#EAPM - Three heads are better than one: How the EU Presidency ‘Trio’ works

The system of a six-monthly rotating presidency of the EU suggests that the individual presidencies work alone during their time at the helm. While this is true in some ways it is not 100% the case, writes European Alliance for Personalised Medicine (EAPM) Executive Director Denis Horgan.

A system has been in place since 2009, formalized by the Lisbon Treaty and called the ‘Trio’, which is made up of the current presidency, and the two that will follow. The trio at the moment is therefore made up of Romania, Finland and Croatia.

Member states holding the presidency work together closely in these groups of three, setting long-term goals and preparing a common agenda determining the topics and major issues that will be addressed by the Council over an 18-month period.

On the basis of this, each of the three countries prepares its own more detailed six-month pro-gramme.

The Brussels-based EAPM will be working with each
Presidency as their terms progress. Indeed, EAPM’s 7th annual conference will be held under the auspices of Romania in April.

The Trio is committed to ensuring a smooth transition to the next legislative cycle, making every effort to ease the process. One main priority is the finalization of any outstanding files, and there is a major focus on those listed in the Joint Declaration on the EU's legislative priorities.

A core foundation of the Trio is to underline the importance of common values of the European Union. These cover respect for human dignity, freedom, democracy, equality (including, EAPM urges, access to the best health care available), the rule of law and respect for human rights, including the rights of those belonging to minorities.

The Trio aims to put special emphasis on strengthening economic, social and territorial cohesion, the Union’s underlying values and shared objectives, for the development of the EU down the line.

It also pays attention to promoting Agenda 2030 for sustainable development, within and beyond the European Union.

This Trio will be in the thick of the Brexit process or, more specifically, overseeing the unity of the 27 member states still in the Union once the UK has left.

Also, work will be taken forward with a view to the adoption of a new Strategic Agenda at the June European Council.

Responsibilities for the current triumvirate also include overseeing negotiations and implementation of the Multiannual Financial Framework for 2021-2027, in close co-operation with the President of the European Council.

Regarding the Single Market, the EU obviously needs a strong industrial policy. The three Presidencies are tasked with continuing discussions on the EU's long-term strategic objectives in this area.

Meanwhile, the Trio works to promote a climate of entrepreneurship and job creation given that on-going efforts are needed to reintegrate the long-term unemployed into the labour market and help younger people develop skills.

Other areas involve tourism, deepening economic and monetary union, reinforcement of the EU as a global actor, and public health.

On the latter point, stakeholders are well aware that further efforts are needed in public health to guarantee access to health care for all EU citizens.

On top of this comes a clear need to ensure patient safety and mobility, and to find ways to take advantage of the opportunities posed by new medical technologies, not least in the fast-moving field of genomics.

The Austrian Presidency

Prior to the current Trio, Austria held the rotating presidency (until 31 December 2018, after which Romania took over for its first-ever turn in the hot seat). Mid-January saw a European Parliament Plenary session review Vienna’s work.

Austrian Chancellor Sebastian Kurz and European Commission President Jean-Claude Juncker gave statements on the subject, as did representatives of Parliament’s political groups.

Chancellor Kurz highlighted the 161 trialogue sessions held and the 53 agreements reached under his country’s presidency, and wished success to Romania.

In respect of Brexit, Austria had been asked to preserve the unity of the 27 member states, and Kurz said that the EU, in the negotiations with the UK, produced a balanced agreement and a politi-cal declaration. Crucially, he added that whatever happens on Britain’s side of the Channel, it’s im-portant to keep any agreement on the same terms.

As Austria’s chancellor, Kurz outlined that if we if want a truly robust Europe, the bloc needs a mo-dern budget, (although the process is still ongoing, of course).

Jean-Claude Juncker said that the Austrian Presidency was well-prepared and had a clear ap-proach in terms of Brexit, while Manfred Weber, the EPP ‘Spitzenkandidaten’, said that the Austrian Presidency achieved a lot for the future of Europe.

