Towards a European Health Union

As the pandemic comes to its second anniversary this March, voices that advocate for the implementation of a European Health Union (EHU) persist.

However, three main questions remain; what is the real political willingness to develop this project and what kind of support does it hold? what do policymakers mean when they talk about a European Health Union? and, finally, how do we get there?

The political momentum and legitimacy of the EHU and its legitimacy

The three main institutions of the EU have all shown crystal clear support to the project. The president of the Commission, Ursula von der Leyen, has highlighted the importance of a Health Union for the EU. The European Parliament’s late President David Sassoli, stated that there is no going back to a pre-covid situation”  and that the “task now is to develop a European health policy” during his address to the Council. The latter has also stressed the central role of the EHU, as it has been one of the priorities of the programs of the former and the current Council presidencies. Moreover, during the last informal meeting this February the 27 health ministers of each member state shared their willingness to share their health sovereignty for the sake of a better public health.

The clear alignment between these three bodies is not the only remarkable milestone regarding its political strength, as the EHU has the support of the European citizens as well. According to the Eurobarometer published in October 2021, health policy has moved up to the second position among the policy areas where young Europeans (15-24 years old) think the EU should get involved, only topped by environmental issues.

What exactly is the EHU?

The Commission describes it as a set of policies that enables all EU countries to prepare for and respond together to health crises, to make innovative and affordable medical supplies available, and to work in a more coordinated manner to improve the prevention, treatment and monitoring of diseases such as cancer.

As such, it aims to better protect the health of citizens, prepare the EU and its Member States to better prevent and combat future pandemics, and improve the resilience of European health systems. It does so by creating sustainable and resilient supply chains (i.e the European Pharmaceutical Strategy aims to ensure the supply of medicines at a fair price) and deepening the harmonization and the cross-border cooperation between Member States (i.e the comprehensive Cancer centre that the Beating Cancer Plan is planning to set up in order to share data and best practices).

Lastly, the development of holistic and global approach to health is also included in the EHU. Regarding the former, the Commission includes animal health and its welfare as an essential part of human health through its One Health approach. As for the latter, the EU has included health as one of the main aspects of its diplomatic action. As such, the president of the Council, Charles Michel, led the efforts for the creation of an international treaty on pandemic prevention and preparedness. Moreover, health ministers have met with foreign affairs ministers to discuss how these two policy areas can be intertwined.

How do we get there?

Two different ways can be considered. Some argue that the treaties should be revised and changed as to give the EU the needed competencies. Therefore, the concept of subsidiarity, included in the article 168 of the Treaty on the Functioning of the European Union (TFEU), should be up for discussion, as it has enabled the EU action on health only through slower and more complex procedures. This would imply a longer process and a more delicate political discussion on the health sovereignty of its member states.

Nonetheless, there are some low hanging fruits that could be reached first, the main one being the joint procurement mechanism. After being proved as an effective tool for the access to medicines, especially for smaller Member States, it could be extended to the purchase of other kind of medicines that are deemed essential.

Furthermore, the different legislative initiatives that the Commission has presented during the last months, including the aforementioned plans, the implementation of a medical certificate that is recognized across its Member States such as the Covid certificate, the creation of a new Directorate General, DG HERA, or the new role of the EMA are the best prove that there is room to push for an ambitious legislative agenda under the current framework.

All in all, it seems that the prophecy of Jean Monnet, who stated that Europe would be the result of common responses to the crises that European states would face, could once again be fulfilled.

Pablo Expósito, Consultant at Vinces.