COMMUNICATION FROM THE COMMISSION TO THE EUROPEAN PARLIAMENT, THE COUNCIL, THE EUROPEAN ECONOMIC AND SOCIAL COMMITTEE AND THE COMMITTEE OF THE REGIONS The European Health Union: acting together for people's health
Date: 2024-05-22
Institutions: Directorate-General for Health and Food Safety, European Commission
Subjects: EU strategy, European Medicines Agency, Health Emergency Preparedness and Response Authority, coronavirus disease, disease prevention, epidemic, health care, health care system, public health, social well-being

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  EN 

   EUROPEAN COMMISSION  Brussels, 22.5.2024  COM(2024) 206 final  COMMUNICATION FROM THE COMMISSION TO THE EUROPEAN PARLIAMENT, THE COUNCIL, THE EUROPEAN ECONOMIC AND SOCIAL COMMITTEE AND THE COMMITTEE OF THE REGIONS The European Health Union: acting together for people's health  
 
 
The European Health Union: acting together for 
people’s health 

1. 

Introduction 

Almost five years ago, the Von der Leyen Commission began its mandate with ambitious plans for EU 
action in health. It committed to supporting Member States in constantly improving the quality and 
sustainability of their health systems1, addressing major societal challenges such as cancer prevention 
and care, ensuring that Europe has a sustainable supply of affordable medicines, and maximising the 
potential of digital health. These initiatives would become central pillars of the vision we know today 
as the European Health Union. 

Less than one month after taking office, the COVID-19 pandemic struck, causing millions of deaths and 
unprecedented  health  and  socioeconomic  damage.  The  pandemic  caught  the  world  by  surprise, 
revealed strategic dependencies and exposed gaps in preparedness. After early challenges, the EU 
responded  with  concrete  and  decisive  action,  showing  the  power  of  solidarity  in  addressing  an 
unprecedented health threat, restoring economic and social life, and highlighting the need for more 
structural, far-reaching solutions. 

The EU Vaccines Strategy2 presented in June 2020 was a European success story that helped the EU to 
deliver vaccines saving at least 1.4 million lives in Europe3. The speed of the industrial ramp up was 
unprecedented,  from  development,  evaluation,  authorisation,  production,  and  rollout;  making 
vaccines available to all citizens at the same time, and with the same conditions, regardless of where 
in the EU they lived. 4.6 billion doses were secured for Europeans and partner countries. During the 
most acute phase, over 80% of the EU adult population were vaccinated against COVID-19, with at 
least  a  primary  course  in  a  historic,  pan-European  drive  to  protect  our  citizens.  The  subsequent 
creation of the EU Digital COVID Certificate helped to reopen Europe’s societies, restore business, and 
allowed people to resume travel safely – moving the EU closer to normal life. 

European cooperation and solidarity extended far beyond our borders, with the EU and Member States 
becoming the world´s largest vaccine supplier when the availability of vaccines was a question of top 
necessity. Over 530 million doses were donated to low- and middle-income countries. The Union also 
ensured the delivery of over 190 million medical and personal protective equipment, such as masks or 
gloves,  to  partner  countries.  These  achievements  would  not  have  been  possible  without  the  close 
collaboration between European Parliament, Member States, Commission, European External Action 
Service,  EU  Agencies,  and  international  actors.  EU’s  core  role  in  the  international  scene  allowed 
access to vaccination for all populations, including the most vulnerable ones, living in humanitarian, 
fragile or conflict affected environments. The EU Digital COVID Certificate became the global standard 
for mobility at international level and supported the re-opening of economic activity at global level. 

1 mission-letter-stella-kyriakides_en.pdf  (europa.eu) 
2 EU Vaccines Strategy (europa.eu) 
3 https://www.who.int/europe/news/item/16-01-2024-covid-19-vaccinations-have-saved-more-than-1.4-million-lives-in-the-who-
european-region--a-new-study-finds  

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Europe’s  determination  and  coordinated  approach  allowed  to  manage  the  COVID-19  pandemic  as 
swiftly  and  effectively  as  possible.  Still,  this  traumatic  experience  provided  harsh  yet  important 
lessons. It revealed weak  points in European health systems and highlighted the need for a stronger 
One Health approach, based on seamless links between human, animal, and plant health on one side, 
and the environment on the other. It also amplified the connections between health and the Union’s 
economic  resilience  and  open  strategic  autonomy.  It  also  emphasised  the  need  for  greater  EU 
leadership in global health recognising the importance of health as a geopolitical factor. 

Perhaps most of all, the pandemic underlined the salience of public health at the top of the political 
agenda, and showed the very tangible ways the Union can complement  and add value to national 
policies  in  improving  citizens’  everyday  lives  and  welfare.  This  approach  delivers  on  clear 
expectations  from  citizens  when  it  comes  to  protecting  and  promoting  their  health.  The  latest 
Eurobarometer and Public Opinion4, 5 surveys have shown that health ranks among European citizens’ 
top priorities. The European Health Union has been created to deliver on their expectations. 

Investing  in  health  always  delivers.  The  pandemic  showed  how  public  health  is  a  prerequisite  for 
societies  and  economies  to  function.  A  health  crisis  primarily  costs  lives,  can  disrupt  the  free 
movement  of  people  and  goods  which  EU  is  committed  to  protecting,  halt  economic  growth  and 
disrupt  essential  social  functions,  from  education,  health  services  to  the  functioning  of  our 
democracies. 

The last five years were marked not only by the COVID-19 pandemic, but also by severe geopolitical 
challenges, notably Russia´s unjustified war of aggression against Ukraine, the Middle East crisis and 
the growing impacts of climate change and the digital transformation, all of which had and continue 
to have profound impacts on the health of EU citizens and beyond. 

The European Health Union is our answer to this rapidly evolving global landscape. It is based on the 
principles that equity in access is a fundamental human right and that health policy can no longer be 
limited to its pre-pandemic boundaries – joint action at European level is crucial to Europe’s societal 
wellbeing, our strategic autonomy and our geopolitical stability. 

4 EP Autumn 2021 Survey: Defending Democracy | Empowering Citizens - February 2022 - - Eurobarometer survey (europa.eu) 
5 Public opinion in the EU in time of coronavirus crisis 2 (europa.eu) 

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Under this new approach, Member States prepare for, prevent and protect their citizens by acting 
together, where joint European action is necessary. It is based on a set of key pillars: 

• 

• 

• 

A  new  health  crisis  framework:  with  effective  rules  to  deal  with  health  threats 
and a new Health Emergency Preparedness and Response Authority allowing the EU and 
Member States to better prepare for and respond to emerging crises together; 

Security of medical supply: with affordable, accessible and innovative treatments 

and medicinal products for all; 

Modern  and  innovative  health  policies:  better  protecting  the  health  of  our 

citizens and drawing on the potential of new technologies. 

Crucially, it was backed by the most ambitious EU health funding programme in history, EU4Health.  

Every action under the European Health Union has been designed and delivered to make citizens safer 
and  healthier.  And  through  these  actions,  the  European  Union  has  taken  groundbreaking  steps  to 
protect and promote health and to strengthen health systems across Europe. 

2. 

