Public consultation on the European Neighboorhood Policy: TBEC calls for greater emphasis on health

You can also inspire yourself from the contribution we have written below:

Do you agree with the proposed areas of focus? If not, what alternative or additional priorities would you propose?

It would be important to place greater emphasis on social sectors – such as health – in the ENP. Health is universally recognised as a basic human right and a precondition to prosperity, stability, inclusive and equitable growth, some of the very objectives of the ENP. Moreover, the wider European region is facing numerous cross-border health problems caused by infectious diseases such as HIV, Tuberculosis (TB), and increasingly drug-resistant Tuberculosis (MDR-TB), and Hepatitis C. Those diseases, which do not know or respect borders, are highly prevalent in our region. Europe is home to a quarter of the global MDR-TB burden and knows the fastest growing HIV epidemic.

Given the interconnectedness of the European Union and its neighbourhood, HIV and TB spikes in Eastern Europe and Central Asia affect us all equally. Health systems in our neighbourhood are often not strong enough to meet the health needs of the populations and are highly dependent on support from international donors such as the Global Fund to fight AIDS, TB and Malaria. However, shifting policies have led these donors to refocus their aid to lower-income countries, leaving gaps in financing and support that are contributing to a rise in HIV cases and the spread of drug-resistant TB. Recent data predicts that, by 2050, 75 million people could lose their lives to multi drug-resistant TB (MDR-TB) at a cost of €15.6 trillion to the global economy—the equivalent of the entire annual economic output of the European Union. These predictions are all the more worrying for Europe, given that the region bears 25% of the global MDR-TB burden, and that TB and MDR-TB already cost European economies an astonishing €6 billion a year. The European Union, as the single most important economic and political power in the region, should ensure that health systems strengthening and infectious diseases control remain at the top of the cooperation agenda with our neighboors.

There has recently been growing political momentum in the field of health security: on 30-31st March, the Latvian Presidency of the EU Council organised a Ministerial Meeting with EaP countries on Tuberculosis and its multi-drug resistance, underlining the need for political dialogue on health between the EU and EaP countries. This initiative should be built on in order to give health a more prominent position in the ENP. In general, political commitment and awareness with regards to health are essential if the social challenges of the region are to be addressed and future health crisis are to be avoided.

How can the EU engage more effectively and respond more flexibly to developments in partner countries affected by conflict situations? What tools would the EU need to respond more effectively to fast-changing developments in its neighbourhood?

The ENP aims to build mutual commitment to values such as human rights. The denial or inaccessibility of care during conflict must be addressed by the ENP at a political level. Health should be one of the priority area in the EU’s political dialogue with ENP countries. The ongoing war in Ukraine and the annexation of Crimea have highlighted the necessity for strong cooperation instruments. Currently in Eastern Ukraine, several thousands multi-drug resistant TB patients do not have access to treatment, therefore spreading the disease further into the communities and across borders. In times of conflict, funds for civil society should speedily be made available in these situations so that community-based treatment can be provided for free, such as in Ukraine.

Should the current geographical scope be maintained? Should the ENP allow for more flexible ways of working with the neighbours of the neighbours? How can the EU, through the ENP framework, support its neighbours in their interactions with their own neighbours? What could be done better to ensure greater coherence between the ENP and the EU’s relations with Russia, with partners in Central Asia, or in Africa, especially in the Sahel and in the Horn of Africa, and with the Gulf countries?

In this vein, it is equally worth noting that the separation between Eastern Europe and Central Asia, and the exclusion of the latter from the ENP, is not only artificial, but greatly contrasts with the ambition of the ENP, limiting the achievement of its major objectives. As challenges are often shared by governments and people of the Eastern European and Central Asian regions, ENP’s outcomes are likely to be greater if the Eastern membership is regarded in the context of its larger geopolitical space. This would entail backing cooperation between the Eastern Partnership states and their former Soviet Union neighbours in Central Asia as a means of allowing for broader exchange and increased cross-border initiatives. In the health sector, for instance, all former Soviet Union states have had to undergo similar transformation of their health systems and continue to face common challenges. This sector, as well as many others, would widely benefit from a wider ENP geographical scope or opportunities for collaboration between Eastern European ENP members and their Central Asian neighbours.

Source: TB Europe Coalition