Social Europe

  • EU Forward Project
  • YouTube
  • Podcast
  • Books
  • Newsletter
  • Membership

Europe’s failure to address Covid-19 shows the need for a European ‘health citizenship’

Joan Costa-Font 30th March 2020

A Europe-wide public-health authority should be a priority to counteract collective-action problems among EU member states.

health citizenship, public-health authority
Joan Costa-Font

The Covid-19 crisis is not just the most important health crisis that higher income countries have suffered over the last century, but also one that comes with enormous consequences for the global economy. It illustrates more than ever that while globalisation can provide benefits, via free trade and mobility, it also entails risks.

Although the exact consequences of the crisis are still to be determined, we already suspect that even under a best-case scenario they will be paradigm changing—and perhaps the tipping point desperately needed to address the challenges of globalisation. A key lesson from the crisis should be that the collaboration and collective action required in Europe to meet these challenges cannot be achieved without transferring powers to a European public-health authority.

Diverse responses

The way the world is organised has proven to be catastrophic for the management of this epidemic. In Europe, each country has reacted in a different way, perhaps revealing the distinct characters of national elites. Germany has managed to keep death rates low with heavy testing, but other European countries have been far slower to react, while some governments appear to have been less open about the situation they were facing and only reacted when the virus was at their doorstep.

Some countries, such as Austria and Poland, have demonstrated nationalist instincts in their responses by closing down their borders. Meanwhile in Spain, the approach has included the centralisation of healthcare responsibilities following the declaration of a state of emergency, even though the relevant expertise is located at the regional level, and some Spanish regions which advocated for a lock down have remained open.

In contrast, In Italy, the regions of Veneto and Lombardy were early movers in setting up a quarantine and urging locals to stay home. In Lombardy, local health authorities established strong containment measures in the initial cluster by quarantining several towns in an attempt to slow transmission of the virus. In Germany, states have taken the lead in fighting the virus, while in the UK Wales and Scotland have acted first by announcing policy measures such as school closures which were then followed by the whole country.



Don't miss out on cutting-edge thinking.


Join tens of thousands of informed readers and stay ahead with our insightful content. It's free.



This being said, solutions must be built on co-operation and trust in existing institutions. Today, humanity faces an acute crisis, not only due to Covid-19 but also due to a lack of public trust. To defeat an epidemic, people need to trust scientific experts, citizens need to trust public authorities and countries need to trust each other.

Europe’s almost non-existent role

Public health was introduced as an express area of EU competence for the first time by the Maastricht treaty and internal market regulation does constitute a significant constraint on health services. European health governance is a multilevel system very much like that of other federations. According to article 3 of the Treaty on European Union, the European Community shall contribute to a ‘high level of health protection’. Although the right to health care is a ‘positive right’, the European Court of Justice has envisaged it as a ‘negative right’ linked with the principle of freedom and non-discrimination.

However, Europe reacted to the Covid-19 crisis fairly late. Only in the second week of March did the president of the European Commission propose that all non-essential travel to the EU should be suspended for 30 days. Alongside Europe’s failure to manage the migration crisis, it can be argued there is now a desperate need to reform the EU’s institutions to enable them to take more effective control over global crises in areas where national reactions are affected by collective-action problems (ie countries only react when they face an immediate cost to themselves).

A European public-health authority

Today, European citizenship is defined by a common European health card as much as a European passport. However, the European role in managing health crises has remained modest. The Covid-19 crisis highlights that public health (the management of global public risks) is an area where the EU should be more proactive. Given the nationalistic and even selfish policies implemented by various member states, the creation of a European wide public-health authority must now be viewed as an urgent matter to consider as part of wider reforms. Being European should entail having a European health citizenship.

The help provided by the German state of Baden-Württemberg to patients in the French region of Alsace is illustrative of the fact that health crises like Covid-19 are global in nature and require collaboration to be eradicated. However, this collaboration and collective action cannot be enforced without transferring health powers to the European level. This should be accompanied by recognition that local knowledge is fundamental to the management of health systems.

Crises like Covid-19 affect Europe in a different way from the rest of the world and there is a clear case for an authority that can ensure co-operative policy solutions across member states. If all European countries had implemented the same policy response that Germany put forward, Europe would likely have far fewer fatalities.

Although the delivery of health services is more efficient when it is decentralised (as preferences and needs are heterogeneous), global public-health crises should be addressed centrally at the highest level possible, namely the EU’s institutions. We should remember this lesson during the next pandemic.

This article first appeared on the EUROPP blog of the London School of Economics; it provides the view of the author, not a position of EUROPP

Joan Costa-Font

Joan Costa-Font is associate professor (reader) in the Department of Health Policy at the London School of Economics.

