Health has increasingly become a supranational and, respectively, federal competence in the EU and the USA and is recognised as a central component of national security and international politics. In November 2020, the European Commission called for a stronger EU competence in health to tackle health threats in an effective and efficient manner that is on a par with global players such as the USA and China. If agreed, the proposed European Health Union would strengthen the legal framework as well as the mandate and preparedness and response capabilities of EU agencies including the European Centre for Disease Prevention and Control (ECDC) and the European Medicines Agency (EMA). It would also introduce a new structure – the European Health Emergency Preparedness and Response Authority (HERA). This new body, referenced in the EU roadmap for an impact assessment, is inspired by the US Biomedical Advanced Research and Development Authority (BARDA). The HERA would complement the activities of existing EU agencies, in particular the ECDC and EMA, in areas such as epidemic intelligence and securing advance purchase agreements for vaccines and medical equipment. With these changes, the organisational architecture of health security in the EU could increasingly resemble that of the USA, where the Centers for Disease Control and Prevention (CDC) carries out similar activities to the ECDC and the FDA has similar functions to the EMA
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