Opinion

The European Union and the pandemic: health and socio-economic issues

Atalayar_Unión Europea

A new series of issues that we believe need to be raised at the Conference on the Future of Europe has been launched, this time on the challenges posed by the pandemic in the health and socio-economic spheres. This time too, we have contributions from leading specialists, all of them on the front line, whose reflections can help us to draw conclusions that may be useful in the context of the Conference.

It is indisputable that, in the face of the pandemic, it is necessary to react and take both preventive and remedial decisions, but it is questionable whether the decisions taken are the most appropriate and, above all, whether they take into account the due weighting of the rights at stake. States, International Organisations, the European Union, do not always show good coordination that takes into account the different variables and, at the same time, gives us a certain security as citizens to know where we stand.

Atalayar_Europa Teresa Freixes

We were used to a globalised world, to freedom of movement and residence in the European Union, to rights in the field of health and social and economic protection and, suddenly, it seems that, like a house of cards, this world is falling apart. We are not facing the same scenario, but the unease that gripped Stefan Zweig in 'The World of Yesterday', when the life we were used to was dissolving like a sugar cube in water, is also pervading us now, when we see bans, controls and coercive measures, which are often not sufficiently coordinated, let alone explained.

In the EU Member States, we looked to these institutions, the Commission, Parliament and Council, as well as the specialised agencies, in the hope that they would give us light, guidance and help. It was difficult for them to react at the beginning of the pandemic, as all the experts consulted have noted. And now that we are overcoming the "second wave", they note that EU action cannot be limited to being merely a source of funding to alleviate the consequences of the pandemic. They have competences that need to be exercised with all the consequences and they have the capacity to make proposals for enlargement in many areas without the need for a reform of the Treaties, which would be complicated and time-consuming. It would be enough to be more proactive in the competences that they already have, especially in the framework of coordination, because it is hard to understand that each Member State is making its own cloak and that, in some cases, the cloak is again divided between sub-state territorial authorities without a clear line of coordinated action, which would undoubtedly multiply the positive effects of what is done.

Atalayar_Europa Teresa Freixes

It is often said, and it is true, that this is the first time that the EU has had to face a crisis such as the one that has caused the pandemic. But, as Gari Durán rightly reminds us, history shows us examples from the past (epidemics of yellow fever, plagues) from which we should perhaps draw lessons that would make us improve prevention, detection and treatment protocols, as it sometimes seems that we do nothing more than what was done centuries ago (confinements, curfews, movement controls, social isolation in short) when today's means could allow us to take a different approach or at least complement it.

It is also true that the health systems of the Member States of the Union had demonstrated a high degree of efficiency and have been strained when faced with an unexpected situation. Antonio González points out that this has highlighted differences that would need to be addressed if all EU citizens were to have the right to receive any type of health care in any of the Member States. He wonders, we all wonder, what could be done to improve in this respect, based on experience, especially by unifying criteria and procedures. We see this, as well, when we look at how difficult it was to organise the vaccination of millions of people and the problems encountered in gaining access to good scientific information.

Atalayar_Europa Teresa Freixes

But, of course, as José Ramón Calvo points out, in our beloved Europe, public health was no longer considered an absolute priority, the budgets devoted to it had been reduced and we had not bothered to produce and stock individual protection products such as respirators and emergency equipment. No wonder, then, that we are at the mercy of a global market that is difficult to apprehend at the right coordinates. Fortunately, some progress is being made on "key" issues, such as vaccination passports. Some voices have considered them discriminatory when they have always existed and, moreover, they cannot be discriminatory insofar as they facilitate the exercise of rights based on an indisputable fact: being vaccinated is not the same as not being vaccinated, so there is no discrimination when different situations are treated differently.

In terms of health, any measures adopted in situations that cause cross-border threats are also of great importance. Julián Domínguez deplored the stinginess of national sovereignties, which made supranational collective action impossible. It would therefore be necessary to extend the competences of the European Union, so that a health authority could lead the response and there would no longer be any anxiety as to whether all vaccines are equally effective, or whether patents could be made more flexible so that everyone could have access to them. 

