A greater EU role in health, increased cooperation with cities and regions, and a shake-up of the drugs market are needed to ensure EU can withstand health crises, local and region leaders say.
Local and regional leaders have given their support to a greater role for the European Union in health issues and to EU plans to safeguard the stability and security of supplies of critical medicine and equipment. However, in a series of recommendations adopted at a plenary session of the European Committee of the Regions on 7-9 May, they also argue that the EU's plans to withstand health crises is undermined by too little attention to the importance of local and regional authorities, which are a cornerstone of health systems in two-thirds of EU countries.
The recommendations, if accepted by EU legislators, would oblige EU agencies – such as the European Medicines Agency and the European Centre for Disease Control – to cooperate closely with local and regional authorities and to realise the full potential of cross-border health-care cooperation. As well as supporting the development of emergency reserves of medical products, the proposals press for a "mapping" of the causes of medicine shortages – a problem that pre-dates the pandemic – as part of efforts to bring more security and transparency to a "dysfunctional" pharmaceuticals market. The CoR is also calling for the emergence of a network of "gold-standard hospitals" specialising in the study and treatment of infectious diseases.
The recommendations are contained in three opinions, one assessing the building blocks of the 'European Health Union' already presented by the European Commission, and the other two focusing on the European Centre for Disease Control and on the European Medicines Agency and the EU's pharmaceuticals agency.
Roberto Ciambetti (IT/ECR), President of the Veneto Regional Council and rapporteur on the opinion 'European Health Union: Reinforcing the EU's resilience', said: "Local and regional authorities are responsible, to varying degrees, for health care in 19 of the 27 member states, and they also help fund health care in many of those countries. A 'European health union' capable of swiftly curbing pandemics is not possible without the close involvement of these authorities. We need a network of gold-standard hospitals, greater production capacities in Europe, large emergency stockpiles, and better data so that we know where our weak points are."
Birgitta Sacrédeus (SE/EPP), rapporteur on the opinion 'Europe's pharmaceutical strategy and legislative proposal for changing the mandate of the European Medical Agency (EMA)' and member of Dalarna Regional Council, said: "We strongly welcome the patient-centred pharmaceutical strategy launched by the Commission to ensure that all patients throughout Europe will have access to safe, effective and affordable medicines, under regular conditions as well as during a health crisis. Since local and regional authorities often play a key role in the funding, evaluation and provision of medicines as well as in crisis management and preparedness, our opinion outlines the need for them to be included in the cooperation developing the Commission's proposals in the pharmaceutical area."
Olgierd Geblewicz (PL/EPP), President of West Pomerania Region and rapporteur on the "Regulation for tackling cross-border health threats and legislative proposal for changing the mandate of the European Centre for Disease Control (ECDC)", said: "The CoR believes that regions shall be fully involved at the political level in drawing up and implementing these plans. We call for the introduction of effective instruments for coordination between border regions, including those on the EU's external borders, and propose that interregional, cross-border contact groups be set up. Furthermore, Representatives of the CoR, as the institution representing local and regional authorities from all the countries of the European Union, should be involved as observers in the work of teams, committees and task forces set up at EU level to deal with public health emergencies, particularly the Advisory Committee on Public Health Emergencies."
In other recommendations contained in the three opinions, the CoR called gave provisional backing to the idea of a new European Health Emergency Preparedness and Response Authority, and urged the European Commission to produce more "concrete" and "robust" proposals to enhance security of supply of medicines, drawing on the needs and experiences of the local and regional levels. It also called for Commission proposals to emphasise data security concerns. The CoR's support for revisions to the mandate of the ECDC emphasises the need for an associated process of capacity-building – for example, of digital infrastructure and telemedicine – and for attention to the potential of international cooperation in border regions.
At its plenary session, held online, the European Committee of the Regions also adopted an opinion on the experiences and lessons learned by regions and cities during the COVID-19 crisis and a resolution on free movement during the COVID-19 pandemic (Digital Green Certificate) and the scaling up of vaccine production. The resolution includes a call for a "temporary suspension of patents for medicines and medical technologies to treat or prevent COVID-19 infections". Recommendations in the opinion on lessons learned from the crisis – drafted by Joke Schauvliege (BE/EPP), member of the Flemish Parliament – also covered non-medical aspects of the crisis, with a particular focus on the experiences of rural and peripheral regions. This opinion, which was requested by the European Commission, will contribute to a report that the European Commission is preparing for the Council of the European Union, the institution in which national ministers from each EU country meet to adopt laws and coordinate policies.
In its first Annual Local and Regional Barometer released in October 2020, the European Committee of the Regions found very significant differences in health-care provision across regions in the EU and also between regions in the same member state. A survey conducted as part of the Annual Local and Regional Barometer found that Europeans trust regional and local authorities more than they trust the EU or their national government, and that they believe granting greater influence to regional and local authorities would have a positive impact on the EU's ability to solve problems. Health was the area where Europeans would most like to see regional and local authorities exercise more influence on decisions taken at the EU level.
European Committee of the Regions reports and studies: Annual Regional and Local Barometer (full report, and health impact in data, from October 2020); The impact of the COVID-19 crisis on regional and local governments (joint CoR-OECD survey, October 2020); Territorial Impact Assessment: the State of the Cities and Regions in the COVID-19 crisis (October 2020); Regional health policy responses to the COVID crisis (October 2020); Implementation of the Cross-border Healthcare Directive in the European regions (October 2020).
Local experiences: CoR Exchange Platform (Experiences of local and regional administrations during the first wave of the pandemic); Reinventing Cities (Eurocities report with dozens of examples of municipal actions, initiatives and projects).
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