Consolidated annual activity report 2021.
Date: 2022-07-21
Institutions: European Centre for Disease Prevention and Control
Subjects: EU Member State, EU activity, European Centre for Disease Prevention and Control, European Economic Area, activity report, coronavirus disease, crisis management, disease prevention, health control, public health

ECDC CORPORATE

Consolidated annual activity 
report 

2021

www.ecdc.europa.eu

ECDC CORPORATE 

Consolidated Annual Activity Report 

2021 

 
 
This report of the European Centre for Disease Prevention and Control (ECDC) was coordinated by ECDC’s 
Executive Office. 
Contributing authors 
Radostina Angelova, Maarit Kokki. 

Suggested citation: European Centre for Disease Prevention and Control. Consolidated Annual Activity Report 2021. 
Stockholm: ECDC; 2022. 

Stockholm, June 2022 

PDF 
ISBN 978-92-9498-573-6 
doi: 10.2900/985986 
Catalogue number TQ-07-22-433-EN-N 

© European Centre for Disease Prevention and Control, 2022 

Reproduction is authorised, provided the source is acknowledged 

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Contents 

Consolidated Annual Activity Report .............................................................................................................. i 
Abbreviations ............................................................................................................................................ iv 
Management Board analysis and assessment ................................................................................................ 1 
Foreword by the Chair of the Management Board ......................................................................................... 3 
Introduction by the Director ........................................................................................................................ 4 
Executive summary .................................................................................................................................... 5 
Part 1. Policy achievements ........................................................................................................................ 9 
Part 2a. Management ............................................................................................................................... 54 
Part 2b. External evaluations ..................................................................................................................... 65 
Part 3. Assessment of the effectiveness of the internal control systems......................................................... 68 
Part 4. Management assurance ................................................................................................................. 72 
Part 5. Declaration of assurance ................................................................................................................ 74 
Annex 1. Core business statistics 2021 ....................................................................................................... 75 
Annex 2. Statistics on financial management ............................................................................................. 100 
Annex 3. Organisational chart .................................................................................................................. 101 
Annex 4. Establishment plan and additional information on human resources management ........................... 102 
Annex 5. Human and financial resources by activity ................................................................................... 104 
Annex 6. Contribution, grant and service level agreements - Financial Framework Partnership Agreements ..... 105 
Annex 7. Environment management ......................................................................................................... 107 
Annex 8. Final annual accounts 2021 ........................................................................................................ 108 
Annex 9. ECDC MB/AF/Coordinating Competent Bodies .............................................................................. 109 
Annex 10. ECDC outputs published in 2021 ............................................................................................... 115 
Annex 11. Negotiated procedures without prior publication of a contract notice conducted in 2021 ................ 122 

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Abbreviations 

Accrual-Based Accounting, the EC integrated budgetary and accounting system 
Antimicrobial resistance 
Agency for Public Health Education Accreditation 
Antimicrobial resistance and healthcare-associated infections 
Association of Schools of Public Health in the European Region 
Building Research Establishment Environmental Assessment Method 
Coordinating Competent Body 
US Centers for Disease Control and Prevention 
Communicable disease threats reports 
Coronavirus disease 2019 
European Antimicrobial Resistance Surveillance Network 
European Environment Agency 
European Economic Area/European Free Trade Association 
European External Action Service 
European Federation Gateway Service 
European Food Safety Authority 
European Health Data Space 
European Health Forum Gastein 
European Legionnaires’ Disease Surveillance Network 
European Medicines Agency 
EU Eco-Management and Audit Scheme 
European Neighbourhood Policy 
Committee on the Environment, Public Health and Food Safety of the European Parliament 
Evaluation of European Union/European Economic Area public health surveillance systems 
Epidemiology Path of the ECDC Fellowship programme 
European Surveillance Portal for Infectious Diseases 
External quality assessment 
European Reference Laboratory Network for Human Influenza 
European Surveillance of Antimicrobial Consumption Network 
European Scientific Conference on Applied Infectious Disease Epidemiology 
European Union 
EU Agencies Network on Scientific Advice 
EU Laboratory Capability Monitoring System 
Public Health Microbiology Path of the ECDC Fellowship Programme 
European Gonococcal Antimicrobial Surveillance Programme 
Emerging and vector-borne diseases 
Early Warning and Response System 
Food and Agriculture Organisation of the United Nations 
European Union Agency for Fundamental Rights  
Food- and waterborne diseases and zoonoses 
Healthcare-associated infection 
Human immunodeficiency virus 
Internal Audit Service 
Information and Communication Technology 
International Health Regulations 
Integrated Management Framework 
Instrument of Pre-Accession Assistance 
Infection prevention and control 
Issue-Resources-Impact-Solidarity (decision-making and prioritisation tool) 
Joint Inter-agency Antimicrobial Consumption and Resistance Analysis 
Joint Research Centre 
Key Performance Indicator 
Memorandum of understanding 
National Focal Point 
National Immunisation Technical Advisory Group 

ABAC 
AMR 
APHEA 
ARHAI 
ASPHER 
BREEAM 
CCB 
CDC 
CDTR 
COVID-19 
EARS-Net  
EEA 
EEA/EFTA  
EEAS 
EFGS 
EFSA  
EHDS 
EHFG 
ELDSNet 
EMA  
EMAS 
ENP  
ENVI 
EPHESUS 
EPIET  
EpiPulse 
EQA  
ERLI-Net  
ESAC-Net  
ESCAIDE  
EU  
EU-ANSA 
EULabCap 
EUPHEM  
Euro-GASP 
EVD  
EWRS  
FAO 
FRA 
FWD  
HAI  
HIV  
IAS 
ICT  
IHR 
IMF 
IPA 
IPC 
IRIS 
JIACRA 
JRC 
KPI 
MoU 
NFP  
NITAG 

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NPI 
OECD 
OIE 
PHE 
RRA 
RT-PCR  
SARI 
SARMS 
SARS-CoV-2 
SNE 
SPD 
SRM 
STI  
TALD 
TB  
TEPHINET 
TESSy  
VectorNet  
VPI  
WGS 
WHO  

Non-pharmaceutical interventions 
Organisation for Economic Cooperation and Development 
World Organisation of Animal Health 
Public Health Emergency 
Rapid Risk Assessment 
Reverse Transcription Polymerase Chain Reaction 
Severe Acute Respiratory Infection 
Scientific Advice Repository and Management System 
Severe acute respiratory syndrome coronavirus 2 
Seconded national experts 
Single Programming Document 
Stakeholder Relationship Management 
Sexually transmitted infections 
Travel-associated Legionnaires' disease 
Tuberculosis 
Training Programs in Epidemiology and Public Health Interventions Network 
The European Surveillance System 
European Network for Arthropod Vector Surveillance for Human Public Health and Animal Health 
Vaccine-preventable diseases and Immunisation 
Whole genome sequencing 
World Health Organization 

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Management Board analysis and assessment 

The Management Board has assessed the ECDC Consolidated Annual Activity Report for the financial year 2021 
and appreciates the results achieved by the Centre during the second year of the COVID-19 pandemic, noting in 
particular, the following: 

Implementation of the work programme 2021  

ECDC has been working in a Public Health Emergency (PHE) mode since January 2020, with many technical 
experts removed from their daily tasks to work on the PHE roster. In the framework of the COVID-19 response, at 
least 112 (32%) ECDC staff members worked in the PHE. With the increased work related to COVID-19 response, 
the Centre delivered 74% of the outputs planned in its Single Programming Document 2021–2023. Nine percent of 
the planned outputs were postponed to 2022, while 16% were delayed or had not yet started at the end of 2021.  

Human resources  

The initial ECDC establishment table foresaw 281 posts for 2021. As part of the review of the ECDC mandate, the 
Centre received 31 posts in 2021. Furthermore, to manage the European Health Emergency Preparedness and 
Response Authority grants, ECDC was approved to recruit an additional 15 posts initially foreseen for 2022. Hence 
the total number of additional posts in 2021 amounted to 46. For the international projects funded by the 
European Commission, ECDC was granted 21 posts, the recruitment of which started in 2021. At the end of 2021, 
ECDC employed 351 staff members, including statutory staff, contract agents for COVID-19 response, European 
Health Emergency Preparedness and Response Authority grants and grant-funded projects staff and Seconded 
National Experts (SNEs).  

Budget 

The core budget of the Centre for 2021 (EUR 168.1 million) increased by 169% compared with 2020 
(EUR 62.5 million). Budget execution in terms of commitment appropriations at the end of the year reached 
99.35%, equivalent to EUR 167.0 million, which is an excellent result. Budget execution in terms of payment 
appropriations at the end of the year reached 64.08%, equivalent to EUR 107 million. 

ECDC carried forward EUR 13.5 million from its 2020 budget to 2021. At the end of 2021, the payments for EUR 
12.5 million had been caried out, which corresponds to a budget execution of 92.41%. ECDC carried EUR 59.3 
million forward from 2021 to 2022. 

External reviews 

In 2021, ECDC finalised the implementation of the recommendations from ‘The external strategic and performance 
review of the ECDC response to COVID-19’ carried out by the Centre in 2020. The main outcomes of this work are 
the amended outputs e.g. changes in the presentation of the Rapid Risk Assessment to be more relevant for the 
reader, and the redrafted Public Health Event (PHE) plan, which considers external benchmarking and lessons 
learned from the COVID-19 response. 

Furthermore, ECDC responded to the Ombudsman’s inquiry on COVID-19 related communication, and with this, 
improved the availability and accessibility of COVID-19 related outputs on the ECDC website. 

Third Joint Strategy Meeting  

ECDC held its Third Joint Strategy Meeting with its key stakeholders (Management Board, Advisory Forum, 
Directors of Coordinating Competent Bodies and National Coordinators), in May, running a series of workshops 
during the summer, and conducting a plenary at the end of September. The themes for discussions were chosen 
based on the third external evaluation, ECDC strategy 2021-2027, and the proposed amended ECDC mandate. 
These included: digitalisation of EU surveillance, silent ‘P’ in ECDC, EU standards for emergency preparedness, 
ECDC’s role in the global health security, and how ECDC could get closer to EU Member States. From the 
Management Board’s perspective this meeting provided an excellent platform for open and strategic discussions 
with ECDC and key stakeholders. 

ECDC Communication Policy 2022-2027 

The Management Board discussed and approved the ECDC Communication policy 2022-2027 in November 2021. 
This policy establishes a common understanding of the Centre’s target audiences and stakeholders, including the 
general public. It also provides priority areas for Centre’s external and internal communication. It builds on 
previous experiences and incorporates the findings and recommendations of the evaluations, audits, and 
performance analysis conducted both within and outside the context of the COVID-19 pandemic. 

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ECDC and the EU bio-defence preparedness plan against SARS-CoV-2 
variants (as part of the European Health Emergency Preparedness 
and Response Authority Incubator)  

ECDC awarded more than EUR 77 million worth of grants to 24 EU/ EEA countries to strengthen whole genome 
sequencing (WGS) and diagnostics infrastructure within national public health programmes. This action was co-
designed with the countries and targeted primarily to early detection and monitoring of SARS-CoV-2 variants. 
Moreover, improving the infrastructure and capacity in countries will contribute to preparedness for future health 
threats.  

In conclusion, the Management Board welcomes the Consolidated Annual Activity Report 2021, which provides an 
excellent overview of the Centre’s achievements as set out in the Single Programming Document (SPD) 2021-2023, 
adopted by the Management Board. 

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Consolidated Annual Activity Report 

Foreword by the Chair of the Management 
Board 

It is my pleasure to introduce the ECDC Consolidated Annual Activity Report 2021, which summarises the work 
ECDC carried out last year – the second year of COVID-19 pandemic characterised by variants of concern of the 
original SARS-CoV-2, and a number of COVID-19 specific vaccines entering national immunisation programmes. 
However, the work of the ECDC Management Board continued to focus on how ECDC delivered within its mandate, 
amended work plans, and how to prioritise non-COVID-19 related work. 

Last year was the first year ECDC was implementing its Strategy 2021-2027. Although the pandemic hampered its 
implementation, ECDC delivered 74% of the outputs planned in its Single Programming Document 2021–2023. 
Nine percent of the planned outputs were postponed to 2022, while 16% were delayed or had not yet started at 
the year-end 2021.  

I would like to highlight some of the Centre’s non-COVID-19 achievements: 

ECDC held its Third Joint Strategy Meeting with key stakeholders in the period June-September 2021, with a 
series of workshop discussions in the areas of digitalisation of EU surveillance, ECDC role in the prevention, EU 
standards for emergency preparedness, ECDC’s role in the global health security, and getting closer to the EU 
Member States. This meeting series provided an excellent opportunity for open and strategic discussions between 
ECDC and its main stakeholders and will guide the implementation of the ECDC amended mandate in the future.  

ECDC Fellowship Programme was successfully transformed to virtual training and cohorts 2020 and 2021 
received their training modules as planned. In 2021, 33 fellows graduated, and at the year-end 71 fellows were 
enrolled (33 from cohort 2020 and 38 from cohort 2021). 

ECDC Communication Policy 2022–2027 was developed, and the Management Board approved it in their 
meeting in November. This was an important milestone, as the ECDC role in communicating to the general public 
had been debated in the Management Board several times over the years. With the agreement on the 
Communication Policy, the general public becomes one of ECDC‘s target audiences. A convincing approach to 
communication is a strong force against misinformation and scepticism towards scientific evidence. 

Regarding ECDC’s work supporting EU/EEA Member States and the EU Institutions in the COVID-19 response, the 
Centre conducted and published 22 rapid risk/outbreak assessments, half of which (11) assess different 
phases and developments in the COVID-19 pandemic. In 2021, ECDC continued to produce the maps in support of 
the Council Recommendation on a coordinated approach to travel measures in the EU, published also on the ECDC 
website. 

Also related to the ECDC COVID-19 work, the Management Board twice approved an amended annual work plan 
for 2021 and approved an amended financing decision four times. Furthermore, the MB gathered for an 
extraordinary meeting to discuss the ECDC grant-based programme in support to the European Health Emergency 
Preparedness and Response Authority Incubator, for the EU/EEA Member States to strengthen their capacities and 
capabilities for whole genome sequencing before finalising the budget decisions. 

Finally, the ECDC Management Board continued to follow up the negotiations on the ECDC amended Founding 
Regulation. Since the political agreement on the text has been reached, it is now awaiting adoption. 
Implementation of the amended mandate will challenge both the staff of ECDC and the Management Board and 
provide a unique opportunity to make the Agency fit for the demands of the future.  

Dr Anni-Riitta Virolainen -Julkunen, Chair of the ECDC Management Board 

2 March 2022 

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Introduction by the Director 

Year 2021 was the second full year of the COVID-19 pandemic, and I would like to start by thanking colleagues in 
Member States for their contributions and openness in our mutual dialogue, colleagues and partners in the EU and 
beyond for their collaboration during the year, and all ECDC staff for their stamina and dedication. 

In my view, this Consolidated Annual Activity Report successfully describes all aspects of the work ECDC conducted 
in 2021; the COVID-19 response under the PHE modus operandi, the non-COVID-19 related scientific work, and 
the work ensuring that the organisation functions smoothly, effectively, and efficiently respecting the regulatory 
boundaries in place.  

I would like to elaborate on two areas of COVID-19 related actions, which largely defined the ECDC work during 
2021 and also provided possibilities for the future.  

The first one is the emergence of new variants of the SARS-CoV-2 and the need to ensure that the capacity to 
detect possible new variants early enough and to monitor them exists in EU/EEA countries. To this end, the 
European Commission tasked ECDC with supporting countries to improve their capacities and capabilities on WGS. 
In September 2021, ECDC awarded more than EUR 77 million worth of grants to 24 EU/ EEA countries, based on 
proposals from the countries to strengthen WGS and diagnostic infrastructures. I would like to thank all parties 
involved for co-creating and implementing this important action, which is also a preparedness investment for the 
future.  

The second is related to COVID-19 vaccine uptake in the countries, as in 2021 COVID-19 specific vaccines entered 
the market and immunisation programmes became a cornerstone in the fight against the spread of the SARS-CoV-
2. Supporting countries to reach the EU target set for vaccine coverage became one of the main goals of ECDC 
work and bringing the knowledge of behavioural science to counteract vaccine hesitancy and disinformation around 
vaccines and immunisation was an important part of it. Therefore, an initiative was undertaken to support 11 
Member States with COVID-19 vaccination uptake lower than the EU average was taken. A series of bilateral 
meetings were held with the relevant authorities and experts, and follow-up activities were developed. In this 
context I visited three countries, which provided me with good insights on the issues countries encounter in 
increasing vaccine uptake. These activities will continue in 2022. 

For me these two COVID-19 related activities have shown new ways how ECDC can come closer to Member States 
and find novel ways of working together, based on the needs expressed by countries. We will learn from these 
activities and further develop ECDC’s work, in particular in the context of the implementation of ECDC’s amended 
Founding Regulation, once it is agreed upon. 

The pandemic has also shown the importance of having international partners to exchange information in a swift 
and transparent manner. In 2021, ECDC concluded three important bilateral agreements, namely with the Ministry 
of Health of Mexico, the Health Security Agency of the United Kingdom, and the Korea Disease Control and 
Prevention Agency. Furthermore, 2021 was the first year of the development of a long-term partnership with the 
Africa CDC in the form of a joint project covering areas of preparedness, surveillance, and workforce capacity 
building, financed by the European Commission. 

I believe that the work carried out in 2021 and the variety of discussions we have been able to conduct with our 
main partners and stakeholders (e.g., during the third Joint Strategy Meeting) will help us in the implementation of 
the amended mandate and in transforming the organisation to be ready for future challenges. 

Andrea AMMON, ECDC Director 

4 March 2022 

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Executive summary 

Agency in brief 

Legal and procedural background 

This document is based on Regulation (EC) No 851/2004 of the European Parliament and of the Council of 21 April 
2004, Article 14.5(d): The Board shall adopt the Director’s Annual Report on the Centre’s activities for the past year 
by 30 March. Following its fifty-fourth meeting on 23 March 2022, the Management Board approved the final 
version of the Consolidated Annual Activity Report 2021. 

Mission statement 

The Centre’s mission is set out in Article 3 of the Founding Regulation1, which states that: 

‘The mission of the Centre shall be to identify, assess and communicate current and emerging threats to human 
health from communicable diseases. In the case of other outbreaks of illness of unknown origin, which may spread 
within or to the Community, the Centre shall act on its own initiative until the source of the outbreak is known. In 
the case of an outbreak which clearly is not caused by a communicable disease, the Centre shall act only in 
cooperation with the competent authority, upon request from that authority.’ 

The Centre’s mandate is derived from Article 168 of the Treaty on the Functioning of the European Union (EU), 
with an overarching principle of ensuring a high level of human health protection in the definition and 
implementation of all Union policies and activities. 

