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| 18.12.2020 | EN | Official Journal of the European Union | C 440/15 |

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Opinion of the European Committee of the Regions – An EU Health Emergency Mechanism

(2020/C 440/04)

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| | | | | --- | --- | | Rapporteur: | Birgitta SACRÉDEUS (SE/EPP), Member of Dalarna County Council | |

POLICY RECOMMENDATIONS

THE EUROPEAN COMMITTEE OF THE REGIONS

General observations

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| | 1. | notes that the COVID-19 outbreak that has hit Europe and the rest of the world in 2020 has not only led to very high rates of sickness and death, but has also had major economic and social consequences of which nobody yet has a full overview. The rapid spread of the virus has put both health and social care and public health structures under increased pressure and generated an extremely high workload for health and care workers, while at the same time preparations also need to be made for further waves; |

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| | 2. | points out that the COVID-19 pandemic has impacted different parts of Europe to different extents, with significant variations not only between countries but also between regions, municipalities, neighbourhoods and age groups, but that people with underlying conditions and those already in fragile health, and living under inadequate socioeconomic conditions, have consistently been hit harder than others; |

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| | 3. | notes that, in the fight against COVID-19, and in order to safeguard and guarantee public health, the Member States have taken measures that restrict individuals’ freedom of movement to an extent that would have been unthinkable under normal circumstances; |

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| | 4. | takes the view that the COVID-19 pandemic clearly demonstrates the importance of skilled, highly-trained staff and well-funded, well-equipped and robust healthcare systems with the capacity to adapt to a new public health and care situation quickly and, if need be, both to strengthen primary and outpatient care and to increase the capacity of hospitals’ general wards and intensive care units; |

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| | 5. | points out that in many countries the treatment of patients with other diagnoses and medical needs has been postponed, building up a ‘healthcare backlog’ that will take a long time to catch up on. Many of those whom COVID-19 hit particularly badly now need rehabilitation, and there are also strong indications that the need for care and treatment of mental health issues has increased in the wake of the pandemic, both in the population in general and among health and care workers. Healthcare, including public health, primary and outpatient care, will therefore need more resources for a long time yet; |

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| | 6. | notes that the EU institutions have actively supported the Member States in their fight against COVID-19, but that cooperation between Member States ceased at an early stage, with for instance national borders closing to medical supplies, just when the need for European cooperation, leadership and engagement was higher than usual; |

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| | 7. | recalls that, according to Article 222 TFEU, the Union and its Members States shall act jointly in a spirit of solidarity; |

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| | 8. | stresses that, while the EU has an important role to play in efforts to improve public health, prevent disease and eliminate health risks, it is fundamentally the responsibility of the Member States themselves to decide how to organise, finance and design their public health, healthcare and social services; |

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| | 9. | is convinced that Europe’s systems of universal healthcare, funded on the basis of solidarity, are a huge asset in the fight against COVID-19; |

General lessons

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| | 10. | considers that there are many important lessons to be learned from the fight against COVID-19 that can be applied both to ongoing work on this global crisis and to other crisis situations; |

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| | 11. | draws attention to the fact that many Member States have opted to give local and regional authorities primary responsibility for health, care and public health. Even in countries with national health systems, responsibility for social services and social care often lies at local level. Local and regional authorities therefore play a very important role in the fight against COVID-19; |

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| | 12. | stresses that it is important for the EU institutions and authorities, as well as the Member States, to ensure that the single market is maintained and continues to operate in crisis situations, that the procurement and transport of medicines, medical devices, personal protective equipment and other goods and services are not hampered, and that health and care workers and other key groups are not prevented from commuting across national borders; |

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| | 13. | highlights the importance of quality-assured data collection, high-quality research and reliable information sources, in order to ensure that authorities can take well-founded decisions and that businesses, organisations and individuals can act responsibly to prevent disease; |

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| | 14. | highlights the importance of mutual assistance and cooperation in cross-border healthcare, including the transport of patients in need to hospitals in neighbouring countries with free capacity, and the transfer of medical professionals and other forms of cross-border cooperation to alleviate the pressure on health systems in the worst affected EU regions; |

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| | 15. | for this reason, insists on the need for the Member States to agree on a common statistical protocol to allow for comparability of the data on the impact of the COVID-19 crisis and future pandemics. This protocol, to be developed under the joint authority of the ECDC and Eurostat, could rely on data provided at NUTS 2 level to facilitate a policy response integrating the use of European Structural and Investment Funds; |

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| | 16. | draws attention to the digital solutions in fields including medical information, medical consultations and contact tracing that have been developed or have made further progress in the wake of the COVID-19 outbreak; the identification of virus carriers does, however, raise legitimate questions regarding privacy and data security, not least in cross-border situations. The pandemic has also highlighted the need for the digital cross-border exchange of patient data when patients receive healthcare in another Member State; |

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| | 17. | stresses the importance both of global cooperation with the World Health Organization (WHO), among others, to combat COVID-19 and other serious threats to health, and of cooperation with businesses and voluntary organisations, families, neighbours and friends in local and regional crisis management; |

