COVID-19 could be incentive to give EU more health powers

Health Commissioner Stella Kyriakides presenting the first proposals of the broader European Health Union. [EPA-EFE/YVES HERMAN/POOL]

With citizens more concerned about health due to the pandemic, questions are raised as to whether the EU’s current instruments are enough, or whether it is time to discuss member states sharing more health competencies with the EU.

There is a well-known limit to how far the EU can go regarding health since the member states have a tight grip on competencies in this field.

Despite this, efforts are being made to strengthen the European healthcare systems in the wake of the COVID-19, such as the European Health Union, the elements of which are not entirely set up yet.

The concept of the EU Health Union reflects, amongst other things, the wishes of European citizens to place public health higher on the EU’s agenda.

Whether to stop there or even possibly give the EU more competencies in public health was part of a recent event organised by the European Initiative of Health and Sustainable Development (EIHSD) and the Foundation for European Progressive Studies (FEPS).

Speaking at the event, former EU health commissioner Vytenis Andriukaitis, although welcoming an initiative like the European Health Union, would like to see more fundamental changes.

“[When I was commissioner, I was] asked why we were so weak in delivery, for example, on vaccines or to help us to have the cheapest medicine, to help us to have easy access to primary health care. Those questions were always on the table,” he said.

“And of course, at political level attention to health is always when some crisis is shocking the EU,” he continued, adding that these crises, he added, had led to the establishment of new agencies like the EU’s food safety agency (EFSA), the European medicine agency (EMA) and the EU’s centre of the infectious disease (ECDC).

“[This is] reacting, but not going into the deepest understanding of why health is not at the top of European Union politics. And now you see [with COVID-19], it’s the same,” he said.

Having experienced the limitations of the Commissions’ public health portfolio, Andriukaitis would like to see the EU help to deliver elements such as universal health coverage for primary health care.

He also wants “ministers gathering minimum six times per year in Brussels discussing shared competence.” “It is impossible without strengthening our treaties,” he said.

FEPS president Maria João Rodrigues agreed that more shared competence between the EU and member states was necessary.

“I think we need a change of the treaty to ensure that we have more precise coordination and to ensure that the coordination and conversions are supported by a strong European budgetary capacity,” she said.

According to her, the EU has created exceptional recovery funds, but these recovery funds should be extended over time to provide a financial basis for European action on health.

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Plenty of instruments to use

Other panellists were not convinced that incorporating the Health Union into the treaties was necessary.

Speaking about the establishment of the Health Union as the Commission has presented it, former Commissioner and former Italy’s prime minister Mario Monti said that “health comes late to the arsenal of EU instruments but is too serious a topic to be the object of these narrow-minded tactical games between of the member states.”

“But I would like to underline that at any rate, the Commission was active in the field of health over the last couple of years. Also, in particular aspects of health policy where treaty powers were not necessary,” he added.

Changing the treaties is indeed a big job and would open up discussions on many other areas than health.

This is part of the reason Martin McKee, professor of European Public Health and Medical Director at the London School of Hygiene and Tropical Medicine, would instead use the full potential of the current instruments before considering changing the treaties, “given that it should be possible to do an awful lot with the measures that we already have.”

“We already have article 168 [in the Treaty of the Functioning of the EU] with a commitment to a high level of human health in all of the EU’s policies,” stressed McKee.

For him. this certainly provides a basis to go forward with many things. “If they can’t be done by treaty, then it’s likely that many of them could be done by inter-governmental action anyway,” he added.

Lastly, Christine Berling, a French official at the ministry of solidarity and health, said that with the current mechanisms, the EU acted swiftly to the COVID crisis, but that “has shown them in a nice illustrated that we need to go further for the better health of European citizen.”

“The French presidency thinks it [might be a good idea] develop a public health pillar, based on the example the European pillar of social rights. This could really constitute a common compass,” she said.

[Edited by Gerardo Fortuna/ Alice Taylor]

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