Calling for a fully fledged health union for the European Union

Submitted by Political Commission 2: Internal European Affairs.
Adopted by the Federal Committee in Prague on 13 November 2022.

The pandemic has revealed what has gone amiss in recent years: there is a greater need for collaborating on issues regarding health across our whole continent and the world. How can we ensure that Europe is better prepared for future health threats? And how can we improve access to health for all citizens in Europe? This resolution aims to give federalist answers to these and more questions.

JEF Europe,

  • Recalling article 25 of the Universal Declaration on Human Rights (UDHR), that states that “everyone has the right to a standard of living adequate for the health and well-being”;
  • Recalling the preamble of the Constitution of the World Health Organization (WHO), which in particular states in its first clause that: “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”;
  • Recognizing the importance of The European Pillar of Social Rights, in particular the Chapter III: “Social protection and inclusions”;
  • Recognizing the importance and peculiarity of the European models as an example of universal welfare;
  • Concerned that Member States and regions have reduced the capacities of the social and health sector across Europe during the Financial Crisis of 2009, decreasing consistently the access and the quality of public services, with a consequent exacerbation of the inequalities, and, recently, leading Europe to face the pandemic with already existing staff and medical supply shortages – such as basic medicines and equipment, personal protective medical equipment, hospital beds etc.;
  • Aware that the demographic changes of an ageing society and decreasing birth-rates will have even deeper consequence on the access and quality of public social and health services;
  • Deploring that the level of quality of the public health system still varies largely on our continent, depending on location, socio-economic situation, environmental conditions as well as the existence of barriers to access health care;
  • Welcoming the EU4Health programme, which provides €5.3 billion over the period from 2021 to 2027 as a first step towards a true European Health Union and also welcoming the fact that Ukrainian NGOs can also apply for these funds;
  • Strongly recalling that the European project was founded on the principle of solidarity as enshrined in the Treaties;
  • Recalling that, according to Art. 168 TFEU, the European Union shall support and complement national policies with regards to public health and, therefore, the EU ’s ability to respond in the field of public health is limited;
  • Reiterating WHO’s call to European authorities that the time is “now” to invest in healthcare systems and its workforce;
  • Recalling JEF Europe’s previous resolutions on the issuance of joint debt and other mechanisms for ensuring direct revenues for a Federal Europe, such as “A Federal Budget for the European Youth: Reforming the Multiannual Financial Framework” and “On the creation of a Fiscal Union in the Eurozone”;
  • Looking positively upon the European Health Insurance Card (EHIC) and the benefits it already gives to patients seeking emergency health care abroad, even though it does not cover the situation where a patient travels abroad with the purpose to get medical treatment;
  • Recalling the direct victims of the ongoing Covid-19 pandemic, numbering an estimated more than 1 million deaths for EU / EEA countries alone and many cases of long Covid, as well as the indirect victims, namely patients needing care for other diseases who were not able to get the care they needed during the pandemic;
  • Recognising that infectious diseases such as Covid-19 or Monkeypox are transnational threats that demonstrate the inadequacy of a purely national response towards transnational catastrophes, which could be better dealt with by federal institutions;
  • Recalling that, beyond pandemics from infectious diseases, there are other transnational threats to health, such as fallout from major industrial accidents with the spread of harmful substances or radiation or the intentional use of ABC weapons by states or other violent actors;
  • Considering that solidarity showed by some European countries during the Covid-19 pandemic was laudable, but strongly convinced that we can not rely on solidarity to face crises, and that therefore institutional solutions are needed to prevent and mitigate health shocks;
  • Recognising the efforts made by expanding the EU’s competencies in the field of health care in the context of the Covid-19 crisis, namely in the functioning of the European Centre for Disease Prevention and Control (ECDC), in the timely and joint procurement of personal protective equipment (PPE) and vaccines, as well as in the setting up of Directorate-General European Health Emergency Preparedness and Response Authority (HERA);
  • Concerned about the low vaccine coverage in certain areas, related to issues with vaccine availability, communication and public distrust, etc., not only hindering the mitigation of Covid-19, but occasionally also leading to the re-emergence of other severe vaccine-preventable diseases, such as polio, tuberculosis, measles and some vaccine-preventable cancers;
  • Welcoming the economic response with the Next Generation EU package and the fact that it is the first example of jointly-issued European debt;
  • Concerned by the fact that all measures going in the direction of further European integration were only made possible because of the Covid-19 crisis;
  • Disappointed that certain actions undertaken by the EU, such as the implementation of Next Generation EU took a long time to materialise, due to the inefficiency and undemocratic functioning of the European Council, thus paralysing the EU at a moment when action was important;
  • Worried by the acceleration of climate change and the impacts it has on human health and on the environment;
  • Recognising, according to the One Health principle, “that the health of humans, domestic and wild animals, plants, and the wider environment (including ecosystems) are closely linked and interdependent”;
  • Welcoming the European Green Deal as the first attempt to give a European answer to reducing carbon emissions with the aim to improve the quality of the environment and to allow residents to live healthier lives;
  • Stressing the importance of involving regional and local administrations in the planning and management of emergency services and proximity healthcare attention;
  • Deploring the COVID-19 vaccination campaign that highlighted a real division between rich and less developed countries, showcasing the paradox of a globalised world that is not equitable, lacks a government and yet is increasingly connected;
  • Believing that the recent Covid-19 pandemic showed the limits of the World Health Organisation (WHO), especially with regard to its lack of resources and problems in the intergovernmental decision-making;
  • Also recognising, again, the limits of an intergovernmental approach compared to a federal system when having to respond to such pan-European or global threats quickly, efficiently and above all for the common interest;
  • Recalling the final recommendations of the Conference on the Future of Europe propose, a fully-fledged, horizontal shared competence on public health;

