Conference Agenda

European Union (EU) health policy has developed through a series of crises and responses (Greer, de Ruijter, and Brooks 2020). In late 2020, we sought to anticipate the direction of developments following the COVID-19 pandemic, based on the initial response and evolving political agenda of EU health policy actors (Brooks and Geyer, 2020). Informed by theories of complexity, we mapped the likely changes, concluding that the EU would be pulled into increasingly contested and uncertain areas of health policy.

Almost five years since the start of the pandemic, we have returned to these conclusions with the aim of evaluating the accuracy of our speculation, and the continued utility of a complexity perspective for EU policy. We approach this in two stages. First, we revise and update our list of major health policy initiatives (treaty base, secondary law, projects and soft law, institutions) that existed at four points in time (2000, 2010, 2020, 2025) and score these against a Complexity diagram, a simple and commonly used tool for thinking about any policy area from a Complexity perspective. Second, we use the Complexity diagram to examine the ‘zones’ of decision-making that EU health policy falls into. Finally, we explore some of the external political factors which might affect the future direction of EU health policy, including the rise of populist parties across Europe and the contrasting preferences of EU citizens and elites.

This qualitative study examines how the COVID-19 pandemic influenced competition law enforcement and policy in the European Union, focusing on the pharmaceutical sector. Through nine semi-structured interviews with senior officials from European competition authorities, legal experts in industry and academics, the study analyses the adaptation of competition law frameworks during the crisis and their lasting implications. Key findings reveal some significant and a number of minor shifts in enforcement priorities and practices, including introducing crisis-related soft laws (such as temporary frameworks and comfort letters) to facilitate necessary cooperation between companies while committing to core antitrust principles. The research identifies several main themes: the challenge of balancing emergency cooperation with long-term competition concerns, the evolution of evidence-gathering methods in a digital environment, and the complexity of pharmaceutical sector oversight during a public health crisis. The study also highlights institutional challenges (for example, in coordinating responsibilities and roles between competition authorities and health agencies). These findings suggest that while existing competition rules proved sufficiently flexible during the crisis, there is a need for more precise guidelines on crisis-period cooperation and improved interagency coordination mechanisms. By contributing to research on the role of EU competition law in the pharmaceutical sector (and focusing on the impact of a health crisis), this research offers empirical insights by suggesting a framework for future health crisis management and regulatory reform.

COVID-19 represents a make-or-break moment in European Union (EU) Health policies and, consequently, in the EU's response to health threats. The efforts developed over 40 years failed to protect the Union during the first stages of the COVID-19 Pandemic and its deadly and destructive consequences at the beginning of 2020. Even though the EU does not have full competence in health, the Union successfully moved from an identitarian and sanitary nationalist crisis to being “the pharmacy of the world” regarding vaccine production and one of the most prominent health security actors. COVID-19 offered an opportunity to learn about how International Organisations (IOs) can collectively address health threats. In this vein, the present paper aims to discuss how the collective securitisation of COVID-19 by the EU resulted in the routinisation of new practices in the health domain and how this process led to an informal integration with the capacity to change the EU health structure. Methodologically, the study follows a qualitative approach, based on discourse analysis of official speeches of the Commission and the European Council, as well as participatory inquiries engaging with communities of health to understand how new practices resulting from the COVID-19 response are shaping health within the EU structure and territory.

This paper builds on previous chapters in the forthcoming monograph, “Solidarity in European Healthcare – An EU law analysis” (Edward Elgar, anticipated 2026), which have explored how solidarity is operationalised in EU law and policy as applied to health, specifically the free movement and citizenship rules, and competition policy. It will make use of the frameworks for examining solidarity developed in a previous chapter to examine evolutions in light of COVID-19.

Specifically this paper examines the development of the European Health Union as a response to COVID-19 and what this can tell us about how solidarity at Member State and EU levels, particularly as the European Health Union evolves with the 2024-2029 Commission mandate.

It further considers how solidarity features within fiscal policy directed towards healthcare systems, notably within the European Semester mechanism introduced subsequent to the 2008/2009 economic downturn, and, in connection with COVID-19, the Recovery and Resilience Facility.

In addition, this paper will examine the development of the EU Pharmaceutical Strategy and how solidarity may be inferred in connection with this, particularly in view of the current emphasis on ‘competitiveness’ following the Draghi report, which may suggest more focus on pharmaceuticals than other aspects of health.

The COVID-19 pandemic has significantly reshaped health policy priorities, emphasizing the need for greater investment in digital infrastructure and resilience, as exemplified by the €750 billion allocated through the Next Generation EU program. A pivotal outcome has been the accelerated adoption of telemedicine, which has shown substantial potential to improve healthcare delivery. While evidence increasingly attests to telemedicine’s benefits often outweighing its costs, unresolved ethical and legal challenges demand closer regulatory scrutiny.

Key ethical concerns focus on the use of patient data, particularly regarding transparency, patient autonomy, and compliance with the General Data Protection Regulation (GDPR). In cross-border contexts, telemedicine raises critical questions about balancing innovation with the safeguarding of sensitive health data. The recently enacted AI Act adds a new layer to this discourse, emphasizing the ethical deployment of artificial intelligence tools in healthcare.

This paper examines the evolution of EU policies, from Directive 2011/24/EU on patients’ rights to cross-border healthcare to the European Health Data Space Regulation (EHDSR). It also explores the role of Article 114 TFEU as a legal basis for harmonizing laws to ensure the functioning of the internal market in health services. Special attention is given to the disparity between the successful standardization of e-prescriptions and health records and the ongoing challenges in telemedicine practices, such as remote diagnosis and treatment. The discussion concludes by exploring potential pathways for addressing these challenges.

These considerations underscore telemedicine’s transformative potential while emphasizing the urgent need for a harmonized and adaptive legal framework within the EU internal market.