What is the future of DG SANTE?

Debates in the EU Ecosystem on the status of DG SANTE

In the last months several rumors have arisen affirming that DG SANTE, the Directorate General for Health and Food Safety which is responsible for health and food safety policy, and the Commissioner for Health may disappear after the election of the new Commission, following the European Elections in May 2019.

The buzz started after the publication of the White paper on the future of Europe in 2017. The idea behind the document was to open the debate about the path that the European Union should follow in the coming years, and to identify challenges and opportunities. In order to do so, the White paper proposes five possible scenarios. In its fourth scenario “Doing less more efficiently”, it states that, in order to focus on certain policies, “conversely, the EU27 stops acting or does less in domains where it is perceived as having more limited added value, or as being unable to deliver on promises” such as “public health”.

From that moment on many people understood that health was no longer a priority in the European Union and that DG SANTE’s competences might be redistributed among other Directorates. Moreover, this year the European Commission presented some proposals for the direction of the Multiannual Financial Framework (MFF), which is the EU budget for 2021-2027, including a reduction of 8 percent of the Health strand in the European Social Fund+. This event fueled the worries about the future of health policy in Europe in the so-called “Eurobubble”.

Nonetheless, many relevant EU stakeholders have expressed a more nuanced opinion on the matter. Former Director General for Health and Food Safety, Xavier Prats Monné, said that the White Paper just opens the reflection about the future of Europe and that it does not mention any concrete proposal on health. Likewise, the EU Commissioner for Health, Vytenis Andriukatis rejected them last May, declaring that several initiatives related to health have been collected in the MFF and that they are expected to be developed.

The key issue is that there actually is a debate on the role of DG SANTE in the EU Institutions. Some consider that most of EU health activities fit better and can be reallocated in other areas and that its role within the European policies is restricted since many health competences belong to Member States. Moreover, in many cases, Member States are not willing to transfer that portion of their sovereignty related to public health to the EU. Others consider that it is essential to have Health as a sole issue on the EU agenda, since its actions cover relevant cross-border issues that would be difficult to tackle separately – such as the European Reference Networks for rare diseases and their financing, sharing information about health technologies, public health challenges like tobacco or major health threats like epidemics. In fact, as Politico pointed out recently “Nearly 70 percent of voters want the EU to intervene more when it comes to their health care”.

Finally, it should be noticed that Europe is facing big health challenges that need to be addressed as efficiently as possible, such as the increase in chronic diseases, ageing of the population, disease prevention or rare diseases cooperation. The latter is especially relevant as, considering the low incidence of rare diseases per state, cooperation can provide additional benefits to tackle the existing challenges in the field. Some consider the only way to do this is through means of an EU where health is a priority and with shared policy lines. It is the moment for all the involved stakeholders to show the relevance of Health in the EU Agenda and develop a future of Europe which can guarantee the Quality of Life of its citizens.


Lucía Sánchez Pérez