Countries want more health money. They don’t want to give up power.
Nearly all EU health ministers — or the national diplomats in their place — stressed at a virtual meeting Friday that they welcomed the new standalone health program EU4Health.
They especially loved its big budget, which increased from €413 million in the Commission’s 2018 proposal to €9.4 billion.
“This ambitious program … sends a strong signal to our European citizens and on our intention to make health a priority,” said France’s Secretary for Child Protection Adrien Taquet.
Countries also gave the Commission the go-ahead to buy vaccines on their behalf, spending more than €2 billion on advance purchase agreements of coronavirus vaccines while they’re being tested.
Despite the enthusiasm expressed Friday, however, countries also had a clear message for the Commission: We’re watching you.
The meeting comes as Brussels faces a difficult balancing act, trying to satisfy growing calls to give the EU more power in health against member states’ desire to maintain their long-held health competence.
The Commission has tried to reassure countries that its proposals are staying within the treaties, but countries have indicated they are wary.
That point was underscored repeatedly on Friday by health ministers and their stand-ins, who said national capitals want a bigger role in implementing the EU4Health program.
“It’s important to also keep member states in the driver’s seat,” said Roland Driece, director of international affairs at the Dutch health ministry, speaking on behalf of his country. “The proposed role of member states in the execution of the program seems too limited.”
Similar statements came from Ireland and Denmark, while the Czech Republic warned that the Commission’s proposal went too far by overstepping its health competence.
“We’re concerned that some activities of the program might not respect exclusive competencies,” said Czech Deputy Minister of Health Radek Policar.
“There’s no doubt that the activities improving health systems’ resilience and sustainability must be supported,” he said. But organizing health care systems is a member state competence, he stressed.
Meanwhile, EU Health Commissioner Stella Kyriakides insisted that countries will get their say.
“Member states will be involved at many different levels and program objectives,” she said, adding that they “will be inputting into the agenda-setting.”
But she also argued that there’s been a “gap between what citizens have expected and what the EU could do in terms of health.”
“This program proposes, with a substantial budget, a different way forward,” she said.
The meeting also revived a long-running battle over health competence involving the Commission’s health technology assessment (HTA) proposal, which has been stuck in the Council for years due to objections from large countries like France and Germany. A few countries lamented this standstill.
Jan Hoogmartens, Belgium’s deputy permanent representative, called it a “pity” that the Council “couldn’t use the properly functioning health technology assessment,” and he urged countries to move forward. Estonia and the Netherlands repeated this line.
But the broader message stressed by countries was that the coronavirus crisis has shown they need to work together.
Kyriakides, speaking after the meeting, cheered that the Commission got “a clear political mandate” for an “EU approach to secure vaccine supply.”
The initiative “will avoid competition, and offer vaccine producers a simplified process,” she said.
France’s Taquet, meanwhile, pointed to a letter — signed by his country, Denmark, Germany, Spain, Belgium and Poland — that calls for more cooperation. He also noted a new vaccine alliance between France, Germany, Italy and the Netherlands to secure a vaccine for Europe.
German Health Minister Jens Spahn said the health program could be a chance to give more responsibility to the European Centre for Disease Prevention and Control, so it can take on such tasks as building a better electronic reporting and surveillance system and establishing a “rapid reaction task force of experts.”
“We have an opportunity,” Kyriakides said. “Let’s not waste it.”