The Italian Constitution obliges the Republic to preserve «healthcare as a fundamental right of the individual» (art. 32) and provides that such duty may «on conditions of equality with other States» allow to «limitations of sovereignty» (art. 11).

The Treaty on the Functioning of the European Union (TFEU) assigns to the latter, in art. 168, only a number of supporting tasks in relation to healthcare policies, which still remain exclusively national-oriented even when «combating serious cross-border threats to health».

The current European Centre for Disease Prevention and Control (ECDC) maintains preventing and coordinating functions, though without an adequate and autonomous operational capacity to contrast the emergency we are living. Art. 196 similarly provides a mere supportive action to civil protection activities, even in the event of «natural or man-made disasters».

We the signatories of this petition REQUEST Italy to promote, in relation to the other Member States of the European Union, a path to define the constitution and the organization of a common organism, with effective competences, aiming at managing grand scope-healthcare emergencies, pandemics and similar phenomena within the EU.

1. Without Treaty changes: achieve an «enhanced cooperation», at least between some Member States. The rules which are already included in the Instituting Treaties of the EU provide the chance for a minimum of 9 Member States to mutually establish a more significant and effective cooperation compared to the one provided by the TFEU up to this point, following the rules expressed in art. 20ff. of the Treaty on the European Union (TEU) and 326ff. of the TFEU. This new form of cooperation will need to be directed towards the creation of a “rapid intervention force” both in the healthcare sector – the so called “blue coats” – and in support of the European Civil Protection. It will need to be adequately and permanently instructed and equipped, assisted by a specific database interoperability system defining homogenous codification and info-gathering criteria, in order to immediately cope with the needs European citizens may have in case of a healthcare threat. This intervention force will be financed by the States that will adhere to the proposed reinforced cooperation.

2. With minimum Treaties changes: establishing healthcare as a «shared competence between the EU and all of the Member States. A new allotment of competences between Member States and the EU will have to be brought forth: this implies transitioning, relatively to healthcare emergencies, from the present system which merely fosters cooperation between Member States, to a system of «shared competences» (art. 4 TFEU), where, under the subsidiarity principle (art. 5.1 TEU), the Union would be granted the tasks to institute, organize, instruct and experiment a rapid intervention and direction force, and to coordinate and operatively support the national and regional healthcare systems in case of a serious and massive transnational emergency.

3. With innovative Treaties changes, of a federal scope: creating a «European healthcare» compartment. Member States will provide themselves with a common healthcare compartment under the jurisdiction of the European Union, with the effective power to predispose, form and organize its own staff, coordinating its ordinary activities with regional and national healthcare systems, operating in specialized and research medical hubs. Such compartment would have consulting functions in programming the needed healthcare skills in case of an emergency. Its staff will need to be in the condition to be immediately activated in the event of a viral or bacterial epidemic or other healthcare emergencies. The European healthcare compartment should also coordinate and finance medical research and production of medicines and vaccines. The European healthcare compartment shall be provided with a budget of its own and with the power to allot its finances, with the relative imposing jurisdiction and its own capabilities in the production of healthcare equipment and material in partnership with private enterprises. The compartment shall exert the power to allow, in the case of a healthcare emergency, the best allotment of tasks between the local-regional, national and European levels. When a common and organic fiscal system – which we strongly hope for – will have been put in place, a specific European tax will be financing this compartment.