Key tasks of ECDC include: 

• 
• 
• 
• 
• 
• 
• 

Operating dedicated surveillance networks; 
Providing scientific opinions and promoting and initiating studies; 
Operating the Early Warning and Response System; 
Providing scientific and technical assistance and training; 
Identifying emerging health threats; 
Collecting and analysing data; 
Communicating on its activities to key audiences. 

ECDC vision 

To improve lives in Europe and globally applying scientific excellence, thus empowering the Member States, the 
European Commission, and other partners to drive public health policy and practice.  

Strategic work areas 

The ECDC 2021-2027 strategy is structured into five strategic objectives: 

Strategic objective 1: Strengthen and apply scientific excellence in all ECDC activities and outputs to 
inform public health policy and practice. 

This strategic objective focuses on the setting and promotion of standards, the provision of evidence and guidance 
for public health policies and practice, the development and implementation of methodologies to increase the 
impact of public health actions in the field of communicable disease prevention and control, and the knowledge 
transfer aimed at bridging the gap between science, policy and practice. 

Strategic objective 2: Support the countries to strengthen their capacities and capabilities to make 
evidence-based decisions on public health policies and practices. 

Disease-specific work is at the core of fulfilling this strategic objective, with a focus on the prevention of infectious 
diseases. This strategic objective tackles the use of country information to improve country support, as well as the 
support to prevention and control programmes, training and emergency preparedness in EU Member States. 

1 Regulation (EC) No 851/2004 of the European Parliament and of the Council of 21 April 2004 establishing a European Centre for 
Disease Prevention and Control, Official Journal of the European Union. 2004; L 142:1–11. 

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Strategic objective 3: Future outlook: Prepare for the future through foresight and innovation 
assessments. 

This strategic objective is focused on applying foresight methods to identify and address knowledge gaps and 
areas of uncertainty, engaging with EU research and innovation initiatives and supporting transformation by 
assessing the impact of new technologies and methods. 

Strategic objective 4: Increase health security in the EU through strengthened cooperation and 
coordination between ECDC and partners in non-EU countries. 

This strategic objective is delivered through developing and implementing programmes to support the Western 
Balkans, Turkey and European Neighbourhood Policy (ENP) partner countries and ensuring collaboration and 
coordination with major Centres for Disease Prevention and Control and international partners, as well as 
coordination with EU Institutions towards the achievement of common objectives. 

Strategic objective 5: Transform the organisation to the ‘next generation’ ECDC. 

This strategic objective is focused on increasing organisational effectiveness and efficiency, ensuring staff 
engagement and enhancing the transparency, visibility and availability of ECDC’s outputs. 

Organisational structure 

The ECDC organisational structure1, in force since January 2020, consists of three operational units, two service 
providing units and the Director’s Office. The Disease Programmes (DPR) Unit delivers the disease-specific part of 
empowering ECDC’s partners to drive public health policy and practice. A major part of ECDC’s outputs come from 
this Unit, guided and supported by the Scientific Methods and Standards (SMS) and Public Health Functions (PHF) 
Units. The SMS Unit leads the processes for strengthening the scientific excellence and the dissemination of 
knowledge within the organisation and to partners, including the quality assurance of ECDC’s scientific work and 
the organisation of the ESCAIDE conference. The Public Health Functions Unit is responsible for the delivery of 
ECDC’s statutory public health functions surveillance, training and emergency preparedness and response support 
and works closely with the disease programmes, providing the data and systems required for the respective 
disease-specific outputs. 

The Director’s Office, the Resource Management Services and the Digital Transformation Services Units support the 
achievement of the objectives of the abovementioned operational units. The Director’s Office oversees the 
implementation of the Centre’s strategy and coordinates the Centre’s strategic relationships with its governing 
bodies and other external stakeholders in and outside of the EU. The Resource Management Services Unit ensures 
the efficient management of the human and financial resources of the Centre, as well as of its premises. It 
provides procurement, legal, meetings organisation and travel arrangement services to the organisation. The 
Digital Transformation Services Unit delivers advice and studies, software products, development expertise, front-
end services, application hosting and enterprise infrastructure services in support to ECDCs’ core missions and 
administration. 

In October 2021, a new structure of the DPR Unit was put in place, regrouping the previously existing seven 
disease programmes into four sections: Antimicrobial Resistance and Healthcare-Associated Infections, Epidemic 
Prone Diseases, STI, Blood-Borne Viruses and TB, and Vaccine Preventable Diseases and Immunization. While this 
change will not have a direct impact on the scientific outputs of the Centre, nor on the relationships with its main 
stakeholders, it will allow for more efficient ways of working through better distribution of the managerial tasks 
and coordination of the core work of the unit. 

The structure of this report reflects the structure of the ECDC Single Programming Document 2021-2023. The 
achievements of the Centre are presented in accordance with the ECDC strategy 2021–20272 structure. 

2021 in brief 

In 2021, ECDC delivered 74% of the outputs planned in its Single Programming Document 2021–2023. Nine per 
cent of the planned outputs were postponed to 2022, while 16% were delayed or had not yet started at the end of 
2021. Most of the delays in delivering the planned 2021 outputs were due to the high COVID-19 pandemic-related 
workload at ECDC, in Member States and/or partner organisations (for details see Annex I Core business statistics 
2021). 

1 See Annex III. Organisational chart, of this document. 
2 ECDC Strategy 2021-2027 available from: https://www.ecdc.europa.eu/en/publications-data/ecdc-strategy-2021-2027 
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Work on the COVID-19 pandemic 

Throughout 2021, for the second consecutive year, the ECDC public health emergency (PHE) plan in response to 
the continuing COVID-19 pandemic was maintained at the maximum level of alert. ECDC had started operating at 
PHE level 2, acute phase on 31 January 2020 and continues operating in this phase at the time of preparing the 
present report. 

During 2021, ECDC efforts in curbing the pandemic included the following: 

• 

• 

• 

• 

• 

Surveillance strategies in different settings, such as long-term care facilities, and transition from emergency 
COVID-19 surveillance towards routine surveillance, covered in a number of rapid risk assessments and 
technical reports. Focus on methods for detection and characterisation of the virus, as well as laboratories 
capability and capacity; 
Vaccination strategies and vaccine deployment plans, resulting in a number of technical reports and 
guidance, as well as the release of visual dashboards such as the Vaccine Tracker, operational since 
February 2021; 
Behavioural insights into vaccination acceptance and uptake, as well as strategies to counter vaccine 
misinformation, covered in a series of technical reports and infographics; 
Follow-up and assessment of variants of interest (VoI) and variants of concern (VoC), resulting in the 
production of timely rapid risk assessments, threat assessment briefs, and technical reports, as well as the 
SARS-CoV-2 variants dashboard (available since May 2021), providing an overview of the proportion of 
variants of concern and variants of interest in EU/EEA Member States. 
Predictive modelling and forecasting, resulting in the establishment of a COVID-19 forecasting hub in April 
2021. 

In order to support all the above-listed activities and address the incoming requests from stakeholders, ECDC 
maintained a robust response duty roster, as well as disease programme duty rosters and functional teams, such 
as the Infection Prevention Control/Non-Pharmaceutical Interventions (IPC/NPI) team. Overall, the Centre 
conducted and published 22 rapid risk/outbreak assessments (RRA/Rapid Outbreak Assessment), half of which 
(11) assessed different phases and developments in the COVID-19 pandemic and responded to over 600 requests 
from stakeholders (European Commission, Member States and the media). The production of the weekly COVID-19 
policy briefs initiated in September 2020 continued throughout 2021. Also, the maps in support of the Council 
Recommendation on a coordinated approach to travel measures in the EU and the Weekly Country Overview 
Report continued being regularly published on the ECDC website. 

To meet the urgent need to strengthen Member States capacity for detecting and monitoring new variants of the 
SARS-CoV-2 virus, ECDC set up an emergency contract to support, in particular but not exclusively, Member States 
with limited or no whole genome sequencing capacity in 2020. In collaboration with the European Commission, a 
second contract for whole genome sequencing services became operational in March 2021, providing support to all 
countries for sequencing of SARS-CoV-2 positive isolates. More than 120 000 samples from 11 EU/EEA Member 
States and four Western Balkan countries were processed between February and December 2021. 

Along with the direct sequencing services, ECDC initiated the implementation of the laboratory capacity building 
activities under the EU Health Emergency Preparedness and Response Authority Incubator Action Area 1: Rapid 
detection of SARS-CoV-2 variants. In September 2021, ECDC awarded more than EUR 77 million to 24 EU/EEA 
countries to strengthen whole genome sequencing and RT-PCR infrastructures within the countries' national public 
health programmes. The immediate objective was to reinforce countries' capacities for early detection and 
enhanced monitoring of emergent and known SARS-CoV-2 variants. The implementation of the infrastructure and 
activities funded by ECDC grants started already in 2021 and will finalise by September 2022. 

Work on the ECDC strategy 2021-2027: main achievements 

Despite the challenge that the COVID-19 pandemic continued to present in 2021, ECDC managed to produce most 
of its regular outputs: 

• 

• 

• 

• 

ECDC updated its Surveillance Atlas of Infectious Diseases with 2020 data and published 30 Annual 
Epidemiological Report chapters covering 2018, 2019 and 2020; 
Regular epidemiological updates for threats under mid- (one to six months) and long-term monitoring 
( more than six months) were published on the ECDC website through the weekly Communicable Diseases 
Threats Report (CDTR); 
ECDC continued producing independent and evidence-based scientific advice. The Centre published 74 
technical reports/guidance documents and 74 peer-reviewed articles in scientific journals; 
Training of cohorts 2020 and 2021 of the ECDC Fellowship Programme was delivered as planned. In 2021, 
33 fellows graduated. At the end of the year, 71 fellows were enrolled (33 from cohort 2020 and 38 from 
cohort 2021); 

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• 

All ECDC hallmark events were successfully organised: the ESCAIDE conference (16–19 November), with 
the highest number of registrations to date; the digital campaign marking the European Antibiotic 
Awareness Day (18 November); the ECDC session at the European Health Forum Gastein (EHFG) 2021 (28 
September). 

In the area of surveillance, ECDC concluded the four-year EPHESUS project after 50 EU/EEA public health 
surveillance system evaluations, with findings that will be instrumental in developing EU/EEA surveillance 
standards. The EpiPulse portal allowing ECDC and Member States users to perform all surveillance operations from 
one single entry point, was launched in June 2021. 

In 2021, ECDC implemented automatic, electronic health record-based surveillance of Severe Acute Respiratory 
Infections (SARI) in seven EU/EEA Member States, with a view to continue implementing SARI surveillance in a 
larger number of countries, and to pilot this type of surveillance for other priority diseases. 

2021 marked the 25th anniversary of the Eurosurveillance journal with various events and special edition 
publications. 

As part of the targeted country support work of the Centre, an initiative aimed at supporting the 11 Member States 
with COVID-19 vaccination uptake lower than the EU average was initiated. 

During 2021, ECDC actively participated in the implementation of the European Health Data Space (EHDS), 
providing the European Commission with requirements for EU level surveillance and with a use case to be piloted 
in 2022. ECDC also started to prepare for the takeover of the European Federation Gateway Service (EFGS), the 
technical backbone of the contact tracing apps used by Member States, initially implemented by the European 
Commission. 

In the area of support to Western Balkan countries, Turkey and ENP countries, the projects funded with European 
Commission grants continued: ‘Preparatory measures for the participation of the Western Balkans and Turkey in 
the European Centre for Disease Prevention and Control with special focus on One-Health against antimicrobial 
resistance (AMR) and enhanced SARI surveillance, 2020 – 2024’ and ‘EU Initiative on Health Security”. In addition, 
the “EU for health security in Africa: ECDC for Africa CDC’ project started in January 2021. 

In the area of communication, while ECDC continued having a high level of attention in traditional media, social 
media and through its websites, there was a noticeable decrease in some of the communication indicators, which 
is the result of the natural evolution of the COVID-19 pandemic and its impact on ECDC’s target audiences’ 
interest. Nevertheless, all figures remain significantly higher if compared with those from before the pandemic. The 
latest ECDC Communication Policy was developed and approved in 2021, with the purpose of defining the actions 
and lines of work of ECDC in the area of communication for the period 2022-2027. 

ECDC held its Third Joint Strategy Meeting with key stakeholders in the period June-September 2021, with a series 
of fruitful discussions in the areas of digitalisation of EU surveillance, prevention, EU standards for emergency 
preparedness, ECDC’s role in the global health security and getting closer to EU Member States. 

Other ECDC areas of activity: ECDC's strengthened mandate 

In November 2020, the European Commission presented a proposal to expand the legal mandate of ECDC. First, a 
draft Regulation changing ECDC’s current Founding Regulation was announced, which contains changes that 
reinforce the ECDC mandate so that the Centre may support Member States and the Commission in the following 
areas: 

• 
• 
• 
• 

• 

epidemiological surveillance via integrated systems enabling real-time surveillance; 
preparedness and response planning, reporting based on defined indicators; 
provision of non-binding recommendations and options for risk management; 
capacity to mobilise and deploy EU Health Task Force to assist outbreak/emergency response in Member 
States and in third countries; 
build a network of EU reference laboratories and a network for substances of human origin. 

After a series of interinstitutional negotiations in the so-called trilogues between the European Commission, the 
European Parliament and the Council of the EU, on 29 November 2021, the European Parliament and the Council 
reached a political agreement on a reinforced role for ECDC. The formal adoption of the changes to the ECDC 
Founding Regulation is foreseen to happen once the agreement on proposal on the Regulation on Serious Cross 
Border Threats to Health has been achieved between the Council and the European Parliament, expected to take 
place during the first half of 2022. 

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Part 1. Policy achievements 

Multiannual indicators 

No. 

Strategic Key Performance Indicator  

Baseline 

Target 

Verification 

Result 2021 

Stakeholder survey 
or existing survey 
used for network 
meetings 

Not measured. ECDC 
Stakeholder survey 
will be carried out in 
2022 

1. 

2. 

3. 

4. 

5. 

6. 

7. 

8. 

9. 

Use of reliable evidence, ECDC scientific advice, recommended 
methodologies, tools and ECDC outputs for decision-making in 
EU Member States -  

NA 

•  Accessibility of methods, tools, outputs, data and evidence; 
•  Use of methods, tools, outputs, data and evidence;  
•  Satisfaction with methods, tools, outputs, data and evidence. 

-TBC 
-TBC 
-70% 

Level of capacity reached compared to target, following ECDC 
standards applied through technical assistance to Member States 
(measured through EULabCap, Preparedness and other assessment 
tools): 

for EULabCap: 7.8 
mean national index 
(2018) 
tbc 

0.3 points 
increase 
compared to 
previous period 

Level of public health microbiology system;  

• 
•  Capability/capacity:  
•  EULabCap Index for EU/EEA countries (mean national EULabCap 

index + potentially inter-country index variation); 
Level of public health preparedness capacity. 

• 

EULabCap,  
International Health 
Regulations or State 
Party Self-
Assessment Annual 
Report / Joint 
external evaluation 

Degree of implementation of post-COVID19 enhanced 
preparedness framework /stakeholder satisfaction with 
preparedness outputs as part of COVID19 response 

NA/ 
50% (2020 
McKinsey survey) 

100%/ 
 70% 

Internal monitoring/ 
Stakeholder survey 

Percentage of countries visited by ECDC upon their demand 
compared to target (based on the needs and the requests on any 
topic in the mandate of the Centre); could be virtual or physical country 
visits 
Number or % of ECDC foresight outputs used by Member States 

Number or % of ECDC guidance and expert opinions that identify 
specific knowledge gaps that could be addressed through 
research 

tbc 

NA 

NA 

100% 

Internal  
monitoring 

70% 

Stakeholder survey 

100% 

Internal monitoring 

Degree of implementation of enhanced post-COVID-19 
surveillance framework/ Stakeholder satisfaction with 
digitalisation of surveillance work 

NA/69% (2020 
McKinsey survey) 

100%/ 
70% 

Internal monitoring/ 
Stakeholder survey 

Degree of implementation of the joint action plans with 
international partners (other CDC, WHO, etc.) 

74% (2019 WHO 
joint action plan) 

100% 

Internal monitoring 

Stakeholder satisfaction with coordination of activities with other 
EU institutions and bodies 

NA 

70% 

Stakeholder survey 

10. 

Decrease in duration of core process instances over time – RRA, 
AER, other scientific outputs (average % of decrease) 

tbc 

10% decrease 

Internal monitoring 

Not measured. 
EULabCap survey not 
performed in 2021 

Public health 
preparedness 
capacity indicator to 
be reviewed after 
approval of new 
ECDC mandate 
To be reviewed after 
approval of new 
ECDC mandate/Not 
measured. ECDC 
stakeholder survey 
will be carried out in 
2022 
100% 

Not measured. ECDC 
Stakeholder survey 
will be carried out in 
2022 
Not measured. 
ECDC scientific 
advice process and 
outputs under 
revision in 
consultation with the 
AF 
Not measured. ECDC 
Stakeholder survey 
will be carried out in 
2022 

85% of activities 
defined by Joint 
Coordination Group 
with WHO 
implemented 
Not measured. ECDC 
Stakeholder survey 
will be carried out in 
2022 
Not measured 

11. 

Overall staff satisfaction  

12. 

Overall stakeholder satisfaction  

51% 

NA 

75% 

75% 

TBC – to be confirmed 

Staff survey 

61% 

Stakeholder survey 

Not measured. ECDC 
Stakeholder survey 
will be carried out in 
2022 

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1. Strategic objective 1. Strengthen and 
apply scientific excellence in all ECDC’s 
activities and outputs to inform public health 
policy and practice 

1.1 Standards: promote standard setting to facilitate the use 
of data and the implementation of public health policies in 
practice 

In 2021, in consultation with the ECDC Advisory Forum, ECDC developed a policy for scientific integrity and 
independence, which will be made available on the Centre’s website following approval by the ECDC Management 
Board.  

In the area of surveillance, ECDC concluded the four year EPHESUS project after 50 EU/EEA public health 
surveillance system evaluations. Some of the findings will be instrumental in developing EU/EEA surveillance 
standards (notifiable diseases, surveillance objectives, system design and common practice, datasets to be 
reported, etc.) in the years to come.  

In response to the COVID-19 pandemic, ECDC published an updated COVID-19 surveillance guidance. In addition, 
a first new set of standards including a common reporting protocol was agreed for the surveillance of Severe Acute 
Respiratory Infections (SARI). Weekly data submission was technically implemented, and at the end of 2021, four 
EU/EEA countries and two non-EU/EEA countries of the WHO European Region had started reporting regularly to 
ECDC. 

1.2 Evidence: provide partners with robust evidence and 
guidance for public health policies and practice 

Throughout 2021, the Centre continued threat detection through event-based surveillance, expanding the range of 
data sources. Surveillance and epidemic intelligence were further integrated to enhance the detection, validation 
and assessment of signals, particularly in response to the great amount of COVID-19 data being generated.  

