EU Policy-making Research Articles

9.C. Round table: The Global Oral Health Action Plan – Integrating Oral Health into the global health agenda

Abstract Oral diseases (OD) are a global public health problem affecting 3.5 billion people, with a global prevalence of 45%, higher than the prevalence of any other non-communicable disease (NCD). Recognizing the global public health importance, the 76th World Health Assembly (WHA) (May 2023) adopted the WHO’s Global Oral Health Action Plan (GOHAP) 2023-2030; a crucial step to bring momentum and mobilise all actors to address the burden of OD and common risk factors for all NCDs, while integrating oral health (OH) as part of general health and promoting cross-sectoral cooperation on good OH worldwide to reach UHC. Drawing insights from other successful global health action plans, this roundtable (RT) will explore key lessons learned in implementing effective strategies to improve OH outcomes at European and global levels, ensuring access to quality care for all. The objectives of the RT are: 1.To present the GOHAP 2023-2030, incl. challenges and opportunities; 2. To draw insights from other global health action plans; 3. To present good examples of civil society organization (CSO) actions supporting the GOHAP’s implementation - The Manifesto of the Platform for Better Oral Health, calling for policy actions by EU policymakers; 4. To present findings from the EU DELIVER (DELiberative ImproVEment of oRal care quality) and PRUDENT projects, funded by the European Commission, aiming to provide and implement a blueprint model for ensuring access to quality OH care for all; 5. To inform follow-up actions and collaboration across EUPHA sections, its strategy, as well as that of European Member States (MS), CSOs and other institutional partners, and to raise awareness across the European public and global health communities. The structure of the RT will include brief interactive presentations with real-time polling to maximize participant engagement and to consolidate key messages to present at the end of the session, incl. to inform follow-up actions across EUPHA. The first brief presentation on GOHAP will highlight the aims and evidence-informed actions, followed by: 1. Insights from other global health action plans, exploring lessons learned in implementing effective strategies, examining the approaches, opportunities, challenges and outcomes; 2. Good examples of actions taken by CSOs; 3. Preliminary findings from the EU DELIVER and EU PRUDENT will be presented, incl. key co-creation tools of deliberative dialogues and the development of a set of quality indicators for applicability on the practice, community and policy levels. Guided discussion will focus on opportunities and challenges in GOHAP implementation, with the targeted questions to panellists on: What can countries learn from other global health action plans? What should be the priorities of EU MS? What is the role the public health community can play? What are key steps needed to eliminate common NCD risk factors to drastically reduce the prevalence and burden of ODs? Key messages • There is an urgent need in the global and public health communities to better understand the processes involved in implementing the GOHAP, incl. challenges and opportunities. • Interdisciplinary and cross-sectoral collaboration is key to address the common risk factors of NCDs, to inform concerted action and evidence-informed policymaking to improve oral health care. Speakers/Panelists Pauline Vassallo European Association of Dental Public Health, Valletta, Malta Benoit Varenne Dental Officer, Prevention of Non Communicable Disease Department, WHO, Geneva, Switzerland Dympna Kavanagh Chief Dental Officer, Platform for Better Oral Health in Europe, Dublin, Ireland Neville Calleja Department of Health Information and Research, G’Mangia, Malta

Health impacts methodology in the European Commission

Abstract The state of play in the implementation of health impacts methodology within European Commission impact assessments reveals both advancements and challenges. The Commission has acknowledged the significance of assessing health impacts and has provided a generic methodological description, as outlined in Tool #32 of the Better Regulation guidelines. However, translating this guidance into practical application encounters obstacles stemming from challenges intrinsic to the policy in question, a lack of skills and knowledge, data gaps, and complexities in establishing causal links. In EU policymaking, health impacts are consistently appraised in relevant Impact Assessments across various policy areas, but the methodological intricacy varies. In the fields of public health, occupational safety, and environmental protection, econometric modelling is often employed to quantify potential health impacts rigorously. This involves sophisticated analytical tools designed to capture the complexity of the interactions. Conversely, in areas where the link between policies and health outcomes is less direct (e.g. food safety) or where data limitations pose challenges, a more qualitative appraisal is applied. This acknowledges the limitations in precisely quantifying health impacts and focuses on providing a nuanced understanding of potential health effects based on available information.

