The EU as a Global Health Actor - Between Securitisation and Cooperation
Chair(s): Katrina Perehudoff (University of Amsterdam)
Discussant(s): Katrina Perehudoff (University of Amsterdam)
This panel explores the EU as a global health actor from two (related) angles: security, and cooperation. While the EU’s role in global health has traditionally been limited, it has increased since the COVID-19 pandemic. On one hand, scholars are looking at the increased EU involvement in strengthening health security within its borders and internationally. At the same time the EU is also raising its profile as a global health actor promoting cooperation and capabilities, especially in the Global South. Arguably, both aspects are sides of the same coin, as health security depends on international collaboration. But this global health collaboration is also underpinned by tensions, as the securitisation of health presupposes an ‘us versus them’ logic of exclusion. The papers by Wenham and by Pereira explore the EU’s health security agenda, with the former focusing the EU’s role in global health security, and the latter on health security viewed from within the EU borders. The papers by Di and by Parwani explore the EU’s soft power as a global health actor: Through the empirical case of the EU’s new global health strategy, Di’s contribution explores the scope for mutual learning and cooperation with China. Parwani’s contribution analyses the EU’s role in enhancing vaccine manufacturing capacity in Africa, critically examining its intended and unintended implications.
Presentations of the Symposium
Straw, Sticks and Bricks, strengthening the EU Health Security: The Collective Securitisation of Covid-19
Ricardo Pereira
Dublin City University
The COVID-19 pandemic stands as a game changer for the European Union (EU) health security. Initially, COVID-19 was treated through a sanitary nationalist approach by member states, which led to the almost fragmentation of the EU identity and values. However, the European Commission's statements in March 2020 were crucial to coordinate and organise the EU response and characterisation of COVID-19 as an existential health threat to the Union and its citizens. Based on the collective securitisation theory, the present article aims to understand how the European Commission’s discourse conveyed the collective securitisation of COVID-19. Applying a discourse analysis to selected statements of the European Commission, the analysis reveals evidence of a recursive interaction between the EU institutions that conducted a change in the EU health status quo. Nonetheless, the emergence of specific mechanisms and measures has culminated in the new role of the EU as a Health actor internally and externally through the development of the health program EU4Health, the EU Global Strategy, and the European Health Security Framework, paving the way for a pertinent debate on the future of Health in the EU.
Enhancing Vaccine Manufacturing Capabilities in Africa: A critical Look at EU’s Role
Pramiti Parwani
University of Amsterdam
Through the pandemic years and beyond, the interconnected nature of public health has become clearer than ever before – no one is safe, until everyone is safe. Citing solidarity and interests of pandemic preparedness, the European Union (EU) has been taking its external role more seriously. In 2021, the Team Europe Initiatives (TEI) – consisting of the EU, EU Member States, the European Investment Bank and the European Bank for Reconstruction and Development launched an initiative on Manufacturing and Access to Vaccines, Medicines and Health Technologies (MAV+) to work with partners in Africa on strengthening local manufacturing capacity there. This is only one of several initiates by the EU to enhance vaccine manufacturing in Africa. In this paper, I seek to critically examine the intended and unintended implications for vaccine manufacturing capabilities in Africa. I first provide a brief conceptual framework for vaccine ‘manufacturing capabilities’, drawing from the Capabilities Approach as well as existing literature on manufacturing capacity. Next, I look at the implications of EU initiatives. In particular, I focus on technology transfer initiatives and state mobilization and regulation of the private sector. Finally, I assess EU actions in multilateral and bilateral trade avenues, examining whether these align with EU efforts and stated objectives in enhancing vaccine manufacturing capabilities in Africa.
European Health Union Gone Global: The Promises Of EU Health Diplomacy
Louise Bengtsson
Sieps, Sweden
The concept of health diplomacy has mainly been studied in a global context where the phenomenon is well-known and has a long history, not least in relation to the WHO (Kickbusch et al. (eds) 2013; Kickbusch & Liu 2022). The same is still not true to any great extent when it comes to the EU. However, the term appears in the EU's new 2023 Global Health Strategy and is seen by its proponents as a way to push the EU:s role internationally when it comes to health issues and the global health architecture.
Drawing on concepts in IR and European studies as well as examples from EU diplomatic initiatives in other fields such as gender and climate, this paper develops a framework to assess the steps taken so far to develop a role for the EU in health diplomacy. The material drawn on for the analysis includes key policy documents and interviews with civil servants.
State-building The Southern Neighbourhood Through EU Health Policies and Actions: Where Do We Stand?
Majd Alshoufi
University of Amsterdam, Netherlands, The
The EU’s state-building agenda in the Middle East prioritises policies and actions on security, rule of law and democracy, and economic growth. However, the EU’s health-related priorities and actions through the European Neighbourhood Policy (ENP) are also an important yet understudied driver of state-building. We assert that a functioning health system is critical to any state being able to perform its core functions, to have legitimacy, and to create a supportive environment for development and prosperity.
This scoping review aims to elucidate whether and how the EU’s health-related policies and actions in the 10 Southern Neighbourhood countries contribute to state-building and strengthening health systems in that region. The framework for analysis is the World Health Organization’s six ‘building blocks’ of functioning health systems (e.i. financing, workforce, information systems, medical products and technologies, leadership and governance, and service delivery), which we argue are important avenues of action for any EU state-building exercise. First, the European Neighbourhood Policy, bilateral action plans, and related documents since the ENP’s inception are searched for explicit health priorities and actions, which will be categorised according to the WHO building blocks. Second, scholarly literature (six academic databases) is systematically searched and the selection is refined using inclusion/exclusion criteria in line with the PRISMA-ScR guidelines. Data is extracted and synthesised according to the type (e.g. proactive systems strengthening/reactive crisis response), mechanisms, nature, and impacts of EU actions and the WHO building blocks to which they correspond. Where possible, explicit EU priorities and actions in the Southern Neighbourhood (step 1) are matched with the mechanisms and impacts reported in step 2.
Preliminary results show that the EU’s actions have had intentional and short-term impacts on certain areas of the health system (e.g. humanitarian medical products) and unintentional, normative influence on institutional decision-making (e.g. pharmaceutical regulation) in the region. An initial analysis suggests that some of these impacts arise from EU actions undertaken outside the ENP. The results of this study will elucidate the opportunities and gaps in the ENP for enhanced state-building and health systems-building through EU-Middle Eastern cooperation.
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