Atalayar_Europa Teresa Freixes

This pandemic is not the first, nor will it be the last. Ricardo Ruiz-López warns that Epidemiology and Public Health experts estimate that there will be recurrent pandemics in the medium and long term. We must therefore be prepared and make up for the shortcomings experienced, for example, in the lack of institutional coordination, the lack of political leadership and the lack of transparency that we suffered, especially in the first stage. Health care models need to be reviewed, for example, in terms of what should be comprehensive care for the elderly or ensuring interdisciplinary care for individual situations. Bioethical measures must be applied to ensure that public health intervention complies with the basic principles in this area, such as effectiveness, proportionality, minimal intrusive interference and justification of the measures.

For all this to be successfully addressed, it would therefore be necessary to extend the EU's competences in the health field. We have seen that the existing ones have helped to alleviate extreme situations and that we are improving care and prevention protocols. But this is not enough, especially when it is foreseen that we will be subjected to this type of situation on future occasions.

Atalayar_Europa Teresa Freixes

It is in socio-economic matters, i.e. in the forecasts for dealing with the social and economic consequences of the health crisis, that the EU has had the greatest scope for action, since this does fall within the competences currently allocated to it. Let us remember that the EU only has the competences attributed to it by the Member States. And although they are important in this area, it would also be important to move forward, as challenges are immense.

This is what Miguel Candel reminds us, who, acknowledging the efforts made, considers that the pandemic has opened a window of opportunity that should allow EU funds to be used with maximum efficiency in terms of welfare and solidarity, so that populations with economic and social fabric negatively affected by the crisis can be the object of beneficial projects that include criteria of social equity in their distribution. The EU must overcome purely mercantile limitations of yesteryear, which sometimes seem to resurface and which must be countered by unity, which requires harmonisation and balance in many areas. This would also entail an improvement in the public's perception of the Union.

Atalayar_Europa Teresa Freixes

If the entire population is the target of the measures that can be taken to overcome the crisis, the efforts and talents of all people must be taken into account, addressing, as Mirian Izquierdo suggests, the gender gap in organisations. Women have suffered specific repercussions in this area, which must be overcome by promoting women's empowerment in economic power and decision-making. In Europe, the majority of women's businesses are micro-SMEs, and in many countries there is a duality in the labour market that also needs to be overcome. There is a need to strengthen internationalisation, improve access to credit and create programmes that promote the creation of technological companies by women. This could lead to more competitive companies and a more sustainable European Union.

This reflection could also focus on what Mariam Camarero is calling for, to complete the Economic and Monetary Union, going beyond what was implemented during the crisis that began in 2007 and which changed economic governance with the Stability and Growth Pact, as this is insufficient to tackle the current crisis. In this respect, it would be necessary to insist on the mutualisation of risks using common funds, to move towards fiscal union with new rules and better coordination, as well as introducing crisis management and evolution mechanisms. Thinking about a seven-year budget, together with the Recovery Plan for Europe that focuses on the institutions and not only on the intergovernmental level, is a step forward that might need to be transferred to the institutional level and to the Treaties.

Atalayar_Europa Teresa Freixes

This Europe, then, in the words of Gonzalo de Mendoza, is a Europe that is reforming itself. It has been doing so since its very creation, since it is an instrument that is evolving, sometimes more slowly than we would like, according to new needs. The pandemic has brought them to light and health equipment has had to be put out to tender at European level, green corridors have had to be set up for the free movement of health equipment, as well as for the supply of food and medicines, thousands of Europeans who had become isolated in third countries have had to be repatriated, the purchase and distribution of vaccines has had to be organised and, in short, major economic measures have had to be taken: The suspension of the debt and deficit criteria, the purchase of bonds by the ECB, the new State Aid, the loans to SMEs from the European Investment Bank, the SURE that allows, among other things, the payment of ERTEs or the ESM funds consisting of loans for the States that need them and opt for this financing. The thought that we also have a Budget organised for seven years and that a European Rescue Fund is also being considered also opens up more windows of opportunity and hope.

Teresa Freixes, Jean Monnet Chair ad personam and Vice-President of the Royal European Academy of Doctors.