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| | 18. | highlights the need to find a better way to protect older and vulnerable people — both those in special accommodation and those living in their own homes — against COVID-19 and other infectious diseases; in this regard, stresses the importance of health and social care policies that strengthen local primary care systems, with a focus on prevention; |

An EU health emergency mechanism

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| | 19. | welcomes the steps that the Commission has already taken to reduce the burden on national, regional and local authorities in their efforts to address the COVID-19 crisis, takes note of the comprehensive recovery plan for Europe presented on 27 May 2020, and takes a positive view of the agreement to use all available funds in this year’s EU budget to help meet the needs of European health systems; |

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| | 20. | notes that Decision No 1082/2013/EU of the European Parliament and of the Council on serious cross-border threats to health [(1)](#ntr1-C_2020440EN.01001501-E0001) has laid crucial foundations for the EU’s emergency preparedness and crisis response, but that in the light of the ongoing health crisis, that there is a need to further develop the EU’s emergency and disaster response capacities; |

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| | 21. | therefore suggests that, in compliance with the subsidiarity principle and the fact that the Member States have primary responsibility for healthcare, public health and civil protection, an ‘EU health emergency mechanism’ should be set up in order to: | | | | --- | --- | | — | coordinate EU action and support to assist national, regional and local healthcare and disaster-preparedness structures to respond effectively to health threats and crisis situations; | | | | | --- | --- | | — | ensure effective cooperation and coordination on preparedness and response with competent international organisations such as the WHO; | | | | | --- | --- | | — | coordinate European distribution of essential medical equipment; | | | | | --- | --- | | — | reinforce the role of health related European Agencies; | | | | | --- | --- | | — | improve the supply of essential medical equipment through joint procurement initiatives and monitor the supply chain for essential products; | | | | | --- | --- | | — | in cooperation with the European Centre for Disease Prevention and Control (ECDC), support Member States in reviewing and updating their pandemic plans, with a focus on also involving local and regional authorities. Member States’ healthcare systems should also undergo ‘stress tests’ analogous to those carried out on financial institutions after the financial crisis, to assess their preparedness for various types of health threat; | |

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| | 22. | takes the view that the future EU health emergency mechanism should also rely on the ‘Emergency Support Instrument’ laid down in Council Regulation (EU) 2016/369 [(2)](#ntr2-C_2020440EN.01001501-E0002); |

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| | 23. | is convinced that the EU Civil Protection Mechanism — not least its instruments rescEU and the European Medical Corps — needs to be further reinforced if the EU is to be prepared and able to respond rapidly, efficiently and in a coordinated manner to any future emergency, biological or otherwise. However, the EU Civil Protection Mechanism should be assessed in light of the experiences from the COVID-19 pandemic, in order to provide it with the most effective possible organisation and structure; |

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| | 24. | proposes strengthening the early-warning capacity of the EU Emergency Response Coordination Centre (ERCC) and developing its links to the Health Security Committee and the ECDC so that it can fulfil its coordinating role even more effectively in the future and give tailored support to local operational management; |

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| | 25. | notes that the COVID-19 crisis has highlighted how vital the ECDC is, and urges the Member States and the Commission to work together to strengthen and develop its role in combating major health scourges. The Committee therefore welcomes the fact that EU health ministers are now discussing strengthening that role; |

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| | 26. | is in favour of many of the actions proposed by the European Commission in its communication of 15 July 2020 on Short-term EU health preparedness for COVID-19 outbreaks; |

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| | 27. | in the interests of safeguarding both freedom of movement and public health, welcomes the European Commission’s proposal for a Council recommendation on a coordinated approach to the restriction of free movement in response to the COVID-19 pandemic, published on 4 September 2020; |

Procurement and stockpiling of medical supplies

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| | 28. | welcomes the fact that, as of April 2020, the joint procurement agreement covers almost 540 million people, including all residents of EU and EEA countries, the United Kingdom and almost all of the candidate and potential candidate countries; |

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| | 29. | therefore welcomes the proposal from German chancellor Angela Merkel and French president Emmanuel Macron on 18 May 2020 to set up a special task force in the ECDC, as part of a strategy for dealing with health emergencies, which would be asked to work with national health authorities to draw up plans for prevention and response measures for future epidemics; |

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| | 30. | appreciates the voluntary nature of the agreement but feels that an opt-in should be replaced by an opt-out system, as this would facilitate a fast-lane procedure while guaranteeing freedom of choice to the participating parties; |

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| | 31. | welcomes the Commission’s proposal firstly to create a new, stand-alone EU4Health programme, as part of the recovery plan for Europe, with a total budget of EUR 9,4 billion, whose purpose would be partly to strengthen health protection and prepare the Union for future health crises, and secondly to boost the EU’s rescEU civil protection mechanism with a EUR 2 billion increase in funding; regrets, however, that the European Council has since lowered its ambitions to EUR 1,7 billion, which will seriously reduce the scope for responding to the negative consequences of the pandemic.. The Committee of the Regions intends to make specific comments about the new health programme in a separate opinion; |

