EU health policy in the aftermath of COVID-19: neofunctionalism and crisis-driven integration

Abstract

ABSTRACT In March 2020, the COVID-19 pandemic shook the European Union (EU). The EU responded to the multifaceted challenge with an integrative leap forward. Member States substantially increased their investment in existing health policy tools such as civil protection and financing for health initiatives. There was innovation in EU law, where a process of redefining public health began, and in strategies for vaccines and pharmaceuticals, where the EU took on a direct and significant role in medicines procurement for the first time. We use the framework of neofunctionalism to analyse developments in health policy during the pandemic to further understand the dynamics of integration and, in particular, to understand why EU Member States opted for further integration in response to the pandemic. As neofunctionalism might predict, Member States solved problems born of integration with more integration: preserving the internal market, insuring against disasters, preventing border closures and enhancing EU power in vaccine development and procurement. Reflecting decades of entrepreneurs who had created various mechanisms, they primarily built on pre-existing, if often weak, structures and enhanced EU governance more than competences.