Health ranks among the top priorities of European citizens according to recent Eurobarometer surveys[1]. Two new reports published today show how the EU has responded to the need and demand for more resilient, robust and equitable health systems, which are better prepared for potential crises. Both documents also spotlight areas in which more work is needed. Four years after COVID-19 cases were first detected, many of the solutions brought forward to respond more effectively to the pandemic have been enshrined into EU legislation. The aim has been to strengthen our collective preparedness against health crises, as part of a strong European Health Union. The 2023 State of Health Preparedness report focuses on the steps taken by the EU to improve its capacity to face serious cross-border health threats.

The State of Health in the EU: Synthesis report 2023 examines how health systems are performing across the Union in meeting the needs of European citizens. It includes dedicated Country Health Profiles, where particular attention is given to the mental health impact of COVID-19 and reforms carried out by Member States to address this growing challenge. For the chapter on Ireland in EU report see page 39.

A better prepared European Health Union

The purpose of the yearly State of Health Preparedness Report is to map EU actions taken since the pandemic to address cross-border health threats. The Regulation on serious cross-border threats to health, in force for almost one year, is the backbone of the EU's health security architecture. It has created a solid basis for more effective preparedness and a coordinated response to cross-border health risks. It will allow Member States to quickly react to future crises.

Structures like the EU Health Security Committee have been upgraded, EU laboratory capacities are being enhanced and EU funding of nearly €100 million from the EU4Health programme is being channelled to Member States, to improve their national surveillance systems. Member States continue to coordinate closely within the Health Security Committee, which has issued an Opinion on preparing COVID-19 and other respiratory diseases for winter 2023/24. This report notes that vaccination continues to be key to preventing the spread of infectious diseases. During the COVID-19 pandemic, the EU Vaccines Strategy supported the development of vaccines and ensured their availability to all Member States as well as to third countries, saving tens of millions of lives globally. However, equally important is routine life-long vaccination and this should be implemented according to the existing vaccination schedules.

In terms of the most pressing health threats, the Preparedness Report sheds light on the issue of antimicrobial resistance (AMR), which causes over 35,000 deaths a year in Europe, and needs urgent action. Threats from animal diseases and the rising health impacts of climate change are two other major challenges highlighted in the report, stressing the importance of taking a ‘One Health' approach to tackling current and future health threats. The EU continues to be actively engaged in the ongoing negotiations for the adoption of an international agreement on pandemic prevention, preparedness and response (the “Pandemic Agreement”). It is also committed to strengthening International Health Regulations.

The mental health disorders reported in the Country Health Profiles range from depression to anxiety, bipolar disorders, schizophrenia, alcohol, and drug-use disorders. schizophrenia, alcohol, and drug-use disorders. In ireland Behavioural risk factors are a major driver of mortality in Ireland In 2019, over 35% of all deaths in Ireland were attributed to behavioural risk factors, including tobacco smoking, dietary risks, alcohol consumption, and low physical activity (Figure 7 of Irish report). Tobacco smoking accounted for about 20% of all deaths, higher than the EU average of 17%, while dietary risks were estimated to contribute to about 13 % of all deaths, which was lower than the EU average. Alcohol consumption was linked to approximately 5% of all deaths, and low physical activity was related to about 3%. Among the various mental disorders, anxiety disorders were the most prevalent, affecting approximately 7.6% of the population, followed by depressive disorders at 5% and alcohol and drug-use disorders at 4.7% (Figure 28 of Irish report).

A strong commitment to improving mental health in our Union

The State of Health in the EU report, accompanied by 29 Country Health Profiles, looks at how health systems across the Union are performing, and highlights three key findings that need to be addressed in the aftermath of the COVID-19 pandemic:

• Mental health of EU citizens deteriorated following the pandemic. Therefore, mental health reforms that cover de-stigmatisation, prevention, treatment and reintegration are needed across all Member States. At EU level, the Commission adopted a comprehensive approach to mental health in June 2023, consisting of 20 flagship initiatives and backed by €1.23 billion in funding.
• The State of Health report stresses the need to address growing health inequalities across the Union, as well as increasing unmet medical needs. The COVID-19 pandemic led to a widening of the gap in life expectancy at birth between 2019 and 2021 across Member States. However, life expectancy estimates from 2022 show a narrowing of the gap. In this respect, cancer is highlighted as a key priority area to address. The Commission has already taken a number of important steps in this regard, including a number of important initiatives under Europe's Beating Cancer Plan.
• The report also highlights the importance of continued investment in health, to prepare for potential future crises. One particularly important area is the continued need for comparable and valid health data, which is key for informed policy making and effective health innovations. The European Health Data Space, proposed by the Commission in May 2022, will help to unleash the full potential of health data and empower EU citizens through better digital access and control of their health information.