Harvard University Press Advertisement

Social Europe Ad - Promoting European social policies

We need your help.

Support Social Europe for less than €5 per month and help keep our content freely accessible to everyone. Your support empowers independent publishing and drives the conversations that matter. Thank you very much!

Social Europe Membership

Click here to become a member

Most Recent Articles

u421983d2 3 The EU’s Landmark Mercosur Deal Promises Much But Delivers LittleSimela Papatheophilou, Werner Raza and Bernhard Tröster
u4219834af 1 Will Denmark Lead Europe Towards a Super-Rich Tax?Isabelle Brachet
611e8de7e149c8763c9d58fc537549c18d20044a0abfeadd41919a1a731b6e64 Britain Rediscovers Europe as Macron and Merz Lead a Democratic ReawakeningPolly Toynbee
u42198346b1 1 Europe’s Appeasement Dilemma: The Price of Standing Against PutinFrank Hoffer

Most Popular Articles

u4219834676 bcba 6b2b3e733ce2 1 The End of an Era: What’s Next After Globalisation?Apostolos Thomadakis
u4219834675 4ff1 998a 404323c89144 1 Why Progressive Governments Keep Failing — And How to Finally Win Back VotersMariana Mazzucato
09d21a9 The Future of Social Democracy: How the German SPD can Win AgainHenning Meyer
u421983462 041df6feef0a 3 Universities Under Siege: A Global Reckoning for Higher EducationManuel Muñiz

Eurofound advertisement

Ageing workforce
The evolution of working conditions in Europe

This episode of Eurofound Talks examines the evolving landscape of European working conditions, situated at the nexus of profound technological transformation.

Mary McCaughey speaks with Barbara Gerstenberger, Eurofound's Head of Unit for Working Life, who leverages insights from the 35-year history of the European Working Conditions Survey (EWCS).

Listen to the episode for free. Also make sure to subscribe to Eurofound Talks so you don’t miss an episode!

LISTEN NOW

Foundation for European Progressive Studies Advertisement

Spring Issues

The Summer issue of The Progressive Post is out!


It is time to take action and to forge a path towards a Socialist renewal.


European Socialists struggle to balance their responsibilities with the need to take bold positions and actions in the face of many major crises, while far-right political parties are increasingly gaining ground. Against this background, we offer European progressive forces food for thought on projecting themselves into the future.


Among this issue’s highlights, we discuss the transformative power of European Social Democracy, examine the far right’s efforts to redesign education systems to serve its own political agenda and highlight the growing threat of anti-gender movements to LGBTIQ+ rights – among other pressing topics.

READ THE MAGAZINE

Hans Böckler Stiftung Advertisement

WSI Report

WSI Minimum Wage Report 2025

The trend towards significant nominal minimum wage increases is continuing this year. In view of falling inflation rates, this translates into a sizeable increase in purchasing power for minimum wage earners in most European countries. The background to this is the implementation of the European Minimum Wage Directive, which has led to a reorientation of minimum wage policy in many countries and is thus boosting the dynamics of minimum wages. Most EU countries are now following the reference values for adequate minimum wages enshrined in the directive, which are 60% of the median wage or 50 % of the average wage. However, for Germany, a structural increase is still necessary to make progress towards an adequate minimum wage.

DOWNLOAD HERE

S&D Group in the European Parliament advertisement

Cohesion Policy

S&D Position Paper on Cohesion Policy post-2027: a resilient future for European territorial equity

Cohesion Policy aims to promote harmonious development and reduce economic, social and territorial disparities between the regions of the Union, and the backwardness of the least favoured regions with a particular focus on rural areas, areas affected by industrial transition and regions suffering from severe and permanent natural or demographic handicaps, such as outermost regions, regions with very low population density, islands, cross-border and mountain regions.

READ THE FULL POSITION PAPER HERE

ETUI advertisement

HESA Magazine Cover

With a comprehensive set of relevant indicators, presented in 85 graphs and tables, the 2025 Benchmarking Working Europe report examines how EU policies can reconcile economic, social and environmental goals to ensure long-term competitiveness. Considered a key reference, this publication is an invaluable resource for supporting European social dialogue.

DOWNLOAD HERE

Social Europe

Our Mission

Team

Article Submission

Advertisements

Membership

Social Europe Archives

Themes Archive

Politics Archive

Economy Archive

Society Archive

Ecology Archive

Miscellaneous

RSS Feed

Legal Disclosure

Privacy Policy

Copyright

Social Europe ISSN 2628-7641

BlueskyXWhatsApp