Active EU Health Diplomacy in the Western Balkans Is a Way to Win the Region over and Prevent the Rise of Extremism

  • Pavel Hanosek
  • 11.2.2021 16:23

With the emergence of the covid-19 pandemic, health rapidly became one of the most important areas to watch for in foreign affairs. Despite its potential to introduce new challenges and conflicts between various countries, it also brings another chance for ever closer cooperation. Good example of this is the EU and its appeal in the Western Balkans. The EU can take the opportunity and increase its health funding and cooperation within the region to tackle the pandemic and strengthen its image. Alternatively, it risks the spread of new virus mutations into the EU and also the rise of radicalism at its doorstep due to economic and social crisis in the region.

During the covid-19 pandemic, health crisis preparedness became one of the most important elements influencing the outcome of the pandemic in different countries. However, the pandemic showed us that it is not only the health related preparedness, but also the ability of the country’s leadership to make the right decisions at the right time that has a major impact. 

A good illustration of this could be found in a number of Western Balkan states which strive for EU membership. For example, even though the biggest country in the region, Serbia, has a relatively strong healthcare system which accounts for around 9 percent of its GDP, it was widely criticized for its handling of the crisis such as punishing doctors who pointed out governmental mistakes. Compared to the EU members, Serbia’s contribution to its healthcare is similar to Italy and higher than Ireland, Slovenia or Poland.

Despite the fact that some Western Balkan countries retain quite robust health services, they still required significant help from abroad to effectively tackle even the first wave of the pandemic. External powers such as Russia and China, but also the EU were active in this endeavour. 

However, the help from the EU was not a part of any systematic programme to strengthen the region's capacities, but rather an emergency action, even though the Union is otherwise very organized and structured in its approach to the Western Balkans. This is reflected by the allocation of the resources in a package offered to the region at the Zagreb summit in May. The goals were to tackle immediate socio-economic burden and slow down the spread of the virus, not a long-term capacity building.

The EU is an active player in the region and the biggest donor of funds critically needed to modernise Western Balkan’s economies. The Union provides assistance to the Western Balkans for a number of years, most notably through Instrument of Pre-accession Assistance II (IPA II), which concludes this year. However, until now, the EU focused primarily on the promotion of smart sustainable economy, energy transition and legislative reforms to align local legal rules with the EU standards. With health emerging as a new core issue due to the pandemic, providing more funds for equipment, expertize sharing and health research will be needed. 


Isolation and radicalization 

It might prove difficult for the European policymakers to settle on substantial support to the Western Balkans in the time when their own countries are struggling to contain the virus and keep their economies alive. However, there are a couple of reasons to think long-term on this issue. 

Firstly, the region due to ineffective bureaucracy could become a breeding ground for the virus from which it could repeatedly spread into the EU. In the Balkans the virus could also hypothetically find a safe haven to mutate into forms resistant to vaccines.

Secondly, the EU has much stronger leverage globally which the Balkans is lacking. It might prove challenging for the Western Balkans to acquire a truly safe and properly tested vaccine. It might already be too late since the Serbian president Vucic, according to his words, placed an order for Russian Sputnik V vaccine, some of which already arrived.

Thirdly, foreign actors were able to use disinformation and their local supporters in the Balkans to amplify their aid in the spring and thus the EU lost some of its influence among the locals, even though its assistance was bigger. This could in the long run lead to the weakening of the support for the EU accession since it would be seen as something alienating to relations with Russia.


“Foreign actors were able to use disinformation and their local supporters in the Balkans to amplify their aid in the spring and thus the EU lost some of its influence among the locals, even though its assistance was bigger.”


These challenges culminate in one major threat, which is a possible rise of poverty and socio-economic burdens that lead to radicalization. If combined with political isolation caused by the inability to get the spread under control in the long-term, reemergence of past conflicts is definitely not unthinkable.


The EU should assist Western Balkans in the health-related sectors

There is a history of misuse of EU funds in the Balkans, especially when it comes to the energy transition projects. To avoid this unwanted scenario, It will be necessary to increase the number of EU personnel supervising certain projects in the region or to cooperate more closely with local partners. A possible solution could be NGOs which would have some level of access to the project goals and data and would thus be able to assess and alert EU authorities in case there is a problem with the project. This goes hand in hand with continuation of legislative reforms allowing for more transparency in the system and better oversight. 


“Acknowledging health affairs as a new major theme in the enlargement process will align the EU and Western Balkans even more, speeding up the accession process.”


The EU should, for the aforementioned reasons assist Western Balkans specifically in the health-related sectors. This could be done by enhancing a policy area “People”, which was already part of the IPA I and II and which dealt with health themes as well. However, more suitable would be to introduce a new policy area “Health” into the IPA III, which would be responsible for more systematic expert knowledge sharing, health research grants promotion, health monitoring in the Western Balkans and equipment acquisition.

Acknowledging health affairs as a new major theme in the enlargement process will not only bring a safer environment for both the EU and Western Balkans, but also would align the EU and the region even more, speeding up the accession process. Not just in the health standards such as acceptance of vaccines and testing methods, but also in a more symbolic and personal way. After all, lives are what matters the most to the people, not the immaterial and enormous vision of EU membership or low carbon emissions, despite their importance.

About author: Pavel Hanosek


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