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| | 32. | takes a positive view of the European procurement and distribution of essential medical supplies to hospitals and other care providers (respirators, ventilators, personal protective equipment, reusable masks, medicines, medical and laboratory equipment and disinfectants), but stresses that hospitals, health centres and care homes in many Member States are run by local and regional authorities that need to be involved in this process, and points out that the joint procurement undertaken in the spring took too long and thus could not fully achieve its purpose; |

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| | 33. | welcomes the rapid creation of the rescEU stockpile of medical equipment and its swift delivery to the worst affected Member States; |

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| | 34. | calls on the Member States and the Commission to establish a permanent European Strategic Stockpile (ESS) as the EU’s repository of antibiotics, vaccines, chemical antidotes, antitoxins, and other critical medical supplies, which have been proven to be effective, in order to guarantee the availability of an ‘emergency reserve’ and coordinate prompt distribution and delivery of essential resources across Europe; |

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| | 35. | welcomes the Commission’s Decision of 3 April 2020 to temporarily exempt medical equipment and personal protective equipment from import duties and VAT. The Commission should consider revising the scope of its Decision so that it includes private companies required to use PPE, and implement the Decision in a way that does not put local EU producers at an economic disadvantage; |

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| | 36. | points out that the shortages of essential products and medicines, including antibiotics and anaesthetics, previously experienced in many regions have been exacerbated by the current pandemic, and calls for efforts to rapidly acquire key basic substances, increase production of testing kits and other medical devices where there are shortages, and launch the development and production of essential medicines on European soil by promoting research and innovation and creating incentives for manufacturers; |

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| | 37. | agrees that the EU must be able to develop, buy, transport and distribute testing supplies and protective gear imported from abroad or produced within the EU. With regard to the production of medicines and other medical supplies, the EU and its Member States must reduce their dependency on third countries and work to make medicines more affordable; |

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| | 38. | firmly believes that it must be possible at all times for protective equipment, such as masks and protective suits, to be quickly and easily supplied on the market. To that end, the necessary conditions should be created at EU level to establish production capacity for protective materials in the Member States, and EU procurement and antitrust rules should be reviewed in light of the pandemic; |

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| | 39. | points to the need to assess what type of personal protective equipment is suitable for use in what contexts, and not only with regard to controlling COVID-19; |

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| | 40. | finds it positive that the European Committee for Standardisation (CEN) and the European Committee for Electrotechnical Standardisation (Cenelec) have agreed to make available a number of European standards for certain medical devices and personal protective equipment, and believes this will help to increase and convert production capacities of EU enterprises to address shortages of supplies; |

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| | 41. | points to the need for personal protective equipment, especially where it is for the general public, to be recyclable as far as possible; |

Vaccines, diagnostics and treatment

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| | 42. | stresses the urgent need to develop vaccines against COVID-19, and urges the EU legislator to take account of the Committee’s call to strengthen EU cooperation on the development, production and distribution of vaccines, complementing public and private medical research to combat COVID-19; |

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| | 43. | welcomes in this context the European Commission’s proposal to increase the budget for the Horizon Europe framework programme for research and innovation to EUR 94,4 billion, and finds it regrettable that the European Council has since proposed reducing that to EUR 80,9 billion; |

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| | 44. | welcomes the agreements that the European Commission has reached with a number of pharmaceutical companies for the supply of medicines and vaccines if and when one of the companies develops a safe and effective vaccine; |

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| | 45. | notes with concern that the global efforts to develop a COVID-19 vaccine, diagnosis and treatment could easily turn into a fierce competition that leaves poorer nations defenceless against the disease; expresses its strong support for multilateral cooperation to develop safe and effective vaccines, diagnostics and treatment, and for fair funding and distribution of future vaccines and medicines; |

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| | 46. | supports the development of a common EU vaccination card and a virtual European register providing information on vaccine stocks and needs to facilitate the voluntary exchange of information on available vaccine resources and shortages of essential vaccines; |

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| | 47. | calls for more action to counter the dissemination of misinformation about COVID-19, treatments for it and vaccines against it online and through other channels. In this fight against disinformation, the WHO, the EU and its Member States, and local and regional authorities all have important roles to play; |

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| | 48. | supports the Commission’s efforts to raise more funds for research into COVID-19 vaccines, and expects Horizon Europe to allocate significant resources to support for research and innovation in this area. |

Brussels, 14 October 2020.

The President of the European Committee of the Regions

Apostolos TZITZIKOSTAS

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[(1)](#ntc1-C_2020440EN.01001501-E0001)  [OJ L 293, 5.11.2013, p. 1](http://publications.europa.eu/resource/oj/JOL_2013_293_R_TOC).

[(2)](#ntc2-C_2020440EN.01001501-E0002)  Council Regulation (EU) 2016/369 of 15 March 2016 on the provision of emergency support within the Union ([OJ L 70, 16.3.2016, p. 1](http://publications.europa.eu/resource/oj/JOL_2016_070_R_TOC)).

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