Why do we need a true European Health Union?

What are the characteristics of a “true” European Health Union? Are existing initiatives sufficient for such a union, or are more extensive measures necessary? “Healthy Europe” asked two Young Gasteiners for their opinion.

To minimise the health risks we collectively face, what we need is a European Health Rights Union.

Portrait of Mechthild Rose
Credit: private

We may not (yet) live in a true European Health Union. But we certainly do live in a European Health Risk Union: in the single market, and in an ever more globalised and interconnected Europe, risks both to public and individual health have come to enjoy a freedom of movement aligned to that of persons, goods, services and capital. If we want to be able to face such collectivised risk, we need more integration across Europe as regards health and healthcare. However, at the moment the European Union is leaving health policy interpretation to the Member States, and this effectively means that policymakers who understandably focus on their fellow nationals, for reasons such as re-election, will likely pay less attention to anyone with another or no citizenship, be they EU or non-EU nationals. But when it comes to public health, we as a society are naturally only as strong as our weakest members. Thus, collective risk and resilience are determined by all members of society – based not on the name of a country in our passports, but on residence, be it short- or long-term. Hence, to minimise the health risks we collectively face, what we need is a European Health Rights Union that grants and guarantees the same high-level rights and access to health and healthcare to all residents. This may sound utopian, especially in our current times of political, economic and social polycrisis. But considering the immense impact of both individual and public health on every aspect of our lives, on politics, societies and economies, it is a utopia worth pursuing. The EU as a supranational governance system, despite its as yet limited competence in the areas of health and healthcare, is in a unique position to do so.

Mechthild Roos is Lecturer in Comparative Politics at Augsburg University. She has been a member of the Young Forum Gastein, the network for young European health professionals of the European Health Forum Gastein, since 2021.

We don’t have a true European Health Union yet, but we can say that we are probably on the right track for an important paradigm change.

Credit: private

When Ursula von der Leyen uttered the words “European Health Union” (EHU) for the first time, health advocates rejoiced. But are we there yet? – No, of course not, but we can say that we are probably on the right track for an important paradigm change. Initiatives such as the European Health Data Space, just to mention one pillar of the EHU in detail, have the potential to overcome many barriers between Member States, helping in turn to strengthen harmonisation within national borders as well. The other pillars also have the potential to initiate necessary changes. This applies to the Pharmaceutical Strategy and Europe’s Beating Cancer Plan, to the newly established European Health Emergency Preparedness and Response Authority (HERA), and also to the European Centre for Disease Prevention and Control (ECDC) and the European Medicines Agency (EMA), whose mandates have been strengthened.

If the EHU pillars begin to deliver on their promises, we can hopefully start harvesting the fruits of this initiative without necessarily waiting for a treaty change, which should nevertheless remain a target. However, true success of the EHU will have to be measured via the tangible impact that it has on Europeans, in particular on patients and healthcare professionals. Since much time was lost before starting to move in this direction, we cannot afford failures or rather “abstract” flagship initiatives with no true impact on individuals. And in order to establish a true European Health Union, it will be essential to listen to the generation that will be most affected by it – ranging from representatives of networks such as the Young Forum Gastein and the European Health Parliament to the representatives of schools and other youth networks at a local level.

Michele Calabrò is Director of EUREGHA, the European network of regional and local health authorities. He has been a Young Gasteiner since 2018.


Since as early as 2007, scholarships for the European Health Forum Gastein have been awarded to promising young health professionals from different backgrounds and with diverse professional experience, enabling them to take part in Europe’s most important health policy event free of charge. They are given the chance to learn about new information on current developments in the area of health across Europe and worldwide, they are able to take on practical responsibilities, such as writing reports on sessions and holding interviews, and they can also form networks with each other and with senior policymakers and academics. The Young Forum Gastein currently has 600 enthusiastic members.