This paper explores the implications of the Lisbon Treaty for the European Union’s (EU) role in global health. It also considers the EU position at the World Health Organization (WHO) and specifically on the reform debate where the WHO’s core business, financing, governance and management operations are under review.
The paper examines the extent to which the EU represents a single voice in discussions and questions where the EU’s performance is undermined by disputes over EU competence on global health, WHO governance procedures, a lack of common EU policy objectives or other incoherencies. It also considers other factors contributing to EU performance in the WHO, and the extent to which the EU brings the experience of EU internal governance practices to the table. The paper is based on qualitative interviews with EU staff, professionals from EU and non EU member states.
Results suggest that vertical integration across parts of the EU/EC was well developed, however there was more scope for integration on global health strategy across the EU. Whilst there was good coordination on the WHO reform, there was also little involvement on the reform across MS (EU and non-EU). Tensions arose between the EU and MS when it came to institutional rather than technical matters. There was more scope for horizontal integration across health, foreign policy, research and development within and across the EU and MS. The ‘single voice’ and effectiveness of EU representation was affected by a number of factors, including MS trust in EU representation, flexibility in negotiations, lengthy EU coordination processes, MS vying for influence within the EU, and MS rather than EU engagement in behind the scenes and ‘soft power’ diplomacy. The results are considered in light of prior theory and research on the EU’s role in global multilateral governance.