This paper builds on previous chapters in Guy’s forthcoming monograph, Solidarity in European Healthcare – a law analysis (Edward Elgar, anticipated 2027), exploring how solidarity is operationalised in EU free movement, citizenship, and competition law and policy as it applies to national healthcare systems. This paper examines the extent to which solidarity can be located in healthcare financing arrangements in light of the need to rethink the European social contract (Auer 2025), and how EU law may shape these given the reservation of healthcare system organisation as a national competence under Article 168(7) TFEU. Particular attention is paid to two discrete aspects of healthcare financing. Firstly, the role of private health insurance within solidarity-based national healthcare systems, and the relevance and influence of EU law (notably competition law and the insurance directives) (Nikolić 2020 and Bénoît et al.2021) as distinct from national law. By examining relevant legal provisions and case law, the extent to which solidarity is manifest is examined. Secondly, the extent to which solidarity may be identified within EU fiscal policy as it relates to national healthcare systems. Here, the experience of the post-2008 economic crisis and the associated fiscal control mechanisms are considered in light of the differentiated effects on national healthcare systems when defined in terms of predominantly economic considerations such as membership of the Eurozone and level of indebtedness. These are juxtaposed with the national projects supported by the post-Covid-19 Recovery and Resilience Facility, where wider considerations come into play, including the EU’s green agenda.

Despite international recognition of health as a human right, forced migrants – both with and without protection status – face persistent barriers to healthcare in host states. These barriers stem predominantly from restrictive, fragmentary or vague legal entitlements that are typically regulated within the domain of migration rather than health policy. This article develops a multi-level analytical framework to trace how international and EU law, national legislation, and subnational implementation interact to shape healthcare entitlements of forced migrants. It then applies this framework to Swedish legislation in this area since the 2015 migration administration crisis. Sweden serves as a key case: reversing the country’s traditionally inclusive asylum policy, governing coalitions of different compositions have pursued similarly restrictive courses under pressure from the far-right Sweden Democrats and in response to various crises, all while seeking to uphold Sweden’s obligations under supra- and international law. Drawing on a framing-focussed qualitative content analysis of ca. 20 legislative acts and draft bills (2015–2025), the study examines how governments attributed responsibility and justified changes in healthcare access by invoking constraints and opportunities across governance levels. The analysis shows how health as a policy domain is depoliticised in the case of forced migrants’ health rights, whereas their pursuit of wellbeing is politicised against the backdrop of growing global migratory movements, far-right political pressure, and crisis politics.

The present research addresses the question to what extent the EU’s collective securitisation of COVID-19 drove the integration of EU responses to the pandemic in the health domain between 2020 and 2025. In this regard, the research covers two key issues in terms of empirical and theoretical research: first, how the Union constructed the pandemic as an exceptional threat not only to EU citizens but also to EU values and structure; second, to what extent measures created to address the pandemic have become routinised within the organisational structure. To accomplish this, the project starts by outlining the status quo that preceded the COVID-19 pandemic. Secondly, the research focuses on EU official speeches to understand how the EU collectively securitised COVID-19 while constructing itself as a global health security actor in a domain where it traditionally has shared competence. Third, the research concludes by analysing how practices resulting from the EU’s response have become routinised within the EU structure. In this last step, the research argues for a clearer explanation of how routinisation occurs and is implemented. Therefore, learning theory is used to support the analysis of routinisation, using concepts such as communication, advocacy, training, and coding to map and depict how measures emerged and have been transformed since the outbreak. Methodologically, the research is guided by an interpretive approach, applying expert interviews and document analysis to collect the data and a discourse and practice approach to analyse it.

This article analyses the process of the European Commission’s proposal of an EU Critical Medicines Act (CMA). The CMA aims to address shortages of pharmaceuticals in the EU, especially medicines classified as ‘critical’, by addressing supply chain vulnerabilities and reducing dependency for raw materials. Publishing a CMA proposal was presented by Commissioner Várhelyi as a priority action to be accomplished within the first 100 days of his mandate. It was published in March 2025, following a sped-up process which bypassed the normally expected impact assessment and included a considerably shortened stakeholder consultation. Expanding and building on our recently published commentary, this article presents a combination of process tracing and discourse analysis to investigate and identify how the connection between language of security and temporality was used to justify this fast-tracking. Our findings suggest a conflation between invoking immediate urgency to justify bypassing Better Regulation processes, with aiming to institutionalise fast-tracking marketing authorisation in the long term. This conflation, we argue, blurs the boundaries between crisis and non-crisis governance, underscoring the constructed nature of the concept of crisis. We interpret the implications of the CMA process in light of the increasing securitisation of health and the broader ‘crisisification’ of EU governance. We argue that, while shortages of medicines is a very important policy issue, and that the fast-changing geopolitical context may dramatically affect availability of medicines, the institutionalisation of crisis-like governance in the EU in this area also comes with considerable long-term dangers both to its (perceived) effectiveness and legitimacy.

The EU increasingly uses legal and policy measures to promote the development and marketing of innovative health biotechnology, from research funding to market incentives (e.g. supplementary protection certificates). The proposed Biotechnology Act, which acknowledges “the EU’s potential to be a global leader” in this field, would further support the sector through measures including access to funding for development, market protection measures, AI as an enabler, streamlined regulatory measures, and biodefence and health security. The measures are likely to shape the protection and promotion of human health and access to health biotechnologies within and beyond the EU. Yet, similar to other policy reforms and novel EU legislation (e.g. proposed Critical Medicines Act), the Biotechnology Act is being developed without a clear normative assessment of how it would affect patients’ access to medicines outside the Union. This paper evaluates to what extent the proposed Biotechnology Act can satisfy the EU’s legal responsibilities regarding access to biotechnology health products extraterritorially in a global health context. First, it maps the proposed measures onto the EU’s established competences (i.e. health, competition, industrial policy) to clarify how these competences delimit the EU’s extraterritorial responsibilities. Second, it examines which of the proposed measures trigger EU legal responsibilities, for example through effective control, causal influence, or foreseeable effects. This paper explores which responsibilities are triggered and what they imply for EU action with regards to biotechnology.