2.1 

Strengthening health security for EU citizens 

Tackling serious cross-border health threats 

In  today’s  increasingly  mobile  and  interconnected  world,  EU  citizens  expect  their  governments  to 
protect them from health threats, which can easily spill across national borders. The experience of the 
last  five  years  has  profoundly  shown  the  necessity  of  Member  States  responding  to  health  crises 
together, and in a coordinated way. 

New EU rules on serious cross-border threats to health respond to this need and are the backbone of the 
EU’s health security framework. These strengthened rules, in force since December 2022, allow the 
EU to anticipate, prepare for, and respond to major health threats – not only infectious diseases but 
also environmental, climate-related, or chemical risks. For example, the Commission, with the Health 
Security  Committee  (HSC),  can  now  swiftly  adopt  guidance  on  response  measures  to  address 
emerging threats or declare a public health emergency at Union level, which would trigger increased 
coordination and could activate emergency funding for medical countermeasures. The Commission, 
working  closely  with  Member  States  and  the  relevant  Union  agencies,  is  also  developing  a 
comprehensive Union Prevention, Preparedness, and Response Plan. 

Today, the EU is better able to help Member States and partner countries to prepare for health shocks, 
and  to  respond  when  a  crisis  strikes.  A  strengthened  EU  HSC  ensures  better  cooperation  and 
coordination  between  Member  States.  The  HSC  played  an  important  role  in  the  Commission’s 
coordination of the EU response to the COVID-19 pandemic, as well as in 2022 in the context of the 
Mpox  and  Ebola  outbreaks.  Today,  it  is  actively  addressing  avian  influenza  among  animals  and 
humans6 and other potential threats. When an emergency overwhelms the response capabilities of a 
country  in  Europe  or  beyond,  it  can  request  assistance  through  the  Union  Civil  Protection 
Mechanism (UCPM), which can include emergency medical support. 

6 Opinion of the Health Security Committee on zoonotic avian influenza - European Commission (europa.eu) 

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Surveillance plays a crucial role when it comes to protecting health, and the sharing of data means the 
EU  is  better  able  to  monitor  communicable  disease  trends,  detect  outbreaks  and  evaluate  the 
effectiveness of public health measures. The Commission is helping Member States to strengthen their 
national  surveillance  systems,  including  wastewater  surveillance,  and  is  connecting  the  EU’s  Early 
Warning and Response System (EWRS) with other EU alert systems. 

Science guided the world out of the pandemic, and scientific cooperation also offers the surest path 
towards  a  more  secure,  healthier  future.  The  EU  Framework  Programmes  for  Research  and 
Innovation,  which  belong  to  the  largest  funding  programmes  for  R&D&I  in  the  world,  have 
supported projects in various fields, including long-term research on mRNA that contributed to the 
development of COVID-19 vaccines. As a response to the pandemic, the Commission pledged EUR 1 
billion for coronavirus research, including for the conduct of large-scale EU-wide clinical trials. With a 
financial support of EUR 100 million, the European Investment Bank was instrumental in helping the 
European  company  BioNTech  to  use  the  mRNA  technology  for  the  development  of  a  COVID-19 
vaccine  candidate.  The  Commission  has  established  a  network  of  world  class  public  health 
laboratories  (DURABLE)  and  designated  the  first  six7  EU  reference  laboratories  for  public  health  in 
March 2024, helping to increase laboratory capacities across the EU and to promote good practices. 
Furthermore, the EU and Member States agreed to streamline and leverage research efforts through 
a European Partnership on Pandemic Preparedness.  

The  COVID-19  pandemic  underscored  the  vital  need  for  robust  manufacturing  capacities  and 
resilient  supply  chains,  exposing  significant  vulnerabilities  that  impact  global  health  and  economic 
stability. In response, the European Commission established the Task Force for Industrial Scale-up of 
COVID-19 Vaccines8. This Task Force worked closely with industry stakeholders to alleviate vaccine 
production bottlenecks, effectively map supply chains, and secure long-term manufacturing capacity 
in Europe, thereby catalysing further measures for critical medicines beyond just COVID-19 vaccines.   

The last five years and the experience of managing the pandemic showed the critical value of these 
initiatives  in  protecting  the  health  of  citizens,  particularly  the  most  exposed  and  vulnerable  ones 
such  as  children,  older  people  and  persons  with  disabilities,  and  overcoming  an  unprecedented 
health crisis. 

2.2 
Authority (HERA)  

The  creation  of  a  Health  Emergency  Preparedness  and  Response 

The COVID-19 pandemic highlighted the vital importance of medical countermeasures during health 
emergencies, including diagnostics, vaccines, therapeutics, and personal protective equipment. It has 
also shown that EU and Member States funding were instrumental in securing access to messenger 
mRNA technologies for COVID-19 vaccines. EU support was crucial to the development of lifesaving 
vaccines in record time. 

In 2021, the Commission created the Health Emergency Preparedness and Response Authority (HERA). 
HERA is designed, in close coordination with Member States, industry and civil society, to strengthen 

7 Antimicrobial resistance (AMR) in bacteria; vector borne viral pathogens; emerging, rodent-borne and zoonotic viral pathogens; high-risk, 
emerging and zoonotic bacterial pathogens; Legionella; and diphtheria and pertussis. 
8 https://single-market-economy.ec.europa.eu/coronavirus-response/task-force-industrial-scale-covid-19-vaccines_en  

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the  development,  manufacturing,  procurement,  and  equitable  distribution  of  critical  medical 
countermeasures to protect Europeans in case of a public health emergency. In a health crisis, joint 
procurement can be a crucial tool to leverage Member States’ purchasing power and secure the same 
products for all citizens, no matter where they live. Indicatively, HERA procured vaccines two weeks 
after the first signs of the 2022 Mpox outbreak in the EU9. HERA is also securing access to pandemic 
and pre-pandemic vaccines to protect Europeans from avian influenza. 

HERA is steering industrial, research and innovation efforts to create the next generation of tools to 
tackle serious cross-border health threats. To ensure maximum flexibility, it has a dual working mode: 
one focusing on preparedness and a second one only activated during emergencies.  Once a public 
health  emergency  has  been  declared,  the  EU  emergency  framework  of  measures  for  ensuring  the 
supply  of  crisis  relevant  medical  countermeasures10  can  be  activated  by  the  Council.  The  Health 
Crisis  Board,  together  with  the  ongoing  work  of  the  HERA  Board,  ensures  coordinated  actions 
between  Member  States  on  issues  related  to  the  development,  production,  procurement,  and 
distribution  of  medical  countermeasures  in  crisis  and  preparedness  time.  In  public  health 
emergencies, the Health Crisis Board and the Health Security Committee work in close coordination. 

To strengthen health preparedness, HERA has launched the Global wastewater surveillance system11, 
which has the potential to become an international lookout system for the early detection and real- 
time monitoring of epidemic threats and outbreaks. By identifying threats and evaluating how to best 
address them with medical countermeasures, HERA is establishing a broad portfolio of initiatives that 
would allow the EU to rapidly respond to disease X12. The Commission and the European Investment 
Bank also created HERA Invest, a EUR 100 million top-up to the InvestEU programme, to support R&D 
in the most pressing cross-border health threats, financed by the EU4Health programme. 

