The COVID-19 pandemic has once again exposed the fragility of the European Union when it comes to public health.
Faced with this life-size test, our national health systems proved overwhelmed. This powerlessness led to our governments initially applying national protection measures as a reflex action.
However, this initial protectionist attitude soon gave way to enhanced European solidarity and coordination.
We are undeniably stronger together, but we still need to activate the available tools to respond to health emergencies of such magnitude. Adopted as and when health crises occur, these instruments do exist and are used side by side or in combination; however, reactive and efficient coordinated EU level action is lacking. The legislative package “Building the European Health Union” published on 11 November last, shows the European Commission’s commitment to bringing coherence to our health crisis anticipation, preparedness, and response mechanisms.
This is a very good start, but we can go further. The regulation on serious cross-border health threats must become a European Health Emergency Plan.
As a hub for crisis management, this legislation will coordinate existing and future European health instruments, legislation, and agencies.
As a Rapporteur of the European Parliament, I fully support the new set of proposals put forward by the European Commission under this new regulation.
Several of these measures were strongly supported by the European Parliament’s resolutions an updated Early Warning and Response System (EWRS), the auditing and stress testing of the national plans, the joint procurement of medical products, the training and mobility of health care professionals and, last but not least, stronger European health agencies.
Beyond these essential measures, I also warmly welcome the taking into account of climate-related threats, the building of a European network of reference laboratories and the possible introduction of an exclusive “European Union” clause in grouped purchasing contracts, which would put an end to national orders interfering with previous Community orders.
In some respects, I am convinced that the European Union could do even better.
Promoting solidarity in the European Union and beyond
The COVID-19 crisis has shown that no single country can tackle a global pandemic on its own.
Our priority must be to ensure “health solidarity” by reducing health inequalities between and within Member States. Every European must have the opportunity to enjoy the same level of protection against health threats and have access to the same health care and treatments regardless of the country they live in.
And our values of solidarity for fair and universal coverage of quality health services must also be promoted beyond our European borders: a strengthened cooperation with third countries in the exchange of knowledge and best practices on threat preparedness and response is essential. To this end, a robust, sustainable, and effective partnership should be established with international organisations and third countries, particularly in Africa.
Coordination at international community level is a major catalyst for all European actions as regards prevention, preparedness, and response to health hazards. That is why, in my report, I put a very strong emphasis on the need for international cooperation, supporting notably the development of an international treaty on pandemics to facilitate the implementation of the International Health Regulations.
Improved operational coordination at European level
The European Union must draw lessons from the crisis and seize this opportunity to establish an effective system to coordinate the European response to future threats of all kinds posed to public health.
The cross sectoral approach “Health in All Policies” must shape our entire crisis anticipation and management framework, whatever the nature of the crisis. The European Union must be prepared to respond to new pandemics or to any kind of environmental or chemical threats. This is why I am working to broaden the scope and instruments of the legislative proposal beyond the communicable diseases. The involvement of the various health agencies in the risk assessment of a threat is perfectly in line with this approach.
The fight against COVID-19 has revealed strengths and shortcomings in the European Centre for Disease Prevention and Control (ECDC) workings, in particular issues related to gaining rapid access to comparable data.
We need to support Member States to ensure data collection and transmission in times of health emergencies. The data provided will enable the ECDC to carry out epidemiological surveillance at Union level.
This surveillance could also be extended to the impact of communicable diseases on non-communicable diseases and population groups at risk. In line with its recommendations to Member States and health professionals, the ECDC could extend its communication to European citizens by establishing a portal providing verified information. This tool would further enhance the fight against disinformation.
Ensuring access to health products in Europe
The COVID-19 crisis has highlighted a long-standing observation: the European Union has become dependent on medical products. To address this dependency issue, a common approach is urgently needed.
The availability of medical supplies, the risks of shortages and the estimated production capacities for these products will need to be assessed in the context of the European and national crisis preparedness and response plans and their audits.
The European Union is stronger when it negotiates with the industry with one voice on behalf of all Member States. Grouped purchasing of medical products must be facilitated.
This collective bargaining aims to ensure equal access for every European citizen at the same time.
The European Medicines Agency (EMA) plays a key role in health crisis preparedness and management and, as such, it should be given a much more prominent role than set out by the Commission in its legislative proposal. Its responsibility in marketing authorisation, in continuous risk assessment of medicines and management of shortages, should put the Agency on par with all other European agencies involved in the assessment of health risks.
Building inclusive health governance
This enhanced crisis preparedness and management system must be based on inclusive health governance.
The strengthening of the Health Security Committee and its working groups, the greater involvement of all European agencies and the establishment of the Advisory Committee on public health emergencies are steps in the right direction.
The COVID-19 crisis has also revealed that the European citizens wanted more transparency and participation in the decision-making process.
Hence, I am proposing that the European Parliament is given an observer role in the Health Safety Committee and that representatives of civil society, an important role in the Advisory Committee.
Beyond the decision-making aspect, the EU should involve all health authorities in the implementation of European and national crisis preparedness and response plans. These plans should foster greater cross-border health cooperation through interregional crisis anticipation planning.
Including regional and local authorities in this process will allow Member States to mobilise funding in a proportionate fashion according to their needs, notably facilitating partnerships in border regions with a view to sharing facilities as well as infrastructure and staff costs.
This legislative proposal, along with those on the revision of the EMA and the ECDC mandates, are the first steps towards a true European Health Union.
With a budget of 5.1 billion euro for the 2021-2027 period, the European Health Programme, EU4Health, finally gives us the means to prioritise coherence and efficiency in our health policy. Let us not miss this opportunity! The European people would not forgive us.