HERA-lding More Integration in Health? Examining the Discursive Legitimation of the European Commission's New Health Emergency Preparedness and Response Authority.

CONTEXT Since COVID-19, the European Commission (EC) has sought to expand its activities in health through the development of a 'European Health Union' and within it, the Health Emergencies Preparedness and Response Authority (HERA). METHODS We applied a discourse analysis on documents establishing HERA to investigate how the creation of this institution was legitimated by the EC. We focused on how it framed health emergencies; how it framed the added value of HERA; and how it linked HERA to existing EU activities and priorities. FINDINGS Our analysis demonstrates that security-based logics have been central to the EC's legitimation of HERA - in alignment with a 'securitization of health' occurring worldwide in recent decades. This legitimation can be understood as part of the EC's effort to promote future integration in health in the absence of new competencies. CONCLUSIONS Securitization has helped the EC raise its profile in health politically, without additional competencies, thereby laying the groundwork for potential future integration. Looking at the discursive legitimation of HERA sheds light not only on whether the EC is expanding its health powers, but also how it strategizes to do so. HERA, while constrained, allows the EC to further deepen security-driven integration in health.