Through  these  actions,  HERA  is  ensuring  that  the  EU  has  the  capacity  to  develop  and  produce 
countermeasures quickly and at the necessary scale in times of crisis. Emergency research funding can 
be mobilised, and EU clinical trial networks can be activated for timely and robust data generation. In 

9 https://ec.europa.eu/commission/presscorner/detail/en/ip_22_4363 
10 https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=CELEX%3A52021PC0577 
11 Launching GLOWACON: A global initiative for wastewater surveillance for public health - European Commission (europa.eu) 
12 Disease X represents the knowledge that a serious international epidemic could be caused by a pathogen currently unknown to cause 
human disease. Disease X is part of the WHO list of priority pathogens (World Health Organization definition). 

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times of crisis, EU FAB, a network of ever-warm production sites around the EU, could produce 325 
million  vaccine  doses  per  year.  In  addition,  backed  by  an  investment  of  EUR  1.65  billion,  the 
Commission  has  established  strategic  stockpiles  of  medical  countermeasures  and  is  working  on 
response equipment  to  Chemical  Biological Radiological  Nuclear  (CBRN)  threats under the UCPM  - 
rescEU, to increase preparedness and as a safety net in case Member States stocks are insufficient. 

2.3 

Stronger mandates for the ECDC and the EMA 

Bolstered by the experience of the pandemic, the mandate of the European Medicines Agency (EMA) was 
broadened to prepare for, prevent, coordinate, and manage the impact of public health emergencies 
and major events on medicinal products and on medical devices. Under its extended mandate, the 
EMA will also facilitate a coordinated EU-level response  to public health emergencies by  providing 
scientific advice and reviewing available scientific evidence on medicines. 

The European Centre for Disease Prevention and Control (ECDC) has played a fundamental role in the 
EU’s  response  to  the  COVID-19  pandemic.  Now,  after  assessing  the  state  of  implementation  of 
Member  States'  national  prevention,  preparedness  and  response  plans  and  their  relation  with  the 
Union's prevention, preparedness and response plan as foreseen by the Serious Cross Border Health 
Threats Regulation, the ECDC can issue recommendations for actions and milestones to be set, both 
to  the  Member  States  and  the  Commission.  The  agency  is  strengthening  integrated  surveillance 
systems  and  is  coordinating  the  new  network  of  EU  reference  laboratories  (EURLs).  The  ECDC  is 
establishing  an  EU  Health  Task  Force  for  rapid  health  interventions  in  case  of  a  major  outbreak, 
complementing the Union Civil Protection Mechanism. 

Improving the safety,  availability  and access to  medicines, 

3. 
medical devices, and substances of human origin 

3.1. 

Access for all to safe, affordable, and innovative medicines 

Across Europe, patients and healthcare systems are faced with unequal access to medicines, shortages 
of medicines and even no medicines at all for certain diseases. In order to address these challenges, in 
November 2020, the Commission presented a new Pharmaceutical Strategy for Europe13 and in April 2023, 
proposed the most significant reform of the EU’s pharmaceutical rules in over two decades. 

The proposed reform includes a redesigned system of incentives, to encourage companies to deliver 

13 https://health.ec.europa.eu/medicinal-products/pharmaceutical-strategy-europe_en  

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on public health objectives, namely on more timely and equal access to medicines in all 27 Member 
States and the unmet medical needs of EU patients,  particularly  the  most  vulnerable  ones  such  as 
children,  older  people  and  persons  with  disabilities.  That  is  why,  the  reform  proposes  several 
measures  to  facilitate  access,  in  particular  in  smaller  Member  States,  that  are  often  neglected  by 
companies,  due  to  their  small,  commercially  not  attractive  market. Equally important, these more 
targeted 
incentives  and  the  broader  simplifications  proposed  will  support  the  European 
pharmaceutical industry in remaining an innovator and world leader. 

Once  adopted  by  the  co-legislators,  the  proposed  reform  will  allow  European  patients,  in  particular 
those living in smaller countries, to receive medicines more quickly. Medicine developers will receive 
greater scientific and regulatory support from the EMA, while SMEs and not-for-profit developers will 
receive additional facilitation. Companies will benefit from accelerated and simplified procedures for 
the  evaluation  and  authorisation  of  medicines,  while  digitalisation  will  reduce  their  administrative 
burden. The use of regulatory sandboxes, will support innovation in forefront technologies, including 
health biotechnology, and ensure the legislative system is future-proof, while maintaining the highest 
standards of quality  and  safety.  By enabling  generic and  biosimilar  medicines  to  reach  the  market 
more  quickly  and simplifying market authorisation procedures, the reform is designed to also give 
patients quicker access to products that are cheaper, yet of high quality. 

Complementing these legislative measures, the European Commission supports cooperation projects14 
to exchange on pricing, payment and procurement policies, in order to improve the affordability and 
cost-effectiveness  of  medicines  and  health  system  sustainability.  The  Commission  is  currently 
evaluating proposals to enable public financing by several Member States to support breakthrough 
innovation in pharmaceuticals, through a first health Important Project of Common European Interest 
(Med4Cure).  This  project  aims  to  support  the  development,  and  first  industrial  deployment  of 
innovative  treatments  and  new  technologies  such  as  mRNA  platforms  to  tackle  antimicrobial 
resistance, rare diseases, and cancer. 

3.2. 

Ensuring the availability of critical medicines and medical devices 

The risk of medicine shortages is a major healthcare concern in both the EU and globally. The European 
Health Union is addressing this challenge with both regulatory and industrial measures. 

The  pharmaceutical  reform  proposes  measures  to  strengthen  the  security  of  supply  of  the  most 
critical medicinal products and gives the EMA a stronger role in coordinating measures to mitigate 
shortages. In October 202315 the Commission put forward additional short and mid-term measures 
to  ensure  more  systemic  and  coordinated  action  on  medicine  shortages.  This  included  the 
publication of a first version of the Union list of critical medicines16 in December 2023, with over 200 
active substances for which continuity of supply is a priority. Moreover, the Strategic Technologies 
for Europe  Platform  (STEP)  will  aim  to  leverage  EU  funds  to  further  support  the  development and 
manufacturing of biotechnologies and critical medicines. 

14 In the group of National Competent Authorities on Pricing and Reimbursement and Public Healthcare Payers (NCAPR)  
15 https://ec.europa.eu/commission/presscorner/detail/en/IP_23_5190 
16 https://ec.europa.eu/commission/presscorner/detail/en/ip_23_6377 

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The Commission launched the Critical Medicines Alliance17 in April 2024, as a cooperation platform to 
address the industrial dimension of shortages. The Alliance brings together public and private actors 
from the European health and industrial ecosystem, to propose recommendations to reinforce security 
of  supply  and  strengthen  global  supply  chains  of  critical  medicines.  Building  on  the  vulnerability 
assessment of critical medicines, the Alliance will  look  at possible ways to mitigate structural risks, 
and  reinforce  supply  by  encouraging  diversification  as  well  as  modernising  and  boosting 
manufacturing  capacity  at  EU  level  where  needed.  The  work  of  the  Alliance  will  also  feed  into  a 
possible legislative initiative for an EU “Critical Medicines Act” in the future. 