Concept of a medical and public health cancer genomics platform

Abstract Background This study aims to produce the concept of an open-access medical and public health cancer genomics platform aimed at aggregating and sharing documentation of ongoing initiatives and data resulting from the CAN.HEAL project, available for EU researchers, healthcare professionals, policy makers, citizens and patients. Methods The context (reference sector, stakeholders and research evidences), feasibility (privacy management and data processing), and platform’s end users were analysed; the CAN.HEAL project deliverables were listed and clustered; aspects related to the definition of the overall platform architecture and modules integration were studied. Results The project deliverables were catalogued into 8 categories which could be the platform’s cloud interface main labels: results from events, policy papers, newsletters, mapping results and reports, datasets, recommendations and guidelines, use cases, courses and training activities. To define the overall system architecture, the following key activities should be implemented: content management system choice, hosting configuration and setup of the development domain, content management system installation, development of HTML web pages, data entry, data visualisation and graphic layout, and test and debug. To the modules integration purposes the following items should be addressed: creation of a server analytics account; social network integration; activation of additional system for sending newsletters. Conclusions Cloud-based data platform allows to securely manage, integrate, analyse and share large datasets. Establishing an infrastructure to help researchers access, store and analyse large amounts of biological data is of paramount importance both to enable advances in research and support health policy making processes. The CAN.HEAL platform could help aligning clinical and population-based interventions for integrating the genome of Europe biobanking initiative into public health genomics for cancer. Key messages • Connecting healthcare data can support the challenge of accessing the relevant information needed for the policy and decision making processes to effectively promote population health and wellbeing. • The set-up of a medical and public health cancer genomics platform promotes the effective translation of genome-based knowledge and technologies into public policy and health services.

Going beyond the Council as brake of EU energy policy: Analysing the internal process of the Council in the recast of the Energy Performance of Buildings Directive

The Council is the voice of the member states' governments in the EU policymaking process and the institutional setting where member states can enforce their national interest. The literature on Council decision-making has previously mostly used expert interviews or voting patterns. Through a detailed examination of one specific legislative file in the recent ‘Fit for 55’ climate package in which subsidiarity and varying national conditions is central, this study focus on how disagreements between member states are resolved and how strategic word framing can aid in resolving political controversies in EU energy policy. This article analyses Council working group meeting notes and revisions of the recent recast of the Energy Performance of Buildings Directive, providing a unique look behind the curtains of negotiations between member states in the Council within a deliberative intergovernmental framework. A mix of quantitative and qualitative text analysis is applied to deliberations and legislative revisions. The findings show that a fragile consensus is reached despite disagreement through enabling of national flexibility in policy decisions, indicating that the Council determines the speed of European integration in the policy domain.

Administering a Chill Pill? Better Regulation and the Potential for Regulatory Chill in European Union Health Policy

The European Union's “good governance” program, known as Better Regulation, seeks to improve the quality of EU legislation by controlling the policy-making process. Despite its importance, it is rarely accounted for in the EU health policy literature. Seeking to address this gap, this article introduces Better Regulation in the context of health policy making. It conceptualizes a model of regulatory chill, drawn from the literature on international trade, to interrogate the impact of Better Regulation on EU policy-making processes. Using examples from the literature and data from a series of interviews with EU officials, it explores potential pathways of response and anticipatory chill, identifying direct enforcement of Better Regulation, its utilization by corporate actors, interpretation of its provision by officials, and feedback loops as possible routes of influence. The article argues that such an approach not only presents methodological challenges but also offers a valuable way of conceptualizing the relevance of political institutions in general, and Better Regulation specifically, for health. As part of broader calls for attention to the political determinants of health, the article's findings highlight the particular, and often overlooked, importance of metaregulatory policy frameworks.

