SPRINGTIME

It is Springtime. The days are getting longer, the weather is getting warmer, mimosa flowers cover the stems, little birds sing their love songs, and politicians sign declarations.

March 25 was a splendid Spring day in Rome and the Leaders of 27 Member States and of EU institutions - convened to celebrate the 60th anniversary of the Treaty of Rome – enjoyed their staying in the eternal city. Even street demonstrations were infected with joy. Instead of livid anti-European protesters, streets were invaded by a jubilant crowd of pan-European supporters.  Could you ever imagine a better scenario to sign a declaration? “The European Union may be a Franco-German construction, - wrote The Economist - but when the project needs a dose of grandiosity it invariably turns to Italy”.

The 2017 Rome Declaration was  eagerly awaited  by most  political commentators, being the first solemn declaration, involving all EU Member States and institutions,  after the Brexit, and after Angela Merkel's statement concerning the two-speed Europe.  The Declaration was prepared by a White Paper on the Future of Europe, and accompanied by a series of parallel initiatives, including a booklet on EU’s past achievements, a dedicated website, various audiovisual products,  60 video testimonials from people across Europe, a GIF competition, and some other activities (even including a European origami).

The Declaration starts by recalling European values and emphasizing the 60 years of peace guaranteed to countries whose main activity was for centuries battling one other (admittedly, not the best argument to advertise “European values”).  Together with peace, the EU has also guaranteed – continues the Declaration –economic growth, democracy, civil and social rights for all. The EU now is “facing unprecedented challenges, both global and domestic”, and the second part of the Declaration is dedicated to a vision of the future. The 27 Leaders commit themselves to work towards, 1) A safe and secure Europe, which includes prevention of crime and terrorism, control on migration flows; 2) A prosperous and sustainable Europe,  which includes growth and jobs, technology innovation, economic convergence, clean and safe environment;  3) A social Europe, which includes  equality between women and men, equal opportunities for all, fight against  unemployment, discrimination, social exclusion and poverty, preservation and promotion of the cultural heritage; and 4) A stronger Europe on the global scene, which includes promoting stability and prosperity everywhere, supporting  European defense industry, collaborating with the NATO, promoting multi-lateralism and a positive global climate policy (too bad, Mr. Trump). Brief, nothing’s missing, but health. “Health” is not mentioned in the Rome Declaration and it has not been included - even implicitly – in the 27 Leaders’ agenda.  This omission is confirmed by other documents produced by the EU for the 60th of the Treaty of Rome. For instance, the booklet on EU’s past achievements – the sole document in which there is a vague reference to health issues – considers them under the wider topic of citizens’ wellbeing, never mentioning health explicitly.  Yet in his first speech on the State of Union, in 2015, Jean-Claude Juncker listed  public health among EU priorities, but that reference completely disappeared in his 2016 speech. Why?

The key for understanding this omission  is in the  White Paper on the Future of Europe,  which describes five possible future scenarios for the EU. The fourth scenario, called “Doing Less, More Efficiently” (the scenario the EU is now going towards, unless the trend is inverted) describes a future in which “the EU27 stops acting or does less in domains where it is perceived as having more limited added value”.  “Public health” is the first domain to be mentioned among non-strategic policy areas to be delegated to national authorities.

Yet, this is not a future scenario, unfortunately it is the present situation. In Europe, there are  as many vaccination policies as Member States and almost no Member State has the same vaccination scheme of another Member State. Even the same words mean different things, in some EU countries the label “mandatory” does not entail any penalty for non-compliance, in other Member States this label implies administrative sanctions (e.g., fines, prohibition to attend school, etc.), in others it could even imply criminal penalties. “Moreover, the enforcement varies in practice. It is possible that in some cases penalties are only theoretical and never applied”. No surprise, then, if a world-wide survey carried out in 2016 shows that Europe has the lowest confidence in vaccine safety. The contradictory message conveyed by EU Member State policies is not certainly made for reassuring their citizens.

National policies to prevent and contain outbreaks were tenable when most Europeans did not cross, or crossed very rarely, their national borders. Today Europeans make over 1.25 billion journeys within the Schengen area every year, 6.5 million of them are currently working in another EU Member State, and more than 9 million students have been participating in the Erasmus Programme. Epidemiologically speaking, there are no longer “national communities” in Europe, but there is a unique community of people, who share germs and infections, and whose health statuses are unavoidably linked.

“Our Union is undivided and indivisible”, solemnly claims the Rome Declaration, adding “we will act together, at different paces and intensity where necessary”. This sounds reasonable in many policy areas, except in public health. A two-speed Europe is perhaps a realistic solution to address economic and political problems;  it is, however, a complete nonsense, when speaking of contagious diseases.