In  2017,  the  Medical  Devices  Regulation  (MDR)  and  the  Regulation  on  in  vitro  Diagnostics  (IVDR) 
established a new, stricter EU legislative framework to ensure better protection of public health and 
patient safety following safety concerns, especially in relation to breast and hip implants. Under the 
new rules, the EUDAMED database will be progressively rolled out from the end of 2025 and provide 
an  EU-wide  overview  of  the  lifecycle  of  all  products  on  the  medical  device  market,  enhancing 
transparency in the overall system and the  ability of market surveillance authorities to adequately 
monitor  the  market.  Legislative  amendments  to  the  MDR  and  IVDR  in  2023  and  2024  extend  the 
transition periods and ensure continuity of supply of critical devices. In addition, the Commission has 
put  in  place  non-legislative  actions  to  support  the  sector  and  mitigate  risks  of  shortages.  The 
Commission  will  launch,  later  this  year,  a  targeted  evaluation  of  the  EU  medical  device  legislation 
including  a  structural  assessment  of  the  impact  on  the  availability  of  medical  devices  and  on  the 
innovation  and  competitiveness  of  the  medical  device  system  in  the  EU,  as  a  first  step  towards 
identifying sustainable solutions for the future. 

3.3. 

Fighting Antimicrobial resistance 

Anti-microbial resistance (AMR) is one of the greatest health threats of our time. Currently, more than 
35 000 people die in the EU every year from drug resistant infections, and without decisive action, this 
figure will rise within a generation. AMR has a huge impact on the economy and healthcare systems, 
bringing an estimated EUR 1.5 billion per year in healthcare costs and productivity losses. 

As  recognised  in  the  EU  Strategic  Approach  to  Pharmaceutical  in  the  Environment18,  the 
environment is a reservoir of antimicrobial resistance that needs further understanding and action, 
as  several  residues  of  pharmaceuticals  (such  as  antibiotics  or  antifungals)  may  enter  the 
environment  during  their  use  by  humans  and  animals.  To  address  these  challenges,  in  2023,  the 
Commission proposed the most ambitious EU actions to date against  AMR,  in  a  Recommendation 
that  sets  targets  to  be  achieved  by  2030  –  including  a  20% reduction in antibiotic consumption in 
humans by 2030 in the EU, advocating for stronger global commitments on AMR. 

The  review  of  the  pharmaceutical  legislation  includes  additional  and  innovative  incentives  for 
pharmaceutical companies to develop new anti-microbials. 

A new joint action is helping EU Member States, as well as Norway, Iceland and Ukraine, to carry out 
the recommended actions with EUR 50 million in EU funding. The Commission is supporting research 
and development of new antibiotics and alternative treatments to address AMR. In this context, the 

17 https://health.ec.europa.eu/health-emergency-preparedness-and-response-hera/overview/critical-medicines-alliance_en 

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future European partnership on One Health Antimicrobial Resistance will be instrumental19. It is also 
enhancing  access  to  newly  developed  antimicrobials,  including  via  future  joint  procurement  for 
antimicrobials and is launching a pull incentive pilot project, taking the form of a revenue guarantee. 

Globally, the Commission is joining forces with the WHO to update the list of priority bacterial and 
fungal  pathogens,  carry  out  pipeline  analyses  for  antimicrobial  and  diagnostics  and  design  target 
product profiles.  The United Nations High-Level meeting on AMR in September 2024 is an important 
avenue for concrete deliverables at global level. 

3.4. 

Safe and widely accessible Substances of Human Origin 

To ensure the highest possible level of protection for those donating or receiving substances such as 
blood, tissues, and cells the Commission proposed new rules in July 2022. A new Regulation updating 
the rules on safety and quality of substances of human origin (SoHO) will be formally adopted in the 
coming months20 to strengthen the protection of all patients treated by transfusion, transplantation, 
or medically assisted reproduction. It improves access to safe and proven SoHO therapies and creates 
more opportunities for patients across the EU to access the treatment they need, regardless of where 
they live. At the same time, the new SoHO rules will support innovation. 

4. 

4.1 

Resilient, accessible, and inclusive health systems 

Making health systems more resilient 

European  health  systems  must  be  strengthened  to  meet  current  and  future  challenges  head  on, 
including  an  ageing  population,  the  growing  prevalence  of  non-communicable  diseases,  climate 
change,  and  increased  risk  of  infectious  diseases.  Resilient  health  systems  need  sustainable 
investment  and  a  skilled  workforce,  the  European  Health  Union  supports  Member  States  in  their 
national efforts. 

The Commission proposed the EU4Health programme in May 2020 with this objective,  its  budget  of 
EUR 4.7 billion (post MFF mid-term revision) for the 2021-27 financing period is the highest amount 
ever allocated to health policy at EU level. 

18 eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX:52019DC0128 
19 https://research-and-innovation.ec.europa.eu/funding/funding-opportunities/funding-programmes-and-open-calls/horizon-
europe/european-partnerships-horizon-europe/health_en 
20 A political agreement was reached in December 2023 

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The  EU4Health  programme  funds  initiatives  to  enhance  healthcare  access,  support  the  health 
workforce, and integrate national health systems, laying the groundwork for resilient, patient-centred 
systems.  It  has  also  allowed  us  to  respond  quickly  to  health  emergencies,  such  as  the  COVID-19 
pandemic and the Mpox outbreak in 2022. It is ready to support actions under the European Health 
Data Space and strengthens efforts to tackle cancer and rare diseases. Synergy with the EU Horizon 
Europe framework programme has boosted research and innovation in many different areas of health. 
For  instance,  a  European  Partnership  on  Transforming  Health  and  Care  Systems21  was  launched  in 
2023. 

Through  the  Recovery  and  Resilience  Facility  EUR  43  billion22  were  allocated  by  Member  States  to 
healthcare-related measures in their national Recovery and Resilience Plans. Those measures aim at 
addressing  infrastructure  gaps,  workforce  shortages,  digitalisation  needs  and  deficiencies  in  primary 
care,  among  other  areas.  The  Commission  provides  policy  guidance  and  health-related 
recommendations  to  Member  States  through  the  European  Semester.  Cohesion  Policy  Funds, 
including  the  European  Regional  Development  Fund  and  the  European  Social  Fund  Plus,  help 
Member States to improve their health systems’ resilience, accessibility and effectiveness. Through 
the  Coronavirus  Response  Investment  Initiatives  (CRII  and  CRII+)  and  the  Recovery  Assistance  for 
Cohesion  and  the  Territories  of  Europe  (REACT-EU),  adopted  in  2020,  EU  support  to  healthcare 
systems under the 2014-2020 Cohesion Policy programmes has been increased by EUR 16.7 billion to 
a total of more than EUR 32 billion. Around EUR 12.6  billion is planned for health under the 2021-
2027 programming period of the Cohesion Policy funds, of which around EUR 1.3 billion is allocated 
for healthcare digitalisation and e-Health. 

The  Technical  Support  Instrument  complements  these  EU  funding  instruments  by  providing 
expertise  to  Member  States,  upon  their  request,  to  implement  reforms  aiming  to  improve  the 
resilience, accessibility and inclusiveness of their health systems. 