Casting Votes into the Void

The European Citizens’ Initiative (ECI) is a unique instrument promising to enable direct democracy, by enabling citizens to directly request the European Commission to propose legislation in areas where the Commission has the power to do so. The instrument is designed to promote democratic participation and increase the transparency of the EU decision-making processes. This article assesses the effectiveness of the ECI as an instrument to enhance citizen participation in the EU decision-making processes, with a particular focus on initiatives relating to environmental concerns and climate change. Despite the ECI’s potential to empower citizens and facilitate their input in EU policymaking, the instrument has been criticized for its complexity, limited impact and inaccessibility. Additionally, there are concerns that the ECI process may not be an adequate tool for addressing complex issues such as environmental concerns or climate change. This article explores these weaknesses and evaluates the extent to which the ECI can be utilized as a tool for enhancing citizen participation in environmental policymaking, analysing case studies of past initiatives in this area and examining their outcomes to determine the ECI’s ability to influence EU policies.

Politicised at Home but not in Council: The European Coordination of Social Security Systems

After seven years of negotiations, the European Parliament and the Council have yet to agree on the reform of one of the most essential regulations facilitating cross-border worker mobility in the EU: the Coordination of Social Security Systems (EC 883/2004). The lack of agreement remains puzzling, as all negotiating partners are generally in favour of the reform. Similar proposals on social policy, such as the Posting of Workers Directive or the Minimum-wage Directive, were also challenging to achieve but could be agreed upon. This article tests whether “unpolitics”—a destructive approach by populist governments in the Council to undermine EU policymaking—is the reason for the persisting deadlock on the file. The central finding of this article is that the interplay of populism and the status of member states as sending or receiving workers shape unpolitical behaviour. Contrary to expectations, unpolitics is largely absent in the behaviour of populist and non-populist governments. Unpolitical behaviour does not promise high gains for the populist governments from Central and Eastern Europe because these member states send workers. The smooth functioning of the freedom of workers is essential for them and their national discourses do not discuss the freedom of movement in the context of welfare chauvinism. Welfare chauvinism is much stronger in countries that receive workers, however, populists were not in power in these member states and therefore there was no unpolitical behaviour. The findings show that unpolitical behaviour is not used by mainstream governments, not even when it would seem likely from the nature of the policy issue. This article highlights that the probability of unpolitical behavior is influenced not only by the nature of the policy issue itself but also by domestic institutional and structural factors, as well as the national discourse.

Blackmailing and Identity Profiling? The Behaviour of Populist Radical Right Governments in EU Development Policy

EU development policy has in recent years become more contested and politicised. One key factor driving this trend is the increasing influence of populist radical right parties (PRRPs). Previous studies have focused on PRRPs as opposition parties. This contribution breaks new ground by exploring the behaviour of PRRP-led governments in EU development policy. More specifically, the article analyses how and to what extent this behaviour is characterised by “unpolitics,” an approach to undermining EU policymaking. We define “cross-policy blackmailing” and “identity profiling” as two potential strategies of unpolitics in EU development policy and probe these in two case studies. The first case concerns the New European Consensus on Development and the second is the EU’s positioning in the negotiations and signing of the Samoa Agreement. In the first case, we find that PRRP-led governments fundamentally rejected the decision-making rules as well as the norms on migration, gender, and sexual and reproductive health rights, using a strategy of identity profiling. In the second case, PRRP-led governments significantly stalled the conclusion of the agreement by combining cross-policy blackmailing and identity profiling. Based on this analysis, we generalise on the scope conditions of unpolitics in EU development policy.

Politicisation of the European Union in Slovenia in the Twenty Years of its Membership

Abstract Ever since Slovenia became independent, the European idea has been viewed fondly by the political elite and the public. The absence of any successful Eurosceptic parties has meant the main goals concerning European integration became national projects. Euroscepticism has remained limited, although in more recent years politicisation has steadily grown through political parties’ positions on EU issues. At the same time, the country’s political elite has lost sight of the specific strategy Slovenia should play in the EU. Moreover, alignment with other EU member states has begun to vary depending on the ruling party. After twenty years of membership, this has led to Slovenia being seen as one of the more submissive actors in EU policymaking. In the article, by applying an analytical framework of politicisation, we consider the changing attitudes to the EU in Slovenia through the twenty years of its membership. The central research question is: in which ways have European issues become politicised over the last twenty years in Slovenia? The research question is addressed by considering a chronological approach and analysis of events, participation in European elections and public opinion data. We argue that, as a newer member state, Slovenia politicises European issues to a limited extent.

