Role of the European Union in global health – Author's reply
Authors: Elizabeth M Speakman, Martin McKee, Richard Coker
Journal: The Lancet Global Health (2017)

We are grateful for the interest in our Comment shown by Lies Steurs and colleagues. Given the constraint of word limit, it is only possible to address selected aspects of the complex issues raised. We appreciate the reference to the previous attempt by the European Union (EU) to address global health, as those of us who were present at the discussions on this initiative recall the enthusiasm with which these first tentative steps were greeted. However, as Steurs and colleagues note, calls for action by both the European Commission and Council failed to deliver a strategy. We believe that there is scope to learn from this experience, placing it within the broader context of the changing nature of EU responsibilities and, specifically, the abolition of the three-pillar system that existed between 1993 and 2009. Arguably, the adoption of a shared competence between the EU and member states in areas such as development assistance might make such an initiative more likely to succeed now. However, this needs to be balanced by suggestions in the 2017 Commission White Paper1European CommissionWhite Paper on the future of Europe. Reflections and scenarios for the EU27 by 2025. European Commission, Brussels2017Google Scholar on the future of Europe, which include reducing involvement in public health. In our view, this strategy would be regrettable. We agree that global health can be viewed from several perspectives. In a previous paper,2Stuckler D McKee M Five metaphors about global-health policy.Lancet. 2008; 372: 95-97Summary Full Text Full Text PDF PubMed Scopus (50) Google Scholar we argued that security was one of five such perspectives. Again, it is impossible to cover everything in a short Comment. However, the focus in earlier commission documents on global health as what we described as the charity and public health perspectives might have contributed to its failure to gain traction with the more powerful member states. This is clearly an area that would benefit from further research. We also agree that it is entirely possible for small groups of member states to come together, as shown by Steurs and colleagues in their Correspondence, although we do not believe that this is a substitute for concerted European action in global health. This online publication has been corrected. The corrected version first appeared at thelancet.com/lancetgh on August 11, 2017 This online publication has been corrected. The corrected version first appeared at thelancet.com/lancetgh on August 11, 2017 MMcK is a member of the EU's expert panel on Effective Ways of Investing in Health and has undertaken research funded by the European Commission and European Centre for Disease Prevention and Control. All other authors declare no competing interests. Role of the European Union in global healthElizabeth Speakman and colleagues (April, 2017)1 propose the development of a European global health strategy. As researchers who have analysed the European Union's (EU's) role in global health in the past, we appreciate a renewed debate on this topic. However, we would like to contest some of the arguments. Full-Text PDF Open AccessCorrection to Lancet Glob Health 2017; 5: e757Speakman EM. Role of the European Union in global health—Author's reply. Lancet Glob Health 2017; 5: e757—In this Correspondence, Martin McKee and Richard Coker should have been included in the author list. This correction has been made to the online version as of Aug 11, 2017. Full-Text PDF Open Access