ECDC updated its Surveillance Atlas of Infectious Diseases with 2020 data and published 30 Annual Epidemiological 
Report chapters covering 2018, 2019 and 2020.  

Enhanced surveillance reports were published for tuberculosis and HIV/AIDS jointly with the WHO Regional Office 
for Europe. Annual epidemiological reports were published for hepatitis B and C and for tuberculosis. For hepatitis, 
ECDC worked on improving the data for surveillance and monitoring by implementing several projects such as 
conducting sero-prevalence surveys. ECDC also evaluated the use and usefulness of the hepatitis online prevalence 
database. 

ECDC published the third report on the Joint Interagency Antimicrobial Consumption and Resistance Analysis 
(JIACRA) jointly with EFSA and EMA. Work on the first ECDC- WHO Regional Office for Europe joint report on AMR 
surveillance in Europe (2020 data) took place throughout 2021 and the report was published on 26 January 2022.  

ECDC continued to provide technical support to public health reference laboratory networks across the EU/EEA and 
enlargement countries, considering WHO networks’ reference laboratory activities. The Centre continued 
benchmarking microbiological capacities in countries, facilitating the development of rapid communication of 
laboratory-based information for surveillance and alert, and supporting Member States in strengthening their 
microbiology capacity, based on gaps identified by the EULabCap indicators and EQA schemes. ECDC offered also 
need-based sequencing support to Member States that have not yet fully transitioned to WGS-based surveillance. 
During 2021, ECDC offered high-capacity sequencing support to Member States to enhance their immediate 
capacity to detect and monitor SARS-CoV-2 variants, under the EU bio-defense preparedness plan against SARS-
CoV-2 variants. ECDC and the European Commission are continuing to provide EU/EEA Member States and 
Western Balkan countries with access to outsourced whole genome sequencing services for SARS-CoV-2 samples. 
More than 120 000 samples from 11 EU/EEA Member States and four Western Balkan countries were processed 
between February and December 2021. Timely and secure WGS data sharing and storage are secured by 
customised protected workspaces for WGS data management. 

In 2021, ECDC provided continuous support to the European Health and Digital Executive Agency and their 
contractors in the EURGen-RefLabCap and FWD AMR RefLabCap projects. This support consisted of strengthening 
the coordination, support and capacity building in national microbiology reference laboratory functions, for testing 
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Consolidated Annual Activity Report 

and surveillance of antimicrobial resistance in priority healthcare-associated infections and in Salmonella and 
Campylobacter in human samples, respectively. ECDC continued to collaborate with EFSA on the detection and 
public health risk assessment of foodborne outbreaks. Work on a new integrated system for WGS data exchange 
and analysis is ongoing. 

ECDC continued to coordinate the European Reference Laboratory Network for TB (ERLTB-Net) and together with 
the implementing consortium a network meeting, external quality assessment and capacity building activities were 
organised. Additionally, for gonorrhoeal antimicrobial resistance, an external quality assessment was carried out 
with Member States National Reference Laboratories and the reports with the results for the 2019 and 2020 round 
were published. 

1.3 Methodologies: contribute to the development and 
implementation of methodologies to increase the impact of 
actions targeted to reduce the burden of infectious diseases 

Throughout 2021, the Centre further improved its Scientific Advice Repository and Management System and 
continued managing and monitoring all its scientific outputs ensuring quality and timely delivery. ECDC 
strengthened its internal capacities and capabilities for in-depth and advanced bio-statistical and mathematical 
modelling analyses, contributing high-quality technical input to COVID and non-COVID work and outputs. 

1.4 Knowledge transfer: bridge the gap between science, 
policy, and practice to ensure sustainable impact on 
prevention and control of infectious diseases 

ECDC is working to develop a Knowledge Management framework to facilitate the management of knowledge 
assets that are critical to the mission of ECDC (instructional documents, governance documents etc). Work has 
progressed on putting mechanisms in place to support knowledge sharing through structured 
conversation/dialogue (both internally and with external parties). This includes proposals for the development of 
communities of practice, and changes to the ECDC website to improve the ability to find guidance, advice and 
information more easily. 

Additionally, work was started on ECDC’s Enterprise Content Management Platform, a unified portal of information 
held within the Centre’s electronic document repositories and the content management systems for the ECDC 
‘Intranet’ and ‘Extranets’. The ECDC Information Asset Catalogue was rethought and improved to provide a 
foundation for more effective content management within ECDC and with external stakeholders. 

As a publicly-funded agency, ECDC makes sure that its scientific output is freely available, both on its website and 
in scientific journals. Open access journals are considered the ‘gold-standard’. In 2021, over 99% of ECDC 
publications in peer-reviewed journals were in those that were open access, demonstrating a continuous increase 
from the 2016 baseline (73%) for compliance with open access. 

Figure 1. Evolution of the rate of ECDC open access publications, 2016–2021 

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The journal Eurosurveillance has served public health experts/scientists and policy makers with high-quality, open 
access information and data relevant for timely public health action since 1996. In the production of the journal, 
the editorial team applies intensive quality control to ensure that the widely accessible and distributed scientific 
information is sound, reliable, understandable, and actionable for a diverse audience. 2021 marked the 25th 
anniversary of Eurosurveillance and its editors conducted a comprehensive campaign showcasing ’25 years of 
public health impact’. This campaign encompassed a dedicated page with a special collection1, and links to 
presentations2 and videos illustrating the journey, achievements, and impact of the journal in the past and present. 
The virtual anniversary seminar during the ESCAIDE conference was dedicated to ‘Epidemiology and immunology – 
from observation to explanation and public health action’3. Renowned international speakers covered aspects of 
influenza, measles, and COVID-19, and nearly 600 participants followed live. Further increased social media 
activities resulted in increased engagement and the journal editors had an active role as facilitators or speakers, 
for example during the European Congress of Clinical Microbiology & Infectious Diseases (ECCMID), EASE 
(European Association of Science Editors Conference), the ESCAIDE conference and a seminar at a national public 
health institute. Eurosurveillance continued to rank among the leading journals in its field. It was awarded an 
Impact Factor (IF) of 6.3 (6.4 in 2020). This placed the journal among the ‘Top 10’ of infectious disease journals 
for the 10th consecutive year. To complete the metrics picture: the SCImago Journal Rank has the journal listed at 
rank 85 among 2 448 journals in the category ‘medicine miscellaneous’. The Scopus-based CiteScore was 13.9 and 
Eurosurveillance was in the 98% percentile of journals in the category Public Health, Environmental and 
Occupational Health. 

Eurosurveillance editors held seminars and workshops on topics related to science reporting (how to get published, 
use of reporting guidelines) and publishing (pre-prints) as part of capacity-building activities. During a series of 
consultation meetings and the full board meeting, the milestones and key deliverables for the journal’s long-term 
strategy 2021−27 and new policies were endorsed, such as publishing the board members’ annual declarations of 
interest on the journal’s website to increase transparency. 

Figure 2. Eurosurveillance 25th anniversary special collection cover page 

1 https://www.eurosurveillance.org/content/eurosurveillance--1996-to-2021--25-years-of-public-health-impact 
2 https://www.eurosurveillance.org/25years 
3 https://www.eurosurveillance.org/seminar#2021 
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The European Scientific Conference on Applied Infectious Disease Epidemiology (ESCAIDE) brought together 
professionals in the EU/EEA and globally, to share scientific knowledge and experience in infectious disease 
epidemiology, public health microbiology and related scientific fields. In 2021, ESCAIDE was held entirely online for 
the second year in a row. With over 3 000 registrations from across Europe and the world it was the biggest 
conference to date, and user feedback indicated that participants rated the relevance, organisation and scientific 
quality of the conference as being very high. 

Strategic objective 1. Performance indicators 

Action 
Area 

Objective 

Performance indicator 

Target 

Verification 

Result 20211 

1.1 

1.1 

1.1 

1.2 

1.2 

1.2 

1.2 

Operationalise the results of the 
EPHESUS project and the lessons 
learnt from the COVID-19 pandemic 

Number of diseases for 
which surveillance 
standards are available 

Identify and define existing 
methods that should be used to 
establish standards for scientific 
processes and outputs to identify, 
assess, prevent and control 
infectious disease threats to public 
health 

Publication of defined 
methods: implementation 
according to project plan 
(schedule, resources, and 
scope) 

Ensure and demonstrate scientific 
independence in all ECDC activities 
in 
consultation with relevant 
stakeholders [on standards for 
safeguarding and demonstrating 
scientific independence] 

Position paper for Advisory 
Forum: implementation 
according to project plan 
(schedule, resources, and 
scope) 

Ensure timely and effective 
monitoring of potential threats from 
infectious diseases 

Carry out routine indicator-based 
surveillance, including generation 
of high-quality, relevant, and timely 
outputs 

Proportion of stakeholders 
(European Commission + 
Member States) positively 
rating the daily and weekly 
CDTR and the RRA. 
Time from the closure of 
Member States data 
collection to the publication 
of the results in the 
Surveillance Atlas 

2021: standard for 
integrated surveillance 
of pandemic-prone 
respiratory viruses (flu, 
COVID-19) published 
on website 

Publication in Q4 2021 

Less than 20% 
deviation from the 
duration, resources, 
and scope of the initial 
baseline 

Publication of 
standard on 
ECDC’s website 

Publication of 
defined methods 
on website 

Quarterly ECDC 
Portfolio Steering 
Committee 
reporting 

Standards endorsed by 
Advisory Forum in Q4 
2021 

Advisory Forum 
minutes 

Less than 20% 
deviation from the 
duration, resources, 
and scope of the initial 
baseline 

Quarterly ECDC 
Portfolio Steering 
Committee 
reporting 

●● COVID-19 surveillance 
guidance 
Standard SARI surveillance 
protocol agreed with Member 
States.  

●● Based on lessons learned 
during the pandemic and in the 
context of the new mandate, 
ECDC initiated the work on 
revising its scientific advice 
processes and outputs.  
● Implementation on schedule. 

● The ECDC Policy on 
Scientific Integrity and 
Independence was discussed at 
the ECDC Advisory Forum and 
submitted to the Management 
Board for approval. 
● Implementation on schedule. 

80% 

Standard survey 
conducted during 
NFP meeting 

● Events and threats have been 
monitored and outputs 
produced. No survey was 
conducted.  

Three months 

TESSy 

● Achieved. 

Proportion of diseases in 
the Atlas with updated data 
of N-1 

80% 

Statistics from 
Atlas 

● 80% 

Coordinate EU level surveillance of 
all EU notifiable diseases and 
special health issues (incl. 
coordinated lab support). 

Provide evidence to support 
Member States to increase public 
health microbiology capacity 

Proportion of surveillance 
reports published 
according to agreed 
timelines 
Proportion of countries 
reaching sufficient capacity 
for at least 10 out of 12 
microbiology system 
targets in the EULabCap 
assessment 

90% 

● Achieved – 100% 

75% 

EULabCap surveys 

● In consultation with Member 
States it was decided that the 
EULabCap tool is to be updated 
and that next survey will be run 
in 2022. 

1 Colour legend for all KPI results throughout the report: 
● Target achieved 
● Target partially achieved, or KPI not measured 
● Target not achieved 

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Action 
Area 

Objective 

Performance indicator 

Target 

Verification 

Result 20211 

Produce consistently high-quality 
scientific work and advice within 
agreed deadlines to support 
evidence-informed decision and 
policy making 

Proportion of scientific 
outputs in the planned 
publication list delivered 
within the programming 
year 

90% 

Uptake of ECDC outputs 
by its stakeholders 

70% 

Ensure that all public health-related 
ECDC actions, are reviewed 
through the IRIS instrument for 
consultation on priority-setting 

Proportion of public health-
related actions in the SPD 
presented to Advisory 
Forum as IRIS proposals  

80% 

Comparison 
between list 
published on 
ECDC website and 
list of outputs 
published on the 
website by 31 Dec. 
Stakeholder survey 
or standard survey 
conducted during 
NFP meetings 

Presentation of 
IRIS proposals to 
Advisory Forum 
compared to 
approved SPD 
2021 

● Not measured in 2021, since 
no publication list was prepared 
in 2021 due to COVID-19. 

● Stakeholder survey will be 
conducted in 2022.  

● ECDC’s IRIS 2.0 process for 
the prioritisation of scientific 
outputs with the ECDC Advisory 
Forum did not take place in 
2021. 

Establish formalised mechanism 
for engagement with national 
Competent Bodies in establishing 
priorities for scientific advice and 
knowledge outputs (in coordination 
with 2.1) 

Consultation mechanism 
with Competent Bodies 
established for establishing 
priorities for scientific 
advice and knowledge 
outputs 

Establish a repository for collation 
of quality-assured guidance 
developed by national authorities 
and professional bodies in EU 
Member States 

Repository for quality-
assured guidance: 
Implementation according 
to project plan (schedule, 
resources, and scope) 

Mechanism established 

Minutes of first 
consultation 
meeting 

● Postponed to 2022. 

Repository available on 
ECDC website in Q4 
2021 

ECDC website 

Less than 20% 
deviation from the 
duration, resources, 
and scope of the initial 
baseline 

Quarterly ECDC 
Portfolio Steering 
Committee 
reporting 

● Repository not yet available. 
● Postponed to 2022. 

Whole Genome Sequencing 
services 

Proportion of requests from 
Member States for 
sequencing services 
accepted by ECDC 

100% 

ECDC surveillance 
section statistics; 
invoices from 
contracted 
laboratory 

● Achieved. 
More than 120 000 SARS-CoV-
2 samples from 11 EU/EEA 
Member States and 4 Western 
Balkan countries 

Develop and assess standards and 
processes that support the 
transparent, consistent and 
efficient production and clearance 
of scientific work and advice. 

Proportion of ECDC 
scientific outputs 
processed through 
SARMS, following the 
respective workflows and 
template 

Develop guidance on options and 
application of enhanced statistical 
methods for trend analysis of 
surveillance data 

Guidance document: 
implementation according 
to project plan (schedule, 
resources, and scope) 

90% 

SARMS 

● 100%  

Less than 20% 
deviation from the 
duration, resources, 
and scope of the initial 
baseline 

Quarterly ECDC 
Portfolio Steering 
Committee 
reporting 

● Achieved. Publication in 2022. 

Further develop and deliver advice 
and support on evidence-based 
public health methods 

Proportion of participants 
that consider the training 
useful 

80% 

Proportion of Member 
States that consider the 
training useful 

Pilot knowledge management 
approaches for strengthening the 
community of practice within and 
outside ECDC 

Pilot for knowledge 
management: 
Implementation according 
to project plan (schedule, 
resources, and scope) 

80% 

Pilot initiated in Q4 
2021 

Less than 20% 
deviation from the 
duration, resources, 
and scope of the initial 
baseline 

Course evaluations 

Assessment 
performed during 
the annual NFP 
meeting based on 
list of trainings 
conducted in year 
N-1 

ECDC annual 
report 
Quarterly ECDC 
Portfolio 
Steering 
Committee 
reporting 

● No trainings took place in 
2021 

● Not measured. 

● Knowledge management 
framework for the Centre 
developed, including proposal 
for development of communities 
of practice. 

1.2 

1.2 

1.2 

1.2 

1.2 

1.3 

1.3 

1.3 

1.4 

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Performance indicator 

Target 

Verification 

Result 20211 

Action 
Area 

Objective 

1.4 

Organise the annual European 
Scientific Conference on Applied 
Infectious Disease Epidemiology 
(ESCAIDE), in cooperation with 
Member States, the European 
Commission and other EU 
agencies, and include a ‘knowledge 
for policy and practice’ track at the 
conference 

1.4 

Ensure production and wide 
dissemination of Eurosurveillance 
as a high-quality journal with good 
visibility 

Percentage of attendees 
that rate ESCAIDE as 
‘good’ or ‘excellent’  

> 75% 

First quartile 

Journal in the first quartile 
for all metrics among 
journals in its category 
(impact factor, cite score, 
SCImago). 

ESCAIDE 
Programme and 
conference 
attendee 
satisfaction survey 
results 

Basket of metrics 
(impact factor, 
SciMago journal 
rank, CiteScore 
percentile),  
Source: Claviate 
analytics, Scopus 

Articles submitted for 
publication from countries 
represented on the 
Eurosurveillance editorial 
board 

60% from 
Eurosurveillance 
countries, and 
minimum two 
continents 

Eurosurveillance 
submission system 

Promote transparency and 
reproducibility in generating 
scientific information among 
Eurosurveillance contributors/ 
audience through respective 
editorial policies 

Proportion of submissions 
to Eurosurveillance with 
checklists (where 
applicable) 

> 90%, 

Proportion of relevant 
articles with genomic data 
deposited 

90% 

Records in 
Eurosurveillance 
submission system 

Less than 20% 
deviation from the 
duration, resources, 
and scope of the initial 
baseline 

Quarterly ECDC 
Portfolio Steering 
Committee 
reporting 

Develop communication formats 
and tools for effective delivery of 
information and evidence to 
specific audiences 

Strengthen the dissemination and 
communication of ECDC key 
scientific outputs to ensure they 
reach their target audience and are 
accessible at no cost for the user. 

Pilot for a tailored 
communication model: 
Implementation according 
to project plan (schedule, 
resources, and scope) 
Number of accesses to 
pilot communication model 

Access to ECDC scientific 
outputs:  
•  number of access 
•  number of downloads 
•  number of citations  

Impact factor of ECDC 
articles in peer reviewed 
journals 

Proportion of ECDC peer 
reviewed articles available 
in gold standard open 
access 

>5 

100% 

n/a 
n/a 
>20 in the 5 years 
following publication 

1.4 

1.4 

1.4 

● 93% of respondents “very” or 
“extremely” satisfied with the 
event. 

● Impact Factor (IF) 6.3, which 
placed the journal among the 
‘Top 10’ of infectious disease. 
SCImago Journal Rank 85 
among 2,448 journals in the 
category ‘medicine 
miscellaneous’.  
Scopus-based CiteScore (13.9): 
Eurosurveillance was in the 
98% percentile of journals in the 
category Public Health, 
Environmental and 
Occupational Health. 

● 85 countries submitted, from 
five continents.  
All but two Eurosurveillance 
countries submitted. 

●● 89% (16/18 submissions 
from countries within the 
journal’s scope including 4/4 
articles in the workflow and 
16/33 rejections); 15 of 17 
rejected articles without 
submitted checklists were from 
lower- or middle-income 
countries outside the journal’s 
scope. 
● Depositing of sequence data 
in published articles 100%.  
● Public Health Emergency 
output toolkit developed, 
including guidance and 
templates to further improve the 
ECDC PHE outputs and in 
particular the summary/green 
box that is included in all Rapid 
Risk Assessments and other 
key scientific outputs. 