Foresight in EU policy‐making: Purpose, mindsets and methods

AbstractThis article examines the foundational principles and methodologies of foresight and their integration into EU policy‐making. It explores how foresight can improve policy analysis to create future‐ready, resilient decisions amid uncertainties. By synthesising empirical evidence and interpreting multifaceted issues through an interdisciplinary lens, foresight provides EU policymakers with tools to make informed decisions that remain adaptable in the face of unpredictability. The author argues that foresight, through comprehensive analysis of trends, uncertainties and potential challenges, can guide policymakers in forming future‐focused strategies. Key foresight methods emphasised include horizon scanning, systems analysis, stakeholder engagement and scenario planning. The article advocates a holistic policy approach, urging analysts to acknowledge biases and assumptions while integrating diverse perspectives. Concluding with a framework for responsible policy‐making, the article argues that foresight can shape evidence‐based, inclusive and transparent strategies, ensuring that the EU will be prepared for unpredictable futures.

Implementing Ireland’s Food Vision 2030 within the Fresh Produce Sector: An Investigation of the Barriers and Enablers Using Systems Thinking Principles

The Irish Food Vision 2030 (IFV 2030) seeks to restructure Ireland’s agricultural food system to deliver long-term social, economic, and environmental sustainability in keeping with its commitment to the European Green Deal and the 2030 Sustainable Development Goals. This study investigates the effectiveness of the IFV 2030 in delivering on this commitment across the fresh produce supply chain in Ireland using a combination of data collected from stakeholders through a survey and systems thinking principles. A review of the literature and Foucault’s genealogical methods guided the development of the survey. Systems thinking principles were used to review the IFV 2030 and assess its capacity to deliver large-scale change for a sustainable Irish food system. Barriers to change were identified, including historical patterns of behaviour between EU and Irish policymakers that have repeatedly hindered progress towards large-scale change events. The results demonstrate that successful, long-term change will depend on the involvement and incentives of stakeholders within the supply chain. Continuous stakeholder engagement is required through a bottom-up organisational and supply chain approach to deliver long-term sustainability within the fresh produce sector. Using a systems thinking lens brings benefits through transdisciplinary collaboration and fosters the multiple stakeholder perspectives needed to deliver new ideas and solutions.

Approaching Environmental Sustainability through Energy Optimization in Polyisoprene Production

The global energy crisis, forced by fossil fuel shortages and supply chain disruption, stimulates EU policymakers to find alternative energy replacement. Modifying the present polyisoprene footwear production plant into a hybrid system by combining different energy sources raises energy efficiency. The proposed hybrid system incorporates classical and solar-based technology, resulting in energy optimization by utilizing waste heat recovery. By installing an economizer for feeding water preheating using flue gas recovery, it results in the volume of the flue gases lowering from to , or by 11.13%, while the flue gases’ temperature is lowered from 204 °C (477.15 K) to 50.99 °C (324.14 K). Further improvement in combining feed water and air preheating results in natural gas savings of 12.05%, while the flue gases’ exhaust temperature is decreased to 30.44 °C (303.59 K). The third option, using condensate heat recovery and feeding water preheating using flue gases, showed natural gas savings as much as 17.41% and exhaust flue gases cooling to 112.49 °C (385.64 K). The combination of condensate heat recovery, combustion air and feed water preheating results in the volume of the flue gases being lowered by 20.42% and natural gas savings by 20.24%, while the flue gases’ temperature is reduced to 45.11 °C (318.26K). The proposed solar application in polyisoprene production predicts the hybrid system showing fuel savings ranging from 77.96% to 87.08% in comparison to the basic process. The greatest fuel savings of 87.08% is shown in a solarized polyisoprene footwear production plant with combustion air and feed water preheating combined with the condensate return system. Integrating the solar heat into the regular industrial process of polyisoprene production showed great potential and showed environmental sustainability through energy optimization in polyisoprene production

