Author: Jelle Zegers

  • ENVI

    ENVI

    Committee on Environment, Public Health and Food Safety

    “(Mental) health crisis: according to the WHO, the COVID-19 pandemic has disrupted or halted critical mental health services in 93% of countries worldwide. How can the EU ensure the continued provision of mental health services to its citizens despite the ongoing battle against the virus?”

    By Júlia Aguilera (ES)

    Relevance of the topic

    The COVID-19 pandemic has affected societies, economies but especially individuals in each and every aspect. Beyond the obvious health impact on those who have contracted COVID-19 throughout these past months, the personal well-being and mental health 1 of the entire European population has also been affected negatively. At the same time it has also created new barriers for people already suffering from mental illness and substance use disorders. 

    A new Joint Research Center (JRC) study provides evidence of this by mapping the determinants of self-reported life dissatisfaction and feelings of anxiety in 25 advanced and developing countries during the COVID-19 pandemic throughout March and April 2020. This study shows that personal characteristics, employment-related consequences of COVID-19, the rising number of cases and deaths due to the virus, prolonged lockdowns, substantial restrictions on public life and an economic downturn negatively affect personal well-being

    Despite having clear evidence of the consequences the virus has had and is having on citizens, the World Health Organization (WHO) recently published the results of a  survey showing that out of 130 countries, 93% suffered from disruptions in mental health services during the pandemic. Furthermore, the WHO has previously highlighted the chronic underfunding of mental health;  prior to the pandemic, countries were spending less than two percent of their national health budgets on mental health. Therefore they have not been able to meet their populations’ needs.

    The pandemic is increasing demand for mental health services even further. Bereavement, isolation, loss of income and fear are triggering mental health conditions or exacerbating existing ones. Many people may be facing increased levels of alcohol and drug use, insomnia, and anxiety. Meanwhile, COVID-19 itself can lead to neurological and mental complications, such as delirium, agitation, and strokes. At the same time, people with pre-existing mental, neurological or substance use disorders are also more vulnerable to a COVID-19 infection  ̶  they may stand a higher risk of severe outcomes or even death. 
    As Dr. Tedros Adhanom Ghebreyesus, Director-General of the WHO, states: “COVID-19 has interrupted essential mental health services around the world just when they’re needed most. World leaders must move fast and decisively to invest more in life-saving mental health programmes  ̶  during the pandemic and beyond.”

    Key actors

    The World Health Organization (WHO) is an organisation that works worldwide to promote health, keep the world safe, and serve the vulnerable. Since the virus struck the world, the WHO has urged countries to allocate resources to mental health as an integral component of their response and recovery plans.
    The European Commission is an EU institution that has the competence to suggest policies on how to tackle mental health during a pandemic. Until now it has only presented the JRC study acknowledging the impact that the pandemic has had on the mental health of individuals.  
    The European Union has a shared competence with Member States when it comes to public health. Member States are responsible for deciding upon the health services they want to offer to their citizens, in response to the needs of their populations.
    The United Nations (UN) is an international intergovernmental organisation which promotes international peace, security and cooperation. It has mediated in the cooperation of countries to fight against the pandemic and has presented online guidelines for those in need of mental health support related to COVID-19. 
    Mental Health Europe (MHE) is a European non-governmental network organisation committed to – among other things – the promotion of positive mental health and advocacy for social inclusion and the protection of the rights of (ex)users of mental health services, persons with psychosocial disabilities, their families and carers. MHE works closely with European Institutions and international bodies to mainstream mental health in all policies and end mental health stigma. Together with its members, MHE formulates recommendations for policy makers to develop mental health-friendly policies.

