The European Union

The European Union has evolved to become a key global health actor. This section provides and overview of its constitutional framework and its central institutions including the Council of Ministers, the Presidency of the Council of the European Union, The European Council, the EU Member State Permanent Representations, the European Parliament, the European Commissionand the European External Action Service.


The Council of Ministers: As an intergovernmental institution, the main source of authority for the EU arises from agreements between its 27 member states. The Council of Ministers is the primary meeting place of the EU member state national governments. The principle responsibility of the Council of Ministers is to take policy and legislative decisions. These powers are shared with the European Parliament and the European Commission, but both these institutions are superseded by the authority of the Council. The extent to which the Council must work with the Commission or the European Parliament depends on the policy area.

President of the European Council: Under the Lisbon Treaty, which came into force 1 December 2009, a new political figure has come on the scene: the fixed full-time President of the European Council. The President's main task is to ensure the preparation and continuity of the work of the European Council - which becomes an institution in its own right - and to facilitate consensus. He will, at his level and in that capacity, ensure the external representation of the Union on issues concerning its common foreign and security policy. The role of President of the European Council is not compatible with other national offices. The European Council has elected Mr Van Rompuy to this post for a term of two and a half years, renewable once. A factsheet on the President of the European Council is available on the Council website.

The rotating Presidency of the Council of the European Union: The Presidency of the Council of the European Union is organised on the basis of a half-yearly rotation system, under which each Member State holds the Presidency for a period of six months. Holding the Presidency is every Member State's duty, and a contribution towards the smooth operation of the Community institutions.

While the extent to which any single presidency can influence the shape and pace of EU policies should not be exaggerated, the momentum gained in ascending to the presidency allows for countries to move policies up the agenda. Presidencies can strategically aim to achieve a consensus on key initiatives. In the case of the EU's role as a global health actor, the Finnish presidency of 2006 was a crucial turning point due to the presidency's support for the Health in All Policies initiative. Another example can be seen in the rise of antibiotic resistance as an issue during the 2009 Swedish Presidency.

Nevertheless, six months is hardly long enough to see through the completion of entire policy cycles, especially where legislation is involved, and presidencies often inherit the left-over challenges from their predecessor. For this reason Member States began to approach the presidency in groups of three, referred to as the Trio or the Trio-Presidency. For example, the current Trio-presidency of Spain-Belgium-Hungary began in January 2010. This institutional arrangement can allow for strategic collaboration on policy issues of key concern between the Trio Member States, including the tackling of more difficult policies, for example, work on the policy on the EU role in global health (forthcoming) began under the Swedish Presidency (6/2009-12/2009), Council will discuss the Commission's proposal on this policy under the Spanish Presidency and implementation will be looked at in following presidencies.

It is a common misunderstanding that due to the creation of a permanent President of the European Council under the Lisbon Treaty that the rotating country presidencies will become a cultural aretfact of the former treaty era.  In fact, they will continue to play a significant role in EU politics and policy. More information is available here.

High Representative of the Union for Foreign Affairs and Security Policy: The High Representative combines three different functions: she will be at once the Council's representative for the CFSP (Common Foreign and Security Policy), the President of the Foreign Affairs Council and a Vice-President of the Commission. She is responsible for steering foreign policy and common defence policy. She also represents the Union on the international stage in the field of the CFSP. The post is designed to enhance the consistency and unity of the EU's external action. Ms Catherine Ashton has been appointed by the European Council with the agreement of the President of the Commission. Her term of office (five years) coincides with the Commission's term of office. In fulfilling her mandate, the High Representative will be assisted by the European External Action Service and will have authority over some 130 delegations of the Union in third countries and to international organisations.  A factsheet on the High Representative of the Union for Foreign Affairs and Security is available from the Council website.

The European Council: The European Council is a two-day meeting of the European heads of state (presidents and prime ministers) and the president of the Commission, also referred to as the European summit. Foreign ministers and other members of the Commission may also attend to provide assistance. The European Council meets twice a year at the end of each Council presidency. Special additional summits can also be held to address priority issues of the European Union. For example, a spring summit was held in Lisbon in March 2000 to address issues of European competitiveness, resulting in the Lisbon process or strategy.