Website statistics 
Website statistics 
ECDC library 
bibliometric review 

● 8 043 416 page views (43% 
decrease compared to 2020). 
● 406 545 PDF downloads in 
2021, compared to 572 051 
PDF downloads in 2020. 
● Average number of citations: 
46.88 

ECDC library 
bibliometric review 

● Impact factor: 11.30 

ECDC library 
bibliometric review 

●● 99% compliance with ECDC 
open access policy. 

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2. Strategic objective 2. Support the 
countries to strengthen their capacities and 
capabilities to make evidence-based 
decisions on public health policies and 
practices 

2.1 Country focus: use country information to better target 
ECDC activities and country support 

Preparatory work continued during 2021 and, in addition, concrete targeted support to countries was initiated. The 
preparatory work was presented and discussed during the three meetings organised as part of the working group 
E in the Third ECDC Joint Strategy meeting (JSM) during June-September 2021. 

Targeted country support focuses on work with the EU/EEA Member States and medium-term priorities. The 
primary contact points are the ECDC Coordinating Competent Bodies (CCBs) through the National Coordinators 
(NC).  

Overall aimed at ‘getting closer’ to countries, targeted country support comprises five key pillars: 

Country missions 

During 2021, an internal procedure on country missions was adopted, based on an analysis of all country missions 
carried out by ECDC in the period 2015-2020. This is aimed to ensure a corporate, harmonised approach for 
country missions, and create a central repository for their reports, available on a bilateral basis to the respective 
Member States and to ECDC. This will make reports more easily retrievable to monitor any required follow-up. 
Country missions will be carried out at the invitation of a country or following a dialogue between ECDC and the 
country experts. ECDC will investigate implementing a consolidated programme of country visits with defined 
steps. 

Country overviews 

This pillar aims at collating, integrating, and analysing country-specific information from a variety of sources (by 
integrating internal quantitative and qualitative data and additionally data from external sources, such as WHO, 
OECD, Eurostat) in a more systematic approach to gain better understanding of the main strengths and 
vulnerabilities of Member States. It provides a comprehensive description and visualisation of information on 
communicable diseases complemented with information on the (public) health system and health status in the 
respective country. Such a user-friendly format enables further analysis, so that strengths, vulnerabilities, 
opportunities, and threats (SVOT) can be identified and discussed bilaterally with Member States. Data sources 
include ECDC, Eurostat and HiT online developed by the European Observatory on Health Services and Policies. 
Unstructured data comes from ECDC mission reports, meeting reports and it can be considered as ‘soft knowledge’ 
on Member States. 

Work on country overviews progressed in 2021, structured along seven areas, each one including several sub-
areas and a group of indicators. The first release is anticipated in 2022, starting with the areas of ‘Country and 
health governance’ and ‘Workforce capacity’. 

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Figure 3. Country overviews structure 

Targeted country support cycle and practical support 

Discussions were initiated as part of the JSM meeting on how a dialogue between a Member State and ECDC can 
be done on a bilateral basis, to identify needs and agree on follow-up actions. 

Facilitating internal processes including procurement to support 
targeted country support 

Work on internal processes, including procurement options for targeted country support continued in 2021 to 
ensure that support activities e.g., workshops, exchange visits, consultancy are in place, as well as the possibility 
of offering support with translation in the national languages. 

EU funding opportunities for Member States 

As ECDC does not have the capacity to address all Member States’ needs, because of insufficient resources or as 
the need is outside of its remit, a list of possible sources of EU funding will be compiled and shared with Member 
States, to facilitate participation in relevant EU projects for improving their health systems and indicators. 

Figure 4. Targeted country support pillars 

In terms of direct support to Members States, the project around providing short courses, including curriculum 
development for a training of frontline healthcare professionals in addressing vaccine hesitancy, vaccinology 
module via e-learning and communication for behaviour change module via blended format continued, even if at a 
lower speed due to COVID-19 related challenges. ECDC was working with the Association of Schools of Public 
Health in the European Region (ASPHER) on identifying training needs for frontline healthcare professionals and 
mapping existing courses in these areas. The project continues in 2022 with developing the actual training 
curricula and delivering the course, focusing on the communication module first.  

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In October 2021 the ECDC Director initiated a targeted country support initiative aimed at supporting 11 Member 
States with COVID-19 vaccination uptake lower than the EU average: Bulgaria, Czechia, Estonia, Croatia, Hungary, 
Lithuania, Latvia, Poland, Romania, Slovenia and Slovakia. A series of bilateral meetings were held with the CCB 
Directors and the national focal points for the ECDC vaccine-preventable diseases and immunisation programme 
and follow-up activities were initiated. The ECDC Director travelled to Bulgaria, Estonia and Latvia where she was 
involved in discussions with experts and media representatives. A webinar on social media and misinformation was 
organised in November 2021 in which three to four experts working directly on these topics were invited form each 
of the 11 Member States. Further activities are planned for 2022. 

In the framework of ECDC TB country support, Member States were offered two workshops on active TB case 
finding and two countries received a consultancy. For the project on hepatitis C prevalence surveys, the needs 
assessment was completed and discussions with Member States on survey planning.  

The foreseen country visits to enhance the prevention and control of AMR and improve the implementation and 
effectiveness of national action plans in line with the objectives set in Council Recommendation 2002/77/EC and 
the latest Council Conclusions on AMR, as well as the Global Action Plan on AMR (WHO), WHO’s European strategic 
action plan on antibiotic resistance and the European One Health Action Plan on AMR, were postponed to 2022 
due to the COVID-19 pandemic. 

In 2021, ECDC continued the coordination and operation of 19 disease networks, including the recently created 
ECOVID-Net (established in 2020) and E-SARI-Net (established in 2021), and seven public health networks. 

2.2 Prevention and control programmes: support and 
strengthen capacity to deliver programmes targeted at the 
prevention and control of infectious diseases 

Strengthen ECDC’s support to targeted prevention and control 
programmes 

Based on robust surveillance data, ECDC continued to support countries to enhance their prevention and control 
programmes depending on the disease. The basis of this work was the production of timely and relevant evidence-
based advice and risk assessments on communicable disease prevention and control to the European Commission 
and EU Member States. 

Specific efforts included work to strengthen vaccination programme delivery and vaccine confidence, provision of 
guidance to develop evidence-based policies for prevention programmes on COVID-19, HIV, and TB, and 
antimicrobial stewardship and infection prevention and control-related activities in healthcare settings. Additionally, 
raising awareness of important public health issues through awareness campaigns e.g., European Antibiotic 
Awareness Day, World Antimicrobial Awareness Week, HIV/hepatitis Testing Week, World Hepatitis Day, World 
AIDS Day, World TB Day, European Immunisation Week, and Influenza Awareness Week and monitoring control 
programmes and country preparedness for a range of infectious disease threats like foodborne outbreaks and 
influenza also took place.  

ECDC published technical guidance on HIV pre-exposure prophylaxis (PrEP). This guidance provides Member 
States with practical recommendations and key considerations to inform the development and implementation of 
PrEP programmes at national and sub-national levels. As a follow-up to this guidance, ECDC developed evidence-
informed indicators for monitoring HIV PrEP programmes. 

Figure 5. ECDC technical guidance on HIV pre-exposure prophylaxis (PrEP) 

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Throughout the COVID-19 pandemic, ECDC has provided relevant and high-quality data and scientific advice on 
COVID-19 prevention and control in support of the European Commission and EU Member States. With the 
introduction of COVID-19 brand-specific vaccines, the European monitoring platform was set up jointly with EMA to 
assess the impact and effectiveness of those vaccines as well as detect possible safety signals, which deserve 
further investigation. Several studies started in close collaboration with EU Member States and WHO EURO.  

ECDC continued supporting the implementation of the 2018 Council Recommendation on Strengthened 
Cooperation against Vaccine-Preventable Diseases, with a special focus on COVID-19 and influenza vaccines. The 
Centre works in close collaboration with the National Immunisation Technical Advisory Groups (NITAGs) and the 
Health Security Committee to support policy-makers and public health experts at national level in the development 
of vaccine deployment plans, rollout of vaccination campaigns, and implementation of vaccination strategies for 
COVID-19 vaccines. Twenty-five webinars with the NITAGs were organised by ECDC in 2021 on those topics, with 
the participation of EU and international stakeholders, such as US CDC, non-EU countries, and WHO. 

In the area of AMR monitoring, ECDC established, jointly with The WHO Regional Office for Europe, a list of 
selected monitoring indicators based on the FAO/OIE/WHO Tripartite Monitoring and Evaluation framework, and 
these indicators were reported in the first ECDC-WHO Europe joint report on AMR surveillance in Europe (2020 
data) that was published on 26 January 2022. Such analytic information on the level of response to AMR is 
intended to assist Member States to understand better where they should prioritise efforts to prevent and control 
AMR. Integration of indicators on structures, resources, and processes for the implementation of infection 
prevention and control (IPC) and antimicrobial stewardship (AMS) programmes in acute care hospitals in the 
EU/EEA countries is ongoing and these will be included in the third point prevalence survey of HAIs and 
antimicrobial use in European acute care hospitals, to be launched in 2022.  

Monitoring of indicators to measure how far Member States have achieved the UN Sustainable Development Goals 
in the areas of HIV/AIDS, hepatitis, and TB together with comprehensive progress reports, provide important 
feedback and data to countries helping them to benchmark and plan better their use of resources.  

In 2021, in close collaboration with Member States, ECDC performed monitoring for hepatitis and HIV and 
published monitoring reports. 

Address the behavioural aspects that are needed for national 
programmes to be successful 

ECDC continued to address the behavioural aspects and effective risk communication of importance to the 
prevention and control of specific diseases. In 2021, these efforts focused mainly on COVID-19 and vaccine 
hesitancy.  

In this area, a number of important reports were published by ECDC:  

• 

• 

• 

Technical report on countering online vaccine misinformation in the EU/EEA, which provides insights for 
national public health authorities into the factors behind the spread of vaccine misinformation online and 
the options and capacities needed for responding to it1; 
Technical report on facilitating COVID-19 vaccination acceptance and uptake in the EU/EEA, which presents 
considerations for diagnosing barriers to acceptance and uptake of COVID-19 vaccination and designing 
and implementing interventions to increase uptake. The report uses the so called ‘5Cs’ model to organise 
and explain the various causes of low vaccination acceptance and uptake, and to categorise potential 
interventions2; 
Technical report on behavioural insights research to support the response to COVID-19 in the EU/EEA. This 
report identified success stories in behavioural insights work in Member States from the first year of the 
pandemic and highlighted areas that need further attention and support3. 

Intensive work was initiated to assist Member States with suboptimal COVID-19 vaccination uptake to increase 
vaccine coverage. It involved webinars for 11 countries and bilateral exchanges (see more information in Action 
Area 2.1). 

1 Report available from https://www.ecdc.europa.eu/en/publications-data/countering-online-vaccine-misinformation-eu-eea 
2 Report available from: https://www.ecdc.europa.eu/en/publications-data/facilitating-covid-19-vaccination-acceptance-and-
uptake 
3 Report available from: https://www.ecdc.europa.eu/en/publications-data/behavioural-insights-research-support-response-covid-
19 

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Emphasise a general ‘One Health’ approach to relevant ECDC work 

ECDC aims to further identify and develop its role in prevention and control of infectious diseases in a zoonotic and 
One Health perspective. In 2022, work will start to develop an ECDC One Health framework with strategic 
objectives. In 2021, in cooperation with EFSA, ECDC provided relevant and high-quality monitoring data and 
scientific advice for food and waterborne disease outbreak prevention and control to support the European 
Commission and EU Member States.  

Trends in AMR in infections from zoonotic bacteria were monitored and compared with those from livestock and 
food using a One Health approach. Results of these analyses were published on 30 June 2021 in the third report 
on the Joint Interagency Antimicrobial Consumption and Resistance Analysis (JIACRA III, jointly with EFSA and 
EMA). Work continues to identify emerging strains with AMR of particular concern, such as MDR, ESBLs and/or 
carbapenemases under the European Antimicrobial Resistance Genes Surveillance Network (EURGen-Net), a 
network for genomic-based surveillance of multidrug-resistant bacteria of public health importance. In 2021, ECDC 
worked on the completion of the carbapenem- and/or colistin-resistant Enterobacterales (CCRE) survey under 
EURGen-Net, and its results will be published in 2022. 

Collecting information on the diversity, ecology and epidemiology of vector-borne human pathogens and their 
vectors continued in 2021. The public health impact of the non-vectorial transmission routes of Tick-borne 
encephalitis (TBE) virus was investigated over a systematic survey. The public health impact of leishmaniasis was 
assessed in the EU/EEA and its neighbourhood counties. The geographic distribution, public and animal health 
impact, surveillance, response and control methods of West Nile virus and Usutu virus infections were studied 
involving public health, animal health, entomology and Substances of human origin sectors in a one-health project. 
The frequency of airport- and luggage-related, imported malaria cases in Europe was analysed. The changes in the 
distribution of relevant pathogen vectors were monitored through biannual updates of vector distribution maps in 
Europe. 

In the area of microbiology, ECDC significantly strengthened public health microbiology structures and activities in 
Member States through the implementation of WGS and RT-PCR infrastructure and capacity-building under the EU 
bio-defence preparedness plan against SARS-CoV-2 variants launched in February 2021. As part of the support to 
the European Health Emergency Preparedness and Response Authority incubator, ECDC awarded more than EUR 
77 million to 24 EU/ EEA countries to strengthen whole genome sequencing and RT-PCR infrastructures within the 
countries' national public health programmes. The immediate objective was to reinforce countries' capacities for 
early detection and enhanced monitoring of emergent and known SARS-CoV-2 variants. 

The funds awarded were based on the individual needs of each country, as described in applications submitted by 
their public health authorities. Activities are 90% funded by ECDC, while the countries are required to finance the 
remaining 10% themselves. Projects started in September and October 2021 and will run until the end of 
September 2022. 

2.3 Training: provide adequate training opportunities 
considering the changing environment for infectious disease 
prevention and control 

ECDC supports the strengthening of workforce capacity with the goal of reaching a sufficient number of trained 
public health specialists in Member States and at the EU level, and ensuring their adequate performance for 
communicable disease preparedness and response, prevention, detection, assessment and control nationally and 
across borders.  

Within the ECDC Virtual Academy, trainers and learners have access to training materials, online courses, webinars 
and communities of practice, through the Continuous Professional Development training offer. In 2021, two new e-
learning courses were accredited via the Agency for Public Health Education Accreditation (APHEA) and two more 
are pending final decision from the APHEA accreditation board. Knowledge transfer is promoted, with support 
provided to participants in trainings to facilitate it. 

Networking with European and global training partners is a key pillar of the ECDC training strategy, and involves 
partners like the European Commission, WHO, ASPHER, European Public Health Association, Africa CDC, US CDC, 
the Public Health Agency of Canada, and TEPHINET, among others. 

In June 2021, the Mediterranean and Black Sea Programme in Intervention Epidemiology Training (MediPIET) 
became an inherent component of the EU Initiative on Health Security, and the launch of cohort 4 of the MediPIET 
will be reported in full under action area 4.1. 

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In 2021, 33 fellows graduated from the ECDC Fellowship Programme and the EPIET-associated programmes (30 
cohort 2019, two EAPs C2018 and one EAP C2017). At the end of the year, 71 fellows were enrolled (33 from 
cohort 2020 and 38 from cohort 2021). The programme, which is an in-service training at public health institutes 
and laboratories located in EU/EEA countries, features an introductory course, training modules, and international 
assignments. 

Figure 6. ECDC Fellowship Programme: number of enrolled participants per cohort, 1995–2021 

45

35

25

15

5

-5

2 1 4

2
7 10 10 9 8 6 8 10 9

3 3

6

6 1 9 9

14 15 12 13

11 12 11 10 10 11 11 13 4 8 10
5 2 5
7 10
6
6
2 2 2 4

5 6 5
7 6 5 6 5
4 4
6 7 12 9 8 9 11

15 7
4

4 3

8

7

19 19 18 17

4
8 12 11 12 9 11 12 12 11 10

5
9
9
1

6
9
9
1

7
9
9
1

8
9
9
1

9
9
9
1

0
0
0
2

1
0
0
2

2
0
0
2

3
0
0
2

4
0
0
2

5
0
0
2

6
0
0
2

7
0
0
2

8
0
0
2

9
0
0
2

0
1
0
2

1
1
0
2

2
1
0
2

3
1
0
2

4
1
0
2

5
1
0
2

6
1
0
2

7
1
0
2

8
1
0
2

9
1
0
2

0
2
0
2

1
2
0
2

EPIET

EPIET-EU

EUPHEM

EPIET-MS

EUPHEM-EU

EUPHEM-MS

EAP

As the COVID-19 pandemic dominated the activities of public health institutes in Europe, EPIET and EUPHEM 
fellows were heavily engaged in a wide range of COVID-19 activities related to the early detection, diagnostics, risk 
assessment, risk communication, preparedness, response and operational research in epidemiology and public 
health microbiology. To discuss and share experiences on COVID-19 response among fellows, training sites and 
ECDC, several think tanks were conducted on various COVID-19 topics. For instance, in December 2021 the think 
tank focused on different aspects of the Omicron surge. 

Its in-service nature and direct contribution to strengthening response capacity to tackle cross-border threats, 
justified all efforts invested to keep the start date of Fellowship for Cohort 2021 and to maintain business 
continuity, despite the challenges (upon cancellation of face-to-face activities). The selection of Fellowship Cohort 
2021 was possible through conducting both the interviews with candidates and the ‘market’ with training sites 
online. During 2021, all modules were conducted online, including the Introductory Course of Cohort 2021. The 
fellows of EPIET and EUPHEM conducted 15 international assignments, mainly concerning COVID-19 and including 
COVID-19 contact tracing, surveillance system strengthening and vaccine effectiveness studies. 

Table 1. Modules and participants, ECDC Fellowship programme 

Programme 

Topic / track 

Participants 

Total 

Fellowship Programme 

EPIET cohort – EU-track 2020 
EUPHEM cohort – EU-track 2020 
EPIET cohort – Member State - track 2020 
EUPHEM cohort – Member State - track 2020 
EPIET-associated programmes 2020 

EPIET cohort – EU-track 2021 
EUPHEM cohort – EU-track 2021 
EPIET cohort – Member State - track 2021 
EUPHEM cohort – Member State - track 2021 
EPIET-associated programmes 2021 

10 (11 and 1 resigned) 
5 
10 (11 and 1 resigned) 
2 
7 (8 and 1 resigned) 

10 
6 
8  
4 (5 and 1 resigned) 
10  

MediPIET (scientific 
leadership) 

In 2021 – 15 fellows from Cohort 3 were under training (see details 
under section 4.1) 

15 

15 

Online consultations with NFPT/TSF about the future Fellowship Programme after the 2019 external evaluation 
guided the definition of the concept and roadmap for improvements that were finalised, consulted with the 
Advisory Forum and approved by the Management Board in June 2021. The working groups that will guide and 
drive the improvement work as outlined in the roadmap have been formed and started their work during 2021. 
The improvements work involves curricular revision, ways to address Member States underrepresentation, 
international assignments, quality improvement, the selection process and simplification of administrative 
processes.  

