The role of EU health attachés for global health diplomacy in times of COVID-19

ABSTRACT

While practitioners around the globe deal with the challenges posed by COVID-19, scholars of diplomacy were wondering where did all the health attachés go? Reviewing the scholarship on global health diplomacy shows, on the one hand, that health attachés are at the core of global health diplomacy while on the other, data about their role and impact is lacking. International diplomatic negotiations on health take place at the bilateral and multilateral level and rely on diplomats – and it is the health attachés that have the highest level of legitimacy. The fact that an empirical repository on these diplomats is missing comes as a surprise as at the regional level of diplomacy – the European Union – there is a considerable network of health attachés in place since the 1980s. Against this background this articles explores five distinct roles that EU health attachés embrace in Brussels and its implications for health diplomacy.

KEYWORDS:

• Health attachés
• health diplomacy
• global health
• EU
• COVID-19

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 Old Member States: The six founding members: Germany, France, Italy, Belgium, Luxembourg, and The Netherlands (1957), and new Member States: Denmark, Ireland, and the UK (1973); Greece (1981); Spain and Portugal (1986); Austria, Finland, and Sweden (1995), Czech Republic, Estonia, Cyprus, Latvia, Lithuania, Hungary, Malta, Poland, Slovakia and Slovenia (2004), Romania and Bulgaria (2007), and Croatia (2013). Since 2020, the UK is no longer a member of the EU.

2 Western Europe: Germany, The Netherlands, Belgium, Luxembourg, Austria, France; Southern Europe: Portugal, Spain, Italy, Malta, Croatia, Slovenia; Greece; Cyprus; Eastern Europe: Poland, Czech Republic, Slovakia, Hungary, Romania, Bulgaria; Northern Europe: Sweden, Finland, Denmark, Estonia, Latvia, Lithuania, Ireland (World Atlas, n.d.).

3 The EU witnessed the rise of Eurosceptic and/or populist parties in its MS, representing dissatisfied and even hostile constituencies towards EU engagement, e.g., Jobbik, and the Law and Justice Parties in Hungary and Poland (Lázár, 2015). In contrast, Germany and France are spearheading European integration efforts.

4 Health attachés interviewed for this research project work for the PermReps of Germany, Estonia, Hungary, France, Belgium, Spain, The Netherlands, Luxembourg, Denmark, and Bulgaria in Brussels. Participating countries are enumerated in mixed order to secure interviewees’ anonymity.

5 The Global Alliance for Vaccines and Immunization (Gavi), also referred to as ‘the Vaccine Alliance’ was founded in 2000 and functions as a PPP geared towards the equitable access to vaccines. Partnering with the WHO, UNICEF, the World Bank, and the Bill & Melinda Gates Foundation, Gavi supports the scale-up of national vaccination programmes, the introduction of new vaccines and the sustainable financing of vaccination campaigns (Gavi, 2020).

6 As a result of the inability of South African institutions to provide enough graduates (South Africa Department of Health, 2015).

7 The remaining are: General Affairs; Foreign Affairs; Economic and Financial Affairs; Justice and Home Affairs; Competitiveness (Internal Market, Industry, Research and Space); Transport, Telecommunications and Energy; Agriculture and Fisheries; Environment; Education, Youth, Culture and Sport (EUR-Lex, n.d.a).

8 The term ‘career diplomat’ is used contrary to people from other employment backgrounds than foreign affairs, i.e., they have not been on a diplomatic college, who may however also be seconded by an official government as de facto and de jure diplomats, meaning that they enjoy the same status as career diplomats (e.g., Weinberg, 2014)

9 The number of votes needed in the Council to pass a decision. To achieve a qualified majority, 55 percent of EU Member States must vote in favour, representing at least 65 percent of the total EU population (EUR-Lex, n.d.b).

10 HTA was on health attachés’ agenda for seven Presidencies (Bulgaria 2018 – Portugal 2021) and is to harmonise clinical assessment and scientific consultations to improve European patient’s access to health technologies. The presidency submitted the outcome of the negotiation to COREPER I for approval, which is to be followed, in the best-case scenario, by adoption by the EPSCO Council and the EP (Council of the EU, n.d.a).

11 The Health Union Package consists of set of proposals to consolidate the EU’s health security infrastructure and to strengthen the role of important EU agencies in crisis planning and response. This includes Regulations on serious cross-border health threats; the re-enforcement of the European Centre for Disease Prevention and Control as well as the European Medicine’s Agency; and a blueprint for a future institution: the Health Emergency Response Authority (HERA) to be proposed at the end of 2021 (European Commission, 2020).

12 OLP: used as the decision-making procedure for the adoption of most EU legislation, where the EP and Council act as the main legislators. A proposal is submitted by the Commission, which will be either adopted or amended by the co-legislators. If EP and Council cannot agree on the suggested revisions, both parties can amend it again. If they still are unable to find an agreement, they enter negotiations. Once these have been completed, both EP and Council can either vote for or against it (European Parliament, n.d.). For a step-by-step overview of the OLP.

13 Trialogues are informal meetings attended by representatives from the EP, the Council, and the Commission possible anytime during the legislative process with the goal of reaching informal agreements on legislative proposals.

14 Every six months, the Council Presidency rotates among EU member states. During this six-month period, the Presidency chairs sessions at all levels of the Council and represents the Council in relations with the other EU institutions, particularly with the Commission and the EP. Its role is to try and reach agreement on legislative files ensuring that the EU’s work is not disrupted (Council of the EU, n.d.a).

Additional information

Notes on contributors

Sabrina Luh

Sabrina Luh is holding a MSc double degree in Public Policy and Human Development from Maastricht University and United Nations University. With a background in European Studies, her research affinity lies in EU diplomacy and public policy, complemented by an interest in foreign policy, security, and human rights topics. The findings presented in this article rely on the research conducted for her Master thesis “Global Health Diplomacy in Times of Crisis: An Assessment of European Diplomatic Cooperation and the Role of Health Attachés”, evaluated with cum laude.

Dorina Baltag

Dorina Baltag holds a PhD degree in EU Diplomacy and Foreign Policy from Loughborough University. She is currently a post-doctoral researcher at the Institute for Diplomacy and International Governance at Loughborough University (London campus) where she was awarded the Excellence 100 Fellowship. Her research deals with questions related to the practice of EU diplomacy in Eastern Partnership (EaP) countries, the democratization process in the EaP and the evaluation of EU foreign policy performance. She contributed, inter alia, to Democratization, the Hague Journal of Diplomacy, the “Routledge Handbook on the ENP” (Routledge, Oxford) and the “External Governance as Security Community Building” (Palgrave, London).