Is this the time to work towards a European health union? That question was discussed by policy-makers at an event in Brussels yesterday (21 Feb), where speakers included Italian’s former prime minister, Prof Mario Monti, the former health commissioner and Christine Berling, Directorate General for Health for the Ministry of Solidarity and Health of France, which currently holds the European presidency.

The idea of a European health union isn’t new but COVID has sparked greater interest in it, as well as popular support. Monti likened the pandemic to the foreign exchange crises of the 1970s and 1980s which led to the creation of the European Central Bank and the euro. “The pandemic worked as a single trigger for health—hence the need for a European Health Union.”

'Consistent data systems across Europe'

Unlike customs, competition or monetary policy, health is not an area of EU action, or competence. The health of citizens is the responsibility of individual countries, Berling pointed out – although, she suggested, that approach may need to change.

Areas such as digital health, IT and human resources, are areas public goods involving cross-border transfer of technology and workers and should be common priorities, said Josep Figueras, director of the European Observatory on Health Systems and Policies. “Digital is the one that everyone agrees on, of course; but there are many others,” he said.

The pandemic showed up some gaps across the continent, according to Prof Martin McKee, professor of European Public Health and Medical Director at the London School of Hygiene and Tropical Medicine.

“One of the first priorities is the need to coordinate our intelligence on the health threats that we’re facing,” he said. “We still don’t have consistent data systems across Europe, for the exchange of data, despite everything that’s being done with GDPR and elsewhere.”

A shift in status of health in Europe

The speakers were uncertain about whether a health union could be achieved without forming a new treaty or legal instrument—but some felt more could be done with the tools that currently exist. Figueras said that Digital Health Europe could be used more effectively. Many member states would also love to have shared health technology assessment, he said.

The pandemic has shifted the status of health within Europe. Vytenis Povilas Andriukaitis, Former European Commissioner for Health and Food Safety from 2014 to 2019, recalled being surprised by the lack of power within the office. A trained doctor, he was minister of health in Lithuania before taking on the role in Europe and said he was “shocked with some of my experiences.” 

Now, he suggests, “health is like a princess--not like a Cinderella.”

For Monti, a closer health union reflects the EU’s founding goals. “This is the moment when a European health union may well shift from being a dream of European fans to a reality – not easy to achieve but something that will be concretely very much looked for,” he said.