The tense food health debate in Brussels just got even more charged, with the leak of the EU Cardiovascular Health Plan’s first draft in late November sparking widespread criticism both within the Commission and from member-states ahead of its expected official unveiling on 16 December.
Spearheaded by EU Health Commissioner Olivér Várhelyi, the plan’s proposal to impose an EU-wide ‘sin tax’ on highly processed food and drink high in fat, sugar and salt by 2026 has emerged as a lightning rod for pushback.
Those familiar with the draft plan confirm that it forms part of the Commission’s broader push on cardiovascular disease (CVD) risk factors such as alcohol, tobacco and diet. Yet critics argue the approach leans on shaky scientific foundations and reaches for blunt, cosmetic fixes to a public health challenge whose underlying drivers remain poorly understood, with its misguided equation of certain foods with tobacco threatening to produce ineffective policy.
Moving forward, the EU would be better served by a more constructive food policy that promotes physical activity and health literacy, harnesses digital innovation, and rests on rigorous, evidence-driven research.
A continent-wide health plague
The severity of Europe’s cardiovascular crisis plainly calls for ambitious and coordinated answers. According to the World Health Organization (WHO), roughly 10,000 people die from CVDs across Europe every day, largely from sudden events such as heart attacks and strokes. In 2022, circulatory diseases caused 1.68 million deaths in the EU, representing approximately one-third of the bloc’s mortality – far above cancer’s 22.3%, with the majority of these premature CVD-driven deaths entirely preventable through enhanced mitigation of risk factors like tobacco consumption and physical inactivity.
Moreover, the continent faces a stark geographic health divide: in 2022, over half of all deaths in Bulgaria, Romania, Lithuania and Latvia were due to circulatory diseases, compared with fewer than a quarter in Cyprus, Belgium, the Netherlands, France and Denmark. According to the OECD and the EU’s Health at a Glance: Europe 2024 report, the marked eastern-western Europe gap is attributable to a range of key factors, including differing levels of smoking, public health spending and health education.
Nevertheless, these countries are united in seeking answers to a shared challenge that remains their single largest health threat, with most EU member-states already operating national cardiovascular strategies tailored to local lifestyles, preferences and available funding. Consequently, when Hungary first floated the idea of EU-level CVD action last year, countries like Germany, Austria and the Netherlands were quick to push back. Berlin speaks for many national capitals in cautioning against policy overlap with the existing ‘Europe’s Beating Cancer Plan’ – which already faces implementation challenges – and arguing that efforts should target non-communicable diseases (NCD) more broadly rather than CVDs alone.
Unpacking the food tax fallout
Member-state resistance to the CVD plan exposes a deeper problem inside the Commission: an instinct to stack strategies and administrative layers without securing results. The backlash is not only external, with four Directorate-Generals expressing opposition to the plan’s food tax proposal, reflecting long-standing complaints about the EU executive’s over-centralisation and weak cross-department coordination. Instead of evidence-led policy built through consultation, the CVD process again risks producing a blunt, poorly-balanced outcome.
The Directorate-General for Agriculture has notably raised “points of serious concern,” reminding the Commission that its recent “Vision for the Future of Agriculture and Food,” includes a commitment to conduct an impact study on ultra-processed foods (UPFs) before taking concrete policy actions. As EU Agriculture Commissioner Christophe Hansen has rightly stressed, “the affordability of food for consumers should be our guiding principle,” rather than food taxation.
Mirroring DG AGRI’s concern with the lack of evidence to back the ‘sin tax,’ DG GROW has warned that the plan’s “scientific accuracy” leaves much to be desired. Moreover, the Commission’s single market and industry department has called for more research “on the extent to which the processing of food itself negatively impacts health.” Meanwhile, DG Budget and DG Taxation also oppose the food tax, citing its lack of clarity as well as the risk that it “could seriously undermine” the EU’s long-term – and already fraught – budget negotiations.
Rather than a tangible roadmap, the EU’s CVD plan appears to offer a series of vague assumptions that jump to policy solutions before anchoring its causal logic in solid scientific evidence. Indeed, the plan’s apparent emphasis on “unhealthy” foods and framing of this poorly-defined category alongside tobacco exposes the fragility of its evidentiary base. Furthermore, the draft text seems to give far less weight to major underlying drivers of cardiovascular disease and obesity, like insufficient physical inactivity.
Better way forward
The Commission’s food tax proposal embodies its long-running focus on negative, punitive measures that lack a strong scientific foundation to improve dietary health and tackle preventable diseases like CVDs and cancer. If Brussels is serious about curbing the EU’s mounting weight crisis – nearly 51% and 17% of adults are now overweight and obese, respectively, and childhood rates are also rising dramatically – it must pivot toward a positive policymaking approach that empowers individuals to lead healthy, balanced lifestyles.
Crucially, this requires addressing the full range of biological, social, psychological and environmental factors driving obesity and CVD. At a time when physical activity across Europe is at historic lows, the EU’s cardiovascular health plan contains no clear flagship initiative to boost sport and exercise, constituting a major missed opportunity. EU action should instead support local authorities in widening access to sports infrastructure and green spaces – especially in lower-income communities most affected by the crisis.
Additionally, EU citizens would benefit from far stronger nutritional health literacy programmes, particularly in schools, to encourage informed choices from an early age. Greater emphasis is also needed on personalised nutrition and on how digital tools can translate medical guidance into daily practice. With its companion app offering private messaging with dietitians, physical activity coaches and psychologists, alongside personalised care pathways tailored to each stage of treatment, France-based Annette represents the innovative digital health solutions that Brussels should integrate into its CVD strategy.
Looking ahead, If Brussels converts its leaked cardiovascular health plan into law without correcting its flaws, the EU will lock in a shallow response to a complex health crisis. Indeed, a food tax framed like tobacco control may win headlines, but not outcomes. With the 16 December unveiling approaching, lawmakers should demand an evidence-based approach and smarter health policies that empower its citizens to engage in greater levels of physical activity, food education and personalised nutrition.