    Key conflicts

    Prior to COVID-19, the world was not equipped to respond to the mental health needs of citizens. Mental health was not a political priority and was chronically underfunded in most countries, ignoring the fact that mental health conditions account for 13% of the global burden of disease. According to the WHO, before the virus there were an estimated 264 million people with anxiety, and 322 million with depression worldwide. In addition, there are nearly 800,000 suicides per year globally, and suicide is the second leading cause of death in young people aged 15-29. Due to the pandemic, these figures have increased considerably. 
    There is a growing body of evidence of the effect that public health emergencies such as COVID-19 have had on the health, safety, and well-being of  individuals, causing, for example, insecurity, confusion, emotional isolation, and stigma. At the same time, it may also have an impact on communities, owing to economic loss, work and school closures, inadequate resources for medical response, and deficient distribution of necessities. These effects tend to  translate into a range of emotional reactions (such as distress or psychiatric conditions), unhealthy behaviors (such as excessive substance use), and noncompliance with public health directives (such as home confinement and vaccination) in people who contract the virus and also in the general population.
    COVID-19 has had a particularly detrimental impact on the mental health of certain groups; for instance, frontline workers. They are vulnerable to increased stress, burn-out, depression, and post-traumatic stress disorder (PTSD). This impacts the individual but also the collective response to COVID-19 due to the incapacity or reduced capacity of the frontline workers affected. As reported recently in the British Medical Journal, in the context of comparison between Ebola and COVID-19: “Burnout is associated with a suite of negative outcomes in addition to workforce departure: provider depression; reduced quality of patient care; interpersonal conflict, among others. In the midst of a pandemic, we simply cannot afford this”.
    COVID-19 patients have also suffered from this mental health impact. They have been very affected by the fear, anxiety and uncertainty about their condition, as well as the physical discomfort and separation from loved ones. A study among hospitalised patients in China showed that 35% of patients had symptoms of anxiety and 28% of depression. At the same time, women are under particular stress during the pandemic as carers of the sick, principle bearers of the burden of childcare, and as people continuing to hold down jobs. In addition, isolation and lockdown have also resulted in increases in violence against women, with estimates that globally, “31 million additional cases of gender-based violence can be expected to occur if lockdown continues for at least six months”. It is imperative that Member States’ governments learn from the impact that pandemic measures have had on citizens’ mental health and strive to leave no one behind as the crisis continues.

    Despite acknowledging the many mental health conditions prior to the pandemic and at the same time the impact of COVID-19 on individuals’ mental health, the results of the WHO’s survey show that most countries paused mental health services at the outbreak of the virus. In most Member States’ health systems, only urgent visits and inpatient treatments for severe cases are provided, and, where possible, online treatments (instead of face‐to‐face ones) have been recommended.  Over 60% of the countries in the world reported disruptions to mental health services for vulnerable people, including children and adolescents (72%), older adults (70%), and women requiring antenatal or postnatal services (61%).

    Measures in place

    On the 13th May 2020 the UN released a policy brief on the need for action on mental health as well as a set of guidelines. In this document it highlighted the fact that the mental health and wellbeing of whole societies have been severely impacted by the pandemic and are a priority to be addressed urgently.
    On the 1st June of 2020 the WHO issued a guide for countries on how to maintain essential services  ̶  including mental health services  ̶  during COVID-19. It recommends that countries allocate resources to mental health as an integral component of their response and recovery plans. The WHO also urges countries to monitor changes and disruptions in services so that they can address them as required. They also hosted The Big Event for Mental Health on October 10th which highlighted the need for increased investments in mental health in the wake of COVID-19.
    At the same time, initiatives such as The Help Hub in the United Kingdom have adopted telemedicine or teletherapy to overcome disruptions to in-person services due to the virus. Other non-governmental organisations (NGOs) such as Mental Health Europe have provided online services and helplines to support European citizens who are suffering mentally during COVID-19. 
    Lastly, the Inter-Agency Standing Committee has developed a guide of basic psychosocial skills for COVID-19 responders, a group very affected by the mental health services disruption, to help them deal both with their own mental health conditions during the pandemic and the people who interact with them. COVID-19 responders include health professionals, first responders, food suppliers, pharmacists, funeral workers and managers of volunteers.

    What now?

    – To what extent is telemedicine or teletherapy sufficiently developed to provide mental health patients with their needed treatments?
    – How should the WHO ensure widespread availability of accessible emergency mental health and psychosocial support?
    – After having lived through months of the pandemic, how can we use the knowledge and experience gathered to change and adapt measures to avoid such negative impacts on citizens’ mental health as the pandemic continues?

