7. Domain of health

The worldwide experience of the COVID-19 pandemic is a painful reminder that health is one of humans’ most valuable resources, as well as an asset that keeps societies functioning. While the overall level of health and capacity of healthcare in the EU are among the best in the world, inequalities in health and access to services become increasingly visible during unprecedented emergency situations.

The cost of health inequalities normally across 25 European countries was estimated to be EUR 980 billion, or 9.4 %of GDP, in 2004 (Mackenbach et al., 2011; WHO, 2014a)2011; WHO, 2014a. Counting the cost and health impacts of COVID-19 and related measures will be an almost impossible undertaking.

Using evidence from the pre-COVID-19 period is vital to set the baseline, recognising existing deficiencies in health systems and identifying the most vulnerable people. Statistics on the COVID-19 outbreak show important sex differences in mortality and vulnerability to the disease (Novel Coronavirus Pneumonia Emergency Response Epidemiology Team, 2020).

Experiences from past outbreaks show the importance of incorporating gender analysis into preparedness plans and institutional responses to improve the effectiveness of health interventions and promote gender and health equity goals (Wenham et al., 2020).

Policies and public health systems have not addressed the gendered impacts of disease outbreaks in the past (Wenham et al., 2020). Recognising the different extents to which disease outbreaks affect women and men is a fundamental step in understanding the effects of a health emergency on different individuals and communities, and in creating effective, equitable policies and interventions (Wenham et al., 2020).

Improving health and reducing inequalities within and between Member States are among the strategic objectives of both the EU third health programme (2014–2020) (European Commission, 2014b) and Health 2020, the WHO-led regional health strategy for Europe adopted in 2012 (WHO, 2013).

The importance of achieving universal health is also enshrined in the SDGs, with Goal 3 focusing on health and well-being while the Goal 5 gender equality targets encompass health issues affecting women. Achieving such goals – or even maintaining the status quo – will be a challenge in the present situation. New, smarter and more efficient ways of providing healthcare are needed to overcome the bottlenecks that have been created.

Among the key activities of the EU’s digital strategy is the promotion of electronic health records to give European citizens secure access to their health data and facilitate the exchange of health data across the EU, as well as creating a European health data space to improve the (secure) accessibility of health data, allowing for targeted research, diagnosis and treatment (European Commission, 2020a).