The race to become the next EU executive health minister has intensified once again after a leading candidate suddenly dropped out.
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Malta's official candidate for the next commission, Deputy Prime Minister Chris Fearne, is a surgeon general and Europe's longest serving health minister, and was seen as the favourite to replace Cyprus' Health Commissioner Stella Kyriakides.
But the medical community was stunned when Mr Fearn was charged by prosecutors in a state corruption scandal, resigned and asked to withdraw his nomination to the EU commission.
Although it is premature with next week's elections on the horizon, inevitably new names are beginning to circulate as possible candidates for the Ministry of Health.
These are some of the names that recur in relation to positions in the Brussels medical community, but these appointments are always complicated by many external factors, for example the balance of the executive in terms of gender and geography.
Why (Probably) Not Kyriakides?
The chances of the outgoing EU health minister winning another ministerial election are quite slim, but still there, and she has not yet said whether she will seek re-election.
“Commissioner Kyriakides remains fully committed to his current job and to the many important tasks and challenges that remain before him during his term,” a Commission source told Euronews.
The Cypriot has weathered the pandemic and has a good reputation on the health front, although she is seen as neglecting a sideline on food safety.
She is highly regarded by von der Leyen and is considered one of the best speakers in the current European Commission, having recently represented the Commission at international forums such as the World Economic Forum in Davos.
But what complicates her re-election is that her party, the National Democratic Union, is no longer part of Cyprus' ruling coalition, even though she is politically active with the centre-right European People's Party (EPP).
It is also extremely rare for outgoing commissioners to be reappointed to the same post, although the current government has made exceptions to this general rule by reappointing experienced senior members Valdis Dombrovskis and Margrethe Vestager.
Dataspace Twins
A likely candidate is Belgium's Deputy Prime Minister and Minister of Health, Frank Vandenbroucke, who currently chairs the Meeting of Health Ministers during Belgium's rotating presidency of the Council.
The Belgian Presidency's health programme was unusually dense and ambitious, more like a statement of intent for health policymaking over the next five years than a six-month to-do list.
Vandenbroucke has successfully concluded negotiations on the sensitive issue of health data space and launched the Critical Medicines Alliance to address the issue of medicine shortages, which is set to be a key item on the Commission's agenda at the next meeting.
But Belgium's choice of commissioner will likely depend on national elections in June, because key positions like commissioner and prime minister are typically agreed in coalition deals using a complex points system.
But if the executive is not functioning by the time Belgium submits the names of the commissioners (it took Belgium 494 days to form a government after elections last time), the current ruling coalition will carry it out.
In that case, Van den Broeck would likely be appointed given that he speaks Flemish and that informal rules stipulate that the post is rotated among the countries' linguistic communities.
Vandenbroucke’s counterpart on the health data space issue, parliamentary rapporteur Tomislav Sokol, is also rumoured to be a possible candidate to represent Croatia if assigned to the Ministry of Health.
As a MEP, Sokol was an active participant in some of the biggest health issues during his term, including the modernisation of EU medicines law, and also served on Parliament's Health Committee and two Select Committees on Cancer and the COVID-19 pandemic.
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The two main issues standing between von der Leyen and the European Commission are Croatia's current Commissioner Dubravka Šujca (who could be reappointed and also take charge of the Ministry of Health) and Croatian Prime Minister Andrej Plenkovic, who is rumoured to be the European People's Party's (EPP) back-up candidate for European Commission presidency if Ursula von der Leyen's candidacy fails.
The “impossible” choice
But other names currently being mentioned seem less likely.
For example, Malta's Environment Minister Miriam Dalli, who is rumoured to be Chris Fearne's successor, was active in health issues as a member of the European Parliament, particularly on the medical use of cannabis – Malta has been a European pioneer on the use of cannabis for medical purposes – but energy issues are her forte and she is likely to become Minister for Transport.
Vlastimir Valek, deputy prime minister and health minister in the conservative government of Czech President Petr Fiala, is a former radiologist and popular in medical circles for the excellent job he did during his time as Czech president in 2022.
But according to an informal coalition agreement, the next Czech commissioner will be chosen from either the Pirate or Liberal parties, and Fiala's choice appears to be Trade Minister Jozef Sikela.
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Estonian Prime Minister Kaja Kallas is expected to become the next EU High Representative for Foreign Affairs, and if she is invited to succeed Charles Michel as President of the European Council, health could be a good area for the country, which has been a leader in the use of health records and genomic research.
Riina Sikkut, Estonia's health minister since April 2023 and a member of Kallas's coalition government, is seen as a good option if this situation were to come to fruition.
