Various EU funding mechanisms can be used to advance public health and support health equity initiatives.
The pandemic has created unprecedented challenges to public health as well as the economy. To help Member States meet these challenges the EU has created an emergency fund named NextGenerationEU, along with its largest European health programme so far.
The EU’s current long term budget, the Multiannual Financial Framework (MFF) covers the years 2021-2027. The total is 1.8 trillion Euros. The MFF regulation shows how much will be allocated to different EU funds to match the EU’s agreed strategic priorities.
Amidst the COVID-19 pandemic in 2020, an additional emergency 'recovery fund' called 'NextGenerationEU' (NGEU) was agreed in parallel to the MFF. The NGEU was designed to help address the short and medium-term effects of the pandemic until 2024. Part of it will be transferred via a new Recovery and Resilience Facility (RRF), set up explicitly to fund investments and reforms in the Member States, including but not limited to their health care systems.
Among other things, EU funds and programmes offer opportunities to make shifts in approaches, to test initiatives, to initiate partnerships and to establish good practices. The most important EU funds which can be used to improve health and reduce health inequalities are listed below.
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The Multi Annual Financial Framework (MFF)
EU Health Programme – EU4Health
EU4Health is EU’s response to the impacts of COVID-19. The programme will oversee the investment of €5.1 billion, therefore becoming the largest European health programme ever in monetary terms. EU4Health will provide funding to EU countries, health organisations and Non - Governmental Organisations (NGOs). It will contribute to European Commission’s work on urgent health priorities such as
The EU4Health programme will:
- Boost EU’s preparedness for major cross border health threats.
- Strengthen health systems so that they can face epidemics as well as long-term challenges.
- Make medicines and medical devices available and affordable, advocate the efficient use of antimicrobials, as well as promote medical and pharmaceutical innovation.
European Structural and Investment Funds (ESIF)
Over half of EU funding flows through the 5 ‘European Structural and Investment Funds’ known as (ESIF). the European Commission and EU countries jointly manage the funds. The purpose of all these funds is to invest in job creation, as well as a sustainable and healthy European economy and environment. Three funds are particularly relevant to health:
- European regional development fund (ERDF) – promotes balanced development in the different regions of the EU. European regional development fund (ERDF)
- European social fund (ESF) - supports employment-related projects throughout Europe and invests in Europe’s human capital – its workers, its young people and all those seeking a job. European social fund (ESF)
- Cohesion fund (CF) – funds transport and environment projects in countries where the gross national income (GNI) per inhabitant is less than 90% of the EU average. In 2014-20, these are Bulgaria, Croatia, Cyprus, the Czech Republic, Estonia, Greece, Hungary, Latvia, Lithuania, Malta, Poland, Portugal, Romania, Slovakia and Slovenia. Cohesion fund (CF)
Two other funds exist:
- European agricultural fund for rural development (EAFRD)
- European maritime and fisheries fund (EMFF)
EU Regional Policy is the EU’s main investment policy. It aims to put Europe’s countries and regions on a more equal footing by reducing disparities between the various EU regions. It is delivered through two main funds: the European Regional Development Fund (ERDF) and the Cohesion Fund (CF). These EU funds invest in health as a key asset for regional, urban and territorial development, in order to reduce economic and social inequalities.
The ERDF aims to strengthen economic and social cohesion in the European Union by correcting imbalances between its regions. The sole recipients of CF are Member States whose Gross National Income (GNI) per inhabitant is less than 90 % of the EU average. In other words, this EU fund aims to reduce economic and social disparities and to promote sustainable development.
The ERDF and the CF focus on key investment priorities:
- Innovation, digitisation and economic transformation.
- A greener, carbon-free Europe.
- The fight against climate change.
- The European Pillar of Social Rights.
- Quality employment, education, skills.
- Social inclusion and equal access to healthcare.
EU Cohesion Fund invests in health as a key asset for regional, urban and territorial development, in order to reduce economic and social inequalities. Investments may address many different areas such as
- Ageing populations.
- Healthcare infrastructure (workforce and services).
- Health coverage.
- Health promotion programmes.
Cohesion funding stands at 234 Billion EUR (in 2018 prices), 10% less compared with 2014-2020 allocations. However, there’s also a 47.5 billion EUR top-up under a new ReactEU programme that’s part of NextGenerationEU fund.
