Óscar Fernández, PhD, is a postdoctoral researcher at Maastricht University. He is a contributor to the Horizon Europe project "ENSURED", which focuses on how the European Union (EU) and its member states can transform global governance. His research sits primarily at the intersection between EU external action and global health governance, but also addresses other policy fields, such as security and defence.
Prior to joining Maastricht University, he was a research fellow at the Institut Barcelona d'Estudis Internacionals (IBEI), a teaching fellow at Esade, a senior researcher at the EsadeGeo Center for Global Economy and Geopolitics, and a junior researcher at the World Health Organization's Barcelona Office for Health Systems Strengthening.
In May 2024, the Saint Pierre International Security Center (SPCIS) initiated a series of interviews under the title European Security and China-Europe Relations. This initiative aims to provide a comprehensive analysis of the political, economic, and social dynamics of EU member states and other European countries, explore the evolving relationship between China and Europe. The series features leading experts from academia and industry, offering insightful analyses, diverse perspectives, and innovative ideas.
SPCIS: Has COVID-19 fundamentally changed the EU’s role in global health governance, or has it only led to short-term policy adjustments?
Óscar Fernández: The COVID-19 pandemic led both to short-term adjustments and to long-term effects. As for the former, health was briefly placed at the top of the EU’s agenda (unprecedentedly so), but priorities seem to have shifted once again. For instance, in the midterm review of the EU’s 2021-2027 Multiannual Financial Framework, the EU4Health Programme – adopted in response to COVID-19 – experienced drastic cuts. There is a clear risk that a de-prioritisation of health will continue and eventually result in another pandemic catching us unprepared.
That said, it would be unfair to disregard some significant institutional advances that will be a legacy of the pandemic. These include the creation of a new European Commission Directorate-General on Health Emergency Preparedness and Response, as well as the strengthened mandates of the European Medicines Agency and the European Centre for Disease Prevention and Control. Furthermore, the EU’s strategy to address the economic fallout from COVID-19 differed significantly from the austerity measures implemented after the 2008 financial crisis. This time around, the EU broke taboos (e.g. joint borrowing) and adopted an ambitious, expansive recovery package (NextGenerationEU). This precedent is important as the EU grapples with other crises – chief among them, Russia’s aggression on Ukraine and the new transatlantic rift induced by President Trump, which have underscored the need to bolster the EU’s security and defence capabilities.
In global health governance, the EU emerged as a strong supporter of the World Health Organization during COVID-19 and will undoubtedly remain so, especially now that President Trump has revived his plans to withdraw the US from the organisation. However, when it comes to underpinning the WHO’s centrality within a highly fragmented global health landscape, the EU’s position is more ambiguous. The Union also faces challenges in terms of establishing cohesive positions across the entire spectrum of organisations with a global health impact, which also include the World Trade Organization, the World Intellectual Property Organization and many others. Forthcoming research for the ENSURED project will address some of these challenges.
SPCIS: Did the EU lack the capacity for public health governance—both internally and externally—before the pandemic, and did it gain greater capacity for collective action in internal and global public health governance during the crisis? If so, how did the EU justify/legitimize this shift/transfer in capacity?
Óscar Fernández: The treaty foundations of the EU’s health policy are rather weak, as it is mostly an area of supportive competence. In other words, legally speaking, health policy remains almost exclusively in the hands of member states. This is true in practice too, but with a few caveats. Before COVID-19, some forms of health integration had already taken place, mostly by leveraging other policy areas where the EU does have more tools at its disposal, such as trade and climate change. Once the pandemic hit, health integration accelerated, through both formal and informal channels. The European Commission, led by Ursula von der Leyen, negotiated the procurement of vaccines and personal protective equipment on behalf of the entire EU. This was presented as an exceptional response to exceptional circumstances, which called for avoiding past stockpiling races among EU member states.
My research shows that the European Commission and its president resorted to framing health policy in security terms – that is, to a “securitisation” of health – in order to justify this authority transfer and other collective measures, building on previous practices during health crises. This security framing, which also permeated the EU’s 2022 Global Health Strategy, seemed to resonate rather well with member state governments and the wider public, as other researchers also suggest. While securitisation can draw resources to health policy and legitimise supranational action at home and abroad, it does not come without risks. For example, it could lead the EU to become more inward-looking and shift attention away from health issues that are not perceived as immediate security threats. To be sure, the EU’s “health security” rhetoric waned as the pandemic subsided, but COVID-19 is likely to leave behind a heightened baseline of securitisation, for better or worse.
SPCIS: You mention that the EU still faces multilateral coordination challenges in global health governance. How do you think the EU can enhance its influence in this field?
Óscar Fernández: The EU treaties explicitly and repeatedly call for health mainstreaming, but that normative goal has struggled to gain any practical traction. According to Article 168 of the Treaty on the Functioning of the European Union, “a high level of human health protection shall be ensured in the definition and implementation of all Union policies and activities”. COVID-19 offered a policy window to turn this aspiration into reality, but it was less fruitful than it could have been. The EU’s 2022 Strategic Compass, for example, features less health-related content than all the key EU security documents released prior to the pandemic. This signals that a mindset shift is yet to occur, with health still being largely regarded as a second- or third-order priority. Since the best avenue for the EU to play a more positive role in global health governance is to genuinely pursue “Health in All Policies” – a long-established EU motto that the recent Global Health Strategy re-emphasised – this finding is not very promising.
My ongoing research for the ENSURED project similarly shows that contradictions abound in the EU’s external action. For example, while the EU has committed to ensuring a more equitable access to vaccines and other medical countermeasures (a guiding principle of the Global Health Strategy), the EU’s agenda at the World Trade Organization and the terms of its preferential trade deals often undermine this goal. It is important to recognise that the EU’s market size makes it a key global health actor almost by default, and sometimes even in spite of itself. What it chooses to do with this influence will inevitably shape external perceptions – particularly in the Global South, where views on the EU’s global health impact are currently lukewarm at best.
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