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Figure 7. Total EU-track fellows (sent and hosted) per country since the start of the Fellowship 
Programme 

In 2021, the Continuous Professional Development programme continued offering a vast array of instructor-led and 
e-learning courses. 

Table 2. ECDC Instructor-led training activities 

Name of training activity 

Duration 
(hours) 

Delivery 
date 

No. of 
participants 

Feedback/ 
satisfaction 

Comments 

APHEA* 
Accreditat
ion (Y/N) 

1 

2 

3 

4 

5** 

6 

Advanced antimicrobial 
susceptibility testing for 
Mycobacterium tuberculosis 
and non-tuberculous 
mycobacteria– theoretical 
(1st part) and practical (2nd 
part) workshop 
Training on epidemic 
intelligence and rapid risk 
assessment 

6 hours + 
5 hours 

15-17 
February 
And  
15-16 
March 

18 hours 

19-23 April 

18 hours 

4-10 May 

ECDC rapid risk assessment 
training 

5 hours 

22 October 

Epitweetr: R-based 
automated open-source tool 
for early detection of public 
health threats from Twitter 
Summer School – 
Supervisors’ Best Practice 

Workshop on entry/exit 
screening - Science and 

5 hours 

16 June 

8 hours 

5.5 hours 

1-2 
September 

14 
September 

19 on the 1st 
part and 8 of 
those in the 
2nd 

100% positive 
evaluation 
(scores 8-10 out 
of 10) 

12 

7 

25 

14 

26 

40 

100% satisfied (4 
answers) 

100% satisfied (6 
answers) 

Health Security Initiative 

Health Security Initiative 

92% satisfaction 

ACPHEED1  

100% satisfied (5 
answers) 

83% satisfied 
with the course 

100% satisfied (7 
answers) 

N 

N 

N 

N 

N 

Y 

N 

1 ASEAN (Association of Southeast Asian Nations) Centre for Public Health Emergencies and Emerging Diseases 
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Name of training activity 

Duration 
(hours) 

Delivery 
date 

No. of 
participants 

Feedback/ 
satisfaction 

Comments 

7 

8** 

9** 

practice (together with 
FRONTEX) 

Virtual workshop on ‘Active 
Tuberculosis case finding in 
vulnerable populations’ 

9 hours 

27-28 
September 

Control of multidrug-resistant 
microorganisms (MDRO) in 
health care settings 
Workshop on After-Action 
Reviews (AAR) and In-
Action Reviews (IAR) 2021 

19.5 
hours 

12 hours 

10**  Winter Workshop 2021: 

After-action reviews 

12.5 
hours 

22, 24, 26 
November 

22, 23, 26 
November 

1, 3, 7 
December 

Delivered instead of 
webinar ‘Screening for 
active tuberculosis and 
tuberculosis infection 
among migrants’ 

11 

57 

20 

45 

Participants 
found the 
workshop 
interesting and 
useful 
97% recommend 
the course to 
others 
100% 
recommend the 
course to others 
90% satisfied 
with the course 

APHEA* 
Accreditat
ion (Y/N) 

N 

Y 

N 

Y 

* Agency for Public Health Education Accreditation (APHEA) 
** Organised by the Continuous Professional Development (CPD) group 

The charts below show the representation in instructor-led courses during 2021 (distribution of the number of 
participants across EU, EEA/UK and third countries).  

Figure 8. Number of participants to instructor-led courses per EU country (Total of 135 participants) 

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Figure 9. Number of participants to instructor-led courses per EEA/UK country (Total of eight 
participants) 

Figure 10. Number of participants to instructor-led courses per other countries and geographical 
areas outside EU/EEA/UK (Total of 133 participants) 

From the figures above we can conclude that: 

• 

• 

• 

135 participants from EU countries attended instructor-led courses organised by ECDC, where most were 
from Denmark, Spain and Sweden (eight each). 
Eight participants from EEA/UK countries attended instructor-led courses organised by ECDC, where only 
Norway and Iceland sent participants (five and three respectively). 
133 participants from countries and geographical areas outside EU/EEA/UK attended instructor-led courses 
organised by ECDC, where most were from Palestine and Lebanon (18 and 16 participants respectively). 

The data in the table below shows the number of enrolled learners, approximate duration and satisfaction for each 
e-learning course available in EVA at the end of 2021. 

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Table 3. E-learning courses in 2021 

No 

Course Name 

Publicat
ion date 

Duration 
(hours) 

Enrolled in 
2021 

1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

16 

17 

18 

19 

20 

21 

Essentials of Writing and 
Reviewing Scientific 
Abstracts: a field 
epidemiology focus 
Introduction to Outbreak 
Investigation e-learning 
Influenza vaccination 
campaigns targeting health 
care workers* 
Rapid Risk Assessment 
e-learning course 
Assessing and grading 
evidence in public health 
e-learning course 
(PRECEPT) 
Influenza bioanalytics 
e-learning course 
Cross-border sharing of 
public health data e-learning 
course* 
e-learning on Migration and 
Health for Health 
Professionals* 
e learning on Migration and 
Health for Law Enforcement 
Officers* 
e-learning on Migration and 
Health for Social Workers* 
e learning on Migration and 
Health for Trainers and 
Coaches* 
e-learning for front-line 
managers on COVID-19 
response to vulnerable 
populations* 
Contact tracing in the context 
of COVID-19 response* 
Introduction to Infectious 
Disease Surveillance - e-
learning pilot 
Antimicrobial Stewardship e-
learning course 
Peer feedback on Writing and 
Reviewing Scientific 
Abstracts: a field 
epidemiology focus April-May 
2021 
e-Learning course on 
introduction to designing in- 
and after-action reviews 
How to design a Table-top 
exercise e-learning pilot 
course 
How to design a Functional 
exercise e-learning course 
Epidemic Intelligence e-
learning course 
Understanding Vaccine 
Acceptance & Strategies to 
Increase Vaccine Uptake 
Total: 

Mar-16 

2 weeks 

124 

Oct-18 

2 

Oct-18 

0,5 

Mar-19 

2-3 

Apr-19 

6-8 

Sep-19 

3-5 

Dec-19 

2-3 

Mar-20 

Mar-20 

Mar-20 

Mar-20 

8 

8 

8 

3 

219 

9 

218 

62 

48 

47 

98 

23 

23 

22 

Nov-20 

1.5 

191 

Aug-20 

1.5 

Jan - 21 

1,5-2 

Feb-21 

0.5 

Apr-21 

0.75 

May-21 

2-4 

June-21 

0.5 

June-21 

0.75 

Sep-21 

2-4 

Dec-21 

0.5 

224 

37 

305 

35 

188 

26 

25 

539 

229 

2692 

Satisfaction 
(1–10) 

8.7 

8.7 

8.7 

8.6 

8.7 

8.6 

8.6 

9.7 

9.5 

9 

9.5 

9 

95% would 
recommend 
n/a 

8.4 

8.3 

n/a 

n/a 

9.0 

8.5 

Obtained 
Certificate 
for 2021 
37 

66 

2 

54 

17 

7 

8 

14 

7 

5 

2 

42 

97 

17 

95 

7 

611 

19 

0 

135 

64 

758 

APHEA* 
accreditation 
Y/N 
N 

N 

N 

N 

N 

N 

N 

N 

N 

N 

N 

N 

N 

N 

N 

N 

Y 

n/a 

n/a 

Y 

N 

1 Of those 61 issued certificates, 26 were issued using Custom certificate activity. 

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Figure 11. Percentage of completion and in progress per e-learning course  

100%

90%

80%

70%

60%

50%

40%

30%

20%

10%

0%

The results of the completion rates are in line with the overall rates for e-learning found in the literature, where 
approximately one in every five participants completes a course1. An older study specific for massive open online 
courses (MOOCs) found results varying from 0.7% to 52.1%, with a median value of 12.6%2. 

%completed

%in progress

1 R. F. Kizilceca, J. Reichb, M. Yeomansc, C. Dannd, E. Brunskille, G. Lopez et al, Scaling up behavioral science interventions in 
online education, PNAS, June 30, 2020; vol. 117, no. 26. 
2 K. Jordan, Massive Open Online Course Completion Rates Revisited: Assessment, Length and Attrition, International Review of 
Research in Open and Distributed Learning, vol. 16, no. 3. 

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During 2012, 21 e-learning courses were made available in EVA for learners to self-enrol, eight of which were new 
e-learning courses, launched in 2021. 

The Senior Exchange visits were suspended during 2021, as travelling was not possible due to COVID-19. 

Many experts and teams at ECDC are behind the production and delivery of the Continuous Professional 
Development activities. Cooperation and multiple iterations between the Public Health Training section and subject 
matter experts made possible the design, development and implementation of the courses included in the ECDC 
Course listing for 2021. 

Needs assessment 

Triennial surveys to assess capacity and training needs in EU/EEA countries help tailor the ECDC training offer, in 
particular the continuous professional development. In 2021, a new survey was launched. It is still open to 
respondents upon request of the National Focal Points for Training to extend the deadline for response, due to 
COVID-19. 

Competency frameworks 

The project to update the core competencies on applied infectious disease epidemiology, including qualitative and 
quantitative methods, was completed and clearance of the resulting technical report is ongoing. The competency 
framework offers a means of developing a shared vision of what constitutes the specific knowledge and skills 
required for effective practice. 

Networking 

The Centre contributes with expert input to the Training Programmes in Epidemiology and Public Health 
Interventions Network (TEPHINET’s) learning advisory council for the field epidemiology training programme, and 
the Strategic Leadership Group to drive the progress of Field Epidemiology Training Programmes (FETPs) 
worldwide as part of a Global Field Epidemiology Roadmap.  

ECDC continued its collaboration with the Global Laboratory Leadership Programme, together with WHO, the FAO, 
the OIE, the US CDC and the American Association of Public Health Laboratories (APHL). 

2.4 Emergency preparedness: support countries in 
emergency preparedness and response, including by 
deployment of public health teams as requested 

One of the ECDC’s core tasks is to provide technical support to the EU-level response to communicable disease 
threats. Decision No 1082/2013/EU on serious cross-border threats to health and the International Health 
Regulations continued to be the policy frameworks under which ECDC operates for emergency preparedness and 
response. In this area, ECDC strengthened the coordination between the European Commission and Member 
States. ECDC’s actions addressed all the countries or groups of countries based on their needs, and in synergy with 
WHO. There was active collaboration with relevant ongoing EU Joint Actions (SHARP, Healthy Gateways, Joint 
Action TERROR: Strengthened Preparedness and Response to Biological and Chemical Terror Attacks) to support 
activities related to preparedness and response and implementation of the International Health Regulations. 

The EU Early Warning and Response System (EWRS) on public health threats is operated by ECDC on behalf of the 
European Commission and serves as a key tool to support the EU-level response to cross-border health threats. 
During 2021, ECDC ensured proper functioning of EWRS and implemented further improvements of the platform 
according to the needs of the European Commission and Member States. ECDC supported the European 
Commission with a survey about lessons learned from the use of EWRS during the COVID-19 pandemic, to guide 
further EWRS development. In addition, the EpiPulse platform was launched in 2021 to facilitate collection of data 
and exchange of experts' experiences in communicable disease outbreaks. 

In 2021, the public health emergency preparedness and response work was in large part directed to supporting 
the European Commission and EU/EEA Member States to undertake actions to mitigate the impact of the COVID-
19 pandemic to the health of the European population. 

ECDC maintained the Emergency Operation Centre in the highest alert level. The ECDC public health emergency 
plan which enables the Director to mobilise resources to support the EU-level response to serious cross-border 
threats to European public health, continued to be in force with the Public Health Emergency (PHE) structure in 
place for the duration of the whole year.  

Experts in the public health emergency preparedness and response team were heavily involved in PHE activities, 
including in functions such as PHE manager, PHE strategic analysts, PHE technical expert, PHE response duty, PHE 
internal evaluators, technical support for PHE managers, team members of COVID-19 task forces, etc.  

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For the duration of 2021, the ECDC PHE plan in response to the continuing COVID-19 pandemic was maintained at 
level 2, the maximum level of alert. The PHE structure was reorganised in two phases after consultations with the 
involved staff at different levels and after approval by the PHE Management Team in May 2021. The overall aim 
was for the PHE structure and governance to evolve to fit the more complex, diverse and broadened work on 
COVID-19 and to facilitate streamlined coordination and decision making. The PHE COVID-19 Task Force (CTF) 
created in 2020 continued to be the focal team handling COVID-19-related Commission, Member States and other 
requests, development of new and updates of older guidance documents. The current structure of the PHE as of 
September 2021 is shown on Figure 12. 

Figure 12. Overview of the ECDC PHE structure for COVID-19, 2021 

A total of 112 ECDC staff members worked in the framework of the COVID-19 PHE. Ten experts and scientific staff 
are on duty every week for the first-line response. In 2021, more than 731 individual tasks were addressed by PHE 
staff, with an additional twelve tasks which recur on a weekly, fortnightly or monthly basis. The Centre is 
maintaining ten types of raw data databases updated daily, weekly or fortnightly, publishes a weekly country 
overview report with multiple surveillance indicators, has developed 20 infographics and 16 short videos and 
maintains 46 webpages on COVID-19. In addition, four dashboards are maintained (Situation dashboard, Vaccine 
Tracker, Variant Dashboard, ECDC-JRC Response Measures Database). 

Based on the ECDC experience from operating the Emergency Operation Centre, managing the PHE COVID-19 and 
taking into account lessons-learnt during the COVID-19 response, ECDC will assist Member States that request the 
development of Public Health Emergency Operation Centre operating procedures, with reference to international 
standards.  

During 2021, ECDC published a number of rapid risk/outbreak assessments aimed at supporting Member States 
and the European Commission in their preparedness and response to public health threats. RRA/ Rapid Outbreak 
Assessment provide a timely summary and risk assessment of public health threats for EU/EEA countries related to 
a specific event. They also include options for response.  

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Out of the 22 rapid risk/outbreak assessments that the Centre conducted and published during 2021, 11 (50%) 
aimed to assess different phases and developments in the COVID-19 pandemic. Furthermore, under the One 
Health approach in response to cross-border foodborne threats through joint ECDC-EFSA rapid outbreak 
assessments, EU level analyses of data were performed in cooperation with EFSA, European Union Reference 
Laboratories, Member States and other relevant parties. The RRA methodology is constantly monitored and 
upgraded. ECDC also prepared for an update of the RRA methodology collecting lessons learned from the many 
RRA related to COVID-19 and the recommendation sent by the EU Ombudsman. 

Work was also initiated for the development of a protocol and a full toolbox of in- (IAR) and after-action reviews 
(AAR). The protocol for focused evidence-based decision-making was published, and work with EU, EEA and ENP 
countries was initiated to review response actions in long-term care facilities. Work on an assessment framework 
with a focus on preparedness indicators was also performed to facilitate further discussions on preparedness and 
response planning assessment and identification of gaps and needs in context of pandemic situations. In 2021, 12 
literature reviews were initiated on COVID-19-related topics such as non-pharmaceutical interventions (NPI) 
effectiveness, seasonality of SARS-CoV-2, risk factors for COVID-19, settings of SARS-CoV-2 transmission, cost-
effectiveness of NPIs, inequalities of COVID-19, among other. The literature reviews have supported the 
development of ECDC and Member State guidance; for example, the concluded review on NPI effectiveness was 
shared with all Member States to support decision-making in the late Delta and early Omicron waves. 

The Centre continued hosting trainings for stakeholders including the ECDC Fellowship programme, the Health 
Security Initiative, Africa CDC and other non-European partners. Training materials for e-learning courses were 
developed to support public health professionals in the EU/EEA and ENP countries to perform in-action and after-
action reviews in Member States. Extensive information on the trainings offered is provided under Section 2.3. 

The ECDC network of National Focal Points (NFP) for Preparedness and Response and the NFP for Threat 
Detection, Early Warning and Response Systems and International Health Regulations was actively involved in 
regular webinars, where topical issues regarding the COVID-19 pandemic were discussed with external and 
internal experts.  

Ten webinars were organised for the network of NFPs, with the number of participants ranging between 65-85 per 
webinar, and topics covering a variety of aspects of preparedness and response to the COVID-19 pandemic. 
Internal and external speakers presented to an audience of NFPs, observers from EU Enlargement Countries, 
CDCs, WHO and the European Commission. 

In order to support all the above activities ECDC maintained a robust response duty roster and supported disease 
programme duty rosters and functional teams, providing particular support to the Infection Prevention 
Control/Non-Pharmaceutical Interventions (IPC/NPI) team. The Centre also provided expert support in response to 
requests from Member States, the European Commission (Directorate General for European Civil Protection and 
Humanitarian Aid Operations, Directorate-General for Health and Food Safety) and WHO in relation to serious 
cross-border health threats. An ECDC expert participated in the Joint External Evaluation of Ukraine by the WHO 
Regional Office for Europe in late November 2021.  

ECDC, in collaboration with the European Commission's Joint Research Centre (JRC), maintained and curated the 
ECDC-JRC Response Measures Database (RMD), a repository of non-pharmaceutical interventions (NPIs) 
implemented since 1 January 2020 in EU/EEA Member States in response to the COVID-19 pandemic. ECDC 
coordinated NPI data collection and data validation with fortnight frequency, with the dissemination of the 
database supported both by JRC and ECDC in their respective webpages and in different formats to facilitate 
different uses. The database webpages received a stable and substantial number of visits during the year. ECDC 
and JRC used the ECDC-JRC RMD to feed regular and ad hoc outputs with information on the different NPIs 
implemented by EU/EEA countries during the COVID-19 pandemic. 

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Figure 13. ECDC-JRC Response Measures Database 

ECDC coordinated or supported the harmonisation of investigations of multi-country public health events and 
threats, as well as national investigations. ECDC also made protocols available to Member States to guide contact 
tracing activities and to investigate COVID-19 clusters, including studies to assess vaccine effectiveness in closed 
or semi-closed settings. In preparation for the work of the EU Health Task Force, the Centre provided technical 
support for preparedness and response remotely, including performing an evaluation of the SARS-CoV-2 testing 
policy upon request of an EU Member State. In collaboration with the Directorate-General for Health and Food 
Safety, ECDC developed plans for joint ECDC- Directorate General for European Civil Protection and Humanitarian 
Aid Operations field deployments for preparedness and response assignments, both inside and out of the EU. 

In collaboration with affected Member State(s), ECDC offered to support after-action reviews to analyse and learn 
from the actions performed during an outbreak of cross-border relevance. The COVID-19 pandemic will most likely 
trigger a review of preparedness and response plans in countries, including capacities in critical areas such as 
surveillance or microbiology. It may also trigger reflection on the implementation, monitoring and evaluation of 
unprecedented non-pharmaceutical measures (such as social distancing, school closures with distance learning and 
work-from-home, etc.), with an effort to balance the mitigation of the pandemic with the ensuing social and 
economic disruption. There is a need to better understand the effectiveness of these measures and/or what could 
have been done better. ECDC will support this review process and engage with countries to identify lessons learnt 
from the COVID-19 pandemic. ECDC initiated an after-action review project on evidence-based decision-making in 
long-term care facilities in three countries (one EU, one EEA and one ENP country - Belgium, Norway, and Georgia) 
in late 2021. 

