The invasion of Ukraine has posed a direct challenge to European and global security and has compelled EU countries to raise defence expenditure. But as the European Commission points out in its recent recommendations on public spending, EU member states especially those in the CEE region must also devote resources to their health systems, which suffer from continuous under-investment. The CEE countries in particular must increase investments in healthcare at a steeper pace to prevent the kinds of future setbacks as witnessed during the COVID-19 pandemic.

Read more about GLOBSEC’s Healthcare Readiness Index, its findings and implications for EU policies in the new blog by Gabriele Grom, Public Policy Lead, Mid-Europe Region, MSD

Europe’s healthcare systems, economy and now security are coming under extraordinary stress in the 21st Century’s third decade and we’re only about halfway through its third year. The COVID-19 pandemic and now the war in Ukraine have up-ended assumptions about continuous peace and prosperity in Europe and raised elemental questions about the basics of our life.

This was the underlying theme at the recent GLOBSEC Forum in Bratislava which addressed head-on the challenge of how to “Build resilience in a divided world”. One might have expected that, with the worst of the pandemic hopefully behind us, public health and the resilience of healthcare systems were low on the agenda.

But, no, this was, thankfully, not the case as the panel I sat on underlined: healthcare is a vital element of national and international security, economic resilience, and social well-being. Universal health secured by adequate investment levels is as indispensable as for example stable liberal democracy, the rule of law, freedom of the press or high-quality educational systems. Governments recognize that public and equitable healthcare is considered a crucially important part of securing the societal stability and trust, and it is vital for future peace and well-being.

The invasion of Ukraine has posed a direct challenge to European and global security, and has compelled EU countries to raise defence expenditure. But as the European Commission points out in its recent recommendations on public spending, EU member states especially those in the CEE region must also devote resources to their health systems, which suffer from continuous under-investment. The CEE countries in particular must increase investments in healthcare at a steeper pace to prevent the kinds of future setbacks as witnessed during the COVID-19 pandemic.

Health is wealth

We already know from GLOBSEC’s Healthcare Readiness Index that the ten Central and Eastern European (CEE) countries accounted for 65% (two-thirds) of excess deaths per capita in the EU-27 since the pandemic erupted over two years ago. Eight of these rank among the top ten for COVID-related mortality. What’s more, data conforms that the more robust and resilient healthcare systems were pre-COVID, the better they performed. In other words, investment pays off.

The impact of the conflict in Ukraine upon health, not least among the millions of refugees and displaced persons, makes that case every day. Vast numbers of refugees are settling in CEE countries (and non-EU neighbours) which can easily aggravate health differences between Western and Eastern Europe.

Healthcare spending in CEE countries may be growing but more slowly than GDP: average health spend per capita can be up to five times lower than in the EU-5 as surveys show. So, health outcomes are inevitably poorer: life expectancy five years lower, death rates related

to heart disease three times higher…And waiting times for innovative, life-saving medicines are significantly longer.

Greater, more efficient health spending will spur better health outcomes, and we have seen the benefits of innovative medicines already. The cancer patients, known and undiagnosed, know up close and personal how true that is. On the long term this leads to raising national output and reserve revenues while, over time, cutting healthcare spending in a virtuous circle. To help make those improved outcomes a reality one key lesson of the pandemic is the need to digitalise healthcare: solid data makes for faster and better decisions. The other one is the need to remove current inefficiencies in the health system such as delayed access to treatment and to address undertreatment, to foster resilience.

Increased spending alone is clearly not the answer to greater healthcare resilience in CEE countries. Alongside investment they need tough decisions about the right mix of spending – and bold systemic reforms to make that spending more efficient and effective. After 25 years working for MSD, I’m more determined than ever to make the benefits of leading-edge research work for all – saving and improving lives not just in the CEE but in Europe and around the world.

Author: Gabriele Grom, Public Policy Lead Mid-Europe Region, MSD

References:

World Bank: https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS?locations=DE

EFPIA: https://www.efpia.eu/media/602947/healthcare-outcomes-and-expenditure-in-central-and-eastern-europe.pdf

EFPIA: https://www.efpia.eu/media/554822/strengthening-health-systems-through-smart-spending.pdf

Cancer burden statistics and trends across Europe https://ecis.jrc.ec.europa.eu/

GLOBSEC Healthcare Readiness Index

European Commission: https://ec.europa.eu/info/system/files/2022_european_semester_spring_package_communication_en.pdf