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The EU ready to play the health cooperation card, but who holds the cards?

Oct 11, 2021

Ursula von der Leyen


On 15 September, European Commission President Ursula Von Der Leyen gave her annual State of the Union address to the European Parliament. After talking about crisis management, she said that “it is time to build the European Health Union”, some of which has in fact already been initiated:

  • Launch of HERA, the new European Health Emergency Response and Preparedness Authority, which was formally adopted on 16 September.
  • Adoption by the European Parliament of the proposal to extend the mandate of the European Centre for Disease Prevention and Control (ECDC), involving:
    • National preparedness and response plans as well as the provision of comparable and good quality data by states.
    • A focus on non-communicable diseases such as cardiovascular and respiratory diseases, cancer, diabetes and mental illness.
  • Adoption by the Parliament’s Budget Committee of its position on the EU 2022 budget, which includes the reinforcement of the EU4Health program, with an additional €80 million to build a strong EU for health and strengthen the resilience of national health systems.
  • Public consultation on pharmaceutical strategy opens until 21 December.
  • Proposal to be finalized on a common Health Technology Assessment (HTA); EUnetHTA has published its White Paper and has been selected to continue (voluntary) cooperation in this area until September 2023.


The State of the Union speech was eagerly awaited, especially in the context of the end of the crisis and the key issues to be addressed for European health. Nevertheless, there were no major announcements in Von der Leyen’s speech. Indeed, the confirmation of the launch of HERA and a budget of 50 billion euros was not a surprise, simply confirming what had been planned in the EU4Health program.

The President of the Commission has nevertheless mentioned a “new European healthcare strategy” with a strong social component, which she will present shortly.

The same goes for a new European text on cyber-resilience with common standards and a collective assessment of future threats, in which health should normally have its place given the issues around data and the explosion of e-health.

However, despite some expectations, health products were largely absent from the speech. Nevertheless, outside the discourse, the Commission has launched a public consultation on the pharmaceutical strategy adopted last November with the aim of “ensuring a regulatory system for medicines that stands the test of time and is crisis-proof”.

On the other hand, the announcement of the launch of HERA in the State of the Union speech did not thrill everyone, starting with MEPs.

The new division within the European Commission will be represented mainly by the Commission and the representatives of the Member States in the Council, with the additional support of representatives of EU agencies and bodies. However, the legal basis does not provide for any involvement of the European Parliament, which seems not to be welcome to participate in the discussions on HERA.

This has provoked a lot of misunderstanding and criticism from MEPs such as Dacian Ciolos, president of the Renew group, who reproaches “doing diplomacy with the Council instead of doing politics with the Parliament”. Tilly Metz, Green MEP, is indignant, saying that “All the key areas in which HERA will intervene fall within the competence of the European Parliament. So why should only the Council have a say in this?”

Finally, in a context of political renewal in Germany, with the loss of Angela Merkel at the power, it seemed like Ursula Von der Leyen already asserted her strategy. Indeed, Ursula Von der Leyen’s speech focused on the issues dear to Emmanuel Macron, as France will take over the Council Presidency on 1 January. However, this presidency is likely to be disrupted by the presidential elections, especially if the current President is not re-elected. In this perspective, von der Leyen would have even more freedom of action for at least a few months. In any case, this does not seem to be very favourable to an acceleration of European construction in the field of health, despite the lessons learned from the crisis.