- National responses to the health crisis have shown that a health Europe is far from a reality.
- However, between the increased risk of drug shortages and the need for cooperation in research, some suggest that tomorrow, Europeans will have to work to improve cooperation in this fundamental area.
- So far, health has remained a national competence. But in a few years, will Europeans be willing to collaborate better?
"Europe will happen in crises and it will be the sum of the solutions brought to these crises", wrote Jean Monnet in his Memoirs. At a time when the European Union is experiencing its greatest health crisis, it will be interesting to see if, in the long term, this maxim of one of the fathers of the European community is true.
Because if certain voices call for strengthening cooperation in health policies, inventing a Europe of health will not be a small challenge.
What has this crisis revealed?
Europe at the time of the coronavirus was dispersed, not very united, each state choosing its version of a more or less strict confinement, a more or less rapid deconfinement. "The crisis has highlighted failures in national health systems and the lack of competence of the EU to respond to these failures", summarizes Claire Dhéret, head of a research program on social Europe and well-being at the European Policy Center. For some, this state management has shown the uselessness of the European Union. Others, on the contrary, believe that a real Europe of health care has never been so urgent.
"We have realized that the EU has fragile health competences and that in these circumstances, it is not enough," insists Véronique Trillet-Lenoir, Renew Europe MEP and cancer specialist. We must learn from this crisis, to put in place rapid and operational measures and prepare for the next. Because there will be other crises, whether infectious, environmental, chemical, food. Now is the time to think about putting in place devices to activate. "
A concrete example of this necessary cooperation comes from research. Certain clinical trials have been launched on a European scale, which has made it possible to increase the number of patients concerned and the resources allocated. The EU has notably announced that a global "telethon" has raised € 7.4 billion to find a vaccine. "It will be decisive to see in the future if the EU manages to find a vaccine, but also to distribute it by prioritizing populations at risk, solidarity over the law of the market," assumes Claire Dhéret.
Another realization: the urgency of relocating the production of medicines to Europe, when we are totally dependent on China and shortages are increasing. "It's on the agenda of the Commission and of Parliament," continues Véronique Trillet-Lenoir. We will have to see how we evaluate drugs, how we set the price, how we manufacture them. Citizens would start to see the interest of Europe if they had safer access to cheaper medicines. "
Very limited means
The European Union today only has support competence on health issues, and therefore cannot impose anything on States. "The EU is not intended to harmonize health systems," sums up Gaël Coron, sociologist and teacher at the École des Hautes Études en Santé Publique (EHESP). It is a treaty ban that has been circumvented. Some health policies are "Europeanized": for example, the authorization to market a drug is decided at European level, because the drug is a commodity and there is a European market. "
Little by little, the EU has certainly acquired health actors: a general directorate for health of the European Commission, equivalent to a ministry of health, agencies, notably on safety and health at work , or on food safety. However, all of these tools have very limited human and financial resources. “Behind these institutions, we must see the real capacity for action, nuance Gaël Coron, specialist in European health policies. For example, 300 people work for the European Center for Disease Prevention and Control (ECDC), [which works like a European WHO], that's 15,000 for the American equivalent ... ”Same problem on the budget. “The health component of the European Social Fund amounts to 413 million euros (2021-2027 period) for 27 countries and over six years. This sum must be compared with the 200 billion that France spent in 2019 on health. "
Towards more cooperation?
Health Europe has often relied on crises to build itself. The ECDC was indeed a response to the SARS crisis, the Food Safety Agency was decided after the mad cow crisis ... "One can imagine that there will be new agencies relating to health which will see the light of day, advances Claire Dhéret. Even if it is not necessarily the fact of creating new entities that will change things, but rather a desire to appropriate the right skills to these agencies. "
It is not Véronique Trillet-Lenoir who will say the opposite. She presented, on April 16 to the European Parliament, a program for a European health force, setting out ways to increase the powers of the EU without upsetting the treaties. How to promote better coordination between member states? "We could in particular build up a strategic reserve of necessary sanitary products (masks, respirators, etc.), we are also organizing to make group purchases at a lower cost and send the equipment to the countries that need it," explains the MEP. . Which ensures that this better coordination will involve strengthening the skills and budget of existing European health agencies. But it's not all about the money. Véronique Trillet-Lenoir therefore calls for the creation of a platform for the exchange of practices between health professionals (for example so that each country counts the deaths of the Covid in the same way) and a site to deliver reliable and educational information to the general public. time of fake news .
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Priorities in shambles
In the opinion of these three specialists, Europe seems to be at a turning point in its history. "This crisis is an opportunity for Europe, but it must seize it, suggests Claire Dhéret. It can affect the credibility of institutions like WHO, and the context can strengthen the role of the EU in international negotiations. For this, there is a real need for political will. But Gaël Coron doubts that this unprecedented crisis is the birth of a Europe of health. “More cooperation in health policies is possible. Integration, less. This would require that there is a clear desire on the part of the member states and the European institutions to affirm this health objective as transversal. However, historically, the community was not built around this question, so the actors of health are not the most influential. Arbitrations will not necessarily be in favor of this construction. "
Second brake: politically, Europe faces multiple challenges: "Brexit, a strong tension with Eastern Europe, a standoff between a Southern Europe, which wants to increase the economic means of EU, and countries like Germany and the Netherlands hostile to a pooling of debts… ”, list Gaël Coron. "The consequences of the crisis can be diverse," adds Claire Dhéret. It's a story that remains to be written. How will the EU respond to the succession of economic, political, financial and social crises in the coming months? If it fails to coordinate, the Eurosceptic and nationalist parties risk strengthening. "
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