What does #SOTEU 21 mean for European health policy?

EPHA analysis of President von der Leyen’s State of the European Union speech 2021

On 15 September, European Commission President von der Leyen gave the annual State of the European Union speech. A flagship address, she highlighted five priorities, setting out her vision for the European Union in the year ahead: 

  • Leading the way out of the global health crisis 
  • The promise of NextGeneration EU
  • Making people greener, more digital, and more socially just 
  • Geopolitics in a post-pandemic world 
  • Shaping the future of Europe, together

Vaccine equity and health crisis preparedness 

Public health remained a prominent topic in her speech, with the Commission President highlighting achievements such as the EU vaccination strategy and reaching the vaccination targets by summer. According to a recent statement, by the end of August 2021, 70% of Europeans over the age of 18 were fully vaccinated. She also mentioned the success of the EU’s digital COVID certificate with over 400 million certificates generated across Europe: “while the rest of the world was talking about it, Europe just did it” she said. In relation to the pandemic, her first and most urgent priority is to speed up global vaccination as well as tackle the “worrisome divergences in vaccination rates in our Union“. 

She also reiterated the need to strengthen our pandemic preparedness. Referring to last year’s goal to build a European Health Union, von der Leyen announced the HERA authority would be up and running soon. In this sense, EPHA welcomes the establishment of HERA and together with EPF set out their vision for the new organization to build on science and learn the lessons from the ongoing crisis. The pandemic has exacerbated inequalities, thus, it is important to make equity in health the cornerstone of EU policies. To this end, the EU needs to increase and strengthen its support towards civil society to guarantee that no one is left behind. 

Tackling social and health inequalities 

In her speech, the President of the European Commission argued the need to invest in both “short-term recovery and long-term prosperity” within the NextGenerationEU programme. “The Single Market is the driver of good jobs and competitiveness” and it should not leave vulnerable groups behind. They remain disproportionately affected by health and social inequalities having long-term consequences on their employability and competitiveness at a large. Therefore, the NextGenerationEU programme must advance an integrated approach towards Europe’s recovery and provide opportunities for access to employment, education and training of good quality, decent working conditions, health and safety at work, adequate wages as well as minimum income and social protection for all.

Young people are among those who have been hit hard by the pandemic in terms of socio-economic participation due to factors such as age, social background, ethnicity, or health status. We welcome the Commission’s proposal for the new ALMA programme, however, its focus should be on ending employment precariousness by promoting young people’s access to quality employment, creating opportunities for mobility, and lifelong learning instead of temporary work experience.

The European Pillar of Social Rights and the European Semester remain the major policy promoting socio-economic rights across Europe and the EPRS Action Plan adopted earlier this year demonstrates notable policy efforts to mitigate the pandemic’s social and economic consequences. However, tackling widening inequalities exacerbated by COVID-19 requires significant investment in the most vulnerable which face higher rates of socio-economic exclusion and disparities in access to essential rights and services such as healthcare and prevention, employment, education and training. 

Climate change and clean air

The public health community welcomed Ursula von der Leyen’s first state of the Union speech, in which she declared that “For me, it is crystal clear – we need to build a stronger European Health Union”, followed by the launch of the European Health Union (EHU) transforming this political programme into policy. Yet, the European Health Union proposals still follow a biomedical approach, with only a promise that the link to the European Green Deal will be elaborated. For a healthy recovery from the pandemic developing the Green Pillar of the European Health Union must be a top priority.

“Climate change is man-made. But since it is man-made, we can do something about it.”  said President von der Leyen. It is indeed essential that we act now. Yet, while the European Climate Law voted in June 2021 aims at cutting the EU greenhouse gas (GHG) emissions by at least 55% by 2030, compared to 1990 levels, it is still not enough. Scientists and NGOs suggest a reduction of 65% GHG emissions by 2030 in order to be aligned with the Paris Agreement objective to keep temperature rise below 1.5°C. Clean energy and transport industries represent two of the most important pillars in achieving both our climate goals and improving the quality of the air people breathe – and thus their health. EPHA, therefore, welcomes the Commission’s commitment to progress in both areas and stresses the need for concrete measures ensuring social equality and a just transition. 

The EU’s commitment to reaching climate neutrality by 2050 is positive but we have to make it real. To deliver on these targets, the European Commission presented the European Green Deal package (or “Fit for 55”) on 14 July 2021. Additionally, the 2021 United Nations Climate Change Conference (COP26) in Glasgow “will be a moment of truth for the global community”. The World Health Organisation (WHO) and the global health community, including EPHA, are calling on governments to commit to more ambitious climate action and to a healthy recovery from COVID-19. The best way to achieve this goal is to have an ambitious plan for zero pollution. The response to this pollution emergency could also be the greatest opportunity to improve population health and wellbeing while ensuring climate and environmental sustainability.  

Finally, also highlighted by the Commission President, it is important to “tackle the energy poverty that already 34 million Europeans suffer from”. This needs to be addressed in a comprehensive manner through dedicated funds, building renovations, and minimum energy performance standards.

Digital health 

Von der Leyen also confirmed her strong commitment to accelerating the digital transformation of society and particularly on theimportance of investing in our European tech sovereignty. EPHA welcomes this proposal, especially in relation to cybersecurity and data protection of sensitive information such as (electronic) health records. Technology has the potential to improve access to and quality of healthcare through the expansion of telemedicine which can help address so-called medical deserts and reduce waiting times. However, the digital transformations of society must complement and improve existing services, not replace them.  

Food systems and NCDs prevention

Missing from the speech was any mention of the need for action on prevention of non-communicable diseases (NCDs) and obesity –  critical for the development of healthy communities to better withstand future pandemics and to ensure young people can grow up in health and well-being-enhancing environments. Likewise, a transition to healthy and sustainable food systems is both a precondition and an opportunity to address multiple fundamental societal challenges at onceincluding diet-related diseases, climate change, antimicrobial resistance (AMR), risk from zoonotic diseases, social inequalities, and biodiversity loss.  The One Health perspective should underlie the approach to all these issues, recognizing the interlinkages between human, animal, and planetary health. The ambitious implementation of the Commission’s Farm to Fork Strategy and Europe’s Beating Cancer Plan should pave the way for important steps in this direction. 

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