The main policy areas within which the European Council deliberates are:

  • the evolution of the European Union
  • constitutional and institutional matters
  • economic and monetary policies of the European Union
  • external relations, including the formation of European positions to be taken in international forums such as the G-8 summits and at the World Trade Organization
  • specific internal policy issues of an especially sensitive or difficult nature that the other institutions have not been able to resolve, for example, when an EU institutional crisis occurred following the 1996 ban on British beef, which was prompted by an outbreak of BSE (mad cow disease)

EU member states permanent representations: The Council also meets in configurations below ministerial level. Each member state maintains a permanent delegation in Brussels. There are many forums in which the national governments meet at below the ministerial level, but the most important of these are the meetings of the Committee of Permanent Representatives (COREPER). There are two configurations:

  1. COREPER I, which consists of deputy heads of mission and deals largely with social and economic issues (including health policy)
  2. COREPER II, which is more senior, consisting of heads of mission and dealing largely with political, financial and foreign policy issues

The European Parliament: The European Parliament must ratify proposals from the Commission and has powers to question or dismiss commissioners. Like a national parliament, the European Parliament exercises its power through the legislative process, through the budgetary process and through control and supervision of the executive. However, there are marked dissimilarities between the European Parliament and national parliaments. Traditionally, the European Parliament has not been regarded as a strong institution. Currently, co-decision procedures, whereby it can block or amend legislation, apply to several policy areas of importance to global health, for example, consumer protection, health, the fight against social exclusion, education, research and internal markets. Areas of co-decision would be expanded under the Lisbon Treaty.

Despite this, the European Parliament is not entirely without effective means to set the agenda for European policy. The Parliament has the right to request proposals from the Commission on matters it considers essential, and the Commission is obliged to respond to such requests. Such a request requires an absolute majority in the Parliament. An easier but weaker way in which the European Parliament influences European policy is by initiating its own reports and recommendations through the committees, and by engaging in pre-proposal discussions with the Commission. It also has a significant amount of say over the annual programme of the Commission as well as over proposed budgets.

The work of the European Parliament is carried out in various committees. The 20 standing committees of the Parliament include the Committee on the Environment, Public Health and Food Safety, a foreign affairs subcommittee devoted to human rights, and committees dealing with development, women's rights and gender equality, and international trade.

The adoption of the Treaty of Lisbon provides for a substantial increase in the authority of the EP that puts it on a more equal footing with the Council. This will include new powers over legislation, the budget and international agreements. The intentions of the reforms are to further the democratic legitimacy of the EU.

The European Commission: The European Commission is the EU's executive organ. It represents and upholds the interests of Europe as a whole. It drafts proposals for new European laws, which it presents to the European Parliament and the Council. It manages the day-to-day business of implementing EU policies and spending EU funds. The Commission also polices European treaties and laws. It can act against rule-breakers, taking them to the European Court of Justice if necessary.

It is led by 27 men and women - one from each EU country assisted by about 24,000 civil servants, most of whom work in Brussels. The president of the Commission is chosen by EU governments and endorsed by the European Parliament. The other commissioners are nominated by their national governments in consultation with the incoming president and must be approved by the European Parliament. They do not represent the governments of their home countries. Instead, each of them has responsibility for a particular EU policy area. The president and members of the Commission are appointed for a period of five years, coinciding with the period for which the European Parliament is elected.

Up until spring 2008, public health and consumer protection were part of the same portfolio and the responsibility of a single commissioner in the European Commission. Today, there is one commissioner for public health and one for consumer affairs. While this has significantly raised the profile of consumer protection policy, these two related policy fields still come under the same directorate-general, signalling their joint importance and substantial interrelation.

The Directorate-General for Health and Consumers (DG SANCO) has traditionally been the central health actor alongside the directorates general that make up the Commission's external relations services such as the Directorate-General for Development (DG Dev) and EuropeAid (DG Aidco), which includes the European Commission's Humanitarian Aid Office (DG ECHO). However, the EU policy initiative of the 2006 Finnish Presidency, Health in All Policies, has led to an understanding that global health issues can affect all directorates. This broader approach to health and, specifically, the importance of global health governance, is reflected in the current EU strategy, ‘Together for Health: A Strategic Approach for the EU 2008-2013'.

Important developments in European policy are first released as communications green papers and/or white papers of the Commission. In order for the Commission's proposals to find broad support, the Commission must take the will of the European Parliament, the Council, and also civil society and business actors into account.