    Links for further research:

    Mental health services disrupted due to COVID-19 – WHO
    The intersection of COVID-19 and mental health – The Lancet
    The impact of the pandemic on suicide rates – QJM: An International Journal of Medicine
    The global COVID-19 financial response is leaving mental health behind – United for Global Mental Health

  • IMCO

    IMCO

    Committee on International Market and Consumer Protection

    “Decolonising fast fashion: The abuse of human and labour rights is rife in the fast fashion industry, and many brands have been refusing to pay their garment workers in the wake of the pandemic. With 80% of the 74 million textile workers worldwide being women of colour, these unethical practices implicate layers of injustice. What can the EU do to eradicate such practices and improve worker protection while keeping clothing accessible to customers?”

    By Lidewij Mes (NL) and Sasuke Ikemizu (NL)

    Relevance of the topic

    Modern society, fueled by a world economy largely reliant on capitalism, is characterised by a constant need for consumption, and fashion is one of the branches of the economy where it is most apparent. Fast fashion is the term used to describe the low-cost mass production of clothing, designed to provide consumers with on-trend pieces as quickly and as cheaply as possible.  Thanks to the fast fashion industry and its 52 micro-seasons a year, keeping up with trends has never been more difficult, and has never offered bigger money-making potential.
    To be able to sell clothes at a low price, most fashion retailers outsource their production to low-income countries such as Bangladesh, Cambodia and China. In these factories, where most of the employees are women, garment workers work under “sweatshop” conditions; they are underpaid, work very long hours and are constantly exposed to health and safety risks. Furthermore, many factories are not enforcing the necessary measures required to make environments COVID-safe for employees. Very little testing is being done and social distancing is not being made possible.

    To make matters worse, since the start of the Covid-19 pandemic, garment workers have been further underpaid or not paid at all. 80% of Bangladesh’s exports and 10% of its GDP depend directly on the textile industry. In March, in Bangladesh alone a total of 3.18bn dollars’ worth of orders were cancelled or put on hold – nearly one-tenth of the country’s annual textile exports. Since coronavirus shutdowns began in the retail industry in March, millions of garment workers in some of the poorest parts of Asia have lost their jobs.

    Key actors

    Consumers, by buying their products, contribute to the fast fashion industry by creating demand and therefore, knowingly or unknowingly, contribute also to the abuse of human and labour rights.
    Fast fashion companies rely on cheap and fast labour, in order to be able to sell their clothing at a low price. Because of this, they outsource their products to factories where human rights are often abused. However, slow fashion companies play an equally important role. Slow fashion is the movement against fast fashion, focusing more on sustainability, quality and fair wages.
    The International Labour Organization (ILO) is an organisation that unites employers, workers and governments of 187 member states to set labour standards, develop policies and devise programmes promoting decent work for all women and men. By giving each actor an equal voice, they ensure that the views of each social partner are included in the making of labour standards and policies. Their main goals are to enhance social protection, encourage decent employment opportunities and make the dialogue on work-related issues stronger.
    In today’s world where social media plays a big role in the daily life of many people, influencers hold an important position in affecting people’s purchasing behaviour. By promoting certain brands, they have the power to change consumers’ habits and push them to not support fast fashion companies. 
    When it comes to legislation and issuing directives and regulations, different bodies of the EU play different roles. The European Commission has the responsibility and initiative to propose legislation; the Commission submits proposals to the European Parliament and European Council, who must agree on the proposal for it to become European law.

