Is EU Healthcare Destined for a More Nationalist Approach?

The recently elected European Parliament now faces the task of supporting national European governments to deliver resilient health services within a context of ageing populations, stressed healthcare systems, and a health industry that is struggling to keep up with global competitors. 

Amid looming threats, the EU’s role in healthcare has never been more critical, said Matthias Wismar, PhD, program manager with the European Observatory on Health Systems and Policies. “The importance of health for the European Union has grown massively. We have seen the capabilities of the European Union to respond to health threats. But the next crisis is just around the corner; whether it is another virus, a refugee crisis, another economic crisis, bioterrorism, you name it, there are so many potential dangers,” he told Medscape Medical News.

The previous parliament laid the groundwork with substantial developments, including increased public health budgets, the creation of institutions such as the Health Emergency Preparedness and Response Authority, and expanded mandates for the European Centre for Disease Prevention and Control and the European Medicines Agency. 

Experts told Medscape Medical News that the new parliament must build on these foundations, focusing on equitable care and innovation across the bloc. Some are optimistic that the new members will follow the trajectory of the outgoing parliament. Others worry that health has lost priority in the parties’ agendas.

What Citizens Want

Citizens across Europe have made it clear that they believe health should be a top priority for the European Parliament. In a recent public debate on the European Union’s health priorities, more than 64% of respondents agreed that the EU’s mandate on health should be strengthened. 

Wismar, one of the authors of the debate’s report, told Medscape Medical News, “Participants asked for health equality to be added to the discussion framework. They thought the European Union must do something about it.”

Participants called for action to reduce inequities in access to healthcare services, medicines, and infrastructure. They emphasized the need for universal health coverage, including for vulnerable populations such as migrants, and fair and equal access to good quality care, and innovative medicines and therapeutic options. “One should not live or die based on the geography of where they were born,” one respondent said.

Building on Past Experience

Health has long been a national responsibility in Europe. But when the COVID-19 pandemic hit, the EU’s role in health policy grew dramatically, almost overnight. 

Mike Morrissey, chief executive at the European Cancer Organisation, told Medscape Medical News that the EU’s cross-border intervention in healthcare during the pandemic was a success story because it meant that “[a] 50-year-old man in Bulgaria received his vaccine at more or less the same time as a 50-year-old man in Germany.” 

The pandemic experience invigorated the EU’s commitment to health equality, leading to initiatives such as Europe’s Beating Cancer Plan, an experiment to inject political priority and financial support into member states’ cancer prevention efforts. “A couple of years into the implementation of [the plan], it is too early to see tangible results in terms of lives saved,” said Morrissey. “But many initiatives are well underway and promise to make a real difference.”

These initiatives aim to reduce health disparities across Europe by facilitating knowledge exchange and best practices among member states. For example, countries with low HPV vaccine uptake can learn from Poland, where vaccination rates were low until the Catholic Church began campaigning in its favor. Croatia’s pilot program in lung cancer screening will inform the rest of the bloc. “This intelligence and research can be shared with other countries so they don’t all have to reinvent the wheel,” Morrissey said.

Experts now call for the new parliament to develop similar plans to coordinate other pressing health issues, such as cardiovascular disease, ageing disorders, and mental health. “The EU needs to demonstrate its relevance to citizens across Europe and member states. By doing work that helps reduce the inequality that exists between countries, the EU will gain a better reputation amongst voters,” said Morrissey.

A Lesson Too Soon Forgotten?

Roberta Savli, executive director for public affairs at the European Federation of Pharmaceutical Industries and Associations, is concerned that the newly elected European Parliament, which leans slightly more to the right of the political spectrum than its predecessor , might reduce its involvement in health and leave the details to its member states. She said she was unsettled to notice that health had a lower priority in the 2024 campaign than in the 2019 elections.

The war in Ukraine and the economic and refugee crises might explain why health has lost ground in the EU’s agenda. But both Savli and Wismar worry that people have quickly forgotten the lessons from the COVID-19 pandemic. Savli called for the new European Parliament to ” consider health as an investment rather than simply a cost.” 

The EU’s strategic agenda for 2024-2029, which outlines the EU’s priorities for the new institutional cycle, highlighted health and pharmaceuticals as key areas of focus. This marks the first time the health sector has been explicitly mentioned in the EU’s strategic agenda, indicating that competitiveness has become a central goal for the EU.

However, Savli expressed concerns that the rise of right-leaning political parties, which are often skeptical of open trade, might challenge this approach. “It is important to keep Europe open to a global supply chain because we would not be able to produce everything in Europe,” she said. “This will inevitably have consequences on prices and accessibility of medicines.”

Morrissey explained that before the election, there was a concern that right– wing nationalist parties might not be as interested as others in healthcare, leading to a trend toward it returning to a predominantly national concern. “As it turned out, the rise in right-wing MEPs [members of the European Parliament] was not as high as expected,” he said. 

“I’m optimistic on the political prioritization,” said Morrissey. “Cancer and other healthcare issues will remain a priority. The key question is, how much money does that political priority get?” 

Manuela Callari is a freelance science journalist specializing in health and medicine.