The wider approach to securing health also inspires a wider sense of Europe. Most obviously, the WHO Euro region consists of 53 countries, almost twice the number of EU member states — and crucially, some of those neighbors harbor alarming levels of infectious disease that pose a serious challenge to the EU28.

A novel regional grant of €6 million was made in September to help counter tuberculosis in the European region, where the high rates of drug resistance, notably in eastern Europe, account for 25 percent of the global burden. HIV infection rates are also soaring there.

WHO admits that in many of these countries there are “uneven surveillance and response capacities.”  And within the EU’s own neighborhood policy covering the countries almost immediately surrounding the EU, a coordinated approach has been adopted to combat HIV/AIDS.

But the wide range of differences within the EU28 also preclude a single approach to health even within member states, since they are not identical, and none of them has homogenous populations. The contrasts in health status of distinct social groups within member states, and between distinct member states, are well documented – with clear evidence that relative levels of wealth, social conditions, education and social integration are key factors.

So securing health generally requires specific action to improve the health of drug abusers, marginalized groups, migrant or itinerant populations. Other factors count, including relative prosperity of the member states: prosperous administrations can afford better healthcare.

As Professor Helmut Brand says, at present the “uneven distribution of disease burdens leaves the countries with the highest Hepatitis C burden in Europe unable to acquire the expensive treatments now available because they are also the countries with the lowest GDP.” Similarly, more effective administrations can do a better job of maintaining air quality or preventing poisonous mining waste seeping into the Danube.

The countries on the fringes of the current EU that aspire to EU membership are also a focus of attention. As the Commission’s deputy director general for health Martin Seychell pointed out recently, his staff works alongside colleagues from the Commission’s enlargement team in the EU accession process, to help these countries — Turkey and states in the Balkans — in reforming health legislation and health systems to meet EU standards.

The logic is the same throughout: disease respects no borders, so untreated disease or insanitary conditions within Europe or on its fringes constitute a threat to the health of the people within the EU.