    Key conflicts

    In today’s world of consumerism, as mentioned before, fast fashion companies try to produce as many clothes and styles as possible in order to keep customers happy and to fuel the market. To do this, they rely on garment factories in low-income developing countries where their products can be produced quickly and cheaply. However, these manufacturing companies are officially not authorized by or affiliated with the fast fashion companies that outsource their production. This way, the fast fashion brands are not obliged to ensure a safe working space and decent working conditions.
    Fashion companies put huge amounts of pressure on suppliers, demanding more and more clothes for less and less money.  This creates extremely high levels of competition in the industry, and results in suppliers sacrificing workers’ rights in order to keep up. Margins are thus unsustainably small and companies, suppliers and garment workers are constantly vulnerable. We saw the consequences of this at the beginning of the coronavirus shutdowns. Companies stopped being able to pay their suppliers the minute the crisis began, demonstrating the lack of ethics in the fast fashion business model. Garment workers’ livelihoods are seen as dispensable, as they are the first to suffer when problems arise. Garment workers are often forced to work overtime and through breaks without being paid, in order to meet targets. When targets are not met, garment workers are often physically and sexually abused as punishment. 
    One of the main things to keep in mind when tackling this problem is that clothes should stay affordable. Most ethical slow fashion brands  that don’t outsource their production to developing countries are often much more expensive than fast fashion brands. Making the fast fashion industry more ethical and sustainable should not come at the cost of its affordability. UN Guiding Principles on Business and Human Rights, and OECD Guidelines for Multinational Enterprises have set standards of corporate social responsibility for Western brands that outsource their production to developing countries. However, these standards are not binding, and therefore companies that don’t follow these standards are not sanctioned. Meanwhile, when it comes to the supply chains and impact on the environment of fast fashion companies, there continues to be a lack of transparency in the fast fashion industry. A lot of companies don’t share details about where and by whom their products are made and how sustainable their companies are, making it hard to make changes in the industry from the outside.

    Measures in place

    CARE is an organization committed to saving lives, defeating poverty and achieving social justice. With help of the EU and the Austrian Development Agency, they set up the ‘Oikko’ project. The aim of this project was to improve the working conditions of women in the garment industry in Bangladesh by helping them realise their fundamental rights, as many of them were unaware of the rights they had. 
    WIEGO (Women in Informal Employment: Globalizing and Organizing) is a not-for-profit organisation that focuses on empowering the working poor, especially women, who work in the informal economy. The informal economy comprises economic activities, enterprises, jobs, and workers that are not regulated or protected by the state. In the informal economy, earnings are typically low but costs and risks are high. WIEGO creates change by building capacity among informal worker organisations, expanding the knowledge base, and influencing local, national and international policies. WIEGO’s work includes its Core Programmes, which, among other things, involve assisting informal workers’ organisations in their advocacy for social protection, and informing policy debates and increasing the political visibility of informal workers by improving the quality and quantity of statistics about their work.
    After the accidents that happened in garment factories in Bangladesh and Pakistan and the repression of protests of textile workers, the European Parliament has adopted multiple resolutions, such as a resolution on “Labour conditions and health and safety standards following the recent factory fires and building collapse in Bangladesh”. Amongst the many commitments made in this resolution is an endorsement of the reforming the labour laws so as to allow workers to form trade unions without prior permission from factory owners.

    Clean Clothes Campaign is a global organization focused on improving working conditions and empowering workers in the garment industry around the globe, by, for example:

    – Putting pressure on companies and governments to take responsibility to ensure garment workers’ rights are respected and implemented
    – Raising awareness
    – Urging people to take individual or collective action.

    During the pandemic, Clean Clothes Campaign started a campaign that introduced the hashtag #PayYourWorkers  to raise awareness around the fact that garment workers were being underpaid or not paid at all, and to put pressure on companies to take responsibility for their garment workers.

    What now?

    – How can it be ensured that clothing stays affordable and accessible for everyone?
    – Is it possible for the EU to create better and safer working spaces, even though the factories are located outside of the EU?
    – Can consumers and influencers be held responsible for perpetuating an unethical fashion industry by participating in it? Do they have the power to effect change or should all the focus be on the companies themselves?

    Links for further research:

    Covid led to ‘brutal crackdown’ on garment workers’ rights, says report – The Guardian
    Fast fashion, slow destruction: this is the price other people pay for the cheap clothes we buy – The Correspondent
    How Instagram Influencers Fuel Our Destructive Addiction To Fast Fashion – Huffington Post
    Factory Exploitation and the Fast Fashion Machine – Green Business Network

  • LIBE

    LIBE

    Committee on Civil Liberties, Justice and Home Affairs

    “Privacy or public health: Where controlling the pandemic in order to protect citizens’ health appears often to come at the expense of those citizens’ privacy, governments must walk a thin line. What should the EU do in order to minimise the impact of the pandemic while taking into account the right to privacy of all citizens?”

