The EU is facing an evolving landscape of health threats, where emerging infectious diseases and extreme weather events can overwhelm national health systems, resulting in significant social and economic losses.
Preparedness is crucial for:
- the EU and Member States to anticipate risks
- detecting emerging threats early
- being ready to respond effectively before a crisis escalates.
The European Commission revised the EU health security framework in November 2020, as part of its efforts to build a strong European Health Union.
Regulation (EU) 2022/2371 on serious cross-border threats to health put in place a reinforced legal basis to enhance the EU's capacity in prevention, preparedness, surveillance, risk assessment, early warning and response.
The recently adopted EU preparedness Union Strategy aims to enhance the EU’s civilian and military preparedness and readiness for future crises, including public health.
The Union prevention, preparedness and response plan for health crises
The European Commission established the Union prevention, preparedness and response plan for health crises, which aims to protect the health and wellbeing of people across the EU/EEA. The Union plan:
- promotes effective and coordinated response to cross-border threats to health at EU level
- provides an operational toolbox for crisis managers in EU Member States and EEA countries, the Commission, EU agencies and bodies
- explains joint arrangements for governance, capacities and resources in the EU
- emphasises cross-sectoral collaboration and cross-border collaboration at regional level
- stands as a key action implementing the EU Preparedness Union Strategy in the health sector, based on Article 5 of Regulation (EU) 2022/2371.
It is structured around the four phases of the health crisis management cycle (Figure 1).
The Union plan for health crises stands as a living document, regularly reviewed to accommodate changes in the legal basis, operational environment and lessons learned from exercises or response to real-life events.
Coordination on prevention, preparedness and response planning
Prevention, preparedness and response planning are essential for effective monitoring, early warning and response to cross-border threats to health. Regulation (EU) 2022/2371 established a comprehensive, continuously updating planning framework for the Member States and the EU (Figure 2).
Every three years, Member States report to the Commission on their prevention, preparedness and response planning, using a reporting template as set out by Commission Implementing Regulation (EU) 2023/1808, which includes:
- capacities implementation under the International Health Regulations (IHR) of the World Health Organization (WHO)
- interoperability arrangements between health and other relevant sectors
- governance, capacity and resources
- national response plans covering epidemic response, antimicrobial resistance, healthcare-associated infections and other serious cross-border threats to health
- actions taken to improve identified gaps
- cross-border interregional and inter-sectoral coordination.
In parallel, the European Centre for Disease Prevention and Control (ECDC) conducts Public Health Emergency Preparedness assessments (PHEPA) to assess the Member States every three years in accordance with Commission Delegated Regulation (EU) 2024/1232. ECDC provides recommendations for the countries to strengthen their capacities.
The Health Security Committee (HSC) coordinates efforts in prevention, preparedness, and response planning for cross-border threats to health. Member States and the Commission work in the HSC to ensure national plans and the Union plan are work seamlessly together.
A culture of exercises
The EU enhances preparedness by conducting regular exercises to test both EU and national plans.
The EU4Health programme supports training and joint exercises to enable countries to share experiences, guidelines and best practices.
These initiatives foster collaboration between national authorities, institutions, and the Commission, ensuring effective information exchange and response during rapidly evolving crises.