Maria João Rodrigues, of the S&D group, begged to differ, accusing the Austrian Presidency of de-livering a Europe of selfishness, without ambitions and solidarity, while the Greens’ co-leader and joint-Spitzenkandidaten Ska Keller bemoaned a lot of legislation getting stuck in Council, and what she felt was the shameful courting of Russian President Vladimir Putin.

Clearly, the jury was out. But Juncker praised Austria’s pragmatic approach, labelling the sixth months a particularly successful presidency, with the country’s Kurz adding that the model for the EU should be unity in diversity.

Romania takes the helm

So, now we move to the Romanian Presidency.

Three potential headaches are already heaving in to view: Brexit, a lack of agreement on the Commission’s proposals for mandatory joint action on health technology assessment (HTA), and the perennial issue of agreeing budgets for the next financial framework.

Taking forward the negotiation process on the Multiannual Financial Framework is a priority for Bucharest, as is developing the EU social dimension, through the enforcement of the European Pillar of Social Rights.

The latter has met with some scepticism, it’s fair to say, with a swathe of commentators believing that Romania is not quite domestically ready itself in this regard.

When it comes to health care, Romania still has to handle any fallout from Brexit, as well as the HTA issue.

In the first case, with UK Prime Minister Theresa May losing - by some margin - a key vote on her negotiated deal, before just about surviving a no-confidence vote, nobody really knows what is going on.

However, in many ways it’s not looking good.

Worried that Britain may crash out of the EU at the end of March with no deal - hard Brexit -  the pharmaceutical lobby group EFPIA very recently called on EU and UK policymakers to put politics aside and prioritise patients in planning for a such a scenario, stating that there are now “very real, tangible and immediate threats to patient safety”.

Meanwhile, Mike Thompson, who is head of the UK’s ABPI group, was quick to warn that “no deal would prove to be extremely challenging”. This despite medicine stockpiling and duplicating manu-facturing processes across the industry.

To add to the clamour, the British Medical Association has gone so far as to call for a second referendum.

Health Technology Assessment

As for the thorny HTA issue, during the latter part of 2018, Austria worked hard to make progress. But ultimately Vienna was forced to acknowledge that disagreements could not be overcome under its watch.

Now the Romanian presidency has said it is keen to avoid the political battle over mandatory versus voluntary aspects of the Commission’s HTA plans.

A compromise seems a long way off, and there is concern that it may actually be left to the Finnish presidency, which takes over in July after the May elections, to finish the job.

At the very least, the hope is that all will be done-and-dusted before Croatia takes over the reins on 1 January, 2020…

Having admitted that it will effectively hold a “transitory” presidency as we head towards the May Parliamentary elections, Romania is however aiming to reach a political agreement among Member States on HTA, according to Sorina Pintea, the country’s health minister.

“Romania’s presidency aims at continuing negotiations in order to make as much headway as possible in order to reach a general approach at Council level,” she said, while talking about a “realistic” approach and relying on collective efforts “and a strong political will”.

More plans from Romania on health

Pintea has also spoken about Romania’s other plans on health. These include producing Council Conclusions on upping vaccination coverage and tackling antimicrobial resistance.

Access to medicines and patient mobility are also top priorities, the health minister said.

An informal meeting involving the EU’s health ministers is scheduled for mid-April in Bucharest, during which access to medicines (with an emphasis on hepatitis treatments) and cross-border health care will be high on the agenda, according to Pintea.

The Romanian presidency has also announced that it is planning a workshop on 9-10 May, cover-ing the topic of vaccines and a further meeting to discuss early diagnosis of cancer at the end of that month.

On top of these activities, an e-health conference is planned for late June, Minister Pintea said.

So, amid these plans, there are clearly challenges ahead for Romania. And Bucharest may need all the help it can get from Finland and Croatia in the coming months.