In  the  face  of  the  pandemic,  the  European  instrument  for  Temporary  Support  to  mitigate 
Unemployment  Risks  in  an  Emergency  (SURE)  also  supported  Member  States  to  finance  health-
related  measures  up  to  nearly  EUR    5  billion.  Of  this,  22%  concerned  measures  taken  in  the 
workplace to ensure a safe return to work. 

A  robust  health  workforce  is  at  the  core  of  resilient  health  systems.  However,  the  EU  is  currently 
facing significant shortages of health professionals, driven by high job strain and  inadequate health 
and safety conditions. Furthermore, the health workforce, is ageing. To help tackle labour and skills 
shortages,  the  Commission  has  a  adopted  an  Action  Plan23    with  targeted  commitments  to  help 
improve working conditions for health professionals. 

In addition, the evolving healthcare landscape calls for providing more for training and development 
opportunities to the health workforce for harnessing the potential of artificial intelligence and digital 
tools,  to  meet  specific  challenges  such  as  multi-disciplinary  geriatric  care  and  climate  change-

21 https://www.thcspartnership.eu/ 
22 Figure as of 28 February 2024. Data are based on the pillar tagging methodology for the Recovery and Resilience Scoreboard and 
correspond to the measures allocated to the policy area ”Healthcare: Resilience, Sustainability, Adequacy, Availability, Accessibility and 
Quality, including digitalisation and infrastructure”. 
23 https://ec.europa.eu/social/BlobServlet?docId=27472&langId=en 

11 

 
 
induced  health  impacts.  The  Commission  supports  Member  States  for  health workforce  planning24 
for retaining health workers and for up- and reskilling the European health workforce25. Under the 
Pact for Skills, the Commission launched a skills partnership for the health ecosystem26, as well as a 
large-scale skills partnership for the European Health Industry. 

4.2 

 Preventing non-communicable diseases 

Non-communicable diseases (NCDs) make up 80% of all diseases affecting EU citizens. These include 
cardiovascular  diseases,  cancer,  diabetes,  and  neurological  diseases,  including  mental  health 
issues. Today,  more  than  90%  of  deaths  in  the  EU  can  be  attributed  to  such  diseases.  In  June 
2022,  the  Commission  presented  the  Healthier  Together  –  EU  Non-Communicable  Diseases 
Initiative, which was created with stakeholders and Member States to reduce the burden27 of  major 
NCDs.  Its  five  strands  cover  cardiovascular  diseases,  diabetes,  chronic  respiratory  diseases, 
including 
mental  health  and  neurological  disorders,  and  cross-cutting  health  determinants, 
environmental,  commercial,  and  lifestyle-related  risk  factors.  It  identifies  priorities,  best  practices, 
and  areas  where  action  is needed. 

Environmental pollution and climate change  are worsening all NCDs.  Through initiatives under the 
European Green Deal28 and in particular under the Zero Pollution Action Plan29, the Commission has 
taken further action to tackle  air, water and soil pollution. Despite significant  improvements  in air 
quality during the  past  few decades,  air pollution continues  to be  the largest environment-related 
health  risk,  with  significant  associated  mortality  (with  estimated  more  than  250.000  premature 
deaths in the European Union each year) and morbidity.30 The Zero Pollution Action Plan also puts 
forward  a  target  that  by  2030  the  EU  should  reduce  by  more  than  55%  the  health  impacts 
(premature deaths) of air pollution (compared to the year 2005). 

Launched in 2021 under the EU Strategy on Adaptation  to  Climate  Change,  the  European  Climate 
and  Health  Observatory  gathers  evidence and expertise to guide policymaking on climate change's 
health impacts. At the climate COP28 in November 2023, the Commission endorsed for EU Member 
States the first-ever Declaration on Climate and Health.  This  Declaration  outlined  vital  actions  to 
strengthen  health  systems,  promote research,  and  adapt behaviours to mitigate climate-related 
health risks. 

4.3 

Europe’s Beating Cancer Plan 

In 2022, 2.7 million people  in the EU  were  diagnosed with  cancer. Cancer will directly affect more 
and  more  EU  citizens  over  time  and  take  a  major  toll  on  European  health  systems  and 
economies, constituting it one of the greatest health challenges of our times. This demands urgent, 
concrete, and collective  action  at  EU  level  to  prevent  and  treat  cancer.  This  is  a  holistic  plan 
bringing  together scientists, patients, researchers for the first time. 

24 The project – JA HEROES | Health Workforce Planning Project 
25 BeWell – Blueprint alliance for a future health workforce strategy on digital and green skills (bewell-project.eu) 
26 https://pact-for-skills.ec.europa.eu/about/industrial-ecosystems-and-partnerships/health_en 
27 https://knowledge4policy.ec.europa.eu/health-promotion-knowledge-gateway/eu-burden-non-communicable-diseases-key-risk-factors_en 
28 https://commission.europa.eu/strategy-and-policy/priorities-2019-2024/european-green-deal_en 
29 https://environment.ec.europa.eu/strategy/zero-pollution-action-plan_en 
30 See, for example, https://www.eea.europa.eu/publications/harm-to-human-health-from-air-pollution/ 

12 

 
 
In  February  2021,  in  the  most  acute  phase  of  the  pandemic,  the  Commission  presented 
Europe’s Beating Cancer Plan, reinforcing its political commitment to turn the tide against cancer. The 
EU  Mission  on  Cancer31  was  launched  in  September  2021,  generating  crucial  knowledge  and 
evidence  to  help  Member  States  implement  effective  cancer  control  strategies.  Europe’s  Beating 
Cancer Plan, backed by EUR 4 billion in funding, a record number of projects, actions and initiatives 
have  been  launched  addressing  the  four  key  pillars  of  the  Cancer  Plan,  always  with  a  people-first 
approach: prevention, early detection, equal access to treatment and quality of life. Together with 
all  actors  and  with  combined  efforts  at  national  and  EU  level,  the  Europe’s  Beating  Cancer  Plan 
brings  together  sizeable  resources,  coordinates  actions,  reduces  fragmentation  and  inequalities 
between countries and delivers a more effective and more equal response to cancer with the patient 
at the centre. 

Prevention is more effective than any cure. It is estimated that about 40% of cancer cases in the EU 
are  preventable.  One  of  the  goals  of  the  Cancer  Plan  is  to  eliminate  cervical  cancer  and  other 
cancers  caused  by  viruses. 
In  2024,  the  Commission  presented  a  proposal  for  a  Council 
Recommendation on vaccine-preventable cancers to help EU Member States to increase the uptake 
of vaccination against Human Papillomaviruses  (HPV) and Hepatitis B virus (HBV). 

When  it  comes  to  prevention,  knowledge  is  power,  and  the  Commission  is  working  to  update 
and  expand  the  evidence-based  recommendations  of  the  European  Code  against  Cancer  and  is 
developing a  Mobile  App  for  Cancer  Prevention  to  communicate  clear  and  accessible  information 
on  the  risk factors of cancer. 

