The death tolls of past and future heatwaves
The current heatwave is not the first one. In 2003, an extreme heatwave killed over 70,000 people across Europe. Certain population groups – such as the elderly, people with disabilities, youth, ethnic and racial minorities, and those experiencing homelessness – are especially vulnerable. These groups, as well as pregnant women, young children, and people with chronic conditions such as cardio-vascular diseases, are at higher risk of suffering from reduced physiological and behavioral capacity for thermoregulation, for example due to a limited capacity to sweat. Socio-economically disadvantaged people also have limited access to information sources where health warnings are shared and awareness is raised about how to protect oneself from the heat. More recently, the 2019 summer heatwaves affected Europe, more specifically France, Belgium, and the Netherlands with over 2500 deaths.
Unfortunately, future prospects are bleak. Researchers at the Joint Research Centre of the European Commission predict that assuming present vulnerability and no additional adaptation, annual fatalities from extreme heat in 2100 could rise from 2,750 deaths now to 30,000 at 1.5°Celsius global warming, 52,000 at 2°C, and 96,000 at 3°C. The highest number of fatalities are expected to occur in France, Italy, and Spain. Given these dramatic figures, effective policy response from the European Union is urgent.
The EU’s policy response
The origins of the EU’s policy response can be traced back to the aftermath of the 2003 heatwaves, whose death toll sent shockwaves throughout Europe and prompted immediate action to develop national heat-health action plans (HHAPs). At the EU level, and the European Commission and European Environmental Agency (EEA) in particular, HHAPs fall under the health domain. Hence, the EU has worked closely with the World Health Organisation (WHO) on HHAPs beginning with the EuroHeat project, which identified eight core elements of HHAPs in 2008. They include an agreement on a lead body, accurate and timely alert systems, a heat-related health information plan, a reduction in indoor heat exposure, particular care for vulnerable population groups, preparedness of the health and social care system, long-term urban planning, and real-time surveillance and evaluation.
However, apart from issuing guidance, the EU has lacked a major role in mitigating the impacts of heatwaves. The question remains about why it does not play a more active role in mitigating the effects of heatwaves and in formulating heat-health policy.
We tried to answer this question as part of a wider study on HHAPs in France and The Netherlands, conducted as part of the first author’s Research Paper in the context of her International Institute of Social Studies (ISS) MA degree. The study was carried out in collaboration with an applied research project led by the second author. The findings are based on desk reviews and interviews with experts and policymakers.
Obstacles to a more effective EU response
We found that heatwaves and climate change in general fall under several different policy arenas including climate mitigation, adaptation, social policy, and health. This fragmentation limits the EU’s actions on heatwaves. In addition, categorising HHAPs as falling in the health domain makes it challenging for the EU to act because of their existing laws and regulations. According to the mandates specified in the Maastricht Treaty (European Union Treaty) and its Article 129(4), the European Union is allowed to spend money on European Union level health projects, but is not allowed to harmonise public health measures in member states. The Amsterdam Treaty and the Lisbon Treaty (article 152(7)) provided further updates making it clear that health policy is the responsibility of EU member states.
Recent progress on climate change policy has been made within the European Union with the EU Green Deal. A key component, Regulation 2018/1999 of the European Parliament (known as the European Climate Law issued in 2021) established the framework for achieving climate neutrality. However, this regulation does not specifically discuss or call for national HHAPs.
Hence, there is currently no institution within the EU responsible for monitoring the heat-health action plans or heat health policy of member states more generally because under the EU’s limited mandate, it cannot enforce the HHAPs in the member states. Also, it is not in the EEA’s mandate to provide a framework for policy action in this area, and they cannot lobby or influence the EU member states much.
Sharing knowledge and funding research is good but not enough
Therefore, the main role the EU continues to have is to create and share knowledge with and between the member states. The EuroHEAT project mentioned earlier was co-funded by the European Commission (EC) Directorate-General for Health and Consumers. It quantified the health effects of heat in European cities and identified options for improving health systems’ preparedness for and response to the effects of heatwaves. By coordinating with the WHO European Region, the project led to the first framework for HHAPs. In addition, through the European Environmental Agency (EEA), in 2012 the EU has set up knowledge and research databases available on the European Climate Adaptation Platform (Climate-ADAPT), which contain a host of data on climate and health (among other topics), including case studies on the impact of heatwaves on vulnerable populations and policy measures taken. In early 2021, the EU climate law led to the establishment of the European Climate and Health Observatory. It is managed jointly by the European Commission and the EEA as part of Climate-ADAPT. However, the Observatory has yet to increase its staffing to be fully operational.
Two other recent research and policy development projects funded by the EU were HEAT-SHIELD (a Horizon 2020 research project addressing the negative impact of increased workplace heat stress on the health and productivity of five strategic European industries) and the SCORCH (the Supportive Risk Awareness and Communication to Reduce impact of Cross-Border Heatwaves) project, which have generated useful academic and policy outputs.
However, besides investing in research and policy development, we believe that going forward, the EU should take a more active role in coordinating national efforts to develop HHAPs. For example, in our interviews, we found that there is a lack of communication between the national policymakers who work on heatwaves across the EU, and a desire for more exchanges on best practices. This could be addressed by funding targeted projects under relevant EU programs such as Interreg Europe. We also believe that it would be desirable for the EU to have a stronger role in monitoring the quality of the various HHAPs (using the elements in the WHO framework) and ensuring that they are integrated with other relevant (national and EU) polices on disaster risk reduction or national environmental planning.