In its executive role, the Commission is closely involved with the management, oversight and implementation of EU policies. Similar to an executive branch of a national government, the Commission is responsible for rule-making in administrative and technical matters, and when quick decisions are necessary. The Commission is also the manager of the EU's finances, seeing to the collection of revenues and the monitoring of expenditure. As far as the implementation of EU policies are concerned, for the most part, the Commission delegates to the appropriate member state or international agencies and contractors. Since 2000, the Commission has been reformed extensively, especially with regard to its external services. Authority has increasingly been devolved to the European delegations.

Much of the Commission's time and resources are spent trying to establish common ground between competing internal EU interests. In negotiations in external settings, however, the Commission has begun to play an important role in forging consensus among European member states, for example, on the executive board of the World Bank, and in negotiations and working groups of the World Health Assembly.


The European External Action Service


The Lisbon Treaty paved the way for the establishment of the new European External Action Service (EEAS). Formally launched on December 1st, 2010, EEAS serves as a European diplomatic corps tasked with implementation of the Common Foreign and Security Policy and related policies, akin to the diplomatic service of national foreign ministries. It is headed by a new position created following the Lisbon Treaty, the High Representative of the Union for Foreign Affairs and Security Policy, currently Ms Catherine Ashton (UK). The EEAS assumes the responsibilities of the former external relations departments of the Council and the European Commission. As a consolidated institution, EEAS is to provide a single European position on a wide spectrum of foreign policy issues, ranging from global negotiations in sectors such as trade and climate change, to international economic and financial governance. EEAS, like the rest of the Union it represents, is committed to peaceful multilateralism and the adoption of a human rights approach in all policy decisions.


Contrary to the initial plans developed by High Representative Ashton, development and neighbourhood policies have not been transferred into the new service's responsibilities, but will remain with the European Commission. However, EEAS will have a voice concerning changes in development policies as proposals are to be prepared jointly with the Commission acting as the lead agency.


At present, EEAS staff consists primarily of European civil servants transferred from the Commission and the Council secretariat. In the future, lager numbers of members of the national diplomatic services are to be seconded to EEAS. On the insistence of the European Parliament, it was decided that the proportion of temporary staff is not to exceed 40% in order to ensure continuity and cohesion within the service. The 136 delegations that serve as Union's "embassies" around the world, formerly part of the European Commission, are now an integral part of the new service. EEAS's total number of staff is expected to grow to about 5,400 in the coming years, up from 1,625 in January 2011.

The Treaty of Lisbon

Signed in December 2007 and entered into force two years later, the Treaty of Lisbon amends the constitutional basis of the European Union, implementing a number of the reform projects initially included in the failed Constitution for Europe. Instead of replacing the founding treaties of Rome and Maastricht with a single legal basis adapted to the Union's growing membership (as intended by the draft Constitution), the Lisbon treaty amended these treaties and introduced a number of key changes to the institutional set-up and decision-making processes of the European Union.


The provisions of the Treaty of Lisbon aimed to create more permanent and flexible structures for the European Union of the then 27 states. Although the six-month rotating EU presidency was kept, the Council of the European Union is now headed by a President elected for two and a half years. The purpose is to balance the need for political stability and programmatic continuity with the differing priorities of the respective national presidencies.


In addition, in order to unify and strengthen European representation on the world stage, the posts of External Affairs Commissioner and High Representative for Common Foreign and Security Policy were merged into the single position of High Representative of the Union for Foreign Affairs and Security Policy assisted by the newly created European External Action Service (EEAS) as a quasi-diplomatic corps.


Other prominent changes concerned the decision-making procedure within the European Union: the Council of Ministers changed its standard voting procedure from unanimity to qualified majority, in order to accommodate the extraordinary growth of its membership following the enlargement rounds of the 1990s and 2004/07. This voting procedure, established by the Nice Treaty (2003), requires a double majority of member states votes that have to represent a certain population share. Through the Lisbon Treaty, Member States agreed to apply this voting procedure in almost all policy areas and decided to replace the more stringent Nice Treaty majority requirements from 2014 onwards. In addition, the European Parliament gained important powers as its role as co-legislator, together with the Council of the EU, was made standard procedure in most policy areas and it now retains the right to approve or reject the draft budget submitted by the Commission in its entirety.


Finally, in respect to the normative underpinning of the European Union, the Lisbon Treaty clarified the legal value of the European Union Charter of Fundamental Rights. The reference to this document contained in the treaty makes it a legally binding text and constituent component of the Unions' legal basis that can be invoked before European and national courts.


The full text and more information on the treaty are available here:


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