The pandemic marked a turning point in European health policy. For a time, protecting health was at the heart of the European Union’s political agenda, shaping priorities, mobilising resources and speeding up decisions that had previously seemed hard to achieve. It showed that, when there is political will, common solutions can be found even to challenges long seen as insurmountable.
The EU’s subsequent focus on preparedness reflects a key lesson from that experience: future crises must be tackled through solid structures, established procedures and capacities built in advance, rather than through responses devised from scratch under emergency conditions. The aim was to turn the momentum of an exceptional mobilisation into a lasting framework for collective action.
This ambition underpinned a wave of reforms that reshaped EU health governance. Strengthening the mandates of the European Medicines Agency and the European Centre for Disease Prevention and Control, revising the rules on serious cross-border threats to health, and establishing HERA gave substance to the European Health Union. The budget initially envisaged for HERA, amounting to €6 billion for 2022–2027, illustrated the scale of that commitment. While keeping responsibility for organising health systems at national level, these changes expanded the EU’s tools for preparedness, coordination and response.
Understanding this transformation and its limits is essential for anyone working in health policy. The centrality health gained during the emergency does not guarantee the continuation of steady political commitment. The challenge remains to consolidate these achievements into a lasting capacity to address shared issues even beyond emergencies.
In this context, “Lineamenti di diritto sanitario europeo”, edited by Giacomo Di Federico and published by Editoriale Scientifica, offers a systematic treatment of an increasingly complex legal framework. It is the first Italian-language handbook specifically devoted to European health law and is fully available in open access.
The volume first examines EU competences and fundamental rights, then analyses public health, governance and the relationship between health services and the internal market. Its discussion of medicines and medical devices, the mobility of patients and professionals, the European Health Data Space and artificial intelligence shows the breadth of a field that extends well beyond crisis management.
The pandemic also inspired my doctoral research on the establishment of HERA and its institutional implications, both for health governance and, more broadly, for the EU. Building on this work, I co-authored with Professor Di Federico the chapter devoted to European health governance. The analysis of responsibilities and relationships among the different actors highlights a core challenge of post-pandemic reforms: translating responsibilities shared between national and European levels into coordinated and effective action.
The handbook draws on research and teaching activities carried out within the Jean Monnet HEAL module, which I had the pleasure of helping to launch. Open access extends its value beyond the classroom, benefiting practitioners, policymakers and patient representatives. Making European health governance easier to understand enables a wider community to contribute to the debate on its future and to help ensure that health retains a central place on the European agenda even when the urgency of a crisis has long faded.
Michele Migliori
European Policy Centre