Tobacco  continues  to  be  the  leading  cause  of  preventable  cancers.  The  Commission  is  also  in  the 
process  of  conducting  a  comprehensive  evaluation  of  the  overall  legal  framework  on  tobacco 
control,  to  support  Member  States  in  achieving  a  Tobacco  Free Generation. The Commission also 
remains  committed  to  the  ambition  set  in  the  Cancer  Plan  when  it  comes  to  reducing  harmful 
alcohol  consumption,  which  remains  a  public  health  concern  in  the  EU.  Early  detection  improves 
chances of curing  cancer  and  saving  lives.  In  2022,  and  for  the  first  time  in almost 20 years, the 
EU  introduced  modern  and  science-based  cancer  screening  guidelines32  to  improve  early  detection, 
covering cancer types that together account for over half of all new cases diagnosed every year. The 
aim  is  to  ensure  that  90%  of  people  who  should  be  screened  for  breast,  cervical  and  colorectal 
cancer  are  offered  screenings  by  2025  and  expand  population-based  cancer  screening  to  include 
other cancers, like lung and prostate cancer. 

Protecting the workforce from cancer is paramount for promoting occupational health and ensuring 
a  sustainable  workforce.  Exposure  to  carcinogens  in  the  workplace  poses  serious  health  risks  to 
workers  and  can  lead  to  long-term  health  complications,  including  various  forms  of  cancer.  In  the 
EU,  significant  strides  have  been  made  in  this  regard  through  comprehensive  legislation  and 
workplace  safety measures  aimed  at minimizing  exposure  to  carcinogens. During  this  mandate,  as 
part  of  the  EU  Cancer  Plan,  the  EU  continued  setting  limits  on  occupational  exposure  to  cancer-
causing substances. 

31 https://research-and-innovation.ec.europa.eu/funding/funding-opportunities/funding-programmes-and-open-calls/horizon-europe/eu-
missions-horizon-europe/eu-mission-cancer_en 
32 Council Recommendation of 9 December 2022 on strengthening p... - EUR-Lex (europa.eu) 

13 

 
 
To  improve  access  to  high-quality  care,  the  first  EU Network  of  Comprehensive Cancer Centres will  be 
established  by  2025  with  the  aim  to  ensure  that  90%  of  all  eligible  patients  have  access  to  these 
centres thus reducing cancer care disparities. The first ever EU Cancer Inequalities Registry provides 
vital information  on  cancer  trends  and  services,  helping  policymakers  to  better understand  and 
address inequalities. In addition, the Plan calls for work on delivering better access to medicines and 
training  for  the  cancer  workforce.  In  the  area  of  quality  of  life,  the  Network  of  Youth  Cancer 
Survivors, launched in February 2022, offers help to young patients through peer support and the EU 
Cancer  Mission  has  launched  a  dialogue  with  young  cancer  survivors,  resulting  in  complementary 
funding  opportunities  under  EU4Health  and  Horizon  Europe.  Quality  of  life  for  those  whose  lives 
have been touched by cancer is a priority of the Plan and work is ongoing to end discrimination in 
access to financial services. 

By establishing guidelines for cancer prevention, screening, diagnosis, treatment and post-cancer care, 
the Cancer Plan enables a high level of care across all Member States and prevents disparities in access 
to quality treatment thus bridging the gaps and providing all cancer patients and their families with 
hope.  The  Plan  shows  how  effective  EU-level  coordination  can  be  in  improving  the  health  and 
wellbeing of EU citizens. 

4.4 

Tackling rare diseases 

Rare diseases, which affect 8% of the EU population, or 36 million Europeans, are another important 
example where cooperation at EU level is essential. There are thousands of rare diseases, including 
cancers, but each disease only affects a relatively small number of patients. This necessitates pooling 
data, expertise, and resources at EU level, where joint action is most effective. 

The European Reference Networks (ERNs), connect specialised healthcare providers across borders, 
and facilitate cooperation, research, and treatment development. Given that the average diagnosis 
time for rare diseases is 5 years, the 24 ERNs have facilitated virtual consultations for over 3,800 patient 
cases helping expertise travel and giving diagnoses, treatment plans and answers to patients and their 
families. ERNs have produced more than 400+ clinical guidelines, established patient registries with 
data  for  over  50,000  patients,  and  are  effectively  improving  care  for  rare  disease  patients  across 
Europe.  Work  is  ongoing  to  embed  ERNs  in  national  healthcare  systems,  by  developing  referral 
pathways for rare disease patients. 

Moreover, recent research funded by Horizon Europe demonstrated that genomics offers important 
potential to tackle many unsolved rare disease cases. Therefore, the EU continues investing into the 
1+ Million Genomes initiative to achieve the necessary critical mass of data by enabling secure access 
to genomics across the continent without transferring the highly sensitive data. 

4.5 

Safeguarding mental health 

When any crisis occurs, it is usually the most vulnerable who suffer most. Even before the COVID-19 
pandemic, mental health problems affected about one in every six citizens in the EU (84 million people) 
– at an estimated cost of over EUR 600 billion (more than 4% of GDP). The launch for the first time of 
the Comprehensive Approach to Mental Health in June 2023 opened an ambitious new chapter for EU 
action in this area. Based on three  guiding principles: prevention,  fighting stigma,  access to quality 

14 

 
care and treatment, and reintegration, putting mental health on a par with physical health, supporting 
mental  health  in  all  policy  areas,  from  education  to  digitalisation  and  urban  planning,  and 
recognising the positive role of nature and a clean environment for both mental and physical health. 

EU programmes offer EUR 1.23 billion in funding opportunities for 20 flagship initiatives to support 
Member States and EU stakeholders. For instance, the EU Best Practices Portal showcases leading and 
promising mental health practices, which can inspire others to act. Awareness campaigns run by the 
European Agency for Safety and Health at Work (EU-OSHA) help tackle work-related mental health 
issues.  The  EU  is  also  working  with  the  World  Health  Organization  to  assist  Member  States  to 
developing prevention-focused mental health approaches. Across these efforts, special focus is given 
to  the  most  vulnerable,  particularly  children  and  young  people.  Initiatives  include  a  project  with 
UNICEF on “promoting a comprehensive, prevention-oriented approach to children’s health”, and the 
development of a child-and-youth mental health network. One of the key policy areas of the  2022 
European  Year  of  Youth  was  to  boost  young  people’s  personal,  social,  and  professional 
development. This included for a special focus on mental health. A number of mental health-related 
initiatives  were 
launched  under  the  European  Year  of  Youth  such  as  the  2022  Council 
Recommendation on Pathways to School Success and the Expert Group for supporting wellbeing at 
school.  This  Expert  Group  developed  concrete  guidelines  for  policy  makers  and  educators  on 
addressing  wellbeing  and  mental  health  at  school,  published  in  May  2024.  The  EU  and  Member 
States are also preparing a European partnership on Brain Health (under Horizon Europe), which will 
also cover research on mental health and develop an ecosystem to facilitate and coordinate research 
and innovation activities. 

