blogs.lse.ac.uk 
<https://blogs.lse.ac.uk/europpblog/2020/03/24/europes-failure-to-address-covid-19-shows-the-need-for-a-european-health-citizenship/>
  


Europe’s failure to address Covid-19 shows the need for a European ‘health 
citizenship’


6-8 minutes

  _____  

 
<about:reader?url=https%3A%2F%2Fblogs.lse.ac.uk%2Feuroppblog%2F2020%2F03%2F24%2Feuropes-failure-to-address-covid-19-shows-the-need-for-a-european-health-citizenship%2F#Author>
 The Covid-19 crisis illustrates that globalisation entails health risks, and 
that the institutional design of public health systems is ill-suited for the 
scale of a pandemic, writes  
<about:reader?url=https%3A%2F%2Fblogs.lse.ac.uk%2Feuroppblog%2F2020%2F03%2F24%2Feuropes-failure-to-address-covid-19-shows-the-need-for-a-european-health-citizenship%2F#Author>
 Joan Costa-Font. He argues that the inefficiency of the policies implemented 
by different EU member states highlights why a Europe-wide public health 
authority should now be a priority to counteract collective action problems 
among different member states. EU membership should be accompanied by a 
European ‘health citizenship’.

The Covid-19 crisis is not just the most important health crisis that higher 
income countries have suffered over the last century, but also one that comes 
with enormous consequences for the global economy. It illustrates more than 
ever that while globalisation can provide benefits via free trade and mobility, 
it also entails risks.

Although the exact consequences of the crisis are still to be determined, we 
already suspect that even under a best-case scenario they will be paradigm 
changing – and perhaps the tipping point desperately needed to address the 
challenges of globalisation.  A key lesson from the crisis should be that the 
collaboration and collective action required in Europe to meet these challenges 
cannot be achieved without transferring powers to a European public health 
authority.

Diverse responses

The way the world is organised has proven to be catastrophic for the management 
of this epidemic. In Europe, each country has reacted in a different way, 
perhaps revealing the distinct characters of national elites. Germany has 
managed to keep death rates low with heavy testing, but other European 
countries have been far slower to react, while some governments appear to have 
been less open about the situation they were facing and only reacted when the 
virus was at their doorstep 
<https://blogs.lse.ac.uk/businessreview/2020/03/23/we-only-changed-our-behaviour-when-we-saw-covid-19-at-our-doorstep/>
 . Some countries, such as Austria and Poland, have demonstrated nationalist 
instincts in their responses by closing down their borders 
<https://www.healthline.com/health-news/how-deadly-is-the-coronavirus-compared-to-past-outbreaks#20022004-severe-acute-respiratory-syndrome-(SARS)>
 . Meanwhile in Spain, the approach has included the centralisation of 
healthcare responsibilities following the declaration of a state of emergency, 
even though the relevant expertise is located at the regional level, and some 
Spanish regions that advocated for a lock down have remained open 
<https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(20)30060-8/fulltext>
 .

In contrast, In Italy, the regions of Veneto and Lombardy 
<https://www.weforum.org/agenda/2020/02/italy-coronavirus-tourism-outbreak-pandemic/>
  were early movers in setting up a quarantine and urging locals to stay home. 
In Lombardy, local health authorities established strong containment measures 
<https://jamanetwork.com/journals/jama/fullarticle/2763188?guestAccessKey=f091850e-a22a-422f-92de-ae8daa6e99df&utm_source=silverchair&utm_medium=email&utm_campaign=article_alert-jama&utm_content=olf&utm_term=031320>
  in the initial cluster by quarantining several towns in an attempt to slow 
transmission of the virus. In Germany, states have taken the lead in fighting 
the virus 
<https://www.dw.com/en/german-states-move-closer-to-near-total-lockdowns/a-52863482>
 , while in the UK, Wales and Scotland 
<https://www.theguardian.com/politics/live/2020/mar/18/uk-coronavirus-live-boris-johnson-pmqs-cbi-urges-government-pay-businesses-directly-saying-350bn-loangrant-package-not-enough>
  have acted first by announcing policy measures such as school closures which 
were then followed by the whole country.

This being said, solutions must be built on cooperation and trust in existing 
institutions. Today, humanity faces an acute crisis not only due to Covid-19, 
but also due to a lack of public trust. To defeat an epidemic, people need to 
trust scientific experts, citizens need to trust public authorities, and 
countries need to trust each other.

Europe’s almost non-existent role

Public health was introduced as an express area of EU competence for the first 
time by the Maastricht Treaty and internal market regulation does constitute a 
significant constraint on health services. European health governance is a 
multilevel system very much like that of other federations. According to 
article 3 TEC, the European Community shall contribute to a “high level of 
health protection”. Although the right to health care is a ‘positive right’, 
the European Court of Justice has envisaged it as a ‘negative right’ linked 
with the principle of freedom and non-discrimination.

 


Stella Kyriakides, the European Commissioner for Health and Food Safety, 
Credit: CC-BY-4.0 <https://creativecommons.org/licenses/by/4.0/> : © European 
Union 2019 – Source: EP 
<https://www.flickr.com/photos/european_parliament/48828011992/> 


However, Europe reacted to the Covid-19 crisis fairly late. Only in the second 
week of March did the President of the European Commission propose that all 
non-essential travel to the EU should be suspended for 30 days. Alongside 
Europe’s failure to manage the migration crisis, it can be argued there is now 
a desperate need to reform the EU’s institutions to enable them to take more 
effective control over global crises in areas where national reactions are 
affected by collective action problems (i.e. countries only react when they 
face an immediate cost to themselves).

A European public health authority

Today, European citizenship is defined by a common European health card as much 
as a European passport. However, the European role in managing health crises 
has remained modest. The Covid-19 crisis highlights that public health (the 
management of global public risks) is an area where the EU should be more 
proactive. Given the nationalistic and even selfish policies implemented by 
various member states, the creation of a European wide public health authority 
must now be viewed as an urgent matter to consider as part of wider reforms. 
Being European should entail having a European health citizenship.

The help provided 
<https://www.france24.com/en/20200321-germany-to-treat-critically-ill-from-virus-hotspot-in-eastern-france>
  by the German state of Baden-Wuerttemberg to patients in the French region of 
Alsace is illustrative of the fact that health crises like Covid-19 are global 
in nature and require collaboration to be eradicated. However, this 
collaboration and collective action cannot be enforced without transferring 
health powers to the European level. This should be accompanied with 
recognition that local knowledge is fundamental to the management of health 
systems.

Crises like Covid-19 affect Europe in a different way from the rest of the 
world and there is a clear case for an authority that can ensure cooperative 
policy solutions across member states. If all European countries had 
implemented the same policy response that Germany put forward, Europe would 
likely have far fewer fatalities.

Although the delivery of health services is more efficient when it is 
decentralised (as preferences and needs are heterogeneous), global public 
health crises should be addressed centrally at the highest level possible, 
namely the EU’s institutions. We should remember this lesson during the next 
pandemic.

 <http://blogs.lse.ac.uk/europpblog/about/comments-policy/> Please read our 
comments policy before commenting.

Note: This article gives the views of the author, not the position of EUROPP – 
European Politics and Policy or the London School of Economics.

_________________________________

About the author

Joan Costa-Font – LSE
Joan Costa-Font is Associate Professor (Reader) in the LSE’s Department of 
Health Policy.

 
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