Former EU health chief: Cooperation between member states still missing

The European Commission’s health policy is just a first step, as it needs to be complemented by increasing the collaboration of the member states in the health field, Vytenis Andriukaitis told EURACTIV in an interview.

Vytenis Andriukaitis is a former EU health commissioner, now a special envoy of the World Health Organisation (WHO) European region and a Chair of All Policies for A Healthy Europe.

“[The] Lisbon treaty is very weak,” Andriukaitis told EURACTIV at the European Health Forum Gastein (EHFG) in Austria, highlighting the difficulty for the EU to deliver its health agenda while health competencies belong to member states.

“The Commission came up with brilliant ideas – a pharmaceutical strategy, Europe’s beating cancer plan, or the Health Emergency Preparedness and Response Authority (HERA). However, they are only the first steps as they have no chance to overcome legal limits,” Andriukaitis said.

In the Lisbon Treaty, common safety concerns in public health matters are ‘shared competence’, while protection and improvement of human health fall under Article 6 as supporting competence.

As such, the EU can only intervene to support, coordinate or complement the action of its member states.

For Andriukaitis, while health topics remain high on the political agenda after the pandemic, the language and messages from politicians are still far from the reality of the measures introduced.

“In Brussels, they see only economic issues. Cows are more important than people’s health. Ministers of agriculture are gathering every month,” he said.

“How often do European health ministers gather in Brussels? Once per half a year. Why? Because there are no competencies at the EU level,” he added.

Health could be key to opening EU treaties

Health policy is at the heart of demands for EU treaty reform after MEPs voted on Thursday (9 June) for EU leaders to establish a constitutional convention to reopen the EU treaties.

Recommendations are not enough

One weapon in Commission’s arsenal is the ability to make recommendations to member states. However, other than that, the Commission does not have the legal tools to do more, Andriukaitis stressed, citing the long procedure to implement Europe’s ambitious beating cancer plan.

In September, the EU executive proposed a revision of the 2003 Council recommendation on cancer screening as a part of the EU-wide plan to combat cancer.

“Now cancer screening [recommendations are] proposed, but how can we encourage member states to cooperate in areas of rare cancers in practice?” Andriukaitis asked.

He added that there is no chance to address those issues for a member state alone due to a lack of knowledge, clinical trials, hospitals, and doctors with the relevant expertise.

Moreover, he said that member states’ time is already dominated by other urgent challenges, leaving health priorities on the back burner.

COVID-19 could be incentive to give EU more health powers

With citizens more concerned about health due to the pandemic, questions are raised as to whether the EU’s current instruments are enough, or whether it is time to discuss member states sharing more health competencies with the EU.

Lack of political will

Another problem, the former commissioner highlighted, is the fragmentation of the different national legislations on health.

“If you compare 27 healthcare systems they all are different. And national regulations are also different,” he said.

“When we’re speaking about cross-border healthcare, the main obstacles arise because of different legal situations and different infrastructural developments, and different data and interpretations,” he continued.

Once again, he drew parallels with the agri-food sector. “We do not have the possibility to have one single market for pharmaceuticals, instead, you have 27 different markets. Compare this to food – food has one single market,” he said.

For Andriukaitis, there is a need for lawmakers to walk the talk when it comes to giving health the appropriate weight in the political agenda.

“We need to strengthen political will at the European Council level,  namely between heads of state and of government,” he said, adding that only EU leaders can decide to increase cooperation in health while the Commission has no right to do so.

“If you remember, many, many years ago, Francois Mitterrand [former president of France], who had cancer, proposed an initiative: Europe against cancer. Why? Because it was his reality and there was political will,” he concluded.

[Edited by Gerardo Fortuna/Nathalie Weatherald]