After the crisis: Proposals for a European Health Union
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    After the crisis: Proposals for a European Health Union

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    The coronavirus pandemic hit the EU and its member states unprepared without a common policy to contain the spread of the virus. Now there are calls from civil society and the European Parliament to create a European Health Union before a second wave hits Europe again.

    After the previous financial crisis, a Banking Union was created to ensure that EU banks are stronger and better supervised. Every time there is a need in a specific area for coordinated action on EU-level, an “Union” is established.

    In her political guidelines, under the slogan “A Europe that strive for more”, European Commission President Ursula von der Leyen, listed a number of existing “Unions” in the economic and financial policy areas and proposed a new European Defence Union. But no-one foresaw the outbreak of the pandemic, despite some warning signals, and there was nothing about a health union.

    “As a physician, I am passionate about health,” she wrote as a President-elect. “40% of us will face cancer at some point in our lives and almost all of us will know the anxiety and grief of a friend or family member diagnosed with cancer. I will put forward a European plan to fight cancer, to support Member States in improving cancer control and care.”

    Von der Leyen is of course right that there is “a lot more to do” to fight cancer, which is a more deadly disease than COVID-19, but fighting infectious diseases requires much more common action, coordination and cooperation between the member states.

    A proposal for a European Health Union was launched on Europe Day (9 May) at an on-line conference organised by 15 NGOs, including civil rights organisation New Europeans. The conference, a kind of Future of Europe conference that the Commission is planning to organise, aimed at sending out a message of hope and togetherness during the corona crisis and to stand up for democracy.

    Commemorating the 70th anniversary of the Schuman Declaration, a team of policy experts and community activists from all parts of Europe called for a new “Schuman Plan” in the form of a more integrated health system in Europe post the coronavirus crisis.

    Lessons learned

    “We have seen that a lack of coordination and integration in Europe in the face of the current epidemic has produced a near collapse of our health care systems in some areas, and the shutting down of borders and our economies,” said Giovanni Brauzzi, a former Italian diplomat, chair of New Europeans-Rome and initiator of the proposal.

    The proposal focuses on lessons learned from the current crisis. “Medical experts knew that we were at risk of a virus pandemic similar to the one we are actually experiencing, rang the alarm bell many times, and requested governments all over the world to update the global influenza pandemic preparedness plan WHO had drafted in 2010.”

    Now the price is much higher but the level of social consensus on new investments in public health is proportionally even higher. Europe can benefit from best practices and frequent mistakes experienced in the crisis. “A consultation of the best minds of the health sector is needed to distil the lessons learned and translate them into wide-ranging programs.”

    The Brussels Times asked Giovanni Brauzzi what lessons can be learned already now. “The main tentative lesson seems to be adopting a comprehensive approach consistent with the broad definition of health given by WHO, namely ‘a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity” for all Europe’s citizens’,” he replied.

    “This is what we should expect from the interaction of the foreseen European Recovery Plan, the EU Green Deal and the Multiannual Financial Framework for 2021-2027,” he added. “The Founding Fathers (of the European project) would certainly have appreciated that we are now at a stage of European integration in which the citizens are in the driving seat.”

    The health care systems and hospitals in most countries were unprepared for the outbreak of the coronavirus and many of them have been underfinanced for years. Are there any figures on how much more needs to be invested in public health care systems?

    Brauzzi does not have the figures but recalls that the magnitude of the task has led the Commission and the Eurogroup to come up with financial assistance, or safety nets, to the member states during the crisis, including the financing of direct and indirect healthcare, cure and prevention related costs due to COVID-19. There are also plans for a recovery fund.

    “This will be the immediate response,” he says. “Probably, in the medium term, we need additional structural changes in the way health care is delivered Europe-wide.”

    Treaty change?

    Currently, public health is a member state competency and the EU treaty states that Union action shall “complement” national policies. During the first weeks of the outbreak of the pandemic, the Commission repeatedly underlined that its task was limited to coordinating the measures taken by the member states. Is there a need for treaty change?

    “It will depend on the level of ambition of any future health reform in the EU,” Brauzzi replied. “A lot is already possible without treaty changes, if there is political will. Our reference to subsidiarity in the proposal focuses on the importance of adequate coordination and harmony among the various EU levels.”

    “It’s probably better to identify first frictions and bottlenecks and only afterwards choose what legal instruments should be used. The objective is to secure a step change in health outcomes with respect to how European governments and the European institutions respond to future pandemics. That is the clear expectation of the citizens who took part in our online conference on Europe Day.”

    “Those who took part are no revolutionaries – they are ordinary citizens like me. We want our Europe to protect us effectively from future pandemics just as passionately as we want our Europe to preserve peace and prosperity. That is why initiatives such as the one being taken by New Europeans to organize an international conference on lessons learnt are so important.”

    Giovanni Brauzzi and civil society organisations are not alone in their call for a European Health Union. The Group of the Alliance of Progressives and Democrats in the European Parliament (S&D) sent an open letter on 7 May to Commission president von der Leyen, Council president Michel and prime-minister Plenkovic of Croatia (which holds the EU presidency), on the same topic.

    “We need to be prepared to respond more robustly and with European solidarity to a future pandemic,” the letter says. “It is time to set up a European Health Union. If not now, when?”

    M. Apelblat
    The Brussels Times