The European Union needs not only to improve the preparedness of its health system but also to address inequalities within the Union and globally. It needs to move quickly to assess the public health action taken to date
Health challenges in the EU in the pandemic context was the subject of a high-level conference held by the European Economic and Social Committee (EESC) on 31 March, focusing primarily on the lessons to be learned from COVID-19.
The conference brought together top officials from the European institutions, the French Presidency of the Council, the WHO, the ECDC, academics, and civil society organisations focusing on health.
Opening the conference, EESC president Christa Schweng said:
First and foremost, it is crucial to improve the Union's capacity to prevent, detect, prepare for and effectively manage cross-border health threats. This can be achieved by strengthening health systems in all EU countries to make them more resilient. We need more investments, including in prevention, and a stronger role for primary care.
Margaritis Schinas, Vice President of the European Commission and keynote speaker at the conference, recalled the EU's bitter experience at the beginning of the pandemic.
At least now, contrary to 2020, we now know the direction of travel, said Mr Schinas.
But, first, we must continue striving towards Europe's strategic autonomy and secure our supply of critical resources. It took a pandemic to realise that the EU was not a place where we have production of personal protective equipment, of masks or ventilators. And we do not want to see such shortages of vital, protective equipment again.
He pointed out that the EU had already created a Health Emergency Preparedness and Response Authority (HERA), modelled on a US example, that would
ensure the EU's readiness in case of health emergencies.
Michel Kazatchkine, a member of the WHO Independent Panel for Pandemic Preparedness and Response, lamented that the international community had acted sluggishly in implementing lessons from previous major epidemics, including SARS and swine flu. Mr Kazatchkine pointed to the need for
stronger leadership and better coordination at all levels, including rapid negotiation of the Pandemic Treaty.
We need to invest in preparedness now and not when the next crisis hits. We need a pre-negotiated platform to produce vaccines, diagnostics, therapeutics and supplies. This will prevent us from negotiating only after the suppliers have presented us with ready products for the market, he added.
Andrea Ammon, director of the European Centre for Disease Prevention and Control (ECDC), stressed that the pandemic was still not over.
We still see a very high virus circulation in several countries and a high number of cases, but the death rate remains low thanks to the vaccines. But the vaccination rate has been plateauing since the end of last year, explained Ms Ammon. She said that it was exactly the possibility of a recurrence of further waves of COVID-19 that made it all the more urgent to undertake a robust evaluation of sanitary decisions taken by public authorities to date. Ms Ammon argued, for example, that while mandatory vaccination is
a measure that might give a momentary increase in people getting vaccinated, in the long run it’s a very polarising measure.
The biggest mistake – draconian lockdowns and lack of randomised evidence
Scientists who took part in the conference criticised some of the measures taken to curb the pandemic, such as major lockdowns, closures of schools and vaccine mandates, which in their view had a tremendously negative effect on education, treatment of diseases other than COVID and public trust. They also noted that, despite an unprecedented volume of work on COVID-19, much of the research was of poor quality and lot of much-needed research had never been done.
Peter C. Gøtzsche, director of the Institute for Scientific Freedom in Denmark, argued that, during the pandemic so far,
we have never done a single randomised trial in which we compared major lockdowns with minor lockouts.
This is a missed opportunity we should not miss next time, Mr Gøtzsche said.
Professor John Ioannidis from Stanford University called for lessons to be learned from past action and for a greater focus on more targeted social distancing measures in the future.
It's very likely that this fall and winter we will have a high number of cases again, but this doesn't mean that we should go into draconian lockdown again, said Prof. Ioannidis.
We need measures which society might tolerate over much longer durations of time.
Both argued against blanket approaches targeting the whole of society and in favour of tackling factors underlying COVID-19 deaths, such as smoking, obesity and dysfunctional health systems. In low and middle income countries, 8.6 million deaths per year are attributed to poor healthcare or non-use of health services, Prof. Ioannidis said.
The conference pointed to social inequalities in access to healthcare in emergencies, which translate into treatment effectiveness for non-communicable diseases as well.
There is a very strong gender dimension to health inequalities, with the pandemic reversing years of progress in women's rights, with particular impacts on mental health, reproductive health, and gender-based violence, said Ines Bulic Cojocariu, Director of the European Network on Independent Living.
The conference echoed the global debate on intellectual property (IP) and vaccines. Tania Buzek, chair of the EESC's International Trade Follow-up Committee, drew attention to the
mismatch between the IP framework under TRIPS (the WTO's framework for IP) and the needs of the public in terms of response to global health threats such as a pandemic. In contrast, Antony Taubman from the WTO stressed that there were also other issues, including supply of materials and technology transfer, that must be considered in terms of access to vaccines in addition to the IP issue. Only these factors taken together can determine whether countries or individuals will have access to health technologies.
The importance of health as a key public good was also stressed, as was the proper implementation of the European Green Deal, which has the potential to enhance people's health and help to avoid future pandemics.
Jérôme Weinbach from the French Ministry for Solidarity and Health pointed out that, in the field of health, the current Presidency was emphasising not only COVID-19 issues but also occupational health.
We are highlighting prevention and combating workplace-related cancers, concluded Mr Weinbach.
We want to protect workers, including their mental health, alongside our social partners.