Ireland’s upcoming presidency of the European Union presents an opportunity to shape priorities across European health policy. David Lynch reports
For the first time since 2013, Ireland will hold the presidency of the Council of the European Union (EU) during the latter half of this year. Many believe this six-month period provides a significant opportunity for Ireland to set Europe’s health agenda in a positive way.
Irish and European medical bodies have already expressed opinions on what Ireland’s health priorities should be during this period (see panel p4).
Just last month, the Standing Committee of European Doctors, representing 1.7 million members in 36 countries, held a major meeting in Dublin. The IMO helped host the gathering. Part of the focus of the meeting was on the digital determinants of poor health.
Social media
The IMO’s incoming President Prof Matthew Sadlier said it was “imperative” Ireland used its presidency to highlight the risks young people are exposed to online and to work to tighten current regulations.
“We are living in an age of almost non-existent social media regulation, which has created a truly toxic online landscape,” said Prof Sadlier, a Consultant Old Age Psychiatrist. “Not only can children and adults alike access at will the most malevolent and dangerous content, but certain social media apps by their design reward that behaviour by directing users towards ever more extreme content.”
He said these platforms were initially marketed as a positive means to connect with friends and family, but they are exposing young people “to a wide range of harms including addictive algorithms, sexual violence, and gambling”.
It was “bizarre” society had worked hard to strengthen children’s safety offline, while failing to address harms posed by online platforms, according to Prof Sadlier.
Public health
Also last month, the Institute of International and European Affairs hosted a panel discussion on Ireland’s presidency and how it could lead Europe’s public health agenda. The meeting in Dublin was addressed by Prof Mary Horgan, Chief Medical Officer at the Department of Health, who outlined a six-month agenda of health initiatives and goals.
Asked by the Medical Independent (MI) whether the recent period of reform for public health in Ireland would have any specific impact on the presidency, Prof Horgan noted the major investment in this infrastructure.
“This [reform] is now led by consultants in public health,” Prof Horgan said.
“We’ve a really strong, central public health office. We also have regional directors of public health who are at the top table in all the regional health areas.”
These regional public health directors have the same input in health policy as directors in secondary care, which she emphasised “is really important”.
Citing the recently published HSE Public Health Strategy 2025–30, Prof Horgan said one of the lessons from Ireland for the EU is that “it is really important to push the prevention agenda”.
“I think it tends to get less attention, [the need for] investment particularly in primary prevention and a focus on child health. One of the main pillars of public health is on child health and that is absolutely vital,” she said.
“I think the big challenge that public health always has is that you don’t see the benefit of it straight away. You don’t see it the same as treatment for, say, cardiovascular or respiratory disease.”
I think the big challenge that public health always has is that you don’t see the benefit of it straight away
Asked what programmes within public health in Ireland could influence its presidency, Prof Horgan highlighted two initiatives in particular.
The first of these is the HSE’s respiratory syncytial virus (RSV) ‘pathfinder’ programme, which aims to protect infants while reducing pressure on hospital services from avoidable RSV-related illness.
This programme has had a significant impact on “not only the hospital sites, but the trauma these illnesses cause to families”, according to Prof Horgan.
“That has been a huge success… and we [Ireland] are an exemplar for that,” she said.
Secondly, she emphasised the importance of increasing influenza vaccination.
Prof Horgan noted that uptake this year has reached record levels, demonstrating the tangible results of sustained investment and leadership in public health.
Again, she emphasised the importance of understanding it can take several years before the full impact of public health investment is realised.
Respiratory health
Also speaking on the panel was Mr José Luis Castro, Director-General Special Envoy for Chronic Respiratory Diseases, World Health Organisation (WHO).
Mr Castro warned that globally, “the momentum for public health change including in respiratory health had stalled.”
He said the Irish presidency would provide an opportunity for progress in these areas.
Mr Castro said he believed action on tobacco was vitally important.
There is a “growing burden of respiratory disease” internationally, he warned. He said that policies around prevention were “powerful tools”. He added the collection and sharing of data on cases of respiratory disease, both in Europe and globally, were also vital.
Industry
The impact of industry on public health was the focus of a separate event in Trinity College, Dublin, last month (see panel p5). Dr May van Schalkwyk, public health doctor and researcher, spoke on the corporate political activities of health-harming industries.
Asked by MI what Ireland’s health priorities should be in this area during its presidency, she said it was “a really good question” for people in Irish healthcare to consider.
“One of the things I think is so important is learning and building on evidence,” said Dr van Schalkwyk, who is research Fellow at the University of Edinburgh, Scotland.
“I would really focus on… how our actual [health] policies develop. So, a lot more about ensuring independence from industry in terms of your health policies. That means a lot more about public health, and having health departments being protected from vested interests when you are designing your health policies.”
Dr van Schalkwyk also stressed the need for policymakers to identify where harm originates, pointing to the alcohol industry as an example. She noted some of the WHO’s guidance in this area is encouraging. Within that framework, she argued for stricter regulation of advertising, ensuring health warnings remain independent, and increasing public awareness – particularly about the links between alcohol and cancer.
Priorities
Separately, a spokesperson for the Department of Health said the Irish presidency’s priorities will be published in June, “in line with normal practice.”
The spokesperson also pointed towards recent parliamentary answers from Minister for Health Jennifer Carroll MacNeill.
On 18 February, the Minister told the Dáil that Ireland’s “health agenda” for the presidency will promote population health and wellbeing as a “vital foundation for European security and competitiveness and highlight how innovation in health systems” delivers better health outcomes.
She added Ireland will work to strengthen the EU’s focus on population health and wellbeing to address public health challenges through “proactive and preventative” measures.
