Remco van de Pas
Senior Research Fellow ITM Antwerp & Vice-President MMI- Network Health for All
A frequent question asked during the COVID-19 pandemic has been why the European Union (EU), its institutions, and member states reacted late and in an incoherent matter to the pandemic? This included the closing of internal EU borders and distributional problems of medical material and protective personal equipment such as facemasks. Each country still has very different approaches to the public health containment of the viral outbreak. Initially also the financing of the development, purchase and distribution of a vaccine seemed to become a national priority rather than a coordinated European endeavour. To answer this question, one should realise that within the EU, health systems governance and essential public health functions, remains the formal mandate of nation states. The EU has limited legal competence in relation to health, which explains the limits on the response to the pandemic.
However, 9 months in the pandemic we see strong calls for a more Europeanised, coordinated and institutionalised approach for dealing with health emergencies. In September 2020 European Commission President Von der Leyen advocated for a European Health Union in her State of the Union address to the European Parliament. Being a gynecologist by training herself, she proposed to bolster the European Medicines Agency and European Centers for Disease Control, and to build a European BARDA – an agency for biomedical advanced research and development. Jointly with Italy a Global Health Summit will be convened in 2021. Furthermore, according to the EC president, the expansion of competences as listed in the EU Treaties is to be discussed in the Conference of the Future of the EU. This idea was echoed by a group of health and political leaders, including former European Commissioners that early October presented a Manifesto for a European Health Union, that urges the EU to create a core health competence in the European Treaties.
At the international level, the EU made a strong political statement by organizing a virtual pledging conference to raise money to fill "immediate funding gaps" in vaccine research. The conference was organized one day after President Trump announced suspension of US funding to the World Health Organization (WHO). In addition, in an EU-brokered resolution on May 19, WHO Member States tasked the WHO to look after “scaling up global manufacturing and distribution capacity for vaccines, tests and treatments” via the use of existing international treaties and trade rules.
As the COVID-19 pandemic enters a pro-longed phase, the EU and its member states are in the position to jointly contain the virus and begin to structurally recover by investing in the development of strong and resilient public health systems both within the union as well as in Low- and middle-income countries. Financially, the EU should work for sustainable financing and reform of WHO, including ensuring autonomy and the global public legitimacy of the organization. Sustainable and long-term predictable financing leads to sustainable human resources planning with staff that can implement reforms and deliver what is demanded of WHO, such as leadership and normative guidance for essential public health functions containing health emergencies such as future pandemics.
Lastly, there is still uncertainty about the future development cooperation budget of the EU for its 2020-2027 program. An immediate issue now resolves about the impeding famines, impoverishment and humanitarian needs that are related to the faltering economies in the wake of the COVID-19 crisis, but are also expected due to the ever more felt impacts of the climate crisis. It is important that the EU will provide sufficient funding addressing humanitarian emergencies in the Middle-East and African continent, while at the same time they must seriously consider to postpone or even cancel, the growing debt burden of several low-income countries. Human dignity must prevail over global health security needs. The EU must live up, and act, according to its values.