The creation of European Health Emergency preparedness and Response Authority (HERA)

Abstract: The last two decades have been marked by pandemics, epidemics and outbreaks of infectious diseases. They have highlighted the challenges and flaws the EU has been standing in front of regarding public health emergency preparedness. Public health officials and scholars have presented the need for more developed coordination, cohesion and communication between the Member States and the EU and its institutions, but without any major changes made. Two years after the COVID-19 pandemic outbreak appeared, the European Health Emergency preparedness and Response Authority (HERA) was created. The puzzle of this thesis is therefore based on the question of why any similar authority did not exist before the COVID- 19 outbreak. The findings indicate how changes within the public health policy in the EU have been difficult for several reasons. The Member States did not want to relinquish their sovereignty and autonomy over health, which affected the cohesion and therefore the coordination within crisis preparedness. The thesis demonstrated how the path dependence in health policy was difficult to break, to change the institutions and hence create anything similar to HERA. What made institutional change difficult pre-COVID-19 could be described as these infectious disease outbreaks were not strong enough to change the robust path dependence.