“We will aim to use our presidency to accelerate work to update the EU tobacco legislation to include vapes and other nicotine products which have been strongly promoted by the industry over recent years,” said the Minister.
Other areas referenced by Minister Carroll MacNeill include a focus on the European Biotech Act (published in December 2025). According to the Minister, the Act streamlines regulations across clinical trials, advanced therapy medicinal products, and biomanufacturing.
“This flagship legislation will dominate health policy discussions during our presidency.”
The Minister also mentioned progress on the European Medical Devices Regulation and In Vitro Diagnostics Regulation that will “simplify and modernise device approval” while maintaining patient safety.
Other issues that are “expected to progress” during the presidency include the Critical Medicines Act, the WHO Pandemic Agreement Annex on Pathogen Access and Benefit-Sharing, and the EU Civil Protection Mechanism reform, if this is not completed during the current Cyprus presidency.
Pick your priority: Plasma collection resilience, fossil fuels, health inequality…
Reducing “health inequities and inequalities” across Europe should be the “high-level thematic” priority for Ireland’s presidency of the Council of the European Union (EU), according to the HSE.
Late last year, the Government launched a public consultation to gather observations, suggestions, and reflections on how Ireland can best fulfil its presidency. A number of health bodies responded, including the HSE.
In its submission, the Executive noted the “huge progress” that has been made in public health in Europe since Ireland last held this role (2013).
“Spurred on by the experience of the Covid-19 pandemic, we have seen great improvements made in emergency planning and response, disease surveillance, genomics, vaccine development, and therapeutics,” according to the HSE.
“But these benefits have not been shared equally: We have seen widening gaps in experience of morbidity and mortality among people in Europe.”
Regarding policy and legislative proposals, the HSE pointed to “strengthening EU social and employment protections”.
“Legislation relating to working hours, minimum wages, job security, and occupational health and safety have direct impacts on health equity. Ireland can advance initiatives that support fairer labour conditions and reduce socioeconomic vulnerability,” according to the HSE submission.
IBTS
The Irish presidency in 2026 will have an opportunity to advance EU health-security objectives, particularly in relation to the resilience of plasma collection and the supply of plasma-derived medicinal products (PDMP), according to the submission from the Irish Blood Transfusion Service (IBTS).
“Several legislative and policy
areas are central to safeguarding Europe’s strategic autonomy in essential medicines.”
Ireland should therefore prioritise the implementation and consolidation of the Critical Medicines Act (CMA), according to the IBTS.
“The CMA provides the framework for strengthening Europe’s resilience against medicine shortages by identifying critical medicines, mapping vulnerabilities, and supporting strategic manufacturing capacity.”
The IBTS said Ireland should use the six months to reinforce Europe’s health security by ensuring that the CMA, European Union Regulation on Substances of Human Origin (SoHO Regulation), and wider industrial and pharmaceutical policies, deliver a sustainable, resilient plasma, and
PDMP ecosystem.
This would ultimately support “EU self-sufficiency and patient access to lifesaving therapies”.
Environment
Irish Doctors for the Environment (IDE) called for an end to fossil fuel subsidies in its submission. According to the IDE, this would release billions of euro which could be reinvested in renewable energy and sustainable public transport systems, ending our reliance on fossil fuels.
“While a short-term increase in fuel prices is inevitable, this may be offset by financially supporting communities in a transition to safe and renewable energy sources.”
The IDE also said an immediate ban on the exploration of fossil fuels is imperative “if we are to halt climate change, mitigate the damage already done, and prevent the impending climate disaster predicted to occur by the end of this century, within the lifespans of our children and our children’s children”.
Keeping track of the commercial determinant of health
A focus on the commercial determinants of health was a “very important area”, Prof Colin Doherty, Head of the Trinity College Dublin School of Medicine, told a meeting last month.
The meeting, which was part of Trinity Health and Sport Week, was titled ‘Is corporate profit prioritised over public health? If so, is another world possible?’.
Prof Doherty, Consultant Neurologist, was introducing the main speaker, Dr May van Schalkwyk. He described the area as “something that occurs between the intersection of medicine, obviously, social science, politics, marketing…”.
During her address, Dr van Schalkwyk, who is a public health doctor and researcher, covered “a lot of industries and a lot of practices”.
“But there is one main message out of this talk, and it is that if we want to promote health, and if we want to prevent harm, we do need to understand and act on the evidence of how major corporations act,” she told the meeting.
“Particularly those that produce harmful products and are damaging the environment – we really need to be acting on that evidence.”
She pointed to sectors such as tobacco, alcohol, gambling, as well as companies involved in the production and use of asbestos, and social media platforms, as key examples.
Reflecting on how her early medical career developed, Dr van Schalkwyk said she was drawn towards researching “how these two industries – the tobacco and the asbestos industry – had really manufactured doubt about the link between their products and harm”.
“And the practices they used to either block, delay, or weaken public health policy.”
She looked in detail at the history of how the tobacco industry has attempted to shape policy.
However, Dr van Schalkwyk noted that “the type of practices they used have been seen again and again and used by many industries that are fuelling many of the major public health issues of our time”.
In its submission on the presidency of the Council of the European Union (see panel p4), the HSE has said that “regulating commercial determinants of health” should be a priority during Ireland’s presidency.
“EU-level regulations on tobacco, alcohol, and unhealthy food are essential to reducing chronic disease and narrowing health gaps,” according to the HSE submission. “Ireland’s proven leadership in public health legislation, from pioneering smoke-free workplaces to implementing Tobacco 21, puts it in a strong position to drive more ambitious EU-level action.”
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