Strategic objective 2. Performance indicators 

Objective 

Performance indicator 

Target 

Verification 

Result 2021 

Networks interactions 

Country support 

Develop scientific advice 
on communicable 
disease prevention and 
control measures 
Strengthen whole 
genome sequencing and 
RT-PCR capacity in the 
EU/EEA  

- Average rate of participation in 
ECDC meeting and activities 
- Rate of expectations met and 
objectives fulfilled with meetings 

-Proportion of requested country 
missions that were conducted 
by ECDC 
Uptake of ECDC scientific 
outputs by Member States 

75% 

75% 

100% 

TBC 

Degree of implementation of 
enhanced genomic-based 
surveillance support activities to 
Member States 

Infrastructure support 
projects initiated for at 
least ten countries 

SRM 

● Not measured in 2021. 

Standard questionnaire to 
participants during 
meeting 

European and 
International Cooperation 
section 
ECDC stakeholder 
survey or consultation 
during NFP meetings 

● Not measured in 2021. 

● Not applicable, due to 
travel restrictions.  

● Not measured. ECDC 
Stakeholder survey will 
be carried out in 2022. 

Grant agreements signed  ● Achieved (24 grant 
agreements signed). 

Action 
Area 
2.1 

2.1 

2.2 

2.2 

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Area 
2.3 

2.3 

2.3 

2.3 

2.3 

2.4 

2.4 

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Objective 

Performance indicator 

Target 

Verification 

Result 2021 

Improvements of the 
Fellowship Programme, 
based on the results of 
the 2019 external 
evaluation 

Number of scientific articles of 
public health relevance by 
ECDC fellowship programme 
(EPIET/EUPHEM) during and 
two years after graduation 

> 50% increase 
compared to the two-
year period before 
entering the 
programme 

Bibliometric analysis in 
PubMED, Scopus (ECDC 
library) 

● 158% increase. 

Offer a Continuous 
Professional 
Development (CPD) that 
responds to the needs 
identified by ECDC’s 
networks, and provide 
tools and support for the 
transfer of knowledge at 
European, national and 
sub-national levels, with 
special attention to 
COVID-19-related needs 

- Proportion of trainings that 

include a session to support 
participants’ knowledge transfer 

100% 

- Proportion of participants that 
consider the training useful  
- Proportion of Member States 
that consider the different 
trainings useful 

80% 

80% 

50% 

Proportion of short courses 
accredited under UEMS/APHEA  

Keep continuous quality 
improvement activities, 
accreditation and 
evaluation as an 
essential part of ECDC 
training programmes and 
activities. 

- Number of enrolments in EVA 
- Satisfaction by participants on 

the usability of the EVA 
platform 

+10% 

80% 

ECDC Public Health 
training statistics 

Course evaluations 

Assessment performed 
during the annual NFP 
meeting based on list of 
trainings conducted in 
year N-1 

Number of accepted 
accreditations (ECDC 
Public Health Training 
statistics) for all trainings 
conducted across ECDC 

EVA platform statistics 

EVA platform survey 
among participants that 
completed the course 

Response rate of the survey 

70% 

Results of the survey 

Maintain the ECDC 
Virtual Academy (EVA) 
as a learning system that 
includes training 
materials, and the 
administration of all 
ECDC training offer 
(face-to-face, online and 
blended) for the different 
training programmes and 
activities 
Identify country capacity 
gaps and training needs 
through the triennial 
assessment surveys 
(CCBs and NFPT), to 
tailor trainings and 
reduce inequalities in 
capacity across Europe 
Provide technical 
support in the three 
phases of the 
preparedness and 
response cycle: 
anticipation, response, 
recovery  

● Not measured.  
● 96% average 
participants satisfaction 
with instructor-led 
courses. 

● 89% average 
participants satisfaction 
with e-learning courses. 

●50% four applications 
for e-learnings (2 
accredited and 2 in 
pipeline). 
For Fellowship this was 
not prioritized due to 
changed 
planning/delivery of 
modules (virtual delivery) 
during COVID. 
● Enrolment in EVA 
courses increased with 
almost 98% in 2021 
compared to 2020 (2692 
participants 2021 vs. 
1360 participants 2020). 
● 89% average 
participants satisfaction 
with e-learning courses. 

● Survey was launched 
in Q4 2021, but still open 
after request of NFPT to 
extend timeline, due to 
COVID-19. 

● Not measured. 
● Not measured. 
●● Support was 
provided as much as 
possible under remote 
conditions; NFP 
webinars were organized 
on a monthly basis, each 
was attended by 65-85 
participants. 

- Rate of participations to ECDC 

meetings and activities 
- Rate of satisfaction with 

meetings and activities (on the 
added value of the meeting and 
on the knowledge and skills 
improved)  

75% 

75% 

Stakeholder Relations 
Management System 
(SRM) 

Quarterly ECDC Portfolio 
Steering Committee 
reporting 

- Implementation according to 

project plan (schedule, 
resources and scope) 

Provide support for 
strengthening 
competencies in the 
area of preparedness 
and response 

- Use of ECDC tools by Member 

States 

- Proportion of participants that 
consider the training useful 

- Proportion of Member States 

that consider the training useful  

Less than 20% 
deviation from the 
duration, resources 
and scope of the initial 
baseline 

On average >50% of 
Member States use ECDC 
tools 

80% 

80% 

Assessment performed 
during the annual NFP 
meeting based on list of 
tools available 
Course evaluations in 
EVA 
Assessment performed 
during the annual NFP 
meeting based on list of 
trainings conducted in 
year N-1 

● Not measured. 

● 97% average 
participants satisfaction 
with instructor-led 
courses and 83% with e-
learnings. 

● Not measured. 

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Action 
Area 
2.4 

2.4 

2.4 

Objective 

Performance indicator 

Target 

Verification 

Result 2021 

Produce and 
disseminate Rapid Risk 
Assessments, and 
response-related duties 

- Average number of downloads 
per RRA/ Rapid Outbreak 
Assessment 

- Number of RRAs for which 

after-action reviews (AAR) have 
been conducted 

Managing requests for 
technical and scientific 
assistance to support 
EU response actions in 
the field 

Proportion of field requests to 
respond to cross-border Public 
Health emergencies for which 
support is provided to Member 
States and the European 
Commission 

TBC 

TBC 

100% 

ECDC annual report / 
web statistics 

Survey among NFPs 

● 934 .pdf downloads on 
average. 
● No survey was 
conducted in 2021 due 
to the COVID-19 
response. 

Emergency Operation 
Centre 

● 100% of requests 
were responded. 

Maintain and network 
for the EOC and Public 
Health Emergency 
(PHE) tools 

- PHE training: all milestones 
timely implemented as per 
roadmap 

- Rate of satisfaction of ECDC 
partners with collaboration 

100% 

75% 

Emergency Operation 
Centre  
Dedicated survey 

● PHE trainings for PHE 
Managers were 
organized together with 
external contractors. 
● No Emergency 
Operation Centre EOC 
network activity took 
place in 2021 due to the 
COVID-19 response. 

TBA – to be confirmed. 

3. Strategic objective 3. Future outlook: 
prepare for the future through foresight and 
innovation assessments 

3.1 Foresight: work with partners to identify and address 
key knowledge gaps and areas of uncertainty, and develop 
new multidisciplinary approaches to prevent and control 
infectious diseases 

In view of the long lead time for developing or implementing public health interventions, and the robust evidence 
to underpin such interventions, ECDC defined the key gaps and the key sources of evidence for its foresight work 
through the review of the findings of a scoping review of foresight approaches to infectious diseases completed in 
late 2020. The findings will be part of the framework for an expert consultation, which had to be postponed until 
2022 due to the pressures and restrictions resulting from the COVID-19 pandemic. In 2021, a new framework 
contract was established, and initial work started at the end of the year with a consortium that will provide 
evidence reviews on megatrends and micro-drivers likely to influence future infectious disease epidemiology and 
impact, which will also be used as part of the framework for the expert consultations now planned for 2022. 

3.2 Engage: promote innovation through active engagement 
with EU research and innovation initiatives 

Throughout 2021, discussions were held with European Commission colleagues regarding a mechanism for ECDC 
to provide input into EU research priorities, and a protocol was developed for collating knowledge gaps and 
research priorities in the field of infectious disease prevention and control as perceived by experts working in 
ECDC, in national public health institutes, and in other ECDC collaborating partner organisations. The protocol will 
be piloted in early 2022, with a focus on identifying knowledge gaps and research priorities in respect of COVID-19 
prevention and control. 

ECDC led an initiative with its partners in the EU Agency Network on Scientific Advice (EU-ANSA) to develop a 
scientific seminar series to increase awareness of scientific activities between Agencies, to stimulate cross-Agency 
projects, and to offer a ‘shared service’ model for continuing professional development of scientific staff in all EU-
ANSA affiliated agencies. ECDC co-organised the first seminar in partnership with the Joint Research Centre (JRC), 
on the topic of COVID-19 and mathematical disease modelling. 

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3.3 Support transformation: promote and contribute to the 
Digital Health actions and support Member States in 
adapting, adopting, and exploiting new technologies for 
infectious disease prevention and control 

ECDC aims to assess and make use of new technologies to modernise its approach to surveillance and risk 
assessment, in light of the infrastructural development fostered by the European Commission and of the changes 
in clinical public health practice in Member States.  

The new ECDC surveillance portal, EpiPulse, went live with event-based surveillance and network communication 
functionality and a visualisation tool for EU/EEA whole-genome sequencing data. A proof of concept for indicator-
based surveillance (based on COVID-19) was kicked off and is to conclude in 2022.  

In 2021, ECDC implemented automatic, electronic health record-based surveillance of Severe Acute Respiratory 
Infections in seven EU/EEA Member States. A call for tender was launched at the end of 2021 to provide additional 
resources and technical support to Member States that are moving towards electronic health record-based 
surveillance. The tender foresees resources to implement SARI surveillance in a larger number of countries, and to 
pilot this type of surveillance for other priority diseases. Learning from the experience with COVID-19, ECDC 
extensively supported the European Commission to ensure that funding from the EU4Health programme addresses 
some of the key surveillance challenges in Member States. A joint action on implementing automated surveillance 
for pandemic prone diseases was launched by the European Commission, based on the ECDC long term 
surveillance framework 2021-25. 

During 2021, ECDC participated actively towards the implementation of the EHDS, providing the European 
Commission with requirements for EU-level surveillance and with a use case to be piloted in 2022. The objective of 
ECDC’s use case is to assess the concordance between national AMR surveillance data submitted to ECDC and data 
from the same country(-ies) and year shared through EHDS. ECDC joined a large European consortium bringing 
together nine national health data platforms and three research infrastructures answering a call for projects to set 
up a test version of the EHDS. These surveillance developments were discussed with Member States during the 
Third ECDC Joint Strategic Meeting. Significant progress was made in the field of epidemic intelligence. A number 
of processes were automated, and a major automation initiative started to detect and assess signals from large 
volume of social media data. This resulted in a more comprehensive and accurate monitoring of global signals, 
including from COVID-19. A new tool was launched (EpiTweetr), and based on the experience acquired, a further 
automation of the signal detection and assessment process will take place during 2022. 

The COVID-19 pandemic also brought along the need for more automated and large-scale contact tracing solutions 
for Member States. The European Commission has taken the initiative to implement several new interoperability 
solutions. In 2021, ECDC started to prepare for the takeover of the EFGS, the technical backbone of the contact 
tracing apps used by Member States. Moreover, Implementing Decision (EU) 2021/858 defines the electronic 
Passenger Locator Form as a new component of EWRS. 

Strategic objective 3. Performance indicators 

Action 
Area 

3.1 

3.1 

3.1 

Objective 

Performance indicator 

Target 

Verification 

Result 2021 

Prediction modelling for 
foresight programme initiated  

Data content developed 
for models for specified 
infectious disease drivers: 
Implementation according 
to project plan (schedule, 
resources, and scope) 

Less than 20% 
deviation from the 
duration, resources, and 
scope of the initial 
baseline  

Quarterly ECDC 
Portfolio Steering 
Committee 
reporting 

Expert consultation on 
simulation models developed 
by ECDC  

Develop a mechanism for 
identifying evidence-synthesis 
needs and knowledge gaps 

Expert consultations: 
Implementation according 
to project plan (schedule, 
resources, and scope) 

Less than 20% 
deviation from the 
duration, resources, and 
scope of the initial 
baseline  

Quarterly ECDC 
Portfolio Steering 
Committee 
reporting 

Protocol established for 
the mechanism: 
Implementation according 
to project plan (schedule, 
resources, and scope) 

Less than 20% 
deviation from the 
duration, resources, and 
scope of the initial 
baseline  

Quarterly ECDC 
Portfolio Steering 
Committee 
reporting 

● Scenario modelling for 
COVID-19 conducted, with 
outputs presented to the 
Advisory Forum, the Health 
Security Committee, and 
published in a peer review 
journal paper. 
● ECDC coordinated a 
European COVID-19 
Forecast Hub as part of its 
COVID-related modelling 
activities. 

● Work initiated in 2021. 

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Objective 

Performance indicator 

Target 

Verification 

Result 2021 

Develop a way for identifying 
and communicating research 
priorities relevant to the 
prevention and control of 
infectious disease  

Protocol: Implementation 
according to project plan 
(schedule, resources, and 
scope) 

Less than 20% deviation 
from the duration, 
resources, and scope of 
the initial baseline  

Quarterly ECDC 
Portfolio Steering 
Committee 
reporting 

(Protocol approved 
by Advisory Forum 
and Management 
Board by Q4 2021)  

Contribute to EU Joint Actions 
and EU research projects 

Proportion of EU joint 
actions in the field of 
Communicable Diseases to 
which ECDC contributed 

N/A 

List of Joint 
Actions 

Establish stronger links with 
EU research initiatives, 
through appropriate 
engagement with EU research 
commissioning bodies in 
priority-setting and evaluation 
of research proposals  

Identification of research 
priorities within the domain 
of ECDC mandate: 
Implementation according to 
project plan (schedule, 
resources, and scope) 

Less than 20% deviation 
from the duration, 
resources, and scope of 
the initial baseline 

Quarterly ECDC 
Portfolio Steering 
Committee 
reporting  

Statement on shared 
priorities for research: 
Implementation according to 
project plan (schedule, 
resources, and scope) 

Less than 20% deviation 
from the duration, 
resources, and scope of 
the initial baseline 

Quarterly ECDC 
Portfolio Steering 
Committee 
reporting 

Collaborate with other EU 
Agencies, through the EU 
Agency Network on Scientific 
Advice , to develop: 
- Identification and 
communication of need for 
research in areas of mutual 
interest.  
- Innovative approaches to 
address issues of mutual 
interest through scientific 
collaboration and sharing of 
expertise in research clusters. 

Explore the feasibility and added 
public health value of 
surveillance, based on electronic 
health records for few diseases 
in selected countries 

E-health programme: 
Implementation according 
to project plan (schedule, 
resources, and scope) 

Less than 20% 
deviation from the 
duration, resources, and 
scope of the initial 
baseline  

Quarterly ECDC 
Portfolio Steering 
Committee 
reporting 

Modernise and integrate EU/EEA 
surveillance platforms 

- Indicator-based 

surveillance platform 
downtime 

- Downtime reduced by 
≥50% compared with 
baseline 

IT statistics 

User survey 

- EpiPulse internal and 
external user rating 

User satisfaction ≥80% 

Assess the potential impact on 
public health key functions of 
recent advances in digital 
technology and microbiological 
diagnostics to guide the future 
technical direction of the Centre. 

Roadmap for gradual 
integration of new 
technologies: 
Implementation according 
to project plan (schedule, 
resources, and scope) 

Less than 20% 
deviation from the 
duration, resources, and 
scope of the initial 
baseline  

Quarterly ECDC 
Portfolio Steering 
Committee 
reporting  

● Protocol developed for 
collating knowledge gaps 
and research priorities in the 
field of infectious disease 
prevention and control as 
perceived by experts 
working in ECDC, in 
national public health 
institutes, and in other 
ECDC collaborating partner 
organisations. 
● Joint Action on real-time 
surveillance for pandemic 
prone diseases.  

● Discussions were held 
with European Commission 
colleagues regarding a 
mechanism for ECDC to 
provide input into EU 
research priorities. Regular 
participation of ECDC in DG 
RTD “research to policy 
action” meetings to facilitate 
the dialogue between the 
research community and the 
public health policy makers, 
and to ensure the timely 
translation of research into 
policy aims to bring together 
the different initiatives. 

● ECDC chaired the EU-
ANSA network for the first 6 
months of 2021. ECDC led 
an initiative with its partners 
in EU-ANSA to develop a 
scientific seminar series to 
increase awareness of 
scientific activities between 
Agencies, to stimulate 
cross-Agency projects, and 
to offer a ‘shared service’ 
model for continuing 
professional development of 
scientific staff in all EU-
ANSA affiliated agencies. 
ECDC co-organised the first 
seminar in partnership with 
the Joint Research Centre, 
on the topic of COVID-19 
and mathematical disease 
modelling 
● Automated SARI 
surveillance ongoing in 7 
countries 
Plans for expanding on the 
number of countries and 
diseases, through a four-
year project.  

● Not achieved for TESSy; 
baseline comparison for 
EpiPulse missing, since first 
year live. 
● No user survey 
conducted. 
● Scoping reviews, mapping 
exercises and technical 
expert consultation 
meetings were performed. 
Findings were published on 
the ECDC website and will 
be used to inform the 
roadmap development.  

Action 
Area 
3.2 

3.2 

3.2 

3.2 

3.3 

3.3 

3.3 

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Objective 

Performance indicator 

Target 

Verification 

Result 2021 

Action 
Area 
3.3 

Implement the molecular 
surveillance strategic framework 

3.3 

Automate signal detection from 
social networks  

Proportion of diseases 
with integrated WGS 
surveillance schemes as 
per strategic framework  

Number of new events 
and threats detected 
automatically from social 
media 

>50% 

WGS data 
reported to ECDC  

●● 50%: WGS data 
reported for 10/20 diseases.  

24 (󠆍~ 2 per month) 

Epidemic 
Intelligence tool 

●● Done to a great extent. 
Significant progress planned 
for 2022 and onwards.  

