Role of the European Union in global health
Authors: Lies Steurs, Remco van de Pas, Kristof Decoster, Sarah Delputte, Jan Orbie
Journal: The Lancet Global Health (2017)

Elizabeth Speakman and colleagues (April, 2017)1Speakman EM McKee M Coker R If not now, when? Time for the European Union to define a global health strategy.Lancet Glob Health. 2017; 5: e392-e393Summary Full Text Full Text PDF PubMed Scopus (12) Google Scholar 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. First, Speakman and colleagues do not mention the developments in the 2000s, when notable EU attention was given to global health.2Emmerling T Kickbusch I Told M The European Union as a global health actor. World Scientific Publishing Company, Singapore2016Crossref Scopus (6) Google Scholar In 2010, there was a high-level conference and the launch of a European Commission Communication,3Aluttis C Krafft T Brand H Global health in the European Union—a review from an agenda-setting perspective.Glob Health Action. 2014; 7: 1-6Google Scholar which stated that the EU's commitment to global health should mainly focus on democratic and inclusive global health governance, ensure universal health coverage, create policy coherence, and invest in research that benefits all. The ensuing Council Conclusions urged for a more central EU role in global health. However, the initiative soon lost momentum.3Aluttis C Krafft T Brand H Global health in the European Union—a review from an agenda-setting perspective.Glob Health Action. 2014; 7: 1-6Google Scholar In addition to other urgent crises (for example, European sovereign debt and migration), which took priority for obvious reasons, the large fragmentation of the European global health community was probably also an explanation for the decreased interest. Moreover, despite attempts to coordinate EU action on global health, influential member states wanted to maintain control of this domain. Second, Speakman and colleagues1Speakman EM McKee M Coker R If not now, when? Time for the European Union to define a global health strategy.Lancet Glob Health. 2017; 5: e392-e393Summary Full Text Full Text PDF PubMed Scopus (12) Google Scholar mainly write from a health security perspective. Although health security is certainly an important aspect of global health,4Rushton S Global health security: security for whom? Security from what?.Polit Stud. 2011; 59: 779-796Crossref Scopus (108) Google Scholar it tends to focus on issues that pose most risks to the countries providing assistance and does not necessarily resonate with the priorities of the countries in need. An updated EU global health strategy should also advocate for shared responsibility for global public goods, in line with EU documents from a few years ago, which claimed that "the EU should apply the common values and principles of solidarity towards equitable and universal coverage of quality health services in all external and internal policies and actions".5European CommissionCommunication from the commission to the council, the European Parliament, the European Economic and Social Committee and the Committee of the Regions. The EU Role in Global Health.http://eur-lex.europa.eu/legal-content/EN/TXT/HTML/?uri=LEGISSUM:dv0011&from=DADate: March 31, 2010Google Scholar In the current difficult international environment, a so-called enlightened interest perspective might be the most viable approach to combine both perspectives. Meanwhile, looser forms of collaboration between European countries in specific health-related areas could be developed—coalitions of the willing, if you will. The She Decides Initiative by the Netherlands and Belgium provides an excellent example of this approach. LS reports grants from the Belgian Development Cooperation, VLIR-UOS during the conduct of the study. All other authors declare no competing interests. If not now, when? Time for the European Union to define a global health strategyThese are dark times for the European Union (EU). The Brexit vote, coupled with the rise of Eurosceptic parties, was a reminder that many Europeans view the EU as an irritant, with little understanding of its positive role. The election of Donald Trump shows that this retreat into isolationism is not limited to Europe. Full-Text PDF Open AccessRole of the European Union in global health – Author's replyWe 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. Full-Text PDF Open Access