Abstract
BackgroundThe COVID-19 outbreak has heightened ongoing political debate about the international joint procurement of medicines and medical countermeasures. The European Union (EU) has developed what remains largely contractual and decentralized international procurement cooperation. The corona crisis has broadened and deepened public debate on such cooperation, in particular on the scope of cooperation, solidarity in the allocation of such cooperation, and delegation of cooperative decision-making. Crucial to political debate about these issues are public attitudes that constrain and undergird international cooperation.MethodsOur survey includes a randomized survey experiment (conjoint analysis) on a representative sample in five European countries in March 2020, informed by legal and policy debate on medical cooperation. Respondents choose and rate policy packages containing randomized mixes of policy attributes with respect to the scope of medicines covered, the solidarity in conferring priority access and the level of delegation.ResultsIn all country populations surveyed, the experiment reveals considerable popular support for European cooperation. Significant majorities preferred cooperation packages with greater rather than less scope of medicines regulated; with priority given to most in-need countries; and with delegation to EU-level rather than national expertise.ConclusionJoint procurement raises delicate questions with regard to its scope, the inclusion of cross-border solidarity and the delegation of decision-making, that explain reluctance toward joint procurement among political decision-makers. This research shows that there is considerable public support across different countries in favor of centralization, i.e. a large scope and solidarity in the allocation and delegation of decision-making.
Highlights
The outbreak of COVID-19 highlights a crucial challenge for international cooperation regarding the availability of medicines
The crisis awakens protectionism and a retreat to national sovereignty in public health. These offsetting responses play out with respect to key aspects of supranational collaboration in public health, including: scope, solidarity and delegation
We report results from a recent five-country randomized survey experiment into public attitudes toward joint procurement and allocation of medical countermeasures in the European Union (EU)
Summary
The outbreak of COVID-19 highlights a crucial challenge for international cooperation regarding the availability of medicines. The crisis underscores the need for states to collaborate in the procurement, allocation and stockpiling of medical countermeasures, in a health emergency.[1,2] On the other hand, the crisis awakens protectionism and a retreat to national sovereignty in public health These offsetting responses play out with respect to key aspects of supranational collaboration in public health, including: scope (to what extent should such collaboration be limited to very specific situations?), solidarity (can priority support be given to countries most in need?) and delegation (can governance be delegated to supranational institutions and expert bodies?). This research shows that there is considerable public support across different countries in favor of centralization, i.e. a large scope and solidarity in the allocation and delegation of decision-making
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