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The German political parties aiming to form a new government agree on one thing: Europe must be better prepared for the next pandemic.
But they differ, sometimes fundamentally, in approaches to European Health Union, pharmaceutical companies, intellectual property rights and a European Health Data Room.
Opinion polls do not look rosy for Chancellor Angela Merkel’s Christian Democrats (CDU). POLITICO’s poll puts them together with their sister party Christian Social Union (CSU) at 22 percent. That places them behind the Social Democratic Party (SPD) at 25 percent.
If the CDU manages to revive itself, there may be a “Jamaica” alliance between the CDU / CSU, the Greens and the Free Democratic Party (FDP). It would mark a change from Germany’s current grand coalition of the CDU / CSU and SPD.
Alternatively, if the SPD wins the election, it could form a “traffic light” coalition with the Greens and the FDP. Another option on the table for the SPD is to merge with the Greens and the Left.
There are other potential coalition permutations, but it is clear that things are likely to change in Germany, leading to a new vision for the country when it comes to EU health policy.
While the Germans go to the polls on Sunday, it could be months before the exact composition of the coalition is known. In the meantime, health policy wonks should have some time to get fully acquainted with what the various German candidates mean for Brussels and the bloc as a whole.
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Intellectual Property and Big Pharma
Germany has been a staunch opponent of a waiver of intellectual property rights for coronavirus products. But with another coalition in power, that may change. The Greens and the Left both support the waiver. The Liberal Party states that “patents can be fatal” and in its manifesto it describes the unequal distribution of vaccines during last year’s German Presidency of the Council as a “scandal”.
Nick Dearden, director of Global Justice Now, said it was “no secret that the German government is preventing the EU from supporting an intellectual property exemption in the World Trade Organization.”
“But everything can change after this election if the CDU rule ends,” he said. Dearden pointed out how both the Greens and the Liberals have supported the waiver.
But agreement on dispensation from the Greens and the left will not be enough – the SPD should come on board under a coalition option on the table.
The Left’s opposition to patents is part of a broader opposition to Big Pharma with an entire chapter in its manifesto on “breaking the power of the pharmaceutical industry.” It describes “imaginary prices” paid for cancer, rheumatism and multiple sclerosis drugs, and demands that these prices be limited by law.
Franziska Brantner, the Greens’ spokeswoman for European affairs in the Bundestag, puts it more gently, saying that “medicines and vaccines must be available and affordable for all.”
“We also need a stronger focus on prevention, more transparency in investments and stricter guidelines for the use of antibiotics,” she said.
A (mostly) common vision of EU cooperation
All the main political parties in the line-up support many of the key principles of the European Health Union, although not everyone sees the need for the EU to run the show.
A spokesman for the CDU said there should be more cooperation between Member States and that measures such as a larger mandate for the European Medicines Agency and European Center for Disease Prevention and Control would support this. The SPD supports strengthening Europe’s role, with SPD MEP Udo Bullmann saying increased cross-border co-operation and co-ordination and the building of administrative capacities to co-ordinate health threats are “crucial.”
The Greens also support the Health Union, where MEP Jutta Paulus said that if the Greens were in a German government, “there is a real chance of a health booster for Europe”, pointing to the work the Greens would do in areas such as clean air and fossil fuels.
While the FDP supports many of the goals with Health preparedness and response authority (HERA), FDP MEP Andreas Glück was not convinced that HERA itself should be a unit. He said the mandate of the ECDC and the EMA could actually be extended to include HERA’s portfolio.
One of the main goals of HERA’s work is for the EU to establish new production capacity and secure supply chains. Glück expressed support for more joint procurement at EU level, adding that diversification of supply chains and “restoration of domestic production must be considered.”
In the case of domestic drug production, it is as if the CDU and SPD have exchanged notes. In both parties’ manifesto, they talk about a return to Germany’s past as “the world’s pharmacy.” The CDU wants to “strengthen Europe’s independence” and ensure that vital medical tools are produced in the bloc.
The SPD is on the same page and warns that dependence on production outside the EU can lead to bottlenecks in supply. “We have faced a lack of urgent need for basic supplies of medical equipment, including masks, protective equipment for vital chemicals needed to manufacture the vaccines,” Bullmann said.
In terms of pharma strategy, Bullmann said there should be “better coordination between developers and manufacturers, encourage the expansion of essential medicines through collaboration between companies and deal with supply bottlenecks.”
The Greens’ Brantner said her party welcomes the drug strategy’s ambition to make the EU less dependent on imports from a few countries such as China. “We need more diversified supply chains and strategic stocks,” she said.
European Health Data Date
Regardless of the composition of the parties that govern Germany next time, digitalisation of the health care system will be an important area of reform.
On the European Health Data Room, Brantner said the Greens are in favor of the data room, but have concerns about data protection and security as well as the need to avoid bias by comparing different data sources.
The CDU also supports the health data room with a spokesman saying it “can only work if we exploit the potential of digitalisation in healthcare across the EU.” “Our red line would be the use of data against patients’ stated desires,” they added.
The SPD sees the health data space as “a more important piece in the larger puzzle of modernizing our health system,” Bullmann explained. However, the SPD also has red lines – it will not support the initiative if it “does not prioritize and safeguard the security of our citizens’ very sensitive personal data.”
While the FDP is “Skeptical” about the health data room, the FDP’s Glück made it clear that the party supports standardized data collection in Europe, adding that the sharing of health data between national health services “should be improved.”
Germany’s history as a global health leader and its work during the coronavirus pandemic to cement this status will not be in vain, as all potentially viable coalition partners have ambitions to strengthen the WHO or global health more generally.
The CDU’s position on the importance of a stronger, better funded WHO is clear – under the Merkel government, Germany has been the largest donor to the WHO in 2020 and 2021.
An SPD-led coalition may not see any significant shift in this area. The party supports strengthening the WHO through a “courageous reform process” and ensuring that there are sufficient coronavirus vaccines to immunize the world.
The Greens and the Liberals are also behind more funding for the WHO. The Greens believe that the WHO’s mandate must be strengthened, and the Liberal Party wants to see an expansion of research into diseases that are said to be “often neglected”, such as HIV, malaria and tuberculosis.
Although the parties have many areas of adaptation, it is the differences – e.g. About intellectual property – which EU politicians, lobbyists, industry and civil society will look at most closely when the results come on Sunday.
This article is part of POLITICO‘s premium policy service: Pro Health Care. From drug prices, EMA, vaccines, pharma and more, our specialized journalists keep you on top of the topics that drive the health policy agenda. E-mail [email protected] for a free trial.