Just a few months ago, the future of the EU’s competence in health seemed uncertain, with genuine concerns amongst the Brussels health stakeholder community that the Health Commissioner portfolio could disappear under the new Commission and that the Commission’s health department (DG SANTE) could even cease to exist. While these concerns were quickly proved false when new Commission President and former medical doctor Ursula von der Leyen took office, renewing the Commission’s focus on health and prioritising a European Beating Cancer Plan, it seems unbelievable today that they existed in the first place.

We need a European Union strong on health

The world is experiencing a global health crisis on an unprecedented scale and Europe is right at the epicentre. The COVID-19 pandemic has surely given new impetus to the need for a European Union strong on health. Coordination and cooperation between countries are crucial at a time like this, and this is one area where the EU is needed most. Trying to coordinate 27 different countries in the midst of a crisis has, however, proved challenging.

While the EU’s response has been criticised by some, much of the initial chaos can be put down to the fact that key powers lie in the hands of Member States, with the European Commission limited to trying to influence their actions. Crisis response and management has historically been a weak point of the EU when faced with health threats, with Member States often reverting to taking national measures, such as border closures and export bans on drugs and medical equipment.

The EU has responded as best it can despite limits to its power  

When the novel coronavirus first arrived in Europe in January 2020, it seemed to be underestimated by the EU as well as by individual countries, viewed as a distant threat that wouldn’t have any big impact on Europe. While the EU may have initially failed to understand the severity of what was coming and plan ahead, as soon as the scale of the crisis became evident it has acted quickly to respond as best it can with the competence it has.

The EU’s response focuses on four key priorities: limiting the spread of the virus, ensuring the provision of medical equipment, promoting research for treatments and vaccines, and supporting the economy. The EU is tackling the problem from all angles, focussing not only on a comprehensive public health response but also supporting Member States to deal with the enormous financial pressures brought about by the crisis. Just some of the measures taken so far include €140 million allocated in research funding to develop treatments and vaccines, and €37 billion from the EU budget made available to support healthcare systems, SMEs and labour markets. In addition, the Commission has put forward a proposal for temporary Support to mitigate Unemployment Risks in an Emergency (SURE), aiming to help people keep their jobs during the crisis by providing loans to Member States of up to €100 billion.

Aside from financial measures, the EU is playing a key role in securing the supply of vital equipment for Member States through the joint procurement mechanism. Three joint procurements have so far been initiated, including for personal protective equipment (PPE), respirators and laboratory equipment.

Post-COVID-19: more EU competence in health?

If history is anything to go by, it’s likely that the EU’s capacity to act in the face of a health crisis will be expanded once the current pandemic is under control. This has been the case in the past, and given that this is a crisis on a scale never seen before, it’s hard to imagine that it won’t be the case this time round.

The joint procurement mechanism is a prime example of increased EU health competence in response to crisis. It was set up in 2010 following the H1N1 (swine flu) pandemic which revealed weaknesses in Member States’ access to and purchasing of vaccines and medication at the time, as countries competed with each other to purchase and stockpile available flu vaccine supplies and antiviral medication.

Another example is of course the establishment of the European Centre for Disease Prevention and Control (ECDC) in 2005. With the overall aim of strengthening Europe’s defences against infectious diseases, ECDC was created in response to the anthrax alerts in the US in 2001, the 2003 outbreak of SARS, and subsequent pandemic influenza threats. It plays a key role in coordinating surveillance and monitoring of communicable diseases and has been a central source of information and guidance during the current COVID-19 pandemic.

So, what will come after COVID-19? Member States have been calling for more cooperation and EU action, and EU leaders have already asked the Commission to come up with proposals for a more ambitious and wide-ranging EU crisis management system. As far as Janez Lenarčič, European Commissioner for Crisis Management, is concerned, “you cannot manage a crisis without a corresponding power to take decisions”. However, even if Member States wanted to hand more power to the EU, this would involve treaty change – a complex process requiring the approval of parliaments and, in some countries, referendums. But if this is an unprecedented health crisis, perhaps there will be an unprecedented response. In any case, Commissioner Lenarčič assures us that there are other ways to bring the EU and Member States closer together, without the formal transfer of power.

What will happen remains to be seen, as for now, the EU and its Member States are focussing their efforts on overcoming this regional and global health crisis. As they do so, we at Incisive Health are working closely with our clients to help them understand how the pandemic is affecting their initiatives and, above all, the patients they serve. We are available to discuss how we can support organisations to navigate this fast-changing health policy landscape and think ahead in preparation for life after COVID-19.