Europe’s Quest for Health Sovereignty

Health sovereignty has emerged as one of the defining political challenges facing the European Union. The COVID-19 pandemic exposed the extent of Europe’s vulnerability to medicine shortages, disrupted supply chains, external manufacturing dependencies, and fragmented national responses in times of crisis. These weaknesses have become ever more glaring amid rising geopolitical tensions and intensifying global competition in biotechnology.

Establishing health sovereignty in Europe must therefore go beyond the capacity to respond to crises and encompass the European Union’s ability to guarantee access to high-quality healthcare, secure reliable supplies and production of essential medicines and technologies, and sustain global competitiveness in health innovation.

Achieving this objective requires a broader vision of health policy, one that recognises healthcare not simply as a social expenditure, but as a strategic investment in Europe’s long-term stability, productivity, and security. This is particularly important at a time when many healthcare systems across the EU are facing mounting pressures from poor public health investment, workforce shortages, widening inequalities in access to care, and growing dependence on fragile global supply chains. Strengthening the resilience of these systems has therefore become central to Europe’s capacity to withstand future crises and maintain its strategic autonomy.

Securing medicines and strategic resilience 

Access to affordable medicines is a fundamental healthcare right and a central component of European health sovereignty. Yet medicine shortages in Europe increased twentyfold between 2000 and 2018, while prices simultaneously continued to rise sharply. In Italy the cost of some essential cancer treatments has increased by as much as 1,500% in recent years.

Europe also remains heavily dependent on external suppliers for active pharmaceutical ingredients, leaving Member States vulnerable to geopolitical tensions, export restrictions, and global supply chain disruptions. Between 60% and 80% of active pharmaceutical ingredients are now manufactured outside the EU. At the same time, extensive intellectual property protections often delay access to medicines and limit the development of affordable biosimilar and generics.

Strengthening health sovereignty therefore will require a more coordinated industrial and pharmaceutical strategy at EU level. Europe must invest in resilient manufacturing capacity, diversify supply chains, and support the production of essential medicines within the Union while maintaining open and cooperative global partnerships.

Strategic resilience must go hand in hand with affordability and equitable access. Public investment in research and innovation should contribute to ensuring that medicines developed with public funded research remain accessible and affordable to patients across all Member States. Coordinated procurement, stronger cooperation on shortages, and support for generic and biosimilar production can all help reinforce both Europe’s resilience and access to care.

From crisis response to permanent preparedness 

The Covid-19 pandemic clearly showed that no Member State can effectively manage large-scale cross-border health threats alone. European coordination proved essential during moments of extreme pressure. Joint procurement mechanisms, cross-border cooperation, vaccine development partnerships, and the creation of the Health Emergency Preparedness and Response Authority (HERA) marked substantial steps towards a more coordinated European health response. 

Yet preparedness cannot remain limited to emergency instruments activated only during crises. We need to move from reactive crisis management to permanent preparedness capacity. This means strengthening European coordination on stockpiling, surveillance and emergency manufacturing capabilities. It also means improving interoperability between national systems and reducing fragmentation that weakens Europe’s ability to act collectively and rapidly. 

The lessons learned from the COVID-19 pandemic are already informing cooperation across multiple areas, reflecting a growing level of trust between EU institutions, Member States, and international health organisations. Maintaining and strengthening this progress will be essential to ensuring future health sovereignty. 

Investing in the healthcare workforce

The EU already faces a shortage of an estimated two million healthcare workers, a gap expected to widen as the workforce ages and retirement rates increase. Low pay, excessive workloads, burnout, and poor working conditions, all pressures that were intensified by the COVID-19 pandemic, have made healthcare careers less attractive. This is driving professionals out of the sector or towards countries offering better salaries and conditions. The result has been growing inequalities between Member States and the increasing desertification of healthcare services in rural and underserved regions.

Addressing these shortages will require coordinated European action on training, retention, mobility, and working conditions. Investments in health innovation and biotechnology must be matched by investments in the workforce capable of delivering care and supporting medical innovation across the Union. 

Prevention and the One Health approach

Achieving health sovereignty must also include stronger investment in prevention and preparedness against long-term health threats. Climate change, antimicrobial resistance, biodiversity loss, and environmental degradation are increasingly shaping public health outcomes across Europe and globally.

In recent decades, 60% of newly emerging epidemic diseases have been zoonotic in origin, including HIV, Ebola, SARS, MERS, and COVID-19. The pattern is clear. Ecosystem destruction, the overuse of antibiotics in agriculture and medicine, and the release of pharmaceutical pollutants into water and soil are not isolated environmental issues; they are growing public health threats.

Antimicrobial resistance alone already causes around 35,000 deaths every year in the EU, a burden comparable to influenza, tuberculosis, and HIV/AIDS combined.

The One Health approach therefore needs to become more systematically integrated into European policymaking, because reducing future vulnerabilities requires policies capable of addressing the structural drivers of health crises before they escalate into emergencies.

Conclusion

European health sovereignty cannot be reduced to preparedness for the next crisis alone. It requires a long-term commitment to strong public healthcare systems, affordable medicines, secure supply chains, investment in healthcare workers, and one health approach. Meeting these challenges successfully would strengthen not only Europe’s capacity to protect public health, but also its social cohesion, economic resilience, and strategic autonomy in an increasingly uncertain world.