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Health governance in Europe

The politics, policy and governance of health in the EU

EU Health Governance at the 2021 UACES Annual Conference

EUHealthGov was thrilled to host three panels, exploring a vast range of EU health governance topics, at the recent UACES annual conference. In this post we summarise the panels and the paper contributions, and provide links to the authors that so kindly joined us to present their work. 

Our first panel, chaired by Dr Mary Guy (Lancaster University), explored the politics of pharmaceuticals in Europe. The first paper, presented by Federica Zardo and Henning Deters (both University of Vienna), offered an overview of vaccine politics in Europe and the leadership of the EU – both internally vis-a-vis its member states, and externally vis-a-vis the global management of vaccines – during the crisis. It finds that the early stages of the crisis were dominated by national leadership, with EU leadership increasing as the crisis unfolded, and that early nationalism this spilled over to affect the EU’s capacity for global leadership. The second paper, presented by Katrina Perehudoff (University of Amsterdam), reported the findings of a scoping review which explores the EU’s influence on access to medicines in low- and middle-income countries (LMICs). The evidence gathered in the review suggests that the EU influences access to medicines beyond its borders in three core ways: via explicit agreements with LMICs, via LMICs’ reliance on EU regulations, standards and methods, and via ‘soft’ forms of governance.  The third and fourth papers focused on the roles of key institutions in pharmaceutical policies. Patrycja Dabrowska-Klosinska (Queen’s University Belfast) and Pedro Villareal (Max Lanck Institute) presented their work on the role of courts in shaping national policies on vaccine hesitancy. The paper documents cycles of linkage between WHO guidance on vaccination and judicial decisions in cases where vaccine policy is challenged, and concludes that judicial reasoning can play a role in underpinning international policy. Finally, Julie Kolokotsa (University of Surrey) presented a study of Greece’s e-prescription policy and the role of the Troika in its development. E-prescription was introduced as part of Greece’s economic recovery programme and the paper documents the Troika’s involvement in its formulation, revealing a dynamic of shaping, rather than forceful imposition. 

The second EUHealthGov panel was titled ‘the political determinants of health’ and brought together papers addressing the wider EU frameworks that shape and affect health. Dr Mechthild Roos (Augsburg University) chaired the session, which opened with a paper from Mary Guy (Lancaster University) that uses Kingdon’s multiple streams framework to examine the windows of opportunity created by the COVID-19 pandemic, so as to formulate different framings of a European Health Union. The second paper, by Eleanor Brooks (University of Edinburgh), presented some early findings from a project on the EU’s Better Regulation Agenda. The presentation reflected on the relevance of the Agenda for health policy-making and the applicability of existing conceptual frameworks for studying such political determinants of health. Finally, Charlotte Godziewski (Aston University) presented a paper on the concept of ‘green and inclusive growth’, and the potential of this idea to re-shape how health is approached within the European Semester. Though more amenable to health interests and increasingly referenced, the paper concludes that there is a need for more research into the discursive and ideational dynamics that shape the meaning of ‘inclusive growth’ and how this should be operationalised. 

The final EUHealthGov panel, chaired by Dr Charlotte Godziewski (Aston University), brought together papers exploring rights and justice in EU health policy. The first presentation, by Vendula Mezeiova (Charles University), explored how the EU can leverage public procurement to enhance health justice. Drawing on examples of how procurement influences health outcomes, it makes the case for conceptualising EU procurement law as a matter of health justice and a tool of EU health governance. The second paper, by Mechthild Roos (Augsburg University), explored the access to healthcare for asylum seekers and refugees in Germany and Sweden during the so-called ‘migration crisis’ of 2015-17. The paper investigates the policy reforms in both countries and finds that, whilst their systems are different, the responses are similar, perhaps indicating that policy response is shaped less by welfare regime type than the existing literature might imply. Sabina Stan (Dublin City University) and Roland Erne (University College Dublin) presented their work on the commodification effects of the New Economic Governance (NEG) on healthcare. Drawing on data from the European Semester process, the paper maps prescriptions relating to healthcare and identifies a converging agenda of health service commodification within these, raising concerns about the impact of NEG on health systems. The fourth paper, presented by Nikhil Gokani (University of Essex), reflected on the failure of food information law to reduce the prevalence of diet-related non-communicable disease. It identifies a flawed logic in the approach of EU food law, which reduces health promotion to consumer information, and maps a series of options – including a reconceptualisation of the ‘informed consumer’ – for strengthening the EU’s legislative approach. 



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