On discharge in respect of the implementation of the general budget of the European Union for the financial year 2024, Section III – Commission

OPINION

The Committee on Public Health calls on the Committee on Budgetary Control, as the committee responsible, to incorporate the following into its motion for a resolution:

1. Regrets that the budgetary expenditure entered in the accounts for the year 2024 is materially affected by error; notes furthermore that the European Court of Auditors (ECA) estimated the overall level of error affecting such expenditure at 3.6%, thus evidencing that a considerable proportion of the expenditure recorded in the accounts is subject to material irregularities;

2. Recalls the findings of the ECA’ Special Report on the Digitalisation of Healthcare, which concluded that Union support to Member States has been overall effective in fostering the digital transformation of healthcare systems; notes, however, that Member States have faced difficulties in utilising Union funds allocated for this purpose and regrets that while the Commission monitors the progress achieved by Member States in the digitalisation of healthcare, it does not yet possess a comprehensive overview of how Union funds are being used to support these activities;

3. Calls on the Commission to take corrective action addressing the shortcomings identified by the ECA and the concerns expressed by the European Parliament.

EU4HEALTH

4. Expresses concern regarding the Commission’s overall implementation of the budget under the EU4Health programme, noting that only 64.5% of commitments and 29.3% of payments were executed;

5. Strongly regrets the disproportionate €1 billion cut to the EU4Health programme schedule for the 2025-2027 period; recalls the importance of the public health policies and the clear political commitment in the 2020 MFF agreement to prioritise health funding;

6. Notes that investments in crisis preparedness and response represented approximately 64% of the EU4Health annual budget for 2024; acknowledges that these investments have significantly strengthened the Union’s capacity to respond to health emergencies, enabling timely interventions such as the procurement of mpox vaccines;

7. Acknowledges that the EU4Health programme has contributed to the InvestEU programme through blending with the EU guarantee, thereby mobilising additional investments; notes in particular the contribution of EUR 110 million via an InvestEU top-up supporting European Investment Bank (EIB) investments in innovative life-science projects related to medical countermeasures;

8. Highlights that special attention was devoted to antimicrobial resistance (AMR), notably through cooperation with the Global Antibiotic Research and Development Partnership; welcomes the establishment of EU FAB, an “ever-warm” network for vaccine production ensuring rapid and sustained manufacturing capacity for future health emergencies;

9. Notes that direct grants to Member States aimed at strengthening national surveillance systems, attracted 23 proposals, launched between October 2024 and January 2025, with a Union contribution of approximately EUR 87 million; further notes that the joint action on counteracting antimicrobial resistance, supported by EUR 50 million, engaged all Member States and a broad consortium of beneficiaries; recalls the programme’s contributions to international coordination with the World Health Organization (WHO) and the European Centre for Disease Prevention and Control (ECDC), supporting efforts to respond to recent Ebola, mpox, and Marburg virus outbreaks in Africa;

10. Observes the continued investment in the EU Early Warning and Response System and in three waves of new European reference laboratories for human pathogens; notes that nine laboratories have been appointed to date, with funding secured for the next seven years;

11. Notes with satisfaction that implementation of the health promotion and disease prevention strand (representing 9.7% of the annual budget) is on track; welcomes the 142 pilot projects under the joint action on cardiovascular diseases and diabetes, as well as the wide participation of Member States in public health interventions across all stages of life;

12. Welcomes the broad involvement in the Mental Health Together joint action, with 20 Member States adopting a comprehensive approach to mental health, and the European Programme for Mental Health Exchanges, Networking and Skills, enabling the participation of around 300 professionals;

13. Notes the launch of new grants for European Reference Networks (ERNs) for rare diseases, with a total budget of EUR 77.4 million and a funding rate of 100%; welcomes the introduction of harmonised work packages and indicators to improve comparability, synergies, and best-practice exchange among ERNs; notes furthermore the joint action on the integration of ERNs into national healthcare systems, launched in January 2024, involving 58 partner institutions across all Member States, Norway and Ukraine, with total funding of EUR 18.75 million;