4. Strategic objective 4. Increase the health 
security in the EU through strengthened 
cooperation and coordination between ECDC 
and partners in non-EU countries 

4.1 Neighbourhood: develop and implement a 
comprehensive programme to support the Western Balkans 
and Turkey and ENP partner countries to strengthen their 
infectious disease prevention and control systems and 
public health workforce 

With the external financial assistance by the European Commission Directorate-General for Neighbourhood and 
Enlargement Negotiations under the Instrument for Pre-accession Assistance (IPA), ECDC continued to implement 
the ECDC Action ‘Preparatory measures for the participation of the Western Balkans and Turkey in the European 
Centre for Disease Prevention and Control with special focus on One-Health against AMR and enhanced SARI 
surveillance, 2020 – 2024’1 (ECDC-IPA6 project). In response to the COVID-19 pandemic, ECDC set up enhanced 
SARI surveillance to support the implementation of fit-for-purpose surveillance systems, as part of the ECDC-IPA6 
project. All six beneficiaries in Western Balkans joined. The network covers all respiratory diseases and is therefore 
an important tool for future pandemic preparedness. In the framework of this project national experts from 
Western Balkans and Turkey participated as observers in 11 ECDC technical network meetings throughout 2021 
and gathered in the Meeting of National ECDC Correspondents in October 2021 to discuss achievements and agree 
on the future of ECDC cooperation. National ECDC Correspondents of Western Balkans participated in monthly 
coordination meetings to update each other on the COVID-19 situation and response measures in the countries, 
and ECDC provided the latest available data and activities. In 2021, the Western Balkans were integrated as 
observers into the National Focal Points for Viral Respiratory Diseases and their associated network EISN and 
ECOVID-Net; E-SARI-Net; the external technical assistance to strengthen SARI surveillance in Western Balkans has 
been provided and will continue in 2022, aiming to enable countries to report SARI data to TESSy as per EU-level 
standards. Western Balkans and Turkey were included in the ECDC EQA schemes for ECDC-SARS-CoV-2; EQA-AST 
for FWD; EuroGASP. Preparatory work for the Training of Trainers workshop on Legionnaires’ disease for 
accommodation site managers in Western Balkans was completed and the workshop is planned to take place in-
person in 2022. In addition, in 2021, under the European Health Emergency Preparedness and Response Authority 
incubator activities, ECDC extended the WGS service to the Western Balkans to support the detection of SARS-
CoV-2 VOC in a similar way as to the EU/EEA countries. 

In 2021, ECDC was delivering the work programme 2021 of the EU Initiative on Health Security2 (HSI), which is a 
five-year programme to enhance the public health preparedness and response capacities of European Union 
enlargement and European Neighbourhood Policy (ENP) partner countries, funded by the Directorate-General for 
Neighbourhood and Enlargement Negotiations. All fifteen ENP partner countries confirmed their participation, with 
the last one confirming at the end of December 2021. The programme was implemented through three 
interconnected work packages: 

1 https://www.ecdc.europa.eu/en/about-us/who-we-work/international-activities/preparatory-measures-participation-western-
balkans 
2 https://www.ecdc.europa.eu/en/about-us/who-we-work/international-activities/eu-initiative-health-security 

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Workforce oriented capability building was delivered through the Mediterranean and Black Sea Programme for 
Intervention Epidemiology Training (MediPIET). In June 2021, ECDC organised a kick-off meeting with the 
MediPIET National Focal Points (NFPs) to formally mark the hand-over from the previous implementer of MediPIET, 
Instituto de Salud Carlos III and Fundación Estatal, Salud, Infancia y Bienestar Social to ECDC. Following a 
successful start of MediPIET under ECDC management, the 4th Cohort kicked off with 16 fellows representing 11 
partner countries. ECDC organised two modules, the Introductory Course in September with subsequent three 
Inject days and the Outbreak Investigation Module in December. To support Cohort 4, ECDC successfully launched 
the MediPIET Programme and Coordination space on the ECDC Virtual Academy (EVA), where fellows, supervisors 
and the MediPIET team work together. To strengthen the overall capacity within the network, MediPIET supervisors 
were invited to attend Train the Trainers events, like the ECDC Summer School and relevant capacity building 
activities within the other work packages. As a side session of ESCAIDE, MediPIET held its Annual Scientific Event 
to discuss the past and the future of a regional field epidemiology programme in the EU neighbourhood. The 
session was attended by over 420 participants (unique viewers) from 60 countries around the world, which is the 
record for any side event in the history of the ESCAIDE Conference. November marked the launch of the MediPIET 
Training Needs Assessment (MTRNA) 2021. This self-assessment is aimed at identifying training needs, methods, 
and priorities in intervention epidemiology for the partner countries, as well as the region as a whole and will also 
serve as a basis for a review of the MediPIET core competencies and curriculum.  

Strong alignment and coordination with the ECDC Fellowship Programme (EPIET/EUPHEM) was facilitated by 
exchange and collaboration among faculty and joint participation of fellows in most online modules. 

Strengthening public health systems and capacities to assess, detect, respond and 
prevent threats from communicable diseases. ECDC organised two five-day basic trainings on 
epidemic intelligence and rapid risk assessment, a training on the Epitweetr tool for early detection of public health 
threats from Twitter data, a joint ECDC/Frontex Regional workshop on the science and practice of entry/exit 
screening, as well as three-day workshop on after-action and in-action reviews. In total, 90 experts from 14 
partner countries participated in the trainings and workshops. To adapt to the local context, ECDC translated 
several training materials, technical reports and methodologies into languages widely spoken in the region. 

To engage in a bilateral cooperation with partner countries, become familiar with their public health systems and 
identify key areas for cooperation, ECDC launched the self-assessment process of public health emergency 
preparedness and response capacities. The process included data collection from partner countries, bilateral 
meetings and final reports summarising the main findings and key areas for cooperation within the EU Initiative on 
Health Security. In total, ECDC produced such reports for nine countries. 

Integration into ECDC systems, knowledge sharing and networking. Throughout the 
year, partner countries who had nominated experts were invited to ECDC organised events like the monthly 
webinars for NFPs for Preparedness, Response and Threat Detection, the annual meetings of the European 
Legionnaires' disease Surveillance Network (ELDSNet) and the Emerging Viral Diseases-Expert Laboratory Network 
(EVD-LabNet) annual meeting. In addition, ECDC opened the possibility for partner countries to join and benefit 
from capacity building activities offered within EVD-LabNet. ECDC invited partner countries to the European Health 
Forum Gastein in September and to ESCAIDE in November. 

4.2 Major CDCs: increase ECDC’s collaboration with major 
centres for disease prevention and control 

Cooperation with other Centres for Disease Prevention and Control (CDCs) across the globe has been amongst 
ECDC’ priorities since its establishment. In 2007, just two years after ECDC was established, the Agency signed 
Memoranda of Understanding (MoU) with the US, China, Canada CDCs and in 2012, with Israel. During 2021, 
collaboration with these MoU partners intensified in the form of bilateral meetings and exchanges of expertise. 
There were also new partnerships with other CDCs in 2021. In June, a MoU with the Ministry of Health of Mexico 
was signed, and in December with the Health Security Agency of the United Kingdom. A MoU with the Korea 
Disease Control and Prevention Agency was also signed. Three Memoranda of Understanding signed in one year is 
a clear and strong signal that ECDC is committed to strengthening and increasing collaboration with partners 
across the globe to join forces to protect the health of citizens. In addition to these MoU partners, ECDC 
established bilateral contacts with Australia, India and Japan. 

Multilateral cooperation is equally important, and the Network of major CDCs established in 2019, serves as a 
platform of information and expertise sharing. In 2021, three meetings of the Network were organised and 
coordinated by ECDC. The main focus of these meetings was COVID-19 and topics such as emergence and spread 
of SARS-CoV-2 variants (especially P1), the current epidemiological situation concerning SARS-CoV-2 VOC and 
variants of interest (VOI), ongoing initiatives to strengthen whole genome sequencing capacity for SARS-CoV-2, as 
well as signals of maternal and perinatal mortality associated to VOC, available evidence of waning immunity after 
vaccination in different groups, how to tackle non-pharmaceutical interventions (NPI) fatigue, as well as levels of 
vaccine coverage needed to reduce transmission. These discussions fed into ECDC’s outputs such as risk 
assessments and reports on specific COVID-19 related topics. 
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With external funding from the Directorate-General for International Partnerships, ECDC started to implement a 
technical four-year partnership project with Africa CDC entitled ‘EU for Health Security in Africa: ECDC for Africa 
CDC’. The overall aim is to contribute to improving health security in Africa, by sharing EU practices and 
strengthening Africa CDC capacities in preparedness, surveillance and response to health threats posed by 
communicable diseases. The project inception phase in 2021 aimed to conduct extensive needs assessments, 
situation analysis and fact-finding activities with Africa CDC in each technical area of the project. The first Project 
Steering Committee meeting co-chaired by the two Directors was held in March 2021 and agreed on the way 
forward of the inception phase. As a result: 

• 

• 

• 

In the area of preparedness and outbreak response, the project included mapping and prioritisation of 
needs and potential areas of support on disease profiles at the African level and continental multi-hazard, 
multi-sectoral contingency plans; a report on risk assessment methodologies used by Africa CDC and other 
organisations was prepared; rapid risk assessment (RRA) training for Africa CDC stakeholders was held on 
29 and 30 November, based on ECDC methodology and guidelines on RRAs; 
In the area of indicator-based surveillance and event-based surveillance, a protocol on mapping of early 
detection procedures and tools of epidemic intelligence used at regional and continental levels by Africa 
CDC was agreed upon, using inter alia completed mapping exercises and analysis of available documents; a 
protocol on mapping of existing networks, interoperability, gaps, strengths, and situation analysis on 
indicator-based surveillance and data sharing was also prepared. Defining priority areas to support 
harmonised One Health/antimicrobial resistance (AMR) surveillance at continental level in Africa is under 
discussion; 
In the area of continental public health workforce development, the mapping of public health training 
resources, identification of capacity gaps and training needs, training platforms used by Africa CDC, 
Regional Collaborating Centres (RCCs) and Member States, defining quality criteria to appraise the 
identified courses was started. A joint workshop with key partners on workforce development to enable 
exchange of practices in field epidemiology training programmes in the EU and AU Member States was held 
on 23 November 2021. 

4.3 Coordination: ensure seamless coordination with EU and 
international partners to enable achievement of common 
objectives 

ECDC has further strengthened the coordination and collaboration with key partners, both at the EU and at the 
global level, including:  

• 

• 

• 

Coordinating with the EU Institutions and bodies, particularly the European Commission (Directorate-
General for Health and Food Safety, European Health Emergency Preparedness and Response Authority, 
Directorate-General for European Civil Protection and Humanitarian Aid Operations, Directorate-General for 
Neighbourhood and Enlargement Negotiation, Directorate-General for International Partnerships, Joint 
Research Centre) and the European External Action Service, to ensure ECDC international actions are 
coherent with the EU’s priorities and policy objectives. 
In 2021, ECDC’s collaboration with the European Parliament, in particular with the Committee on the 
Environment, Public Health and Food Safety ENVI, and with the Council of the EU was further strengthened 
with topics such as preparedness and response to the COVID-19 pandemic and the reinforced ECDC 
mandate high on the agenda. ECDC also participated in hearings with the European Economic and Social 
Committee and with the European Committee of the Regions on these issues. 
Collaboration with other EU agencies in particular the European Medicines Agency, the European Aviation 
Safety Agency, the European Maritime Safety Agency, the European Union Agency for Railways, and 
FRONTEX around issues related to COVID-19 was intensified during 2021.  

Close collaboration with WHO continued in 2021. ECDC and the WHO Regional Office for Europe held three 
meetings at the Directors’ level to discuss and align strategic priorities of the two organisations, including 
collaboration during the COVID-19 pandemic. The strategic dialogue and emergence of new areas for cooperation 
triggered preparations for the revision of the Memorandum of Understanding between the two organisations, to be 
concluded in 2022. On a technical level, ECDC and the WHO Regional Office for Europe have worked very closely 
and jointly implemented on 66 activities within different disease programmes. ECDC also initiated contact with the 
WHO Hub for Epidemic and Pandemic Intelligence. 

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Strategic objective 4. Performance indicators 

Objective 

Performance indicator 

Target 

Verification 

Result 2021 

Gradually integrate the 
Western Balkans and 
Turkey into ECDC systems 
and networks via enhanced 
technical cooperation and 
support their preparations 
for participation in ECDC 
activities and their 
advancement on ‘One 
Health’ approach against 
AMR 

- Participation rate and 

satisfaction in ECDC activities 
by the Western Balkans and 
Turkey 

- Technical cooperation on One 

Health against AMR: 
Implementation according to 
project plan (schedule, 
resources, and scope) 

- Activities as described in the EU 
Initiative on Health Security: 
Implementation according to 
project plan (schedule, 
resources, and scope) 

- Attendance rate and satisfaction 
in meetings and ECDC activities 
by ENP countries 

Support the progressive 
integration of ENP partner 
countries into ECDC 
activities and enhance 
health security through 
improving public health 
systems capacities and 
capabilities, including 
training through the 
continuation of MediPIET to 
respond to health threats 
related to communicable 
diseases and enhancing 
regional cooperation 

85% participation and 
80% satisfaction 

This includes: 
-  Attendance of 

meetings (source: 
SRM) 

-  Participation in surveys 
(e.g., ENLabCap) 
-  Data reporting (Tessy)  

Quarterly ECDC 
Portfolio Steering 
Committee reporting 

Quarterly ECDC 
Portfolio Steering 
Committee reporting 

SRM system, and EIC 
section statistics 

Less than 20% 
deviation from the 
duration, resources, 
and scope of the 
initial baseline 

Less than 20% 
deviation from the 
duration, resources, 
and scope of the 
initial baseline 

85% participation and 
80% satisfaction 

Following the request from 
European Commission, 
continue assessment of 
partner non-EU countries 
and follow-up the 
assessment of the Western 
Balkans and Turkey and 
ENP partner countries 

- Uptake of ECDC 

recommendations by countries 

65% 

- Number of countries who have 
developed a post-assessment 
action Plan 

EIC section statistics 

tbc 

tbc 

Tbc 

80% 

80% 
70% 

85% 

Manage MediPIET, under 
the ECDC Action on 
strengthening health 
security in EU 
neighbourhood financed by 
the European Commission 

- Number of MEDIPIET enrolled 

fellows per country 

- Proportion of participants that 
consider the training useful 

- Proportion of countries that 
consider the training useful 

Strengthen bilateral and 
multilateral collaboration with 
major CDCs for which 
cooperation agreements are 
signed and with potential new 
bilateral cooperation partners 

Evaluation and consolidation 
of cooperation within the 
network of major CDCs and 
expansion of the network 

Rate of implementation of Joint 
action plans, when available 

Attendance rate in ECDC 
meetings 

MEDIPIET statistics 

Satisfaction forms 

Assessment performed 
during the annual 
meeting 
Joint action plans  

Attendance to both 
virtual and physical 
meetings organised by 
ECDC 

● 80%. Evaluation 
project started in 
December. 

● Participation rate 
irrelevant as an 
indicator due to 
transition to 
virtual/hybrid 
meetings; ENLabCap 
survey did not take 
place. 
● Satisfaction 
measurement will be 
coordinated with the 
ECDC stakeholder 
satisfaction survey. 
● Achieved. 
● Activities executed 
as planned with the 
pandemic related 
deviations that are 
less than 20% from 
the duration, 
resources, and scope 
of the initial baseline.  

● Average 
participation rate is 
within the set target of 
85%. 

● Feedback collected 
through surveys 
indicates high level of 
satisfaction with the 
events within the set 
target of 80%. 
● Uptake of 
recommendations: 
Kosovo-81%, 
Montenegro- 100%, 
North Macedonia-
50%, Serbia-72%. 
● 4 out of 6 assessed 
countries developed 
action plans (Kosovo, 
Montenegro, North 
Macedonia, and 
Serbia).  

● Programme runs as 
per plan with 16 
fellows enrolled. 

● Not measured. 

● Not measured.  

● 60%. Work partially 
started due to focus 
on COVID-19 
activities. 

Action 
Area 
4.1 

4.1 

4.1 

4.1 

4.2 

4.2 

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Objective 

Performance indicator 

Target 

Verification 

Result 2021 

“ECDC4Africa CDC” project: 
Implementation according to 
project plan, as agreed with 
Africa CDC (schedule, 
resources, and scope) 

Inception report with 
plan of activities  

Quarterly ECDC 
Portfolio Steering 
Committee reporting 

Initiate the implementation of 
a technical partnership 
project ‘ECDC4Africa CDC’ to 
contribute to health security 
in Africa by sharing EU 
practices and strengthening 
Africa CDC capacities in 
preparedness, surveillance, 
and response to health 
threats 

● Partially achieved 
Needs identification in 
various technical 
areas has been 
initiated, but not fully 
achieved as per 
agreed schedule, 
resources, and scope, 
thus the inception 
phase has been 
extended to Q2 2022. 
● 100% 

- Number and proportion of 

95%  

SARMS 

requests from the European 
Commission and Member 
States answered within agreed 
deadlines 

TBC 

Bibliometric analysis 

● Not measured. 

- Number of references to ECDC 
in the EU legislation or in EU 
policy documents 

Action 
Area 
4.2 

4.3 

4.3 

4.3 

Nurture the collaboration 
and coordination with the 
EU Institutions and bodies 
particularly the European 
Commission (Directorate-
General for Health and Food 
Safety, European Health 
Emergency Preparedness 
and Response Authority, 
Directorate General for 
European Civil Protection 
and Humanitarian Aid 
Operations, Directorate-
General for Neighbourhood 
and Enlargement 
Negotiations, Directorate-
General for International 
Partnerships, DG JRC) and 
the European External 
Action Service and other EU 
agencies in particular with 
the European Food Safety 
Authority (EFSA) and the 
European Medicines 
Agency (EMA) 
Invest in maintaining 
appropriate relationships 
with the European 
Parliament, in particular 
with ENVI 

- Number and proportion of 

requests from the European 
Parliament answered within 
agreed deadlines 

- Participation by ECDC to 

European Parliament events 
and meetings 

TBC 

SARMS 

● 100% 

Stakeholder Relations 
Management system 
(SRM) 

● 17 events and 
meetings with EP 
Committees and 
MEPs attended. 

Enhance further 
collaboration with WHO to 
ensure complementarity of 
actions and avoid 
duplication of efforts 

Rate of implementation of 
annual joint action plan 

90% 

Monitoring of Annual 
Joint action plan 

● 85% 

TBC – to be confirmed. 

5. Strategic objective 5. Transform the 
organisation to the next generation ECDC 

5.1 Integrated management framework: increase 
organisational effectiveness and efficiency through 
improved processes and enhanced monitoring of 
organisational performance 

In the beginning of 2021, the ECDC Director approved the ECDC Integrated Management Framework (IMF) 
document, describing the four pillars of the system, namely governance, organisational performance management, 
quality management, and internal control framework, and two cross-cutting areas: innovation and change 
management. The objectives of the IMF are to improve the clarity and transparency of the framework in place, 
while ensuring that it is not overcomplicated and minimising its administrative burden; equip all ECDC staff with an 
easy access to the documentation describing how ECDC is run and how activities are done in the Centre; and to 

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ensure that ECDC management is provided with the information needed to take well-informed and timely 
decisions.  

