Affiliation:
1. Global Health and Tropical Medicine Instituto de Higiene e Medicina Tropical Universidade Nova de Lisboa Lisbon Portugal
2. National School of Public Health Public Health Research Centre Comprehensive Health Research Centre Universidade Nova de Lisboa Lisbon Portugal
3. Public Health Unit Group of Primary Care Centers of Porto Oriental North Health Regional Administration Ministry of Health Porto Portugal
Abstract
AbstractIn this article we argue that the Member States of the European Union (EU) have consistently, since its inception, developed a shared framework to measure, monitor and intervene to improve the health status of its population, while invoking the subsidiarity principle for the health sector. As a result, a European Health Union (EHU) has been emerging insidiously and consistently, following the concept of a system for health. Using the World Health Organisation Building Blocks Framework, we analyse the normative and institutional developments related to EU citizens' health that have created a de facto EHU. Developments towards an EHU remain unequally distributed among the different building blocks analysed. The existing EHU is the result of a fragmented and incremental process, mostly grounded in governance, health intelligence and services' development. Health crisis, the Commission's agenda‐setting activities and market pressures have been the most important push factors for these step‐by‐step processes.