Through  EU4Health,  the  Commission  is  funding  projects  to  support  improving  mental  health  and 
psychosocial wellbeing in migrant and refugee populations, with a particular focus on people from 
Ukraine. Over EUR 34 million from the EU4Health programme to help people fleeing Ukraine in urgent 
need  of  mental  health  and  trauma  support,  including  through  a  project  with  the  International 
Federation  of  Red  Cross  and  Red  Crescent  Societies  providing  psychological  first  aid  support  for 
Ukraine’s displaced and affected people. Additional projects are also on-going with non-governmental 
organisations for best practices to improve mental health and psychological well-being in the migrant 
and refugee populations. 

4.6 

Harnessing the power of digitalisation in health 

The  European  Health  Data  Space  (EHDS)  is  a  flagship  European  Health  Union  initiative,  and  a  game 
changing approach aiming to harness the power of digitalisation and to empower patients to better 
control and share their health data. It was proposed by the Commission in May 2022 and political 
agreement was reached  by the  co-legislators in March 2024, leading to adoption by the European 
Parliament in April 2024. The EHDS will introduce  clear rules for the use of  electronic  health data, 
and  will  facilitate  better  healthcare  delivery,  research,  innovation,  and  policymaking,  in  full 
compliance with the EU's data protection standards. 

Patients will have immediate, free and easy access to their data in electronic form and will be able to 
share these data with healthcare professionals across Member States. Healthcare documents, such as 
patient summaries, e-prescriptions laboratory results, images, image reports, and discharge reports, 
will  be  exchanged  in  a  common  European  format.  This  will  improve  the  healthcare  that  patients 

15 

 
receive, wherever they are in the EU. It will also reduce needless and costly repetitions of what are at 
times invasive medical procedures and tests. 

In parallel, the EHDS will empower the use of health data for research, innovation, policy-making and 
regulatory  activities,  under  very strict  conditions  protecting  those  personal  data.  This  will  advance 
research  and  innovation,  support  the  development  of  important  new  treatments,  identifying  side 
systems. 
help 
effects 

medicines 

health 

fortify 

and 

to 

of 

The  EU  invests  in  novel  technologies,  including  artificial  intelligence  combining  multiple  types  and 
sources of health data. To this end the power of data leveraged through the European Health Data 
Space and specialised data infrastructures (such as 1+Million Genomes, Cancer Image Europe or EOSC- 
Life),  combined  with  high-performance  computing  will  enhance  early  detection,  prediction  and 
prevention, further improving diagnosis and treatments.  

5. 

Global Health 

The COVID-19 pandemic highlighted how, in our interconnected world, health is a global policy area 
and  with  a  clear  geopolitical  dimension.  The  pandemic  underscored  the  urgent  need  for  a  more 
coordinated EU approach to global health, and for greater global cooperation in the face of interlinked 
health threats like pandemics, the triple planetary crisis (climate change, environmental pollution and 
biodiversity loss) and antimicrobial resistance. These threats are likely to grow, and the EU – and the 
world – need to be ready to respond. 

The EU played a central role in the rapid development, scale-up and equitable distribution of COVID- 
19 vaccines, therapeutics, and diagnostics. Around two-thirds of vaccine doses produced in the EU – 

3.1 billion doses – have been exported to the rest of the world saving millions of lives. The EU was a 
founding  member  and  strong  supporter  of  the  Access  to  Covid  Tools  Accelerator  (ACT-A)  and  the 
largest donor to COVAX – the multilateral initiative for global equitable access to COVID-19 vaccine. 
The EU is determined to continue this path and is committed to preventing and combatting health 
threats globally, applying a One Health approach. 

The EU also seeks to reduce supply chain vulnerabilities resulting from dependencies by promoting 
diversification. Given the complexity of pharmaceutical products, EU industry needs to have access 

16 

 
 
to a broad range of essential inputs. Trade policy and partnerships aim at opening new markets and 
diversifying sources of supply and complement enhanced efforts to reduce excessive dependencies 
for critical supply chains by thorough implementation of preferential trade agreements, as well as of 
the work within international fora such as the G20, the G7 and the WTO. 

The EU Digital COVID Certificate set a global standard for international travel and has been the most 
widespread system in operation at international level. 51 non-EU countries and territories across four 
continents have benefited from this system.  On 1 July 2023, the EU handed over the system of digital 
COVID-19  certification  to  the  WHO,  in  order  to  develop  a  system  for  global  verification  of  health 
documents to deliver better health for all and protect citizens across the world from health threats. 

The  EU  is  continuously  working  multilaterally  to  shape  a  new  global  health  order  through  a  more 
strategic,  and effective  engagement.  This  includes  building  a  robust  global  governance,  prioritising 
international  partnerships  and  dialogue  at  multilateral,  regional  and  bilateral  level,  addressing 
disinformation,  and  providing  more  effective  funding.  The  EU  has  become  increasingly  active  in 
multilateral fora, including the G7, G20, the UN General Assembly as well as the WHO, and under its 
Neighbourhood, Development and International Cooperation Instrument is a major donor to global 
funds (e.g. the Pandemic Fund, GAVI, Global Fund). 

In the current geopolitical context, with the ongoing Russian war of aggression on Ukraine and the 
conflict in Gaza, the EU has supported the medical evacuation (Medevac) of patients. Since Russia’s 
war against Ukraine, over 3100 medical evacuation operations were conducted through the Union 
Civil Protection Mechanism (UCPM). The Commission  has been closely cooperating with the WHO, 
notably  in  the  establishment  of  the  EU  Medevac  hub  in  Poland  to  support  Ukraine,  and  in  the 
deployment of Member States’ medical experts to support WHO operations in Gaza.   

The  EU  is  playing  a  leading  role  in  the  negotiations  of  the  Pandemic  Agreement,  which  aims  to 
strengthen international rules on pandemic preparedness and response. 

The Commission published a new EU Global Health Strategy in  November 2022 to ensure  a coherent, 
effective,  and  focussed  approach  worldwide33.  First  and  foremost,  the  Strategy  indicates  the  EU’s 
determination  to  reassert  its  responsibility  and  leadership  in  global  health,  based  on  fundamental 
values like solidarity, equity, and respect for human rights. It positions global health as an essential 
pillar of EU external policy representing the external dimension of the European Health Union. and a 
key component of  Global Gateway which builds partnerships of equals with partner countries based 
on joint responsibility and co-ownership. Under the Global Gateway the EU and Member States are 
helping  to  tackle  inequalities,  improve  health  security  and  increase  health  systems’  resilience 
globally, engage with global partners to ensure equitable worldwide access to diagnostics, vaccines 
and  treatments,  pandemic  preparedness,  prevention,  and  early  detection  of  health  emergencies. 
The  Team  Europe  initiative  on  manufacturing  and  access  of  vaccines,  medicines  and  health 
technologies  in  Africa  (MAV+)  has  mobilised  more  than  EUR  1.3  billion  in  funding  from  the  EU, 
Member  States  and  European  financing  institutions  to  implement  actions  through  89  projects  at 
continental,  regional  and  local  level.  In  Rwanda  for  instance,  Global  Gateway  provides  over  €103 
million  support  to  local  manufacturing  and  access  to  vaccines,  medicines  and  health  technologies 

33 https://ec.europa.eu/commission/presscorner/detail/en/ip_22_7153 

17 

 
 
including a local plant for manufacturing of vaccines with mRNA technology. The EU is also working 
to  deepen  cooperation  on  manufacturing  vaccines,  medicine  and  health  technologies,  and 
strengthen health systems in the context of the EU- Latin America and the Caribbean (LAC) Health 
Partnership. Strengthening global health is an investment in global health security, in the Sustainable 
Development Goals, and in the protection of the health of all people, wherever they are. 

