German Chancellor Angela Merkel’s 16-year long reign is coming to an end after the elections on September 26. By examining the positions of Germany’s leading parties, this piece assesses how a new German government might shape EU health policy.
Health policy is a top priority for policymakers in Germany and the EU. The COVID-19 crisis not only revealed deficits in EU cross-border health coordination, but also emphasized the need for safer and more independent supply chains – establishing a strong digital infrastructure and promoting Germany and the EU as competitive locations for pharmaceutical research and development.
Today, Europeans see health policy as one of the policy areas where urgent action is most required. In Germany for example, the 2021 Edelman Trust Barometer revealed that Germans see improving healthcare as being more important than tackling climate change. For Germany – long known as the “world’s pharmacy” – the upcoming elections hold the potential to shape its global competitiveness in a time of rising challenges.
Germany’s road towards a European Health Union will remain rocky
On an EU level, Germany is generally expected to work towards more health coordination between member states. Yet German parties are split over the extent to which the EU should influence national healthcare systems. While the current German government has been cautiously supportive of European Health Union proposals, a more progressive, left-leaning coalition including the Social Democrats (SPD), Greens and Left parties (“Red-Red-Green”) could change the EU’s health landscape, by throwing Germany’s political weight behind these initiatives.
The Greens display a more European approach, with calls for the creation of a European Health Union, favoring EU-wide data sharing. The Greens also back the establishment of a Health Emergency Preparedness and Response Authority (HERA), a strengthened European Center for Disease Prevention and Control (ECDC), and closer cooperation with national health authorities. Both the ruling parties CDU/CSU and SPD are expected to call for relative continuity, while still favoring closer EU health cooperation to a certain extent. On the other hand, the Liberals have focused on positioning Germany and the EU as pharmaceutical production hubs with subsidies designed to encourage production sites. Yet, despite supporting European cooperation, they remain skeptical of sharing health policy competencies with the EU within the framework of building a European Health Union.
At the same time, Germany’s plans to strengthen EU’s health policy go hand in hand with ambitions to foster global cooperation, e.g., to combat the pandemic (the WHO Hub for Pandemic and Epidemic Intelligence just started operating in Berlin in September). All major parties are sending out a clear signal that Germany is willing and able to take the lead when it comes to global healthcare and show a very strong support for a (reformed) WHO, aiming to increase cooperation and funding. So be prepared a new government will not only be looking to accelerate Germany’s leadership in this policy area in Europe, but also across the world.
The so-called “Red-Red-Green” alliance is expected to place a strong emphasis on price-regulation and patents
Overall, parties agree on the need for more EU research cooperation – something which has been a key priority for pharmaceutical companies. Germany is expected to support the European Commission’s push for creating a European Health Data Space (EHDS), which aims to address the EU’s fragmented health data landscape. With regards to health technology assessments (HTA), a new German government is likely to remain protective of its national procedures and competencies.
In 2020, Chancellor Angela Merkel called for a common EU approach to health crises, and for greater medical and pharmaceutical autonomy. This call for action was reflected in the European Commission’s 2020 Pharmaceutical Strategy for Europe, which notably made achieving strategic autonomy one of its core objectives. The pursuit of more medical and pharmaceutical autonomy is therefore likely to remain a common goal for both the EU and Germany – even under a new German government.
The Greens, the Christian Democratic Union (CDU/CSU) and the Social Democratic Party (SPD) agree that at least 3.5 percent of economic output should be invested in research and development by 2025. This focus on R&D is likely to align well with the European Commission’s ambition to boost innovation across the EU via its €95.5 billion Horizon Europe program.
Nonetheless, pharmaceutical sector regulation is likely to become a future battlefield – for example on price-regulation and patents. A left-wing Red-Red-Green coalition would have to deal with the Left Party’s demands for drug price limitations, pharmaceutical industry “democratization”, and socially responsible patent exploitation (equitable licensing). On the other hand, with the Liberals in government, the preservation of patent rights would become more important.
More common ground is likely to be found on healthcare digitization. The new German government is therefore likely to push for policies to be included in the European digital agenda, including policies such as the electronic patient files, telemedicine, and health applications, as well as common data and interoperability standards in eHealth networks.
Looking forward: A decisive role for Germany
At a time when national and EU institutions are beginning to examine the issue of medicine affordability and IP incentive frameworks, Germany’s new government composition could have deep ramifications for the health sector. Healthcare actors in Germany and the EU must therefore build clear positions, while also navigating regulatory and political risks, and strengthening trust amongst their stakeholders to safeguard their license-to-operate.