1st May 2004 represents a both historical and symbolic landmark in the process of European integration.
Initiated more than 50 years ago, the concept of the European Union now includes some of the countries that once belonged to the former Communist block.
While undoubtedly a milestone in the ‘ever wider and closer’ European experiment, this new enlargement also raises a whole range of serious challenges particularly in terms of health and health policies.
Importance of Enlargement
In terms of scale: the addition of 10 new countries will create the world’s largest economic and political bloc and the EU population will grow by almost 30 %.
Geographically the centre of gravity of Europe will shift Eastward and the new neighbours include Russia, Ukraine, Moldova and Belarus.
In terms of the diversity of the new Member States, some of which have much lower levels of development and Gross Domestic Product (GDP) than the EU-15.
The new Member States bring a number of key public health challenges including HIV/AIDS and communicable diseases as well as overall lower life expectancies.
These East-West health gaps must be a priority for EU policy-makers. However, for health advocates in addition to the challenges faced, enlargement may represent a major political opportunity.
The priority to improve population health from the new Member States may finally tip the balance in the Council and result in a consensus to put health into the heart of EU policies and programmes.
Specifically, during the accession process, the new Member States developed a clear understanding of the impact on their healthcare services of EU legislation on pharmaceuticals, medical devices based on the internal market. The new draft Directive on Services is set to further liberalise service provision throughout Europe.
Re-drafting the EU Treaty
New Member States could be instrumental in developing a stronger health competence for the Union covering both public health and the broad determinants of health as well as healthcare services where the need for increased cooperation has become a key European focus.
If the dynamics of the internal market, EU legislative and budgetary mechanisms can be harnessed to contribute towards health rather than undermining health promotion efforts and healthcare services, then the EU will finally have met it’s Treaty commitment to ensure that all policies contribute to a high level of health protection.
Strengthening the EU role in health, a subject that successive Eurobarometer surveys shows is close to the heart of most Europeans, could also be a tool for bringing the EU closer to citizens. This critical step must be taken for the new Treaty to avoid rejection in the many referenda planned across Europe.
EPHA’s members are committed to the goal of increasing the interest and involvement of citizens in decision-making in Brussels, because it has direct relevance for their lives.
We look forward to continuing our advocacy efforts in an enlarged Europe and in working closely with our members and partners in the new Member States.
