Recovering from the COVID-19 and ensuring health equity – The role of the European Semester

10 November, 2020
Banner European Semester 2020

On November 10, 2020, EuroHealthNet organised a members-only event where we presented the main outcomes of the EuroHealthNet & JAHEE report “Recovering from the COVID-19 pandemic and ensuring health equity — The role of the European Semester”, and discussed the future of health in the European Semester from a health equity perspective.

Read the 2020 Semester report here.

A new analysis of the European Semester process 2020 by EuroHealthNet and in cooperation with the Joint Action on Health Equity (JAHEE) has highlighted the potentially severe impacts of the COVID-19 pandemic on health inequalities. It also identifies several actions that will put the European economies on track for a healthy economic recovery which takes wellbeing into account.

The European Semester is the EU’s annual cycle of economic and social policy coordination. For this analysis, EuroHealthNet conducted structured interviews with national experts, reviewed Semester Country Reports, Recommendations and associated evidence, and liaised closely with the national experts and authorities of the JAHEE consortium.

All experts highlighted the social and economic components of the COVID-19 pandemic and most noted a widening of inequalities. All said that it has affected access to health systems, including for chronic conditions. People without digital skills struggled more. Most interviews also indicated an inequitable impact on mental health.

Before the COVID-19 pandemic, economic growth was uneven – for example, Europe’s 2020 poverty target was not met. This imbalance had knock-on effects on health outcomes and health inequalities. Now these imbalances are being exacerbated by the economic and social effects of the pandemic” said Giuseppe Costa, JAHEE Leader on sustainability.


As we start to rebuild, using the European Semester as a central instrument, we must truly work towards wellbeing economies, which put our health, social and economic ambitions on equal footing. Our analysis shows that these ambitions are interdependent, the one can’t do without the other.” said Caroline Costongs, EuroHealthNet Director.

The release of this report comes following a proposal for a stronger ‘European health union’ which would see stronger coordination between member states on crisis preparedness and a proposal for an increased budget for EU actions on health.

Moving towards recovery and wellbeing economies 

The European Semester has significant health and social impacts. It is crucial for health stakeholders to be aware of this process. The importance of the Semester has now increased with the integration of the governance of Europe’s Resilience and Recovery Fund (RFF).

Based on the evidence gathered, 10 recommendations for improving the process are given.

  1. Use the European Semester and EU Recovery Funds to strengthen public health and health promotion and its connections with primary and community care.
  2. Apply health and social equity impact assessments for effective policy making.
  3. Better gathering, monitoring and use of existing and new forms of data and evidence is needed, including voices from the field. This will improve understanding of new demands.
  4. Integration should be improved across sectors in whole of government approaches and at all levels.
  5. Prioritise the needs of children, with particular attention to early years support, education and equal opportunities for wellbeing.
  6. Implement the EU Skills Agenda equitably. This is critical to tackle skills shortages for people in new forms of work, the green deal, and digital transition contexts.
  7.  Act to address living conditions such as overcrowded households, homelessness or bad housing conditions. This will be key for a fast recovery.
  8.  Use the Semester to implement the European Pillar of Social Rights. Social protection measures for people in need throughout the life-course have been shown to be essential lifelines.
  9. The new needs for social care and ageing have been ‘elephants in the room’ in many states: Address them.
  10. Substantially change access and inclusion in the European Semester and related governance and design processes, and involve all relevant stakeholders.

Read the 2020 Semester report here.

The European Semester from a health equity perspective – EuroHealthNet analyses

The European Semester is the EU’s annual cycle of economic and social policy coordination. The Semester affects health care, early childhood education, unemployment, as well as social transfer and pension systems.

Similarly, the Semester is also a tool and a mechanism that can assist health agencies in their work to improve public health and act of the determinants of health. Therefore, it is essential they understand what it is and how to work with it.

Every Semester cycle, EuroHealthNet analyses the Semester from a health perspective and provides support to organisations affected by it. Find our previous analyses here.

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