    By Thijs Verdam (NL)

    Relevance of topic

    Since the beginning of the coronavirus pandemic, governments have been searching for the best ways to contain the virus. Naturally, they first looked towards traditional measures such as mandatory quarantine and manual contact tracing. However, governments are also looking at more innovative ways to combat the virus. Numerous countries have, for instance, come up with apps to track close contacts of their citizens. These forms of digital surveillance might be essential in winning the battle against the virus, though many civil rights groups, citizens and national parliaments have expressed their concern about the threat to the right of privacy many of these digital surveillance techniques pose.
    The area in which governments run the greatest risk of compromising their citizens’ right to privacy in the context of the pandemic is digital contact tracing. Digital contact tracing can be executed through apps working with GPS and/or Bluetooth, and through QR codes that you scan to fill in personal details or to map out your route before leaving the house, as in Moscow. Manual contact tracing presents several issues, including recall bias and delays in communicating with high-risk contacts, not to mention its potential to compromise personal freedom, as we see in France with the attestation form system. Digital contact tracing apps have come under scrutiny with regard to the potential for governments and other groups to access personal information, and use it for other purposes. The lack of confidence in the security of these apps is a crucial challenge, as in order for them to be effective they must reach significant levels of adoption, which requires widespread public trust.

    Key actors

    The World Health Organization (WHO) is the body of the United Nations (UN) concerned with issues of health. As such, they monitor the development of the pandemic worldwide, undertake research into the virus and give guidance to national Health Departments.
    Google and Apple play a major role in the development of contact tracing apps, as software developers for some of the most used mobile phone operating systems. Surprisingly, they have even collaborated with each other in releasing the basic software for Bluetooth-based contact tracing apps. This software could then be used by national Health Departments to develop their own apps.
    The Council of Europe (CoE) is the main European human rights organisation. The main achievement of the Council was the establishment of the European Convention on Human Rights (ECHR). The ECHR established fundamental human rights such as the right to freedom of expression, the right of assembly and also the right to privacy. It is also the initiator of Convention 108 on data protection. The Council of Europe has put together a coronavirus toolkit to guide governments as they make difficult decisions with regard to human rights in their responses to the pandemic.
    The European Commission, the Council (of Ministers of the EU) and the European Parliament are the principal European lawmakers. The General Data Protection Regulation (GDPR) was instituted by the European Commission, the Council and the European Parliament. Changes to the GDPR would have to undergo the same legislative process again.
    The European Data Protection Board (EDPB) is a European body tasked with ensuring consistent application of the GDPR and promoting unity between national Data Protection Authorities (DPAs). DPAs are tasked with ensuring compliance with privacy regulation, especially the GDPR, and provide expert advice on data protection issues. The Chair of the EDPB has said that data protection rules (such as GDPR) do not hinder measures taken in the fight against the coronavirus pandemic, and that even in these exceptional times, the data controller must ensure the protection of the personal data of the data subjects.National governments are the institutions taking measures to attempt to mitigate the negative impacts of the Covid-19 pandemic. These are often limitations of essential freedoms, such as freedom of movement (e.g. in the form of lockdowns) and, of course, the right to privacy. While public health is a competence shared between the EU and its individual Member States, primary responsibility for health protection and, in particular, healthcare systems continues to lie with the Member States. These healthcare systems are responsible for testing, quarantine and contact tracing policy.

    Key conflicts

    It is in the interests of all parties to work as quickly as possible to combat the pandemic. Some say that the health data gathered through digital surveillance is essential for fighting the pandemic as manual contact tracing is too slow: once all contacts have been tracked down, they could already have passed on the virus. In South Korea, Singapore and China mobile apps have been used to great effect. However, the used methods of digital surveillance can mean a significant breach of our right to privacy and the apps in South Korea and China have come under data protection scrutiny.

    Two main methods are in use for contact tracing: GPS and Bluetooth. Users’ GPS data is collected by apps or is provided by telecom providers. While all EU governments claim that the data is anonymised, it can be quite easy to attach a person’s name to anonymised data. Bluetooth contact tracing is more anonymous and seems to be more effective and precise too, but can provide a malicious government with even more valuable information about a person’s close contacts. Even in the case of a benevolent government, there is still a risk that the data will be used for other purposes than to fight the pandemic. How can we ensure that citizens’ movement data is kept anonymous, while the data essential to digital contact tracing is collected to help monitor and control the spread of the virus? 