JEF Europe therefore,

On the European level,

  1. Applauds the ECDC for its monitoring of the Covid-19 pandemic and vaccination campaign and calls upon the ECDC to replicate the effort made for tracking Covid-19 vaccination for other diseases;
  2. Calls for all the Schengen members to better coordinate responses to health emergencies to avoid restrictions to the functioning of the Schengen Area, especially in border regions, unless these closures are required for public health reasons and in time-delimited consultations with European institutions, such as the ECDC;
  3. Calls for longer-term economic recovery responses to health emergencies to improve the resilience of affected communities to future emergencies as well as be sustainable and socially just;
  4. Strongly emphasises the importance of implementation of checks and balances in order to maintain the full functioning of the democratic institutions at all federal levels in times of crisis;
  5. Calls for abolishing the veto right in the European Council, which currently blocks decision-making and which unfairly favours the interests of a minority of Member States rather than the general interest of Europeans;
  6. Calls for actions by the EU to help the local and national actors – in the respect of subsidiarity – to align the level of public health as closely as possible to the highest standards currently existing in the EU as soon as possible and to improve the access to health care, in particular for underserved regions, people living in relative or absolute poverty and people with a migratory background;
  7. Calls for the EU to facilitate cross-border treatments and to establish a permanent home for a European Hospital and Medical Research Institute focused on both treating and researching the rarest and most complex surgical and medical procedures;
  8. Recommends to develop the EU Health Platform to integrate EU citizens patients, researchers and health professionals; an online EU health card; drugs correspondences, combination risks, bills; local systems comprehension and language filters; online consultation; exam history; document request; health information, professional research tools and chats; the platform might include Electronic Health Records (EHRs), enable Patient Health Records (PHRs) through Health Management Information System (HMIS), and be transferable through Patient Accessible Health Record (PAEHR);
  9. Urges the EU to better coordinate research on our continent, so as to avoid redundancies and optimise means to have the most impact;
  10. Looks forward for the recently announced communication on mental health by the European Commission (“a comprehensive approach to mental health”) and therefore asks for EU actions to better recognise the challenges of mental health problems and provide patients with the care they so urgently need;
  11. Calls all Member States’ governments to ensure that people in refugee camps, who are especially vulnerable, are able to receive the care they need in clean and hygienic facilities, and urges EU to support and control that these standards are upheld;
  12. Advocates for broader health literacy, addressing all generations, by improving education on prevention and on science-based solutions to health care
    problems, such as, but not limited to, vaccination;
  13. Asking for a reform of the TFEU in order to enable a more integrated European health crisis response, to offer the opportunity for European minimum standards on good-quality healthcare and also to safeguard the European Parliament’s involvement in decisions on European-level procurement of medical goods;
  14. Calls for the funding of the European-level measures to come from a European budget that is replenished by own resources rather than Member State contributions;
  15. In the medium-term, calls for the European Health Union to be a coordinating factor of innovating healthcare amidst the changes outlined above with the goal to deliver quality public healthcare, accessible and either affordable or free to all living in the Union;
  16. In the long-term, calls for a health union that represents the comprehensive health policy of a federal Europe, spearheaded by a Minister of Health, supported by their services ECDC, EMA and HERA;
  17. Strongly believes that the only way to guarantee and improve the European models of welfare, in order to guarantee social justice and high standards of healthcare for everyone, is to advance the European integration process towards a European Federation, equipped with its own fiscal resources and fully democratic institutions;
  18. Calls for an integrated and coordinated approach to medical education and human capital management in the healthcare sector across member states to ensure proper staffing in all the regions;
  19. Calls for the EU to make joint procurement of medical equipment and medicine for maintaining a common emergency stock of medicine and medical equipment that be distributed among member states in case of supply difficulties.

On the global level,

  1. Calls for the strengthening of research into zoonotic diseases;
  2. Calls for a better and earlier detection of diseases through improved diagnostics made accessible to all countries;
  3. Calls for the better spread of best practices and lessons learned about treatments, as well as for a better access to treatments everywhere;
  4. Calls for a sense of urgency to be shown in this matter by all international actors and for it to be part of the agenda at major international meetings;
  5. Notices with disappointment that governments did not significantly reallocate funding to implement the Sustainable Development Goals (SDGs), with a consequent lack in the resources and therefore asks for fully replenishing Global Funds on Climate and Health, boosting funding for education and other Sustainable Development Goals, and supporting innovative forms of financing like Social Impact Bonds;
  6. Calls for giving more competences and resources to the World Health Organisation to enhance its effectiveness in preventing and mitigating health emergencies and in reducing the inequalities in the health care systems around the world, for instance making the vaccines more equitably manufactured and distributed around the world;
  7. Advocates for federal reform of the multilateral institutions, in particular the UN, including through the creation of a world parliament, based on the principles of subsidiarity, democracy, and the rule of law, to address the interconnected challenges of a globalised world, such as climate change, minimum level of life and health condition and peace.