencies to guarantee full public access to pre-market studies of drug safety and effectiveness, and pharmacovigilance data;
• requiring pharmaceutical companies to fulfil their obligations concerning packaging;
• developing and reinforcing sources of comparative, unbiased information on treatment choices;
• optimising communication between patients and health professionals;
• directly including patients in reporting of side effects of drugs;
• putting an end to the confusion of roles between p
• full implementation and enforcement of the European regulation on drug promotion.

©Joint Declaration of HAI Europe, ISDB,AIM, BEUC, Medicines in Europe Forum 3 October 2006