    The EU has released an interoperability gateway (see under Measures in place) in order that digital contact tracing apps can work across borders. This gateway now works for the German, Irish and Italian apps. However, this platform may risk citizens’ data falling into the hands of national health departments or governments that are not their own. Could this risk decrease citizens’ willingness to use such apps?
    A breach of the right to privacy via these tracing apps may pose future risks to other rights, such as the right to freedom of expression and the freedom of assembly. Montenegro, which is a candidate Member State, is a good example of the possible effects of the breach of privacy. There, the government puts up listson the internet of people who are or should be in quarantine, asking citizens to help enforce it. ‘People whose health status, identities and location are publicly exposed are at greater risk of stigma and discrimination, which can have detrimental effects on their private and family lives and social and professional situations’, according to the United Nations Development Programme. While the UN states that tracking without violating the right to privacy is possible, the topic is controversial and public trust in the concept of mobile tracing apps has already been eroded. This poses a significant threat to the success of digital tracing apps, as it is important for their efficacy that they are used by a large part of the population.

    Measures in place

    The first measures on a European level on the topic of data protection were taken by the Council of Europe in the form of Convention 108. Because this Convention was instituted by the Council of Europe, it is binding for more countries (47 countries) than the law of the European Union discussed below. The Convention is an elaboration on the right to privacy laid down in Article 8 of the ECHR.
    In 2018 the EU launched the General Data Privacy Regulation (GDPR). Its main goal is to give individuals control over their personal data and simplify the regulatory framework for international business by unifying privacy regulation in the EU. Under the GDPR, data controllers must clearly disclose any data collection, declare the lawful basis and purpose for data processing, and state how long data is being retained and if it is being shared with any third parties or outside of the European Economic Area (EEA). Public authorities, and businesses whose core activities consist of regular or systematic processing of personal data, are required to employ a Data Protection Officer (DPO), who is responsible for managing compliance with the GDPR. There are provisions in the GDPR that allow for the collection, use and necessary sharing of personal data related to health in the context of an epidemic. However, these provisions are vague, while the GDPR as a regulation is quite rigid. This means it is very difficult to balance the provisions with the requirements of the fight against a pandemic.
    The WHO has released a guide on essential and recommended surveillance. It lists several key actions for COVID-19 surveillance. Among them are the use of surveillance and contact tracing systems, expanding testing capacity and the implementation of immediate reporting (of statistics).
    The European Commission has published guidance for the data protection standards of apps fighting the pandemic. This guidance sets out various standards, including that the use of the app should be voluntary; that data is not kept longer than necessary; that data should be stored on an individual’s device and encrypted; and that DPAs be consulted in the development of an app.
    The European Data Protection Board (EDPB) and the Council of Europe have released similar statements on the question of privacy in the times of the pandemic. They state that the GDPR and Convention 108 do not pose a restriction to measures taken to fight the coronavirus. They do emphasize that these measures are proportionate and limited to an emergency period.
    Many national Health Departments have now already introduced apps which trace your close contacts. For instance, the German ministry of Health launched their app in June. The Belgian app was launched in September and the Dutch launched their app in October. All three of these apps work with Bluetooth technology. The European Commission has also brought out an interface so that national contacting tracing apps could work cross-border.

    What now?

    It is clear that it is and it will be difficult to strike a balance between individuals’ rights and health surveillance. Some questions we could pose in this regard are:

    – Should we go back to or stay with manual contact tracing to maintain the right to privacy?
    – Should digital contact tracing track movements in more detail and notify people further down the contact chain in order to to further improve its efficacy?
    – If implemented, how long should digital surveillance measures stay in place and could these measures not pose a risk to our privacy after the pandemic?
    – Should it be monitored more carefully (possibly using location data) that people are observing quarantine rules, and how will this impact the mental welfare of citizens?

    Links for further research:

    Your Data Privacy During a Pandemic – The Medical Futurist
    Ensuring data privacy as we battle COVID-19 – OECD
    In a global pandemic, do we still have a right to privacy? – United Nations Development Programme