The COVID-19 pandemic brought the EU health mandate under unprecedented scrutiny, providing a new impetus for action. The European Commission launched the ‘European Health Union’ (EHU), bringing a number of pre-existing and newer policy initiatives under a common umbrella. This contribution looks back at the recent developments in EU health law and policy, taking the 2019–2024 parliamentary term as a boundary. It offers an overview of what the EHU currently is, and what it could become. Despite its potential, the EHU is not yet a game changer. This can only happen if changes are brought to the EU’s competence and budgetary frameworks. The contribution provides first a brief introduction to the EU’s complex health competence framework and its general policy orientations in the field. We turn next to COVID-19, offering a condensed overview of the EU’s response and of the subsequent changes brought to the legal framework applicable to health emergencies. We finish by casting a closer look at the EHU, examining the descriptive and normative aspects of this concept, and making recommendations to increase the clarity, quality and legitimacy of EU action in the field.

The COVID-19 pandemic served as a catalyst to build a stronger European Health Union to protect the health of Europeans and to develop a new Global Health Strategy to contribute to global health security. In positioning itself as a key player in global health governance, the EU seeks to assert its responsibility as a global health actor and deepen its leadership in global health law.

Part of the controversy surrounding competition and health care stems from the complexity connected with delineating the applicability of competition law – encompassing both the provisions governing anticompetitive agreements and abuse of dominance and the state-aid rules. Cases determined at the European Union (EU) level within the past 30 years have developed a broad framework, and notable trends have emerged – for example, a distinction between health care providers and managing bodies (purchasers). The former have been subject to an ‘abstract’ test and the latter to a more sophisticated ‘concrete’ test. In this paper, we chart the development of the EU courts’ approach to developing the ‘undertaking’ concept in health care and examine the current EU competition law framework with a view to identifying future directions. van de Gronden has recently identified a ‘three-prong’ test of exemption from competition law in connection with the recent CEPPB case: firstly, where the supply of services is predominantly dependent upon public financing; secondly, the public funding aims to achieve a public interest goal and thirdly, the activities concerned are closely related to this public interest goal. We examine this test in a health care context, drawing on our findings regarding Dutch competition reforms.