The emergence of post-Westphalian health governance during the COVID-19 pandemic: the European Health Union

The global response to the Covid-19 pandemic in 2020/21 was dominated by the Westphalian primacy of national territory and sovereignty, significantly worsening and prolonging this global health crisis. Global platforms for cross-border coordination and cooperation, set up by the WHO and other global health partnerships, were constrained by national self-interest. Arguably, the lack of a global supranational (or post-Westphalian) authority in global health governance is one important structural reason for the fragmented, chaotic and ineffective global health response to a post-Westphalian challenge like Covid-19. We argue that the failure of Westphalian governance responses to the pandemic provides a unique window of opportunity for post-Westphalian governance structures to be established and play a vital role in reforming international pandemic preparedness. While we realise that this is unlikely to happen anytime soon at the global level, we show that a comprehensive post-Westphalian health governance framework is indeed emerging at EU level in the form of a European Health Union. Through a combined conceptualisation of supranational governance and the securitisation process of international health crises, we demonstrate how COVID-19 has pushed the door wide open for the emergence of post-Westphalian health governance at EU level coordinated by the European Commission.