6. 

Looking ahead 

Overall, and thanks to the cooperation between the Commission and the Member States, the EU is in 
the area of health now in a much stronger position than five years ago. But complacency is not an 
option.  Much  work  remains  to  be  done  to  further  improve  our  health  policies.  Health  therefore 
needs to remain a political priority. 

New threats will continue to emerge, and particular attention should be paid to AMR, climate change- 
induced  health  threats  and  CBRN  threats.  Cooperation  is  required  at  multiple  levels  –  European, 
national, regional, and global to continue to bolster our health security. 

The  EU  faces  a  multitude  of  health  challenges  beyond  disease  outbreaks.  Shortages  of  medicines 
across Europe are disrupting treatment plans for chronic illnesses, like cancer and diabetes. Adopting 
the  proposed  reform  of  the  EU’s  pharmaceutical  legislation  will  be  vital  to  improve  access  to  and 
availability of medicines, together with other actions addressing shortages of critical medicines such 
as the work carried out  by the European Medicines Agency and the Critical Medicines  Alliance. To 
support Member States in accessing medicines in the  area of rare diseases  and orphan medicines, 
instruments such as Joint Procurement could be further explored.  

Similarly, Europe would benefit from strengthened medical research, and a boost to biotechnologies 
and  biomanufacturing,  in  line  with  the  recent  Communication  “Building  the  future  with  nature: 
Boosting Biotechnology and Biomanufacturing in the EU”34. The slow development of new medicines, 
diagnostics,  and  therapies  leave  everyone  vulnerable  to  future  diseases  and  makes  it  harder  to 
manage  existing  ones.  AMR  is  a  prime  example.  Investing  in  research  for  new  antimicrobials, 
alternatives to antimicrobials, and rapid diagnostics, while tracking the spread of resistant bacteria 
and  identifying  emerging  threats,  is  essential.  This  requires  a  close  cooperation  across  multiple 
sectors, according to a One Health approach, promoting research and further advocating a prudent 
and  responsible  use  of  antibiotics.  To  accelerate  research  and  development  for  antimicrobials  and 
medical countermeasures for future pandemics, together with Member States, we should continue 
working to make clinical trials in the EU attractive, efficient, and fast. Strengthening pan-European 
clinical trials should continue. 

At  the  same  time,  learning  from  the  experience  of  the  COVID-19  pandemic  and  conscious  of  the 
challenges ahead, health systems should continue to be strengthened, with a resilient, well-trained 
health workforce at the heart. The Commission will keep up its support to reforming national health 
systems, by providing advice and financing with EU funds. 

Europe’s  population  is  ageing  and  that  comes  with  consequences  for  health  policy  –  including  on 

34 https://ec.europa.eu/commission/presscorner/detail/en/ip_24_1570 

18 

 
 
healthy longevity, non-communicable diseases, including neurodegenerative diseases. This requires 
exploring  how  to  deal  with  longevity  so  that  our  societies  stay  healthy,  even  as  they  age.  Finding 
effective treatments and ultimately cures for debilitating conditions like Alzheimer's and Parkinson's 
disease  requires  significant  research  investment  and  international  cooperation.  The  future  of 
healthcare will also depend  on personalised medicine  approaches.  Advances in genomics and  data 
technologies,  such  as  artificial  intelligence,  can  enable  the tailoring  of  treatments,  improving  their 
effectiveness and reducing side effects. 

Non  communicable  diseases  remain  a  top  priority.  The  EU  has  shown  its  commitment  to  tackling 
NCDs, with a focus on prevention across a person’s lifetime, promoting healthy lifestyles and policy 
coordination  across  sectors,  using  Europe’s  Beating  Cancer  Plan  as  a  template,  and  strengthening 
existing  initiatives  such  as  the  ‘Healthier  Together  Initiative’  to  tackle  key  challenges  such  as 
cardiovascular  diseases.  Through  the  2023  Mental  Health  Communication,  the  Commission  will 
continue to prioritise the most vulnerable groups in our societies, with a focus particularly on children 
and youth. The European Health Union is already preparing for these challenges. The EHDS has the 
potential to revolutionise healthcare in the EU by maximising the immense potential of digital health. 
The current multiannual financial framework which runs until 2027 will continue to provide financial 
and technical support to Member States and stakeholders in this area, including through EU4Health 
Programme and the Digital Europe Programme. It is essential to also explore how to integrate artificial 
intelligence  into  healthcare  and  the  digital  upskilling  of  healthcare  professionals  for  improved 
efficiency, accessibility, and sustainability. 

Serious health risks – from rising pandemic or epidemic threats to the health impacts of climate change 
and NCDs – are interlinked and driven by the triple planetary crisis. A strong, innovative, and inclusive 
European Health Union requires cooperation at all levels in a One Health approach. 

Moreover, in the coming years, preparing for a larger Union will require ensuring that a future enlarged 
EU is resilient to health challenges and that the public health policies are well-coordinated among the 
Member States, and with countries in the accession process. 

7. 

Conclusion 

The COVID-19 pandemic was a global health crisis that turned our world upside down. It challenged, 
our societies, our economies,  and our very own European way of life. It also highlighted the weak 
points in our health systems and left us with some clear lessons. The innovative working methods used 
during and after the COVID-19 pandemic show that the EU can deliver in a strong and united way, 
applying creatively the rules, for the benefit of its citizens.  The most powerful lesson was also the 
simplest  –  we  are  stronger  and  more  resilient  when  the  Commission  and  all  EU  Member  States 
collaborate  in  solidarity,  and  when  with  like-minded  international  partners  we  bring  together  our 
strengths for a better global response. 

During  this  mandate,  the  Commission  and  the  Member  States  came  together  to  deliver  a 
comprehensive  response  to  the  greatest  health  threat  in  a  century.  In  parallel,  they  took 
unprecedented steps to go beyond merely firefighting the pandemic. Drawing on the solidarity and 
resolve shown during the crisis, the EU has built a strong and resilient European Health Union for all 
its citizens. The European Health Union seeks to ensure that all Member States are better prepared 

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and respond together to future health crises. To promote European innovation and competitiveness 
in  the  healthcare  sector,  so  that  the  needs  of  patients  can  be  addressed  with  the  support  of  all 
necessary actors. Solidarity and cooperation go hand in hand with resilience, with hope, with security, 
with  meeting  citizen  expectations  across  all  territories,  including  rural  and  remote  ones,  when  it 
comes to delivering optimal health care. This is the European Health Union in action, answering to 
the needs of citizens, putting equity in access and care at the heart of the European Union. 

Over  the  coming  years,  the  European  Health  Union  will  continue  to  evolve  and  grow  to  further 
promote the health and wellbeing of people across the EU and beyond. 

The  world  has  changed  irrevocably  since  2019.  And  it  will  continue  to  change. Thanks  to  a  robust 
European Health Union, the  EU  is now  better prepared for what tomorrow  brings for our citizens’ 
health. 

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