LibGuides: 157th CoR Plenary Session (10-11 Oct 2023): Debate on a health union for Europe and its regions

Debate on a health union that works for Europe and its regions

European Health Union: Protecting our health together
The European Commission is building a strong European Health Union, in which all EU countries prepare and respond together to health crises, medical supplies are available, affordable and innovative, and countries work together to improve prevention, treatment and aftercare for diseases such as cancer.
The European Health Union helps:
- Better protecting the health of our citizens
- Equipping the EU and its Member States to better prevent and address future pandemics
- Improving the resilience of Europe’s health systems.
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EC website
European Health Union: Supporting the transition to the new medical device framework
There are more than 500,000 types of medical devices on the market, ranging from low-risk products such as thermometers to high-risk devices such as pacemakers. The 2017 medical devices Regulation and the Regulation on in vitro diagnostics, establish a modernised and more robust EU legislative framework to ensure better protection of public health and patient safety. Despite considerable progress with the implementation, the transition to the new rules has been slower than anticipated. Today, healthcare systems throughout the EU are facing a risk of shortages of life-saving medical devices for patients.
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EC publication, 2023
How a European health union can strengthen global health
The COVID19 outbreak has had two political consequences for the European Union: it has put closer integration of EU internal health activities on the agenda, and it has pulled the EU in a leading position on global health policy. The present call for a European Health Union by the European Commission brings an important political opportunity for the geopolitics of global health as its internal legal and political capacity for health immediately interacts with the EU's capacity to strengthen global health. It is still the case that the EU can only act externally to the extent that internally it has the competence to do so. Yet given the present geopolitical pull on the EU to play a role in global health, this will also benefit the Member States internally.
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Ilona Kickbusch, Anniek de Ruijter, THE LANCET Regional Health, January 25, 2021
Do we need a European Health Union?
In the past 2 years, the resilience of the European health systems has been tested as never before. Europe was not prepared for public health emergencies. Health systems struggled, particularly in the early stages of the COVID-19 pandemic, plagued with shortages of beds, medical equipment (such as ventilators and personal protective equipment), and staff. To reinforce Europe's capacity to respond to new cross-border health threats, in October, 2020, EU Commission President Ursula von der Leyen called for a European Health Union—to better protect the health of its citizens, equip the EU and its Member States to better prevent and address future pandemics, and improve resilience of health systems.
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THE LANCET, Public Health, Editorial, Vol.7, Issue 11, Nov 2022
The European Health Union: European Union’s Concern about Health for All. Concepts, Definition, and Scenarios
The COVID-19 pandemic brought visibility and intensified the discussions on the European Union’s (EU) health mandate. The proposals of the European Commission (EC) to move towards a European Health Union (EHU) can be seen as a starting point towards more integration in health. However, the definition of what the EHU will look like is not clear. This paper searches to find a common definition, and/or features for this EHU through a systematic literature review performed in May 2021. “European Union’s concern about health for all” is suggested as a definition. The main drivers identified to develop an EHU are: surveillance and monitoring, crisis preparedness, funding, political will, vision of public health expenditures, population’s awareness and interest, and global health. Based on these findings, five scenarios were developed: making a full move towards supranational action; improving efficiency in the actual framework; more coordination but no real change; in a full intergovernmentalism direction; and fragmentation of the EU. The scenarios show that the development of a EHU is possible inside the current legal framework. However, it will rely on increased coordination and has a focus on cross-border health threats. Any development will be strongly linked to political choices from Member States.
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Marie Nabbe and Helmut Brand, Healthcare 2021, 9(12).

Towards a European Health Union – What Role for Member States?
Calls for a European Health Union apparently challenge long-standing beliefs that national healthcare system organisation is a Member State competence. Interaction between Member State and European Union levels therefore fundamentally requires reflection in the design, overall structure and legal basis of any European Health Union. Article 168(7) Treaty on the Functioning of the European Union provides the current version of the seemingly limited EU competence with regards to national healthcare system organisation and has received surprisingly little attention thus far. On the one hand, within the wider EU health competence ‘web’, Article 168(7) TFEU constrains EU adoption of measures incentivising Member States to use particular treatments or to increase intensive care units in response to COVID-19. On the other hand, Article 168(7) TFEU is challenged by the perceived influence of Country-Specific Recommendations issued in the context of the European Semester on national health policies. This opinion piece provides an original assessment of Article 168(7) TFEU to argue that Treaty change to redress the balance between EU and Member State competence regarding national healthcare systems may be uncalled for given both the flexibility afforded by the provision and the complexity and diversity of Member State healthcare systems.

Mary Guy, European Journal of Risk Regulation, 2020

Preparing Europe for future health threats and crises: the European Health Union
It has been a little over 3 years since a novel coronavirus, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), spread across Europe and the world. During that time, health systems were put under pressure like never before. The coronavirus disease (COVID-19) pandemic revealed that most health systems were ill-equipped for a crisis disproportionately affecting the most vulnerable communities. The pandemic also uncovered the persistent inequality in prevention and care between and within countries in the European Union (EU) and between different population groups. Economies and societies continue to face uphill battles in coping with the lingering effects of a disease that led to too many lives lost.
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Sandra Gallina, Eurosurveillance, Volume 28, Issue 5, Feb 2023