The direction has been set: healthcare no longer looks at the European Union from the sidelines, but steps inside the European system of knowledge, standards, and responsibility.
By Azir Aliu
In several European countries, JACARDI demonstrates how EU4Health is being transformed from a European programme into practical healthcare change. JACARDI is a joint action of the European Union on cardiovascular diseases and diabetes, financed through EU4Health, which connects institutions, experts, and healthcare systems around the common goal of reducing the burden of heart attacks, strokes, and diabetes, improving prevention, enabling earlier detection, and providing more organized patient care. Within this initiative, 143 pilot projects are being implemented across 18 European countries, covering health literacy, the quality of health data, screening of high-risk groups, integrated care pathways, disease self-management, and support for people with chronic illnesses to remain active in the labour market. This example illustrates the true value of EU4Health: European funding is transformed into a concrete organization of care, knowledge, and better outcomes for patients.
Such examples are important because they remove European integration from the language of political declarations and rhetoric and bring it into the space where citizens experience the state most directly: the hospital, the clinic, the home, and the family. When the European Union finances better prevention, better data, and better coordination, we are not speaking about a distant institutional address, but about the possibility of practical support for patients and healthcare professionals. This is why models are being developed for health literacy, self-monitoring, coordination among healthcare providers, and structured follow-up after hospital discharge. In this way, European values are translated into everyday security: ensuring that the patient knows what comes next, that the physician has better data, that the system does not react too late, and that families are not left alone. Through EU4Health, 11 projects with nearly €62 million in support are working precisely on such solutions to reduce the burden of stroke through screening, early detection, digital tools, artificial intelligence, integrated care pathways, and improved system coordination. This is the essence of EU4Health: an opportunity for healthcare systems to enter a higher systemic order of operation, defined by greater knowledge, standards, competition, partnerships, and a higher degree of accountability.
By signing the agreement on participation in EU4Health, our country gains access to the European Union’s largest healthcare programme. This programme has an operational budget of €4.4 billion for the period 2021–2027. It is important to emphasize that these funds are not automatically allocated to our country. This means that our institutions, public and private healthcare entities, the academic community, professional organizations, and the broader healthcare sector gain the opportunity to participate in European calls, direct grants, joint actions, and partnerships under the same rules and with the same project discipline as all other participants in the programme.
There is also an important distinction: these funds do not represent a reward for rhetoric. Their accessibility and effective utilization will depend on our preparedness and developed capacities. Quality projects, clear indicators, partnerships, institutional coordination, and the ability to transform ideas into measurable results will all be required.
For this reason, I do not perceive our entry into EU4Health as an administrative success, but rather as European confirmation that the reforms we have initiated possess direction, credibility, and institutional logic. The agreement comes at an important moment. Nearly one year after assuming responsibility for the healthcare system, we can say that our greatest achievement lies not merely in individual decisions, but in the direction we have established. Healthcare is emerging from the long-standing logic of daily “firefighting” and entering a systemic and self-sustainable logic based on data, digitalization, prevention, workforce planning, quality, transparency, and European standards.
The signature in Brussels is therefore not an end point; it is proof that the first year was not time lost, but rather a year dedicated to laying foundations. In politics, the most important achievements are sometimes not the loudest ones. They do not always arrive with grand words, but rather through the moment when an institution finally positions itself on the right trajectory. EU4Health is precisely such a moment: a strong confirmation that healthcare can move towards the European Union as a system.
Within the context of EU4Health, our priorities have been clearly defined: digital health and health data; prevention and screening; oncology and cardiovascular health; mental health, especially among young people; preparedness for health crises; access to medicines and medical products; strengthening the healthcare workforce; and improving governance, regulation, and services for citizens. These are the issues that determine the difference between a system that waits for problems to become crises and a system that knows how to prevent them.
EU4Health also opens the door to European networks, meaning that our clinics, institutes, faculties, professional associations, and patient organizations can become part of broader consortia, learn from already-tested European models, adopt and adapt good practices, and build capacities that extend beyond national boundaries. In modern healthcare, isolation is costly. Knowledge moves quickly, technology changes rapidly, and risks do not recognize nationally defined borders. Therefore, the response must also be European, interconnected, and coordinated.
The application procedure is precisely structured, but it requires knowledge and institutional seriousness. Calls are published through HaDEA and the EU Funding & Tenders Portal. For each call, the annual work programme defines the objectives, eligible applicants, activities, expected results, and conditions. Organizations wishing to apply must first register in the Participant Register, and through the portal they can also search for project partners. Applications are evaluated by HaDEA and the European Commission, with the possibility of involving external experts. The basic co-financing rate is up to 60 percent and, in certain cases of exceptional value, may reach up to 80 percent.
This means that our task begins now. The state must act as organizer, coordinator, and driving force. The Ministry of Health will have the responsibility to bring the programme closer to all potential beneficiaries: universities, medical faculties, clinics, hospitals, institutes, professional associations, patient organizations, and relevant partners. We will not allow this European opportunity to remain merely as information presented to the public. In the coming period, it will be transformed into a working agenda, a project calendar, and institutional mobilization.
What is particularly important for our healthcare system is that EU4Health does not finance only infrastructure or isolated activities. The programme supports systemic transformation. The European Commission has positioned the programme as an instrument for building stronger, more resilient, and more accessible healthcare systems, with a focus on crisis preparedness, prevention, cancer, digitalization, medicines, the healthcare workforce, and the European Health Union. Therefore, I also understand this programme as a test of our maturity and readiness for quality projects and partnerships, as well as a test of our capacity to work within European deadlines, indicators, and standards.
Because of these high European expectations for our healthcare system, we are already entering the next phase with strong momentum: transforming the European approach into a domestic institutional culture. A period of applications, partnerships, projects, and visible benefits from EU4Health for our citizens lies ahead.
Ultimately, EU4Health is a political, institutional, and civilizational message that our healthcare system is leaving behind the position of an observer and entering the space where European healthcare solutions are created. This marks the beginning of a new responsibility, in which the European approach will become domestic practice and reforms will be measured through a European lens. The direction has been set: healthcare no longer looks at the European Union from the sidelines, but steps inside the European system of knowledge, standards, and responsibility.
The author is Minister of Health in North Macedonia