The EU Response to COVID-19: From Reactive Policies to Strategic Decision-Making.

ObjectiveThere is no European Union (EU) health system but there is an EU health policy and this health policy is rapidly changing due to the COVID-19 responses of the EU and Member States. The aim of this panel discussion is to analyze and put into context the rapid evolvement of EU health policy during the pandemic. This panel discussion will therefore focus on 1) EU public health policy 2) EU action for health 3) the EU Market shaping health 4) the fiscal governance 5) the institutions, processes and powers.BackgroundEU health policy has often been overlooked and was never on the political agenda. COVID-19 and the pandemic response, however, changed this dramatically. EU-health policy has become centre stage followed by bold investments and new regulatory initiatives. Obvious examples are the EU4Heatlth programme, the Recovery and Resilience fund, the new agency HERA, the new remit for the European Medicines Agency and the European Center for Disease Control. There are also new European Commission mechanisms with regards to the purchase of personal protective equipment, supplies, medicines including vaccines and medical technologies. But will the new EU health policy strengthen health systems of Member States or just focus on stronger emergency responses? Will the constitutional asymmetry between health and internal market be addressed? Will EU-health policy remain after the crisis a centre-piece of European Integration? This panel is based on the COVID-19 update of the EU-health policy handbook ‘Everything you always wanted to know about European Union health policies but were afraid to ask'InteractivityThere will be a high level of interactivity. After an introductory presentation, attendees can use the chat-box to choose specific topics from the aforementioned five themes. These topics will be presented in a table. The chair will then pass the questions and topics to the panelists.Speakers/Panelists Sarah Rozenblum University of Michigan, Ann Arbor, USA Holly Jarman University of Michigan, Ann Arbor, USA Nick Fahy University of Oxford, Oxford, UK Anniek de Ruijter University of Amsterdam, Amsterdam, Netherlands Eleanore Brooks University of Edinburgh, Edinburgh, UK Key messages The European Health Union will be one of the most important constitutional and policy outcomes of the pandemic.It is essential that the European Health Union is not only strengthening emergency planning and response but also accessibility, equity and resilience of health systems.

Risk perception of COVID-19 among Portuguese healthcare professionals and the general population

Europe to boost development of new antimicrobial drugs

Issue The politics of European Union (EU) health policy are also the politics of European integration. Debate about EU policies always entails debate about the appropriate role and powers granted to the EU. Description From some angles, the EU looks more like a federation (ex EUA), deeply entrenched in its citizens' lives. It has a powerful shared culture among leaders and strong, entrepreneurial, and statelike political institutions. Its legal system is entwined with member state law to such an extent that member state courts have driven legal integration and change as much as EU institutions, both in general and in health. From another angle, it still looks like an international organization (ex WHO) or a regional trade block (ex Mercosur). We ask what policy a member state might make, but, in the case of the EU, many ask if the EU should have a policy at all. Should it respond, and, if so, how and to whose benefit? Results Like international organizations or confederations, though, the EU responds primarily to and is shaped by the demands of its member states. They have actively maintained this dichotomous structure so as to prevent transfer of power and loss of sovereignty. Member states ultimately determine the direction of the EU, and they have supported EU expansion only when they require a “European rescue of the nation state”. Lessons The EU's weak public health and social policy responses to the crisis reflect this effort on the part of member states to limit its role over the decades, whereas the major expansion in its role over the summer of 2020 reflects the perceived interests of member states, which now seek another European rescue of the nation state. Main messages This crisis of COVID-19 leave behind a different EU. Between the redefinition in salience, resource, and law of public health, shared European actions and the development of EU debt for member states, it is likely that a step forward promoted integration in health and beyond.

