The European Health Union: European Union's Concern about Health for All. Concepts, Definition, and Scenarios

The COVID-19 pandemic brought visibility and intensified the discussions on the European Union's (EU) health mandate. The proposals of the European Commission (EC) to move towards a European Health Union (EHU) can be seen as a starting point towards more integration in health. However, the definition of what the EHU will look like is not clear. This paper searches to find a common definition, and/or features for this EHU through a systematic literature review performed in May 2021. European Union's concern about health for all is suggested as a definition. The main drivers identified to develop an EHU are: surveillance and monitoring, crisis preparedness, funding, political will, vision of public health expenditures, population's awareness and interest, and global health. Based on these findings, five scenarios were developed: making a full move towards supranational action; improving efficiency in the actual framework; more coordination but no real change; in a full intergovernmentalism direction; and fragmentation of the EU. The scenarios show that the development of a EHU is possible inside the current legal framework. However, it will rely on increased coordination and has a focus on cross-border health threats. Any development will be strongly linked to political choices from Member States.

Automated summary

The COVID-19 pandemic has brought attention to the EU's health mandate, leading to discussions on the establishment of a European Health Union (EHU). However, the specific nature of the EHU remains unclear. This paper suggests that the EU's focus on health for all could form the basis of a common definition for the EHU. Key drivers for the development of an EHU include surveillance and monitoring, crisis preparedness, funding, political will, public health expenditure vision, population awareness and interest, and global health. The paper also outlines five scenarios for the development of the EHU, highlighting the importance of coordination and addressing cross-border health threats, while emphasizing the role of political choices made by EU Member States.