Managing Health Crises At the EU Level and Ensuing Policy Change: The H1N1 Case

The EU is said to have a minimal role in the field of public health with limited legal competence for collective action. More broadly, beyond health, the dynamics of change in EU governance more generally are said to be incremental rather than ‘revolutionary’. We propose to look more closely at these assumptions and assess in detail what happens at EU level in terms of institutional dynamics in public health during and after a health crisis. We look specifically at the EU handling of the influenza A H1N1 pandemic on the basis of interviews with actors across the EU institutional spectrum, policy documents and legislative proposals.

The paper shows that, contrary to expectations, the EU has in fact an extensive array of health crisis management capability for action at its disposal during pandemics. The paper points at an expanding institutional and formal role in public health for the EU, legitimized as responding to ‘health security’ demands and built up in the aftermath of major health threats, compositing around its limited legal competence in the field of public health. Health crises seem to serve as a ‘trigger’ to justify and legitimise an expansion the legal competence for the EU in the field of public health, with policy change in this sovereignty- charged area occurring in a ‘revolutionary’ rather than incremental fashion. The crisis mode seems to escalate the urgency of the problem-solving mode among the member states, leading to an expansion of EU’s role and of the legal and institutional framework for common action at the EU level, suspending traditional sovereignty objections to deeper integration.