Leadership in EU policy-making: a deep dive into the extension of the EU emissions trading system

ABSTRACT This article offers insights into how leadership can be provided to advance the EU policy-making process through a case study of the policy-making for the new EU emissions trading system for buildings, road transport and additional sectors (ETS-2). Conceptually, it contributes to the literature on leadership in the EU by developing a three-part framework for observing leadership in EU policy-making, focussing on the intentions of an actor, the effects of the actions of an actor and the perceptions of other actors. The article also contributes to the literature on interactions between leaders in EU policy-making. Empirically, we provide a process tracing analysis of leadership in the policy-making process for the ETS-2. Using our framework, we examine five key leadership moments, showing how Denmark provided cognitive leadership, Germany provided exemplary and structural leadership, and the Commission and rotating Presidencies provided cognitive and entrepreneurial leadership. Our empirical analysis shows that various types of leadership were partially simultaneously and partially consecutively provided, with some leaders following up on the leadership strategies of others. We term this dynamic ‘sequential leadership’. Our finding confirms the importance of seeing leadership as a relationship, not just between leaders and followers, but also amongst leaders.

Analysing the impacts of a reform on harmful fishery subsidies in Spain using a social accounting matrix

The effects of discontinuing harmful fishery subsidies in Spain were analysed using a social accounting matrix. The study found that the removal of these subsidies would have negative consequences for the economy. Specifically, there would be a significant decline in the production value of marine resource industries, and industries dependent on fish and shellfish as inputs would experience increased production costs. The exports, mainly to EU countries, would also be impacted, and certain marine resource sectors would experience significant job losses. Fishing families would suffer the greatest reduction in income once subsidies are removed. However, there is potential to mitigate most of the negative impacts by redirecting the removed subsidies, as it is shown for the case of their redirection to research and development industries. The findings of this study provide valuable insights for EU policymakers in implementing specific policies to address the potential consequences on affected sectors, families, and employers as part of the next European strategy, Horizon 2021–2027.

Digital sovereignty - Rhetoric and reality

ABSTRACT In recent years, the language of digital sovereignty has become ubiquitous in Europe. However, we still lack systematic knowledge if and to what extent the discourse on digital sovereignty is accompanied by actual policy change in different areas of EU policymaking. Drawing on a range of both qualitative and quantitative methods, the various contributions to this special issue examine discursive and policy change in nine major areas of EU digital policymaking. While they find policy change towards more control of the digital across all policy areas examined, this shift is only sometimes accompanied by discursive change towards digital sovereignty. This, we argue, is the result of ideational trade-offs actors face when using the language of digital sovereignty in different venues, policy areas, or countries. Considering current geo-political and geo-economic challenges, this special issue sheds light on recent transformations of EU digital policymaking and its discursive politics in the digital age.

EIB policy entrepreneurship and the EU’s regulation of Green Bonds

ABSTRACT This article investigates how the European Investment Bank (EIB) influenced EU policymaking by promoting Green Bonds as an asset class. The article argues that the EIB has been instrumental in formulating the EU’s recently agreed Green Bond Standard. The EIB’s expertise and successful coalition building later allowed it to put Green Bonds on the EU’s policy agenda and develop a blueprint for the EU’s rules. The article concludes by drawing implications about the conditions under which the EIB might be able to engage in policy entrepreneurship more generally.

