Coordination was the right path for the EU’s vaccine strategy, but lessons need to be learned

The EU’s vaccination campaign has gathered pace and is expected to further accelerate in the coming weeks following a surge in available vaccines. This gain in momentum is sorely needed: there is much public frustration over the EU being outpaced by countries like Israel, the United States and—probably most painfully—its former member, the United Kingdom. Inevitably, the question arose whether the EU was acting smartly by attaining and distributing vaccines as a joint effort rather than having member states negotiate contracts individually.

This question was also raised in a recent webinar organised by the European Health Forum Gastein (EHFG) in partnership with the vaccine company Valneva, entitled “Starting shot for vaccines—Early lessons from the ups and downs of covid-19 immunisation roll-out(s).” Did solidarity as a leading principle in the bloc’s vaccine strategy slow things down? Had the procurement of vaccines been left to national governments, it is highly likely that some member states would have been able to reach agreements with vaccine companies sooner, which in turn would have enabled them to roll out their respective vaccination programmes faster. At the same time, it is also likely that other member states—especially smaller and less wealthy ones, lacking bargaining power—would have fallen by the wayside. We got a glimpse of this issue earlier this year when EU leaders squabbled over the distribution of 10 million extra vaccine doses.

In the EU, matters related to health policy lie predominantly within the competences of individual member states. The provision of healthcare services is deeply embedded within the institutional context of individual health systems. Hence, in many areas, there is little reason or willingness to reconsider the current division of competences. A pandemic, however, poses a supra-national hazard that does not stop at borders, especially not at those within an economically and socially integrated union. John Ryan, Director of the Public Health directorate at the European Commission, argued during the webinar that the high intensity of intra-community travel and the interlinkage of services make it desirable to limit immunisation disparities across member states. In his words, “it may be preferable to have a slower train rather than an express train in these circumstances, because at least everyone arrives at the station at the same time.”

However, it is also clear that the current pandemic may be followed by similar health crises in the future. In order to avoid health, social, and economic impacts of the magnitude experienced during the covid-19 pandemic, the EU must be better prepared next time. In the context of vaccines, this means that a well-structured framework needs to be put into place that increases efficiency for developing, procuring, and distributing vaccines. Such a framework should also incorporate the build-up of support structures for vaccine research and production within Europe, as well as accelerated standardised procedures for regulatory approval that minimise bureaucratic hurdles while still ensuring maximum safety. The so-called HERA Incubator, the EU’s bio-defence preparedness plan presented in February, currently focuses on the fight of new variants, but may also provide the opportunity to enhance vaccine development and production in general. Moreover, there is considerable room for improvement in terms of transparency throughout the procurement and distribution process, which is essential for building trust among the public.

The potential for coordinated efforts in health-related fields, however, goes far beyond equitable and timely access to vaccines. Thomas Steffen, State Secretary of the German Federal Ministry of Health who was also among the panellists of the webinar, proposed a common EU pharmaceutical strategy as a top priority for the future. The European Commission adopted such a strategy in late 2020 to address challenges such as the increasing dependency on imported drugs and other medical goods. Steffen also brought up the issue of financing the combat of pandemics and called for a consideration of joint efforts in this regard.

Despite the setbacks and shortcomings of the EU’s covid-19 vaccine strategy, it seems clear that future pandemics and other cross-border health threats will require increased cooperation on a European level—not just in the context of vaccines, but also in other areas of health policy. The European Commission has started to promote the idea of a European Health Union and individual member states are beginning to acknowledge that the bloc should be granted more power when it comes to health matters. It remains to be seen whether this is merely lip service or if member states will in fact recognise what is to be gained from joining forces to fight health threats.

 A full recording of the webinar is available to watch here

Miriam Reiss is a researcher at the Health Economics & Health Policy Department of the Institute for Advanced Studies in Vienna and member of the Young Forum Gastein. 

The opinion piece was published first online for BMJ Opinion on 4 June 2021.

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