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For a European Health Union

by host

The Covid-19 pandemic has changed everything. In Europe as well. Before this nightmare ends (and, unfortunately, we are not there yet!) we have to build on the lessons learnt and create something new and positive out of this this dramatic experience. This was the message of the call for a European Health Union that we launched on May 9th – 70th  anniversary of the Schuman Declaration – with the “New Europeans” group of the former Labour MEP Roger Casale. 

We are pleased that the idea has been brought up by the President of the European Commission, Ursula von der Leyen in her Speech on the State of the Union on September 16th, also in light of the World Health Summit which will be organized in 2021 by the Italian Presidency of the G20. 

Also, while Member States are struggling to cope with the second wave of infection, it is reassuring to see that at least the European Commission is developing a coordinated strategy to ensure the best effectiveness of future vaccines. Only united and determined we will overcome this tragedy.

After all, it was Columbus’ egg: during the forced lockdown that radically transformed our lives, it was quite straightforward to think how the European Union would have resisted only through a bottom-up model of renewal, instead of focusing on the illusory closures of walls, quotas and duties against the invasions of viruses, migrants and underpriced products. Such model should have been based on the needs that unite us, the values in which we recognize ourselves and the synergies that emerge while working together. 

A model for Europe

Doctors suggested the “One Health” model proposed by WHO as the approach that would have allowed to organically link the prospects of a health reform on a continental basis to the more general transformation of our society required by climate change and the search for sustainable, green, fair and digital development.  We should not choose between health or climate, solidarity or innovation, sectoral reforms or overall paradigm shift: “Win-win? Yes, we can!”. 

It is an overall package, built on a precise vision and synergies. Yet, it must be explained and assimilated. Primum vivere, deinde philosophari. The bet then becomes reconstructing through our survival instinct, stimulated once more by the pandemic. It becomes trying to shake off the existential discomfort of an atomizing complexity which dismays us and often makes us slaves of charlatans, who speak directly to our emotionality with hypocritical messages that are too easy to grasp. 

Let us start instead from the rediscovery of health as a “global public good”, which can constitute the basis for a renewed social contract where the European demos can rediscover its common identity, made – from the Beveridge Plan onwards – of a universal health care. When confronted with a disease, “no one must be left behind”. Here is a fundamental step on which we need to make maximum clarity: the hypothetically future European Health Union would be based on the reform of the Treaties signed by sovereign nation states but it should most importantly focus on the rights and duties of individual European citizens, regardless of their passports and identity cards.

Hence, the call to Ursula von der Leyen: we cannot speak of a “European Health Union” only among Governments and Parliaments. The matter must in fact become one of the main pillars of the announced Conference on the Future of Europe, as a widespread procedure of consultation and planning for a common future.   

Regarding health, the European Union theoretically possessed – already at the beginning of the pandemic – the tools for a propulsive role. Instead, we have written dark and demeaning pages of selfishness, hypocrisy and disorganisation, which certainly did not honor the bonds solemnly enshrined in the European Treaties.

The call precisely aims at addressing the challenges emerging from the pandemic and the lessons learnt in different areas: health, of course, but also economics, subsidiarity, education, citizenship and external relations. Only the combination of such reflections with the consequent action plans will manage to relaunch the “European project” Coronavirus seemed to hit, thanks to incredible unintended consequences (naked and in scattered order in the face of the evil, now instead more cohesive and determined not to repeat similar experiences).  

Regarding health, the European Union theoretically possessed – already at the beginning of the pandemic – the tools for a propulsive role. Instead, we have written dark and demeaning pages of selfishness, hypocrisy and disorganisation, which certainly did not honor the bonds solemnly enshrined in the European Treaties. It is enough to read Article 168 of the Treaty on the Functioning of the European Union (TFEU), which expressly prescribes that “action by the Union, which shall complement national policies, shall be directed towards improving public health, preventing physical and mental illness and diseases, and obviating sources of danger to physical and mental health. Such action shall cover the fight against the major health scourges, by promoting research into their causes, their transmission and their prevention, as well as health information and education, and monitoring, early warning of and combating serious cross-border threats to health.” One could possibly not be clearer! If Covid-19 is not a “major scourge”, what would be? 

The Solidarity clause in Article 222, point 1(b) of the TFEU should be recalled as well: “The Union shall mobilize all the instruments at its disposal, including the military means put at its disposal by the Member States, to … to provide assistance to a Member State on its territory, at the request of its political authorities, in case of natural or man-made disaster”. Such clause appears to have been used to activate a European coordination of emergency supplies to China. However, when the Italian Permanent Representative to the European Union invoked the same clause to receive emergency masks and ventilators, the same mechanism immediately stopped functioning. It is therefore clear how Europe turned deaf ears and brought up all the possible red tape to Italy, while generously distributing almost the same goods to the other end of the world. 

The necessary means

Luckily, winds have now changed. German President Frank-Walter Steinmeier’s Easter speech was beautiful: “Germany cannot come out of this crisis strong and healthy if our neighbors are not strong and healthy too. This blue flag is not here by chance. Thirty years after the Unification of Germany, seventy-five years after the end of the war, we Germans are not only called upon, we are obliged to solidarity! […]. After this crisis we will be another society. We don’t want to become a fearful, distrustful society. We can, instead, be a society with more trust, more respect, and more optimism”. To put it simply, coronavirus is nobody’s fault, and we cannot continue to fight against one another: we are all in the same boat and we must not let it be overturned. 

As Mario Draghi clearly stated in 2012 to defend the euro, we must do “whatever it takes”. But four years have passed between the Lehman Brothers crisis and the declaration of the Governor of the European Central Bank. Luckily, it took only few months for Angela Merkel to recall the saying “you have to move quickly when the ice is melting”. Haste is obviously a very temporally dilatable concept for Brussels, which, however, seems to have set now the right pace. Perhaps, it will even permanently establish instruments such as the Recovery Fund, to allow an explicit European economic policy without the current impositions to the European Central Bank. 

However, a European response to global health challenges is not just a matter of money. It also requires adequate governance. Subsidiarity then comes into play, not only to guarantee space for local authorities in the optimal management of territories, but also to call for supranational direction/coordination of tasks that would otherwise get out of hand. Complexity can be governed if there is the will.

It is also impossible not to shed a light on the topic of education, especially in an inter-generational perspective. Scientific and technological education are crucial means against our evils and denials, to eventually overcome the “digital divide”. Civic education is essential too, because without a clear awareness of the interrelation between rights and duties, it will be impossible for our societies to overcome the challenges of contagion and its deadly pitfalls. Citizenship therefore emerges as a key element in the bottom-up construction of the European Union we want, made of rights and duties, guarantees of fundamental freedoms and the rule of law, an indispensable condition for our physical and mental health.

While remaining certain and thorough in demanding respect for these priorities of ours, we must not turn a blind eye on the rest of the world. It seems lost in a worrying scenario of turmoil, among authoritarian, populist and sovereignist drives, all sharing the desire to pass on their problems to others. Can Europe, instead, aspire to stand as a beacon for those who, everywhere, think differently and find in the terrible pandemic a further reason for solidarity, vision, willingness to work together, in mutual respect?

We would like to talk about this issues at the G20 Summit in 2021 on world health and, even before that, at the Conference on the Future of Europe, which should start before the end of the year under the German Presidency. 

In preparation for such events, “New Europeans” has started discussing about it again in an online conversation on November 5th.

Contact New Europeans ([email protected]) if you would like to learn more about the call for an international conference on the lessons learned from Coronavirus and the European Union for Health (#EuropeanHealthUnion).

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