What do you see as the most crucial EU initiatives for health? What are the challenges and opportunities associated with them?
The COVID-19 pandemic showcased the decisive role of EU coordination in the emergency, repair and recovery phases. If we want to have a coordinated approach to strengthening health systems and a fit-for-purpose health security framework in the EU, then building a European Health Union is the way ahead.
First of all, the European Commission adopted Communication and legal proposals in November 2020 to strengthen the mandates of the European Centre for Disease Prevention and Control (ECDC) as well as the European Medicine Agency (EMA). In addition, we also established a new Health Emergency Response and Preparedness Authority (HERA), which operates within the Commission. With this, we can ensure that all Member States are better prepared for the next health crisis.
For example, the new EMA mandate allows EMA to closely monitor and mitigate shortages of medicines and medical devices during major events and public health emergencies and to facilitate faster approval of medicines that could treat or prevent diseases.
We are also putting in place other building blocks of the European Health Union. I am referring specifically to Europe’s Beating Cancer Plan, the Pharmaceutical Strategy for Europe, and the upcoming European Health Data Space.
Creating a European Health Data Space (EHDS) is undoubtedly one of the critical priorities
Adopted in February 2021 Europe’s Beating Cancer Plan, together with the Horizon Europe Mission on Cancer, aims to improve access to prevention, early detection and treatment of cancer and reduce cancer inequalities across Europe. Around EUR 4 billion are earmarked through a number of EU funding instruments for the implementation of this plan.
The Pharmaceutical Strategy for Europe, which was also adopted in November 2020, aims to ensure a strong, competitive and green industry in this sector that delivers medicines for patients and health systems. The strategy also takes stock of the vulnerabilities in the EU’s pharmaceutical framework exposed by the COVID-19 pandemic. The strategy sets a long-term vision for a crisis-resistant European pharmaceutical system. One of the deliverables will be the revision of the pharmaceutical framework by the end of this year.
Creating a European Health Data Space (EHDS) is undoubtedly one of the critical priorities of the European Commission in the area of health. The objectives of the EHDS are to ensure that individuals have improved access to and control over their own health data; can benefit from a wealth of innovative health products and services based on health data use and reuse; and that researchers, innovators, policy-makers and regulators can make the most of the available health data for their work while preserving trust and security.
The challenges, but also the opportunities, lie with aligning all stakeholders in supporting and implementing the vision put forward by all these initiatives. This includes the Member States, the Council, the European Parliament, the industry, NGOs, the health professionals, the researchers, and the citizens themselves. We need to work in partnership to realise the full benefits of these new policies.
What are the outcomes of recovery plans implemented during the COVID-19 pandemic? How far do we still have to go?
The Recovery and Resilience Facility (RRF) is the main instrument of the NextGenerationEU package – the plan for Europe’s recovery from the COVID-19 pandemic. It is another example of strong coordination at the EU level, this time for the recovery phase. Thanks to the RRF, significant funding is allocated to the Member States to overcome the impact of the pandemic by investing in the green and digital transitions and resilient health systems.
By the end of February 2022, 22 national Recovery and Resilience Plans (RRPs) have been adopted by the Council and the Commission. In the adopted RRPs, around EUR 37 billion are planned for health investments and reforms. This is a considerable amount for a wide range of measures but tailored to what each Member State prioritises according to its own specific needs. For example, many investments concern infrastructure and equipment for hospitals. But some countries, such as France, plan substantial investments to support the digitalisation of the health system.
There are also investments in primary care and mental health (Portugal), cancer care (Croatia and Czechia), public health and disease prevention (Greece), treatment of communicable diseases (Slovenia), improving the cost-effectiveness of the health system (Finland), strengthening the health workforce (Latvia and Spain) and biomedical research (Italy).
We are still at a very early phase in the implementation of the RRPs. We need to be patient to see their full impact in the years to come. Therefore, the Commission has established a Recovery and Resilience Scoreboard , a web platform open to the public that provides up-to-date information on the implementation of the plans with detailed information on the different measures, including health:
Importantly, we need to keep in mind that there are other EU instruments to complement the work of the RRPs. For example, the REACT-EU programme, the Cohesion Policy funds, as well as the InvestEU, Horizon Europe, Digital Europe and EU4Health programmes offer several options to the Member States to invest in strengthening the resilience, accessibility and effectiveness of their health systems.
Where will the policy go next to build resilient healthcare in Europe? What do you see as the remaining gaps to fill?
As mentioned above, the EU has adopted several important health initiatives in the last two years. They are either going through the process of political agreement or are at the very beginning of their implementation. It is crucial that we see through their full implementation. As I mentioned before, this can only happen if all stakeholders are engaged and supportive.
What we need to focus on now is successful implementation. In order to succeed with the implementation of many reforms and investments for resilient health systems, we need to ensure that health authorities have the necessary capacity and know-how to implement ‘on the ground.’ In many cases, knowledge exchange and strong cooperation between the Member States are key to building capacity for implementation.
The Council Conclusions on Strengthening the European Health Union adopted in December 2021, under the Slovenian Presidency, make explicit references to the need for such cooperation. The 2021 Companion Report on Resilient Health Systems (part of the State of Health in the EU project) stresses the need to understand better the long-term effects of the pandemic on health systems, the importance of harnessing the digital health dividend, and the importance of further investing in the health workforce. For all these areas, we can contribute by launching some key projects to support cooperation and capacity building.
One example I can mention concerns the strengthening of primary care. The pandemic highlighted the critical role of primary care, for instance, in managing COVID-19 patients and reducing pressure on hospitals. To reinforce the capacity of health authorities in Member States to address important aspects of primary care reforms, we will launch this year a Joint Action with EUR 10 million funding from the EU4Health programme to transfer good practices in primary care into new locations in a number of Member States.
Another area for improvement relates to better planning and improved working conditions for a more resilient health workforce. The COVID-19 pandemic underlined the requirement for a well-trained health workforce, in suitable numbers and with the right skills, including digital skills, to address the health challenges of the 21st century. We also need to consider actions to accelerate the use of digital health solutions in all care settings by building on the increased adoption experienced during the COVID-19 pandemic. The pandemic was an opportunity in this regard if we consider how it led to a rise in the number of remote consultations in all EU countries – an increase of more than 50% in Bulgaria, Finland, Hungary, Ireland, and Latvia between June/July 2020 and February/March 2021.
To this end, we have just launched a call for proposals, with EUR 29 million funding from the EU4Health programme, for training actions for the health workforce (clinical and non-clinical). The objective is to implement a number of training modules for the continuous professional development of health professionals. These will include training courses for building digital skills and other relevant skills needed for surge capacity in crises and for the transformation of health systems into new care models that provide more integrated healthcare. Furthermore, we are going to launch later this year another Joint Action with EUR 7 million funding from the EU4Health programme to help Member States work together to improve their capacity for health workforce forecasting and planning.
Finally, we will support the Member States in detecting critical health system weaknesses against many different shocks. The EU4Health programme will fund a project this year with the OECD and the European Observatory on Health Systems and Policies to develop a methodology for the Member States to test the resilience of their health systems and, when applicable, help develop remedial action. This methodology will be designed in collaboration with national/regional health authorities and the ECDC.