European Union (EU) health policy debate is in a peculiar stage: on the one hand, there is an established community of EU health policy experts who understand that a broad range of EU policies that might have major consequences for health care systems. On the other hand, there are the many managers and policymakers around the EU who know little about EU health policy and have seen few or no effects. I argue that it is because EU health policymaking has slow effects, and that the challenge is in influencing it before it has had important consequences. This article first reviews the policy issues, explaining why so much EU policy activity has produced so little concrete effect - and why that situation will probably change. The establishment of a EU role in health care policy means that influence now will shape policies in the future. The second half of the article analyses the problems of coordination and attention that interfere with health care systems’ ability to identify the important issues. I...

This paper explores the new field within European social policy of European Union (EU) health policy. My principal aim is simply to identify the main constituent parts of this emerging new policy field. Although a number of social and political scientists have drawn attention to an emerging European Union health policy, this area has as yet been the subject of little attention from the legal perspective. Therefore, this paper will focus on the legal construction of the EU's health policy, paying particular attention to the ways in which legal concepts and mechanisms are contributing to the contours of this new field of EU activity.

Health in austerity: hard decisions for hard times

Many countries in western Europe are experiencing increasing numbers of sickness spells and early retirements due to mental disorders and problems.1 However, the importance of good mental health is still...

Editorial: Governing the EU's climate and energy transition through the 2030 Framework

200th ENMC International Workshop “European Reference Networks: Recommendations and Criteria in the Neuromuscular field”, 18–20 October 2013, Naarden, the Netherlands

Bringing together the results of a large-scale review of European Union (EU) policies affecting health and a large-scale analysis of social policy and federalism, this paper uses comparative federalism to identify the scope and tensions of EU health policy at the end of the Juncker Commission. Viewing health care and public health policy through the lens of comparative federalism highlights some serious structural flaws in EU health policy. The regulatory state form in which the EU has evolved makes it difficult for the EU to formulate a health policy that actually focuses on health. Of the three faces of EU health policy, which are health policy, internal market policy and fiscal governance, health policy is legally, politically and financially the weakest. A comparison of the EU to other federations suggests that this creates basic weaknesses in the EU's design: its key powers are regulatory and its redistribution minimal. No federal welfare state so clearly pools risks at a low level while making markets so forcefully or creating rights whose costs are born by other levels of government. This structure, understandable in light of the EU's history and development, limits its health and social policy initiatives and might not be stable over the long term.

The Developing Role of the European Union

Chapter 6 considers public health, a domain where the EU has very little competence and where one should not expect theoretically the EU to engage in capacity building. However, this did not preclude the EU from stepping in. The EU created HERA (European Health Emergency Response Authority) and EHU (European Health Union) whilst also expanding the mandates of the ECDC (European Center for Disease Control) and the EMA (European Medicines Agency) without transferring authority to the EU level, but rather by dramatically strengthening its coordination capacity. The level playing field was maintained to a certain extent through a common vaccine policy—which would have put smaller and poorer countries at a disadvantage if they had gone alone—but the EU did not preclude domestic factors (trust, vaccine hesitancy) from creating territorial disparities.

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.

Personal protective equipment has become an important and emotive subject during the current coronavirus disease 2019 epidemic. Coronavirus disease 2019 is predominantly caused by contact or droplet transmission attributed to relatively large respiratory particles which are subject to gravitational forces and travel only approximately 1 metre from the patient. Airborne transmission may occur if patient respiratory activity or medical procedures generate respiratory aerosols. These aerosols contain particles that may travel much longer distances and remain airborne longer, but their infective potential is uncertain. Contact, droplet and airborne transmission are each relevant during airway manoeuvres in infected patients, particularly during tracheal intubation. Personal protective equipment is an important component, but only one part, of a system protecting staff and other patients from coronavirus disease 2019 cross-infection. Appropriate use significantly reduces risk of viral transmission. Personal protective equipment should logically be matched to the potential mode of viral transmission occurring during patient care - contact, droplet or airborne. Recommendations from international organisations are broadly consistent, but equipment use is not. Only airborne precautions include a fitted high-filtration mask, and this should be reserved for aerosol generating procedures. Uncertainty remains around certain details of personal protective equipment including use of hoods, mask type and the potential for re-use of equipment.