Brussels launches the 'health union' to avoid lack of coordination in the face of the pandemic

Brussels on Wednesday intoned the

for the serious limitations of the European reaction to the covid and has laid the foundations for a health Union with which to put an end to the lack of coordination and jointly face future pandemics or emergencies in the area of health.

The battery of legislative projects approved by the European Commission represent an unprecedented leap in the integration of health policies that, at present, are fragmented at the national or even regional level.

The new rules will provide Brussels with supervisory powers and establish permanent structures for surveillance and coordination comparable, in a way, to those that already exist within the euro zone in the economic and financial field.

"Today we begin the creation of a European Health Union", said the President of the European Commission, Ursula von der Leyen, after the approval of three draft regulations that aspire to transform the prevention and response capacity of the EU to cross-border health crises.

Von der Leyen acknowledges that "the coronavirus pandemic has highlighted the need for greater EU coordination, more resilient health systems and better preparedness for future crises."

The proposals represent the large-scale development for the first time of Article 168 of the Treaty on European Union, which allows Brussels to complement the action of the States in health policy, always respecting national competences.

The irruption of the Commission into such a sensitive area of ​​national politics often provokes resistance from national governments.

But the messiness of the response during the first wave of the pandemic - when borders were closed in an uncoordinated manner and essential intra-community exports were blocked or slowed down - set off alarms about the need for a community response.

Already in the early stages of the pandemic, three Spanish MEPs, the socialists César Luena, Javi López and Doménec Ruiz Devesa, urged the Commission to activate Article 168 and approve a draft regulation to react to cross-border threats.

The Commission was reluctant, given the emergency situation at that time.

But faced with the shock of the second wave of the virus and the health, logistical and social challenge that vaccination campaigns will pose, the Commission has decided to launch a 'Health Union' that raises the response to pandemics like the current one at European level .

The project needs the approval of the Council of the EU (where the 27 countries of the EU sit) and the European Parliament.

And the resistance of some capitals to give powers to Brussels is foreseeable.

The European Health Commissioner, Stella Kyriakides, believes, however, that COVID-19 has demonstrated the added value of concerted action.

And it reassures the reluctant countries by assuring: "our proposal adheres precisely to the provisions of the Treaty," that is, Brussels does not plan to interfere in areas of exclusive national competence.

Emergency mechanism

But the new rules not only strengthen and expand the powers of existing structures, such as the European Medicines Agency (EMA) or the European Center for Disease Prevention and Control (ECDC, in its acronym in English), but also grant also to the European Commission the power to issue guidelines related to the response to a health crisis and communication policy;

the power to review national plans for response to health emergencies or the power to organize education and training activities for national health personnel.

The EU also reserves the right to activate emergency mechanisms without having to wait for the World Health Organization (WHO) to declare a state of emergency.

The Commission considers that this autonomy of the world body will give the EU more flexibility in areas such as the strategy of storage or acquisition of essential medical supplies in times of crisis.

And it will allow Brussels to intervene immediately at the first signs of a possible crisis to ensure the proper functioning of the internal market and the free movement of goods necessary for human health.

The Commission wants to avoid the stampede that occurred in the first months of the current pandemic, when some States, in particular Germany, hoarded medical supplies and banned their export to partners who, like Italy, were hit first by the COVID-19. 19.

Brussels also proposes a gigantic leap in the coordination of the health authorities with the establishment of a Health Security Committee comparable, according to the Commission, to the very powerful Economic and Financial Committee, which during the euro crisis became the

where they cooked up the drastic measures approved later by the ministers of Economy and Finance in the Eurogroup.

Under the presidency of the Commission, the Committee will be made up of representatives of the Member States and will be in charge of applying the new Regulation on cross-border health threats and will be able to decide on whether or not the measures adopted in a country to respond to a pandemic or any other another cross-border crisis in the health area.

In times of emergency or when the agenda "includes politically sensitive matters", the Secretary of State for Health will sit on the Committee, a rank that also equates the new body with the current structure in the economic area.

The Commission does not hide its intention to take advantage of the health crisis, as happened with the financial crisis of 2008, to reinforce Community powers.

But when it comes down to the specific data, perhaps the numbers know little.

As announced by the Commission, the staff of the ECDC will be increased by 73 people, and the EMA by 40, in addition to adding 21 more employees to the General Directorate of Health.

