The Europeanization of Public Health: How Does It Work? The Seminal Role of the AIDS Case

Abstract

This article analyzes the path that led the European Union from a somewhat accidental involvement in fighting AIDS to a new and sustainable policy of communicable disease control. It responds to three main questions: Why did an unexpected case lead to the organization of a new sustainable policy? How was this achieved despite national competency over the given policy sector? How did the new policy succeed in covering the enlarged EU? The explanation combines political factors and public health issues. European integration and eastern enlargement made transborder disease management a political necessity. Treaties gave legitimacy to EU policy, while the AIDS matrix furnished the practical procedures: networking, data harmonization, peer-conducted policy coaching, and participation. This pattern of public health management is compatible with national competency, and it is consistent with the democratic values the EU promotes throughout and beyond the enlarged EU. From a theoretical point of view, these patterns of activities constitute the empirically grounded content of the much used but less defined concept of cognitive Europeanization.

Europeanisation of health systems: a qualitative study of domestic actors in a small state

“…Studies on the Europeanisation of health care were identified for cross-border mobility [ 36 – 38 ], health care coverage [ 39 ], alcohol policy [ 40 ], communicable disease policy [ 41 , 42 ] and cancer [ 43 ]. However, to date no empirical studies were found that investigated the attitudes of domestic stakeholders towards health system Europeanisation.…”

Mapping HIV-related figures of risk in Europe’s blood donation regime

“…While effective antiretroviral therapy became available and the quality and accessibility of epidemiological data in Europe increased significantly in the mid-1990s (Steffen, 2012), subsequent Guides were only slightly modified. Only in 1999 was it stated under the category 'AIDS': 'the information provided may vary between countries according to the local epidemiological data' (Council of Europe, 1999: 19).…”

The rise of a European healthcare union

“…One line of research focuses on crises-or problem-driven dynamics where the outbreak of communicable diseases, such as AIDS or the BSE crisis, or shared public health problems, such as obesity, have pushed for European solutions. In this expansion of Union involvement, the European Commission is presented as a successful entrepreneur that seized the window of opportunity and expanded EU power and provisions (Lamping and Steffen 2009;Steffen 2012;Kurzer and Cooper 2011;Greer and Löblová 2016, this volume). Confirming the neo-functionalist focus on the stimulating role of non-state actors, the DG SANTE is presented here as a key institution that accepted political leadership and ensured EU involvement in public health.…”