EU social dialogue revitalisation: Between rhetoric, new rights, political commitments and historical caution

The Council Recommendation on strengthening social dialogue is a positive recognition of the key role of social dialogue in the EU's social market economy. At the same time, episodes of institutional disfavour of the social partners’ co-determination role and resistance to robust sectoral collective bargaining warrant a cautious assessment. This article looks at the current state of EU social dialogue, examining its primary dimensions: the involvement of social partners in policymaking and the scope of collective bargaining. It assesses the Council Recommendation, along with other measures adopted during the Von der Leyen presidency, to ascertain their collective contribution in realigning EU social dialogue with the principles of the EU Treaties. Overall, the analysis reveals a nuanced picture, with both positive and challenging aspects. While collective bargaining has been given a new (albeit partial) boost, the same cannot be said for the social partners’ participation in EU policymaking. Notably, the Council Recommendation reaffirmed the Court of Justice's decision in the EPSU case, solidifying the Commission's discretionary authority to decide on the legislative implementation of framework agreements, to the detriment of the social partners’ regulatory agency. Finally, the article proposes a blueprint for further advancing the EU's aspiration for social dialogue, seeking to reconciling it with the social objectives that, constitutionally, the Union aspires to achieve.

Assessing the EU Climate and Energy Policy Priorities for Transport and Mobility through the Analysis of User-Generated Social Media Content Based on Text-Mining Techniques

For over three decades, the European Union’s (EU) transport policy has aimed at fostering environmental sustainability and energy efficiency. Since 2015, European policymakers have focused more on three key sustainable development goals: decarbonizing the transport system, promoting low-emission mobility solutions, and transitioning to renewable and alternative fuels. To effectively communicate priorities and engage stakeholders, EU policymakers regularly use social media platforms like Twitter (now known as X). This active discourse involves policymakers, industrial stakeholders, the media, and the public, offering insights into the role of transport policy in addressing climate change and energy transition challenges. The current research endeavors to track and analyze the evolution of user-generated content related to climate change, energy transition, and smart mobility on Twitter from 2011 to 2021. This research uses text-mining and social network analysis techniques to quantitatively and qualitatively assess the dynamics of relevant EU policies and their effects. The study’s findings can be used to establish a robust monitoring and evaluation framework at the EU and national levels. This framework will assess the effectiveness of communicating strategic priorities for sustainable transport development. It also holds potential for application in other sectors, broadening its impact.

Could it Happen in the EU? An Analysis of Loss Distribution between Shareholders and AT1 Bondholders under EU Law

Abstract In March 2023, the Swiss bank Credit Suisse’s so-called Additional Tier 1 (AT1) bonds were written down to facilitate the bank being taken over by UBS, its national rival. Ensuing discussion and market reactions went well beyond Swiss borders, as the write-down was completed without Credit Suisse’s shareholders first being wiped out, thereby deviating from the principle that shareholders bear losses ahead of all other investors. This article asks whether such an outcome is possible under EU law. A comprehensive analysis demonstrates how this question is governed by the combined operation of contractual clauses and the resolution authority’s statutory powers. Combining applicable EU law with empirical analysis of contractual terms employed by EU banks issuing AT1 bonds and their capital requirements, the article argues that an outcome akin to that of the Credit Suisse write-down is unlikely for EU banks. Building on this analysis, it is shown what reform is needed if EU policymakers consider it desirable to have AT1 bonds absorb losses outside of cases requiring intervention by the resolution authority.

Can failure be useful in policymaking? The case of EU equal pay policy

Although equal pay for equal work between women and men is a founding principle of the European Union, enshrined in the Treaties since 1957, the gender pay gap stands at 12.7 per cent in 2021 and has only changed minimally for two decades. This article explores a policymaking paradox: the EU equal pay policy seems unaffected by failure, on the contrary, failure seems to contribute to the legitimisation of the policy. The article asks how and why a policy implementation failure framing has been developed in the field of EU equal pay promotion? What is the political function of this framing and what is its impact on the EU policymaking process? Over the years, the EU equal pay policy has been associated with a repeated experience of implementation failure. This failure framing has been particularly present in the debates over the implementation of the 2006 Recast Directive, especially since this frame has been impelled by the quantitative and symbolic strength of the gender pay gap’s percentage. The article shows that this framing performed important functions. From a policymaking perspective, the implementation failure framing allowed the gender equality policy community to keep the issue firmly on the EU agenda and to ride out the dismantling storm. The article also shows that the analytical definition of what constitutes a policy failure should be more nuanced. To conclude, the article asks if this type of failure framing can continue to produce results in an increasingly polarised context such as that of gender equality.