Slovenia’s health minister Janez Poklukar in an interview on what worked well in the response by the European Union and the Member States to the COVID-19 pandemic, and why better coordination will be necessary in future.
Infectiologists, epidemiologists and other health experts have been warning for decades about the possibility of a pandemic. How well were the European Union and the Member States prepared for the COVID-19 pandemic?
Janez Poklukar: Looking back, we can all admit that the pandemic caught us unprepared, regardless of the relevant mechanisms that were in place in the European Union (EU) and the Member States. For example, in Slovenia we worked with the World Health Organization (WHO) on a joint external evaluation to strengthen the International Health Regulations core capacities. However, the magnitude of the epidemic required far greater response capacities and additional mechanisms for cooperation between the Member States. Due to the lack of funding and the underdevelopment of preparedness and planning systems, the response of the Member States and EU was in many ways ‘ad hoc’ and temporary. As a result, coordination and cooperation between the Member States was difficult and partial, appropriate structures were not in place and measures were delayed.
At the same time, we must acknowledge what worked well: the EU and Member States have deployed a number of new initiatives that were designed and implemented in record time, enabling lives to be saved and helping health systems to respond to increased demands for health services. The added value of working together as the European Union has been particularly evident in the areas of joint procurement and the production of vaccines and other equipment, as well as in the EU’s leading role in global action. In particular, the EU has been effective and successful in responding quickly by taking action and mobilising financial resources to reduce the risk of another economic recession.
The key points that we have learned for future crises are:
* the significance of coordination at EU level,
* the need for a coordinated rapid crisis response, including the establishment of a preparedness and crisis response body,
* the importance of continued investment in strengthening the preparedness and overall resilience of health systems, and
* the value of EU leadership in global efforts to curb pandemics, such as support for WHO and COVAX.
How well – or badly – did the EU and the Member States respond to the pandemic? Did they react too slowly?
Janez Poklukar: In Slovenia we have a saying that everybody can be clever when the battle is over. The fact is that we all responded as best possible given what was known. We could perhaps have invested more in a coordinated response right from the start. This was one of the key lessons learned and I believe we are much better prepared now.
Did the COVID-19 pandemic boost nationalism as well as multilateralism?
Janez Poklukar: I would say that countries initially reacted to protect their own nations, which is normal, but very soon it became clear that multilateral solutions can benefit us all. The perfect example is a joint procurement scheme to deliver vaccines which indeed simplified negotiation processes and was much more efficient compared to running individual purchases. It was beneficial for all Member States regarding speed, supply, and costs of operation. I believe that the pandemic has brought us all closer and we are now in a better position to understand the real value of a common response as the EU.
What should be done in the EU and its Member States to be better prepared for a pandemic next time?
Janez Poklukar: It is crucial to build a stronger and resilient European Health Union that will be better prepared for any possible health threats. Based on the experience with COVID-19, we have already made very important steps for a common and structured approach at EU level. I am very happy that the Slovenian presidency began with a political agreement on a significant regulation for cross-border health treatments and on the revised mandate of the existing key organisations in the Council, the European Centre for Disease Prevention and Control (ECDC) and European Medicines Agency (EMA). This opens the doors for negotiations with the European Parliament and the Commission in the autumn. The new regulations will allow for earlier anticipation and detection of risks, better contingency planning, as well as a swifter and more effective joint response. The new European Health Emergency Preparedness and Response Authority HERA was launched on September 16th and is another particularly important step towards being better prepared for a pandemic in the future.
Health politics are in principle a matter of the Member States. Is it sufficient to bolster the role of existing EU health institutions or should the EU develop a Health Union and prepare an according amendment to the European Treaties?
Janez Poklukar: I believe that we are already building a stronger Health Union with steps such as Europe’s Beating Cancer Plan, the pharmaceutical strategy and the new EU4Health programme, besides the regulatory proposals that I have already mentioned.
To what extent is it possible to prepare perfectly for a natural event such as a pandemic at all?
Janez Poklukar: In the health sector we have some catching up to do in order to be better prepared. The pandemic has showed that there are some key areas that are worthy of investment at a national level:
* During the pandemic, we recognised the importance of further investment in crisis communication within the health sector. An understanding of behavioural patterns in different sections of the population was lacking and it would be important to invest in research in this area.
* Another crucial area is investment in primary health care and public health capacities. It has been shown that some investment in infrastructure is also needed at hospital level.
* Major progress in introducing additional e-health solutions was made in record time, but there is still more to be done.
* In addition, integration of different health care services, organisational structures with greater flexibility, and investments in the health workforce capacity have been identified as being crucial for better preparedness.
The physician Janez Poklukar was previously Director of the Ljubljana University Medical Centre, the largest hospital in Slovenia, and has been Slovenian health minister since February 2021. Slovenia is holding the presidency of the EU Council in the second half of 2021.