14. Welcomes the health systems and healthcare workforce strand (representing 5.4% of the annual budget) for delivering tangible results, including the publication of Health at a Glance: Europe 2024 and progress under the new regulatory framework for medical devices; takes note that by October 2024, 10 554 certificates for medical devices and 1 273 certificates for in-vitro diagnostic devices had been issued; welcomes the creation of an IT platform to support the implementation of the Health Technology Assessment Regulation, involving nearly 500 users from EU and EEA countries, as well as the training of 350 patients to contribute to joint work on assessments;

15. Acknowledges EU4Health support for Member States in implementing the new Substances of Human Origin Regulation, and notes funding for studies on pricing and reimbursement and on the Clinical Trials Regulation;

16. Welcomes the digital strand’s contribution (3% of the annual budget) to the digital transformation of healthcare, particularly through the expansion of MyHealth@EU and HealthData@EU, both key enablers of the forthcoming European Health Data Space; stresses that 22 countries launched 44 key projects to improve interoperability and access to health data;

17. Welcomes the implementation progress under the cancer strand (21.5% of the annual budget) contributing to Europe’s Beating Cancer Plan, with 74 initiatives launched; regrets, however, that only 18 Member States participated in the CanScreen-ECIS project, underscoring persistent gaps in national data collection capacities and the need for further EU support and funding in this area;

18. Regrets Commission’s decision to eliminate operating grants for civil society - health NGOs – representing thousands of patients, healthcare professionals and communities from the EU4Health 2025 Work Programme. Operating grants accounted for just over 1% of the EU4Health budget in 2024. The absence of operating grants has meant a significant reduction in staff, halted projects, cancelled convenings, and, most importantly, broken continuity of support to people and public health.

HERA

19. Notes that DG HERA, established in 2021, has continued to grow the number of its staff and to expand its operations, in 2024; welcomes the progress of HERA’s efforts in ensuring the Union’s preparedness and crisis response readiness for health emergencies as well as its involvement in collaborations with international partners

20. Recalls the Commission’s commitment to carry out a thorough review of the implementation of HERA’s operations by 2025 and to consider changing its structure and governance, including in order to transform it into a genuine agency with an autonomous budget;

21. Recalls that Parliament advocated for enhanced parliamentary oversight of its activities;

22. Notes furthermore that the targeted revision of the MFF in 2024 resulted in reductions across several programmes, including EU4Health and Horizon Europe, which had a direct impact on the resources available for health preparedness; welcomes the Commission’s decision to mitigate the impact of these reductions by postponing the majority of the budgetary adjustments to 2027, when the budget for preparedness will reach its peak level;

23. Observes that, because HERA’s activities draw upon existing Union programmes, they are subject to multiple legal frameworks and governance arrangements, each involving different stakeholders and reflecting broader policy objectives beyond HERA’s specific mandate; stresses, therefore, the need for effective coordination among the relevant Commission services, as well as for close cooperation between HERA’s stakeholders and Member States’ representatives participating in the governance and programme committees of the respective funding instruments;

24. Notes that concerns have been expressed regarding the potential risk of duplication of tasks and a lack of clarity concerning HERA’s role within the wider framework of Union public health, civil protection, and research funding; takes note that questions have arisen in relation to HERA’s interaction with other Union bodies and mechanisms, including ECDC, the Health Security Committee, the Advisory Committee on Public Health Emergencies, and the European Medicines Agency (EMA), particularly in the areas of medical countermeasures and critical medicines;

25. Further notes that the public profile and external communication of HERA have, in some cases, led to confusion among external stakeholders regarding institutional responsibilities and representation, notably as to which entity speaks on behalf of the Commission in matters related to health emergency preparedness and response.

Conclusion

Is of the opinion, based on the data and reports available, that discharge can be granted to the Commission in respect of expenditure in the areas of public health for the financial year 2024.