How the EU vaccine troubles could have partially been prevented ten years ago

Abstract

Political failure that harks back to swine flu The political troubles for the EU over the delayed roll out of vaccines across the European continent are far from over. Yet, the current story was foretold with the EU handling of the Swine Flu outbreak in 2009 and everything that did not happen afterwards. At the time, some Member States, particularly also the UK, hoarded vaccines, which caused a panicked EU response [1]. In the beginning, this left some eastern European Countries with no vaccines and other countries with less. Due to this lack of EU coordination and solidarity among the Member States, many of them paid too much for vaccines they ended up not need. To ameliorate these failures, the EU created an ad-hoc and voluntary system for vaccine distribution, so that Member States could offload Swine Flu vaccines that were bought in excess [2]. After the Swine flu outbreak, the EU floated the idea of more power and capacity to jointly procure vaccines in cases of health emergencies to the Member States. Not only for a voluntary system, but a system where they could have had the centralized power to determine roll out schedules based on medical need. But the Member States only wanted to agree to a voluntary system [3], where they themselves in the end would have the final say over the number of vaccines to purchase and the actual funding to contribute. The explanation for this is that health is a classical welfare state issue, and to centralize powers in this area in the EU, would diminish the power of the Member States in an area where national elections can be lost or won. However, if Member States would have centralized purchasing and operationalized a stronger role for the EU in case of a pandemic at the time, it would have allowed the EU to build up capacity and centralize funding and know-how, so that it would have been better equipped to quickly negotiate advance purchase agreements for COVID19 vaccines. But none of that happened. Now we are in a situation where the EU has had to do everything on the fly. This has meant that when the COVID-19 pandemic hit the EU, its Member States still had to agree on new legislation that would allow the EU to centrally organize the joint procurement and distribution of vaccines. More importantly, the funding was not in place, and the conditions under which funding would be available for the EU to purchase vaccines was not established. This meant that all the negotiating and politicking that is needed to get 27 Member States in line to entrust the EU with billions of euros, had to be done in a manner of months. Furthermore, the EU had to operationalize the roll out, keep track of exports and ensure its communication and messaging was ironclad. Currently the EU's handling of the vaccine procurement and roll out is critiqued [4], with good reason: Some of manufacturers are not delivering with the promised speed, and the EU has had little control over where the vaccines that they ordered were shipped to. The EU is making one panicked mistake after the other, heeding the debate on a need for a ‘return to nationalism’, just after the unified dealing with the Brexit had left the EU in a more united state [5]. Yet the current problems are caused by precisely this reflex for a return to nationalism and ‘go at it alone’ mentality that we witnessed in the Swine Flu outbreak. The failures we are now witnessing could have, at least to some extent, been prevented. Swine Flu should have been a better lesson for the EU Member States: if you want the EU to be better prepared for a major health emergency, you have do it – and get it – together, before the crisis strikes. Declaration of Competing Interests Dr. de Ruijter has nothing to disclose.