#EAPM - Co-operation under microscope in #COVID-19 crisis

As coronavirus infections soar across the planet, and the death toll rises everywhere, not least in Europe, many are asking why European Union member states have been so disconnected from each other strategy-wise, and what the EU can do about improving co-ordination, writes European Alliance for Personalised Medicine (EAPM) Executive Director Denis Horgan.

Well, given that health care is a jealously guarded member state competence, locking-down the answer isn’t easy, and never has been. But that doesn’t help Europe’s citizenry, given that Covid-19 is no respecter of borders and national sovereignty.

EAPM has always argued for more EU-wide cooperation and co-ordination in health care, and the current crisis has only made that need more obvious. 

Indeed, for the best part of a decade the Alliance has been calling for policies to tackle diseases of many different types - not least cancer - through new science and personalised healthcare, with the backing of many Members of the European Parliament.

EAPM’s recent ‘virtual’ conference, held online towards the end of March, discussed COVID-19 and related issues, and you can read the report here.

On the topic of much-needed co-operation, the European Commission is striving to do what it can and has, among other things, formulated some guidelines on EU emergency assistance for cross-border cooperation in healthcare.

With a great deal of understatement, the Executive says that Covid-19 has “placed great stress” on EU health systems, with certain member states asking for help from the EU and fellow member countries.

The Commission calls it “encouraging” that several German states, plus Luxembourg, have offered help to other countries and adds that authorities should offer more hospital beds to patients while enabling healthcare professionalsto share their expertise across Europe’s borders.

It has also been reported that the Commission will help finance patient transfers, which are being overseen by the Health Security Committee (HSC).

The HSC can also co-ordinate available intensive care units and medical staff.

This is all good news, but begs the questions of why Europe wasn’t already prepared in this sense for such a viral outbreak, and why it the good stuff didn’t all happen a lot more quickly.

At any rate, the Commission is encouraging teams of qualified medical personnel to go to other Member States to help, and is encouraging health authorities to use cross-border agreements that already exist.

Meanwhile, a not-before-time debate is now underway on whether it is possible to give the EU greater competence over health and healthcare.

But in a recent interview with Politico, Michael Hager, the cabinet chief for Commission Vice President Valdis Dombrovskis, basically binned the idea. At least for now.

Hager said: “At this time of crisis, a general debate on competences would be rather bad. What we need is crisis management to put out the fire. And I believe that the interaction…with the member states is extremely important.”

So when exactly are we going to talk about it? We’ve been battling cancer and other diseases separately, rather than together, for many years against the backdrop of the EU’s Treaty pledges to do the best that it can for all its citizens.

Questions such as how to get tested, how often and for what, how to get equal access to treatment across all Member States, how to pay for it and any drugs, how to get into a clinical trial, and how to see a medical professionals and get the fastest possible diagnosis, have been around for ever.

Some progress in cooperation has been made, not least via the Declaration on the One Million+ European Genomes project, plus EU regulations in areas such as IVDs, medical devices, clinical trials, Big Data and more, but coordination and workable structures are still far from optimal where they exist at all.

And every time a crisis such as the one that surrounds the novel coronavirus emerges, the gaps become more glaringly obvious.

MEP Peter Liese, a regular at EAPM events, is well aware of this. Peter recently said he is “increasingly concerned about how the coronavirus crisis is developing” and “how European cohesion is endangered”.

The German deputy said he would love to see more Member States sharing their hospital capacities “and show more solidarity” by taking in patients from another country if they have the capacity to do so.

Meanwhile, it has emerged that the Parliament’s ENVI committee plans to debate the coronavirus response with commissioners on 20 April, according to its yet-to-be-finalised schedule.

ENVI wants to talk to Health Commissioner Stella Kyriakides and Crisis Management Commissioner Janez Lenarčič, with Executive Vice President Frans Timmermans also down as a possibility.

When it comes to ‘solidarity’, at least member states seem to have (mostly) changed their tune over export bans and closed borders in relation to the spread of COVID-19. Perhaps it helped that the Commission was “very clear” that such bans violate EU treaties…

We mentioned Germany earlier and, as of 26 March, the country had taken almost 50 Italian patients to six of its own hospitals, with more being moved since then. One possible problem down the line, however, is when and if a country such as Germany needs its own beds for its own citizens.

Belgium is not taking the latter risk. The cabinet of Prime Minister Sophie Wilmès has already confirmed that the country is not taking patients from others. This despite requests from Italy and the Netherlands.

Meanwhile, Belgium’s CSC-Public Services, the Christian union for government employees, has called for Federal Health Minister Maggie De Block’s resignation.

The union claims she has made key mistakes in handling the pandemic, such as showing a lack of foresight on face mask stockpiles before being involved in the ordering of faulty masks.

Staying in Belgium - and Brussels specifically - the European Parliament has offered the city the use of one of its buildings, as well as its vehicles, to help in the fight against coronavirus,

“The building could be used as a hospital or temporary residence for people who need care. Drivers could help carry food or medicines,” a spokesperson said.

Every little helps, of course, and it’s certainly a wonderful (and, of course, highly symbolic) gesture. But against the backdrop of such a huge crisis, what else can be put on offer?

Cash for health-care systems

Back to the Commission, and the Executive has said it wants to put €3 billion of EU budget reserves towards the bloc’s health-care systems. 

The cash would be earmarked to increase testing for COVID-19 (much-needed, according to many experts), build an EU stockpile of protective equipment, and get virus-related clinical trials under way.

Around Europe

Over in Iceland, the government signed the EU’s joint procurement agreement this week. Every EU member state, plus Britain and Norway, has now signed up.

In France, the number of patients suffering with COVID-19 currently exceeds the number of ICU beds that were available in the country before the coronavirus epidemic. 

And in the Netherlands, the country is looking to increase its stock of ICU beds, hoping to avoid doctors having to make tough decisions over who should get the ones available, and who should not.

Health Minister Hugo de Jonge said: “We’ll do everything in our power not to get into that phase…But there is that possibility, we have to be honest about that.”

In Poland, Warsaw has now made it mandatory for anyone with the virus to download a smartphone app,backed by the government, which is designed to track their movements during the 14-day isolation period.

Expect to see take up in other countries very soon.

And finally, for now, Hungary is once again upsetting the Commission and much of the rest of the EU after the country’s parliament voted to let Prime Minister Viktor Orbán’s government rule by decree without a set time limit.

Many see this as representing anti-EU values, a power grab, and a not-very-subtle assault on freedom and democracy.

Without actually naming Orbán, the leader of the European Peoples’ Party and ex-Commission bigwig Donald Tusk said that governments using the crisis for such purposes would be “politically dangerous, and morally unacceptable”.

Tusk added that the crisis should not be used as an excuse for state overreach. “The state of emergency, or the state of danger, must serve the governments in their fight against the virus, and not strengthen their power over the citizens,” he insisted. 

Have the best weekend possible, keep safe and heres that link to the report here.

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