key: cord-306583-ttz6oszw
authors: Jordana, Jacint; Triviño-Salazar, Juan Carlos
title: Where are the ECDC and the EU-wide responses in the COVID-19 pandemic?
date: 2020-05-13
journal: Lancet
DOI: 10.1016/s0140-6736(20)31132-6
sha: 
doc_id: 306583
cord_uid: ttz6oszw

nan

As the EU continues to face the COVID-19 pandemic, an unprecedented transboundary crisis, its member states resort to measures within the boundaries of the nation state. This situation questions the capacity of the EU to deploy public health instruments to cope with pandemics. One such instrument, the European Centre for Disease Control (ECDC), seems to show a discreet involvement in this crisis, suggesting emerging isolationist behaviours of the member states.

The ECDC was established in 2004 with a mandate that aimed to "identify, assess and communicate current and emerging threats to human health from communicable diseases". 1 However, such a mandate was not complemented with enough resources to help the ECDC become a European knowledge hub in communicable diseases. To put this into perspective, the US Centers for Disease Control and Prevention (CDC) have legal powers and cover a greater range of public health areas through bodies such as the National Institute for Occupational Safety and Health or the National Center for Health Statistics. The CDC also has a much larger budget than the ECDC (approximately US$8 billion for 2020, 2 whereas the ECDC received €60 million 3 ) and staff (10 796 employees in 2018, 4 whereas the ECDC employed 271 people that year 5 ).

The ECDC was established within a context that involved inconsistent national laws on pandemic planning across the EU member states, which already had their own institutes and agencies of public health. 6 In fact, it has been noted that the protectiveness of member states concerning their national privileges sometimes blocks agreement on practical and collective measures. 7 In our research on the role of EU agencies in crisis episodes, we described how the low cooperation in public health issues within Europe severely hampered the involvement of the ECDC in the European response to the 2014 Ebola outbreak. 8 Although the massive dimensions of the current crisis are not comparable to the 2014 Ebola outbreak, the restrictive political mechanism at play previously shows what might be standing in the way of a coherent response to the COVID-19 pandemic.

In January, 2020, the member states did not see the need for the EU to coordinate their responses, as they tended to underestimate the impact of the pandemic and the resources needed. However, the pandemic intensified within a very short period and became a large threat for the entire European population. Such a quick escalation became an obstacle to coordination at the EU level-a scenario where the ECDC could have been called to have a more active role, on behalf of the European Commission and the member states. The lack of coordination at the EU level became even more evident when national leaders sought to legitimise their decisions by giving voice to national experts, in the absence of multinational meta-analytical infrastructure or supranational coor dination mechanisms, or even coherent systems for sharing procedures and protocols. The European Commission advisory panel on COVID-19 was set up by the EU member states as late as March 16, 2020. 9 From a policy perspective, a European public health response to the COVID-19 pandemic was not possible because emergency structures had not been set up. Neither was it perceived to be a public good, not even when it spread across European countries. For instance, the creation of a strategic EU medical stockpile was approved by the Commission in March, 2019. 10 However, it was only implemented after WHO declared the outbreak a global pandemic on March 11, 2020, and several member states had difficulties in purchasing medical equipment. 11 We have found that only when key actors in the EU polity agree on a common response that is less politically costly than disagreement can European-wide public health mechanisms such as the ECDC adopt a more active role. However, for this situation to occur, institutions need enough time to frame coordinated responses and a political leadership capable of going beyond national responses and confronting such global challenges in a more effective way.

We declare no competing interests.

Regulation (EC) no 851/2004 of the European Parliament and of the Council of 21

Budget statement of revenue and expenditure of the European Centre for Disease Prevention and Control for the financial year 2020 (2020/C 107/05)

The role of networks in the European Union public health experience

EU agencies' involvement in transboundary crisis response: supporting efforts or leading coordination?

Commission Decision of 16.3.2020 setting up the Commission's advisory panel on COVID-19

Commission Implementing Decision (EU) 2020/414 of 19 March 2020 amending Implementing Decision (EU) 2019/570 as regards medical stockpiling rescEU capacities

COVID-19: Commission creates first ever rescEU stockpile of medical equipment