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What role for the European Centre for Disease Control? Global Governance and the Missing Role of the EU in the COVID-19 Pandemic

08 April 2020
Jacint Jordana and Juan Carlos Triviño-Salazar

Article published in the blog of the European project GLOBE on April 8, 2020

As the EU faces the COVID-19 outbreak, an unprecedented transboundary crisis, its Member States resort to recipes within the boundaries of the nation-state. This situation questions the capacity of the EU to coordinate the Member States effectively in the aftermath of a large health crisis and to deploy instruments in the field of public health that contribute to coping with pandemics. One of such instruments, the European Centre for Disease Control (ECDC), seems to be publicly absent from media debates despite its aim to provide updated risk assessments and recommendations to support the decisions taken by the leaders of member states, or even those of the EU. The seemingly discreet involvement of the ECDC in this crisis appears to be indicative of a lack of political coherence in the response across Europe and reveals emerging isolationist behaviours of the Member States. However, we believe that we have not arrived at this situation by chance: indeed, different factors have contributed to the timid role of the centre during this outbreak so far.  

The ECDC was born in 2004 with an informative mandate that aimed to “identify, assess and communicate current and emerging threats to human health from communicable diseases” (Regulation (EC) No. 851/2004). However, such a mandate limited the potential role of the ECDC, as it did not grant the centre relevant capacities to support the Member States, nor enough resources to help it become a European knowledge hub in communicable diseases. To put this in perspective, the US Center for Disease Control (CDC) has legal powers and a workforce of nearly 10.000 employees[1], whereas the ECDC lacks such powers and only employs 267 individuals[2]. In this sense, while the World Health Organization (WHO) has been quite visible at the international level as an authoritative voice on the COVID-19 pandemic —despite its small operational capacities—,the ECDC has lacked a significant voice in Europe for the time being. Actually, up to now the ECDC seems to face difficulties to become an effective public mediator between global international organizations —as the WHO— and European country governments throughout the crisis. These difficulties make it more complicated for the ECDC to build consensus across the continent by offering coherent and reliable information, technical advice on best practices as well as scientific opinions.

The centre was established within a context that included a fragmented European public health sector with uneven and inconsistent national laws on pandemic planning across the EU Member States[3]. This scenario complicates harmonization among key actors (namely, the Commission and the Member States) in the field of communicable diseases, given the impossibility to offer neither multinational metanalytical infrastructure nor supranational coordination mechanisms in response to transboundary threats or even coherent systems for sharing procedures and protocols. In fact, it has been noted that the protectiveness of Member States concerning their national privileges sometimes blocks agreement on practical and collective measures.[4]

Is there an explanation for this situation, beyond broad claims about the failure of the European project? In our research on the role of EU agencies during crisis episodes[5], we uncovered how the low cooperation among key actors when it comes to public health issues in Europe severely hampered the involvement of the ECDC in the European response to the 2014 Ebola outbreak in Sub-Saharan Africa, notwithstanding the technical capacities that it could provide. This situation only changed when infected EU citizens were repatriated, a nurse in a Madrid hospital got infected, and European countries committed to answering an urgent request by the WHO and the CDC to participate in an international mission in the heart of the epidemic: due to its expertise in infectious diseases, the ECDC emerged as the entity that could satisfy such a request despite lacking the formal competences to do so. Thus, the centre rapidly developed coordination and operational capacities that allowed it to fulfil its scientific role on the ground. In this situation, the political compromise between the Commission and the Member States to offer a unified response to the outbreak opened the scope for the centre to become part of the international mission in Africa. Although the massive dimensions of the current crisis are not comparable to the impact of the Ebola outbreak on Europe, the political mechanisms at play back then help us see how an agreement among key actors leads to a coherent European response.

This time the ECDC did not have such a window of opportunity. Initially, the Member States considered that any public health organisation, even at the subnational level, could deal with a disease that had limited infectiousness and a low mortality rate. In other words, they did not see the need for European-wide action. Then, in a very short period, the pandemic escalated sharply in Europe —although not simultaneously in every Member State— and emerged as a large threat for the entire population. Such a singular sequence, and the non-lineal transformation of the situation in a very short period of time, prevented a natural escalation of the problem to the EU level —where the ECDC could have been called to play a role. Quick action was needed, and the Member States chose in a context of high uncertainty to cope with the pandemic on their own, often without adequate policy tools.

As opposed to the high politicisation of intrinsically salient issues in the European agenda such as immigration, public health in Europe has traditionally been dominated by technical debates on how to better respond to transboundary threats —as past experiences such as the mad cow crisis, the 2011 E. coli outbreak or the 2014 Ebola outbreak have shown. Thus, the initially low politicisation and local impact of the COVID-19 crisis prevented a Europe-wide political discussion that could facilitate greater involvement of the ECDC. In this context, the WHO was the institution that provided national decision-makers with a global view on the pandemic.

When the escalation of the outbreak led the most affected Member States to start politicising the crisis response, short-term political tensions and immediate needs prevented a wider European collaboration from happening. This issue became even more evident when national leaders sought to legitimise their decisions before their citizens by giving voice to national experts, in the absence of an European-wide scientific integrated instances. From a policy perspective, a European common response to the COVID-19 was not perceived to be a public good when the pandemic reached the continent, not even when it began to spread around Europe. This situation hindered coordinated action at the EU level. At the time of writing these lines, the European Commission prepares the launch of a wide action framed as a European public good; this action is centred around an economic response to the consequences of the outbreak. As for public health, such a response relegated it to a secondary role.

The lessons from the Ebola outbreak teach us that only when key actors in the EU polity deem agreement on a common response less politically costly than disagreement can European-wide mechanisms in public health such as the ECDC adopt a prominent role. This might be the case in the coming weeks, when hard policy choices will be required as to how to deal with the pandemic after its peak is over. Against this backdrop, global transboundary crises such as the COVID-19 place transnational and European-wide actors in a better position to coordinate responses to transboundary and global threats. However, for this situation to occur, institutions need enough time to frame coordinated responses to crises as less politically costly than individual action. In this scenario, the construction of resilient and transnational technical instruments that grant a prominent role to European entities such as the ECDC require political leaderships capable of going beyond national responses in order to confront such global challenges in a more effective way.

 


[1] See www.cdc.gov
[2] See 2018 Annual Report from the Director, p.3
[3] See Jacobson, P. (2012). ‘The Role of Networks in the European Union Public Health Experience’. Journal of Health Politics, Policy and Law, 37, 1049–1055.
[4] See Rhinard, M. (2009). “European Cooperation on Future Crises: Toward a Public Good?” Review of Policy Research, 26, 439–455
[5] See Jordana, J., and Triviño‐Salazar, J.C. (2020). "EU Agencies' Involvement in Transboundary Crisis Response: Supporting Efforts or Leading Coordination?" Public Administration. DOI: 10.1111/padm.12652