EuroHealthNet ESIF Support Desk and where to get support
- The Europe Direct is a point for access to information about the EU. The services can help you through the jungle of information about the EU and point you in the right direction, as well as provide concrete specialised answers to practical questions.
- Your Managing Authority can give advice, through each stage of the project application under the Cohesion Policy.
InvestEU is the EU's flagship investment programme to help grow the European economy. It brings together the multitude of EU financial front-loaded instruments currently available to support investment, innovation, and job creation in Europe. The programme will run between 2021 and 2027.
InvestEU is based on three pillars:
- The InvestEU Fund. This will support four policy areas: sustainable infrastructure; research, innovation and digitisation; small and medium-sized businesses; and most importantly for health improvements - social investment and skills.
- The InvestEU Advisory Hub. This will provide technical support and assistance to the countries to help with the preparation, development, structuring and implementation of projects, including capacity building.
- The InvestEU Portal. This will bring together investors and project promoters by providing an easily-accessible and user-friendly database.
The Just Transition Fund to support the European Green Deal
The JTF is a financing tool which aims to mitigate the adverse effects of the transition towards a climate-neutral economy.
The Just Transition Fund will seek to support regions, sectors and workers affected by the green transition by fostering:
- Economic diversification and modernisation of the local economy.
- Up-skilling and reskilling.
- Active inclusion of jobseekers in the labour market.
Member State co-financing as well as cohesion policy resources will compliment the Just Transition Fund Budget.
Common Agricultural Policy
Common Agricultural Policy (CAP) is designed to support a fair income for food producers, and rebalance power within the food supply chain.
Most importantly, it forms a vital part of how sustainable European food systems can be. Inevitably, it also impacts on environmental conditions, public health and levels of poverty and social exclusion in the EU.
Horizon Europe is the EU research and innovation (R&I) programme (2021-2027). It will aim ‘to deliver scientific, technological, economic and societal impact from the Union’s investments in R&I, to strengthen the scientific and technological bases of the Union, and foster its competitiveness in all Member States’1European Commission, Factsheet, Horizon Europe.
In other words, through this programme, the European Union aims to:
- Boost productivity through investments in research and innovation.
- Transform our societies digitally and ecologically.
- Battle the coronavirus outbreak through ensuring collaborative development and universal deployment of diagnostics, treatments and vaccines.
In addition, Horizon Europe will incorporate research and innovation missions to increase the effectiveness of funding by pursuing clearly defined targets. To this end, the five EU missions are linked to societal challenges, all of which have links to health and health determinants:
- adaptation to climate change
- healthy oceans
- climate-neutral cities
- healthy soil and food
Due to the recent COVID-19 pandemic coupled with the environmental crisis, health and environment are taking central stage in the programme. In the health domain, research efforts will focus on addressing ‘challenges such as the Coronavirus pandemic, the extension of clinical trials, innovative protective measures, virology, vaccines, treatments and diagnostics, and the translation of research findings into public health policy measures’2European Commission, Factsheet, The role of research and innovation in Europe’s recovery. On the other hand, in the environmental domain, the research effort will focus on promoting a recovery consistent with the goals of the European Green Deal and supporting innovations by small and medium-sized enterprises, and start-ups.
Horizon Europe will amount to €95.5 billion, including 5.4 billion from the NextGenerationEU. This represents about 33% increase from the budget for the previous research programme, Horizon 2020/
The Digital Europe Programme will support digital empowerment across the EU for a wide deployment of digital technologies as well as a faster recovery from the COVID-19 crisis. The programme will boost five main areas of the digital sector: supercomputing, artificial intelligence, cybersecurity, advanced digital skills, and a wide use of digital technologies across the economy and society.
Recovery and Resilience Facility (RRF), and Technical Support Instrument
The Recovery and Resilience Facility is a new large-scale financial tool to support reforms and investments. It stands at the core of the NextGenerationEU (the overall EU recovery financial instrument) and has been closely intertwined with the European Semester.
It will support countries in setting out major reforms programmes 2021-2027 years to face short- and long-term challenges as well as bringing innovation in those sectors that will benefit the most.
This initiative forms part of the NextGenerationEU stimulus package. It aims to continue and extend the crisis response and repair measures that cohesion policy has already started delivering, while enlarging the scope to cover green, digital, and growth-enhancing investments.