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Open Letter: European Semester and the national Recovery and Resilience Plans: drivers to promote health and wellbeing in the European Union?

3 December, 2021
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Open letter to:

EPSCO Representatives of the Permanent Representations of the EU Member States to the EU


EC Secretariat General, EU Commissioners Schmit, Kyriakides, Gentiloni, Executive VP Dombrovski

Dear Health and Social Policy Attachés,

Your Excellency,

On behalf of EuroHealthNet, a European partnership of national public health institutes and regional health authorities, I am writing to ask you to make health, wellbeing, and action against health inequalities central in your discussions ahead and during the upcoming EPSCO Council. Policy debates on the European Semester, and conclusions on strengthening the European Health Union will be impactful only if they address health, fairness, and wellbeing for all people in Europe. These concepts are crucial to European stability and prosperity.

European Semester: investing in recovery and resilience

Perhaps the most important lesson from the COVID-19 pandemic, often described as a syndemic (1), is a profound appreciation of the fundamental importance of health and the effects of its inequitable distribution within our societies.

Looking towards the launch of the new European Semester cycle, EuroHealthNet recently published the assessment report ‘Recovery and Resilience Plans: drivers to promote health and well-being in the European Union?‘. Based on a series of expert interviews and analyses of eight national Recovery and Resilience Plans (2), we concluded that to rebuild inclusively and effectively we need to scale up measures to improve living and working conditions, and strengthen the social fabric of society in ways that co-create and deliver positive health and wellbeing for all.

This is not only about recovery, but also about building resilience to future shocks. Much more emphasis should be put on building and capitalising on social resilience. This calls for investments in people’s assets and skills, their health, and social and environmental capital. Intelligent ways forward include: local and individual empowerment; co-creation; investments in communities of prevention, and informal and self-care; and improving  people’s living conditions.

For the European Semester process, EuroHealthNet recommends:

  • Creating more enabling environments for healthy lifestyles and encouraging the uptake of policies and action with co-benefits for health, green and sustainable environments.
  • Investing in primary and community care, including public health
  • Investing in measures to promote mental health.
  • Improving monitoring and surveillance systems with an equity focus.
  • Strengthening the health and social workforce.
  • Investing in digital inclusion and skills, and digital health literacy.
  • Supporting families and young people.

Strengthening the European Health Union: widening the scope and putting health equity at its heart

This is a critical moment for all of us in Europe. As we try to jointly organise effective response mechanisms to the pandemic and prepare for the future, we need to also consider the emerging evidence of wider impacts of health crises. Non-communicable diseases, mental health problems, and health inequalities are all on the rise, as described in the newest Health at a Glance 2021 report from the OECD (3).  Public health, health promotion, and disease prevention measures along the life-course, across policy sectors, and with intensity proportionate to the need (4) can address these challenges. They must be central to a comprehensive European Health Union. This will have long-term benefits for the sustainability and efficient coordination of health and social protection systems and services.

Your work can lead to a rapid, efficient, and inclusive recovery by aligning measures towards common goals of sustainability and fairness, while ensuring investments in the resilience and wellbeing of people. These opportunities should not be missed, and we hope our report and recommendations can facilitate your progress therein.

To make this happen, you can count on our continuous support and collaboration.

Yours faithfully,

Caroline Costongs

Director, EuroHealthNet

EuroHealthNet is the leading Partnership for Health, Equity and Wellbeing in Europe, with key activities in policy, practice as well as research. Its unique focus is on reducing health inequalities through action on the social determinants of health, integrating sustainable development goals, and contributing to the transformation of health systems. Its main members are authorities and statutory bodies responsible for public health, health promotion, and disease prevention at national, regional, and local level.

(1) Di Ciaula, A, Krawczyk, M, Filipiak, KJ, Geier, A, Bonfrate, L, Portincasa, P. Noncommunicable diseases, climate change and iniquities: What COVID-19 has taught us about syndemic. Eur J Clin Invest. 2021; 51:e13682. doi:10.1111/eci.13682

(2) Austria, Belgium, Finland, Italy, the Netherlands, Slovenia, Spain, and Portugal

(3) OECD (2021). Health at a Glance, 2021.

(4) Proportionate universalism

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