In total, the budget contribution will amount to 605 million euros between 2021-2027.

"I would say that it is little", has recognized the commissioner Kyriakides.

Just to compare: ECDC has a budget of about 50 million per year and 300 employees;

the CDC, its equivalent in the United States, has a budget of 12,000 million more than 10,000 workers.

Furthermore, the European offensive may be successful as long as the emergency lasts.

But it could decline if the pandemic subsides or is neutralized.

In the financial case, the Banking Union, launched in 2012 at the most critical moment of the euro crisis, started with enormous vigor but was bogged down by the resistance of Germany, among other countries, to complete it.

The calm in the markets extinguished the emergency and left in the air the most ambitious economic project launched since the birth of the euro.

Health policy had hitherto been treated with a certain indifference, considering that it was a national competence.

The limited progress had been focused on the industrial and pharmaceutical part of the sector, with the creation in 1995 of a European Medicines Agency charged with evaluating the safety of drugs for human or veterinary use.

Binding measures

Another example of limited powers is the ECDC, born in 2004, after the SARS crisis, with the aim of preventing future epidemics.

But the Stockholm-based body has no regulatory power.

And when he was tasked with coordinating a response to the coronavirus, it became clear that his mandate, competencies, and human and material resources are limited.

Softer words are used among politicians and technicians in Brussels: “You have been doing a wonderful job within your limits and resources,” says a community source.

"The question is whether it was enough to provide a coordinated response."

The new regulation proposes that the ECDC have, as far as it can be stretched without invading external competences, the capacity to issue “stronger recommendations” on measures to control outbreaks (until now it could only develop guidelines, but in any case, it will not have the capacity to dictate binding measures) and deploy a health work group, until now non-existent, in the places where they are needed, to give a local response in the first moments of a health threat.

At the same time, the intention is to intensify the analysis and the elaboration of models to support the States in the control of outbreaks, with greater use of tools that are currently scarce in the Stockholm-based organization, such as Big Data and Artificial Intelligence. .

Perhaps the breakthrough is that, from now on, providing data will be mandatory for Member States.

As for the Medicines Agency (EMA), whose role becomes key now, when it has to face the approval of possible vaccines that appear, it will also be assigned a preventive task of monitoring events that could cause a shortage of medications during future crises, in addition to monitoring possible drug shortages in the midst of a crisis.

In his case, as the aforementioned community source explains, it is a matter of formally collecting tasks that the EMA has had to assume in a sudden and de facto way during this pandemic.

For example, it will play, as stated in the Communication sent yesterday by the Commission to Parliament and the Council, "a fundamental role in the development and speedy approval of medicines to treat or prevent a disease that causes a public health crisis", which is precisely the hot topic these days.

Commissioner Kyriakides has tiptoed over the issue of vaccines, another of the measures approved this morning at the meeting of the College of Commissioners, and perhaps the most anticipated: Brussels, as confirmed by a spokesman for the Community Executive, has authorized the signature of the contract for 300 million of the promising doses of Pfizer and BioNTech, whose effectiveness in clinical trials exceeds 90%, as announced Monday by these companies.

"They will be distributed when the vaccine is proven to be safe and effective," the spokesman said.

Now they must follow the mandatory EU health certification process, precisely through the EMA.

Kyriakides has ventured a possible date for its distribution, towards the end of 2020 or the beginning of 2021 "in a positive scenario", in which however there could be "setbacks".

The example of vaccines is perhaps one of the favorites in Brussels to affirm that "unity is strength": if they have already managed to sign four contracts (if the latter is included) to have access to nearly 1,000 million doses of vaccines, it is precisely because the Commission has taken the initiative and negotiates on behalf of the Twenty-seven.

When efforts are divided, however, cracks appear and one finds borders closed in an unbalanced way, and the markets for medicines and health equipment become more expensive and out of stock.

Somehow, it gives the feeling that the EU has woken up from the lethargy of uncoordination and dawns in the real world: the one in which states fight to elbow their way, and the EU, when it adds up, is a bloc gigantic to consider.

Information about the coronavirus

- Here you can follow the last hour on the evolution of the pandemic

- This is how the coronavirus curve evolves in the world

- Download the tracking application for Spain

- Guide to action against the disease