The IMF working group was established to support the further development and improvement of the IMF and its 
main task in 2021 was to support the Executive Office in finalising the IMF implementation plan 2022-2027, which 
provides the future state of the IMF and the steps to be taken in all the areas included in it. 

In 2021, within this framework, the implementation of a new instructional document management system was 
initiated, as well as the work to review and optimise existing processes. Furthermore, in the coming years the 
Centre will pursue implementation of an ISO 9001:2015 based quality management system. In 2021, a gap 
analysis which will feed into an implementation plan of the future quality management system, was carried out as 
part of the IMF implementation plan. As all the work in the context of the IMF will change the way ECDC works, 
the change management element was introduced in these projects. 

In accordance with the Integrated Management Framework, ECDC successfully pursued the assessment and initial 
development of its IT systems and architecture for support and steering activities. During the period, a 
comprehensive analysis of systems and requirements in several key areas such as planning and monitoring, human 
resources and finance, service delivery, e-workflows, and enterprise content management was undertaken, leading 
to the establishment of an initial tranche of work under a wider programme. The first tranche focuses on a new 
planning and monitoring system, tools for developing and monitoring key performance indicators, data 
management, business processes, e-workflows, and the optimal solution for events and logistics management. The 
individual projects are at various stages of implementation that will continue into 2022 and beyond. The large area 
of work in 2021 was the feasibility study for the new ECDC planning and monitoring system, which will continue in 
2022 with proof-of-concept studies to select the most suitable system foreseen to be implemented in 2023. This 
system will replace the present management information system. 

ECDC made good progress in several administrative areas in 2021. Work has commenced on a ‘People Strategy’ as 
an overarching framework for how ECDC supports and invests in its staff to achieve its overall vision. The definition 
of the pillars in the framework is ongoing, while individual projects under the strategy have commenced in specific 
instances. Electronic workflows and signatures were further consolidated, leading to a mostly paperless 
organisation. Notable achievements in this regard were made in financial management and procurement 
(electronic workflows for commitments and solicitation processing), as well as processing staff training. Driven by 
the changes in working modalities due to the pandemic, ECDC conducted a workplace assessment that will help 
guide its future approach to service delivery in its physical and IT spaces. 

5.2 Engaged staff: recruit and retain capable, motivated, 
and resilient staff 

2021 was characterised by a significant volume of recruitment, associated on-boarding of new staff, support 
services to ensure the wellbeing of personnel and projects to improve HR services in the long run. The 
aforementioned ‘People Strategy’, will guide the modernisation and consolidation of ECDC’s HR management 
services in the years to come. Individual projects under the strategy have already commenced in specific instances 
(e.g., skills-development project, revamped induction programme, actions aimed at respect at the workplace, and 
e-recruitment), whereas others will follow in due course. 

5.3 Stakeholders and external communication: enhance the 
transparency, visibility, and availability of ECDC’s outputs 

It is ECDC’s obligation to communicate the results of its work and to provide objective, reliable and easily 
accessible information about communicable diseases to target audiences and stakeholders through the ECDC 
website and other relevant channels, as well as to work in collaboration with the European Commission and 
Member States on risk communication and campaigns.  

In addition, Member States consider consistent communication messages to citizens based on robust and 
independent evaluation of public health risks a vital area of cooperation when responding to serious cross-border 
health threats.  

The latest ECDC Communication Policy was developed and approved in 2021. The purpose of the policy is to define 
the actions and areas of work for ECDC within communications for the period 2022-2027 and to establish a 
common understanding of the Centre’s target audiences, stakeholders, as well as internal and external priorities. It 
builds on previous experiences and incorporates the findings and recommendations of evaluations, audits and 
performance analysis conducted both within and outside the context of the COVID-19 pandemic. It also reflects 
the needs and media use of its target audiences and stakeholders, as well as the current trends and innovations in 
e.g., risk communication, crisis communication, and behavioural/social science research, amongst others. 

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While ECDC continued having a high level of media attention (through traditional and social media and through its 
websites), there were noticeable decreases in some f communication indicators, which is not unexpected and only 
a result of the natural evolution of the COVID-19 pandemic and its impact on the interest of ECDC’s target 
audiences. Nevertheless, all figures remain significantly higher when compared with before the pandemic.  

Throughout 2021, as well as performing routine communication work, ECDC marked a number of awareness days 
such as World Tuberculosis Day, World Hepatitis Day, World Hand Hygiene Day, World Field Epidemiology Day, Flu 
Awareness Week, European Immunisation Week, World AIDS Day, and European Antibiotic Awareness Day, with 
the development of communication campaigns, including public health messages and using traditional media, 
social media, videos, toolkits, infographics and other materials. Some of these materials were translated and 
shared with partners and stakeholders across the EU.  

Press and media 

In 2021, ECDC continued to engage actively with journalists across the EU and internationally regarding the 
COVID-19 pandemic, influenza, antimicrobial resistance, and other topics. In close cooperation with the European 
Commission, the Health Security Committee Communicators Network and the WHO Regional Office for Europe, 
ECDC provided EU-wide communication response to public health issues. 

The press office received 963 media requests in 2021 (50% fewer requests than in 2020) from various media 
sources. These requests ranged from interviews with experts to written replies. Experts gave 115 media interviews 
over the course of the year, and the press office provided 732 written responses.  

The requests came from a wide range of sources, from major international news outlets and wire agencies to fact-
checking organisations. Over the entire year, the largest number of requests came from the BBC (44 – radio, 
television, and online news articles), Reuters (30), Sveriges Radio (21), AFP (19), RTE (19) and Politico (18). 
Andrea Ammon gave the most interviews (24), followed by experts such as Bruno Ciancio (17), Piotr Kramarz (12), 
Josep Jansa (10) and Pasi Penttinen (7). 

ECDC was continuously present in mainstream media during 2021, with 56 069 clippings in the European and 
international media. Most of the coverage was neutral or positive and included content related to COVID-19, 
vaccination issues and antimicrobial resistance. A high volume of articles and other outputs originated in Italy, 
Greece and Portugal. The ECDC press and media team added 466 journalists to its journalists’ database (compared 
with 357 in the previous year).  

Figure 14. Number of requests to the press office 2016-2021 

Social media 

The number of followers on ECDC’s corporate Twitter account (@ECDC_EU) grew by 21 246 new followers, up 
from 74 314 followers in 2020, to 94 560. ECDC’s outbreaks Twitter account (@ECDC_Outbreaks) grew by 3 044 
new followers, reaching 23 482 in total. ECDC now has 148 000+ followers across nine Twitter accounts, which 
represents a 18% increase compared with 2020.  

The top performing tweets from ECDC_EU in 2021 included the face masks video (827K impressions, 8K 
engagements), the maps in support of the Council recommendation on a coordinated approach on travel measures 
(best: 606K impressions, 140K engagements), the face masks report update and related infographic (360K, 7K), 
the first threat assessment brief about the Delta variant (226K impressions, 3.4K engagements), a rapid risk 

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assessment published in February (320K impressions, 3K engagements) and news about the Janssen vaccine 
approval (130K impressions, 0.7K engagements).  

The number of fans and followers on the ECDC Facebook page continued to increase, amounting to 59 732 fans 
(44% increase) and 263 206 followers (13% increase). Most of the ECDC Facebook fans and followers come from 
Italy, Germany, Spain, Romania, France and Portugal.  

A total of 294 posts were published (38% decrease), reaching 19 million users. The top content on this platform 
included news about the approval of the Spikevax vaccine for 12- to 17-year-olds (250K reach), the maps in 
support of the Council recommendation on a coordinated approach on travel measures (all of them, reach ranging 
from 150K to 250K), an infographic about the variants of concern (199K), news about AstraZeneca’s investigation 
of side effects (190K), a hand hygiene video (164K).  

In 2021, there were 365 LinkedIn page updates, reaching 1.8M users, gaining 97K clicks, 27K reactions (likes), 
more than 500 comments and 5.6K shares. The top performing posts were the first ECDC Director statement on 
Omicron (22.3K impressions, 8.5K views); a hand hygiene video (posted three times: 60K, 20K), the infographic 
about the variants of concern (23K, 1K), and the mosquito handbook (16K, 2K).  

Figure 15. Some of the top performing content on social media in 2021  

Table 4. Follower count for all ECDC social media accounts in 2022 and 2021  

Websites  

The ECDC website continued to have high traffic in 2021, although not as high as in 2020, with a peak in July, due 
to the high interest in the maps in support of the Council recommendation on a coordinated approach on travel 
measures, ahead of the summer season and because of an increase of COVID-19 cases in some parts of Europe. 
The highest number of page views in one day was recorded on 15 July with 324 882 views. There were 18 043 
416 page views, representing a 43% decrease compared to 2020.  

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Overall, 10 863 890 website sessions were recorded during 2021, compared with 18 330 149 in 2020 (41% 
decrease). Additionally, there were 406 545 pdf downloads in 2021, compared to 572 051 downloads in 2020 
(29% decrease). The majority of visits on ECDC’s website came from Europe, with 9.5 million sessions (40% 
decrease) recorded from users in European countries. 600 261 sessions were recorded from Asia, followed by the 
Americas (451 762), Africa (146 456) and Oceania (36 577).  

The proportion of returning visitors decreased slightly compared with 2020 (58% to 54%). However, the higher 
percentage of ‘returning’ to ‘new’ visitors suggest users continue to value the ECDC website as a reliable source of 
information and data throughout the pandemic. Returning users accounted for 48% of traffic pre-pandemic.  

Although there are noticeable decreases in visits and sessions, this is not unexpected and probably a result of the 
evolution of the COVID-19 pandemic. However, traffic remains higher than before the start of the pandemic.  

Figure 16. Page views of the ECDC website in 2021 by month  

Figure 17. Page views of the ECDC website from 2012 to 2021  

Table 5. The most popular web pages in 2021 

Between 1 February and 31 December 2021, the COVID-19 situation dashboard (desktop version) received 1 273 
270 page views. The mobile version received an additional 68 054 views. Similarly, ECDC website traffic peaked in 
mid-July with 10 259 page views recorded on Thursday 15 July. Since its launch in February 2021 and as of 31 
December 2021, the COVID-19 Vaccine Tracker (desktop version) received 1 353 169 page views. The mobile 
version received an additional 345 246 page views.  

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ECDC launched the European Vaccination Information Portal in April 2020 as a cross-agency/EU project, ‘An 
initiative of the EU’. It was developed in close collaboration with the Directorate-General for Health and Food Safety 
and the European Medicines Agency (EMA) in the context of the Council Recommendation on strengthened 
cooperation against vaccine-preventable diseases (adopted in Dec. 2018) in which ECDC was tasked to establish 
the website.  

The website is available in all EU/EEA languages and is written for non-technical audiences. As more content was 
added on COVID-19, it had a significant increase in popularity throughout 2021. In 2021, the EU Vaccination 
Information Portal received 1 512 351 page views (95% increase) and 955 494 sessions (96% increase). Traffic 
peaked in October when the website received 192 323 page views over the month.  

Figure 18. EU Vaccination Information Portal web statistics 2021 

Audiovisuals  

ECDC published 74 infographics, posters, and animations on its social media channels, mostly on COVID-19 but 
also about antibiotic resistance and influenza. The topics included vaccination rates, the importance of vaccines, 
the use of masks, the fact that antibiotics don’t work for COVID-19 and the need to protect the frail during the 
influenza season 2021-2022. Some of these materials were translated and made available on the ECDC website, as 
well as shared in editable versions with partners and stakeholders across the EU.  

ECDC produced 69 videos (23% increase compared with 2020) and published most of them on YouTube, getting 
1.7 million impressions (32% decrease) and 127K views (28% decrease). The current subscriber count is 2 870, up 
by about 300 from 2021. Most videos have also been shared on ECDC’s social media accounts, becoming some of 
the most popular content as described in the social media section.  

In August 2021, ECDC started publishing a bi-weekly podcast – ECDC: On Air. 12 episodes were aired, gathering 4 
157 plays. The podcast is available on all major podcasting platforms (Spotify, Apple Podcasts, Google Podcasts 
and others), as well as YouTube and SoundCloud. The most popular podcasts were those about the start of the 
pandemic, vaccine hesitancy and misinformation, the Director’s insights and ECDC’s work brining experts together. 
Two Twitter Spaces took place, and the recordings are publicly available. 

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Figure 19. A selection of videos published in 2021  

Marking awareness days  

On the occasion of World Tuberculosis Day, World Hepatitis Day, World Hand Hygiene Day, World Field 
Epidemiology Day, Flu Awareness Week, European Immunisation Week and World AIDS Day, ECDC used the 
opportunity to inform interested public and technical experts alike about the Centre’s work in the area and shape 
respective public health messages. As in previous years, ECDC, in collaboration with the WHO Regional Office for 
Europe published joint enhanced surveillance reports on tuberculosis and HIV/AIDS, regular influenza updates and 
joint news items.  

In support of world health days, ECDC developed communication campaigns, using traditional media, social media, 
videos, toolkits, infographics and other materials that were shared with partners and stakeholders across the EU 
and that could be easily adapted to local languages and practices.  

European Antibiotic Awareness Day was marked on 18 November 2021 with a digital campaign1 and in partnership 
with the World Antimicrobial Awareness Week. Video statements2 from high-level speakers and experts from 
EU/EEA countries were published across channels. A collaboration with 27 social media ambassadors from 19 
EU/EEA countries who highlighted European Antibiotic Awareness Day key messages on prudent use of antibiotics 
and antibiotic resistance in their national languages was also in place, accounting for a total of 157 publications 
social media publications. Other activities including a Twitter Space on antibiotic resistance, media relations, web 
updates, a digital launch event3 as part of ESCAIDE with more than 200 active participants, a global Twitter storm 
together with partners across the globe, enhanced collaboration with EU-level professional and patient 
organisations. A communication toolkit including the latest data and editable materials was shared with partners 
and stakeholders in October. 

Internal communication  

In 2021, 314 news items were published on the ECDC Intranet. The most popular content was related to staff 
issues such as working from home, voluntary return to the office, and vaccination possibilities in Sweden, amongst 
others. Awareness days were also marked internally, highlighting the contributions from colleagues from different 
sections and Units. More than 30 news items were about the Director’s speaking engagements, to ensure 
transparency but also to invite staff to participate in events that were open to the public. Summaries of ECDC 
appearances in media were also published weekly, with a link to the media monitoring reports produced externally. 

A special focus was given to ECDC’s strengthened mandate, through enhanced use of internal communication 
channels to share information, including a dedicated Intranet page, news items when significant developments 
took place, features on the internal newsletter ECDC on the spot, regular updates during the Director’s Weekly 
Briefings, and a dedicated inbox for questions from staff. The Communication Section launched the Meet Your 
Colleagues series, which was a way to learn more about staff, and to connect at a different level while so many 
were working from home.  

1 https://bit.ly/EAAD2021Digital  
2 https://bit.ly/EAAD2021YT  
3 https://www.escaide.eu/en/news-events/european-antibiotic-awareness-day-2021-eaad-event  

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Other information sharing mechanisms and outputs  

ECDC continued producing the weekly COVID-19 policy brief, with 51 issues delivered to the Commissioner’s team 
and other colleagues at the European Commission. The objective of this output is to present short and easy-to-
read analysis of key indicators, trends and developments of the COVID-19 pandemic in the EU/EEA. Along with 
latest epidemiological trends and updates on measures taken by Member States, the policy brief informs about the 
latest outputs by ECDC, with a particular focus on policy implications. 

The annual meeting of the National Focal Points for Communication took place in September 2021 and provided a 
platform to discuss the challenges and opportunities experienced by communicators in the EU/EEA countries 
during the COVID-19 pandemic, to look into lessons and to learn from leading experts about misinformation, 
disinformation and infodemic management in the context of the pandemic.  

3 545 information requests (9% decrease) were registered. Those requests were partly replied to by 
communication officers directly, partly by the mailroom with advice from the Communication Section, while others 
were forwarded to other groups or staff across ECDC. Finally, the publication newsletter had 5 366 subscribers in 
2021, which represents a 5% decrease compared with the previous year. 

In 2021, ECDC continued nurturing the relationship with its host country, Sweden, and with key stakeholders at 
the EU-level, such as the collaboration with the EHFG. The ECDC session at EHFG 2021 which took place on 28 
September, focused on ‘Community engagement during health emergencies - Integrating lessons learned from the 
COVID-19 pandemic’. The feedback received from the participants was very positive. 

Strategic objective 5. Performance indicators  

Objective 

Performance indicator 

Target 

Verification 

Result 2021 

Review and mapping 
of ECDC key 
processes 

- Proportion of key processes 

20%  

reviewed and mapped 

- Proportion of processes 

100% as per roadmap  

digitalised as per roadmap for 
digitalisation 

85%  

90%  

Introduce an 
integrated 
management 
framework (including 
frameworks for 
governance, 
performance 
management, quality 
management system 
and internal controls) 
and a learning culture 

- Proportion of activities 

implemented of the annual work 
programme 

- Rate (%) of external and 
accepted internal audit 
recommendations implemented 
within agreed deadlines 
(excluding 'desirable') 

- Integrated management 
framework: proportion of 
deliverables timely implemented 
as per project plan 

100%  

Project plan 

Monitoring of the list of 
key processes 

● 20% of key processes 
reviewed. 

Monitoring of the 
roadmap for process 
digitalisation 

● 100% (14 processes) 
digitalised. 

Annual report 

● 74% 

Internal control 

●● 0% within original target 
deadlines, however, 100% 
of the recommendations 
open at the end of 2020 
implemented in 2021. 

● 75% (3 out of 4 
roadmaps developed). 

Initiate the 
implementation of the 
selected Quality 
Management system 
at ECDC 

- Implementation of the selected 
Quality Management system at 
ECDC: Implementation according 
to project plan (schedule, 
resources and scope) 

Less than 20% deviation 
from the duration, 
resources, and scope of 
the initial baseline 

Quarterly ECDC Portfolio 
Steering Committee 
reporting 

● 100%  

Implement integrated 
system of Key 
Performance 
Indicators to support 
the achievement of 
Strategic Objectives 

- Key performance indicators 

management process: 
Implementation according to 
project plan (schedule, resources 
and scope) 

Less than 20% deviation 
from the duration, 
resources, and scope of 
the initial baseline 

- Rate of completeness of the KPI 
results reported in the annual 
report 

- Percentage of indicators reaching 

100% 

90%  

the target (90%) 

Gradual 
implementation of the 
roadmap for the IT 
Integrated 
Management Systems 

Roadmap for IT Integrated 
Management Framework 
systems: all milestones timely 
implemented as per roadmap 

90% 

Quarterly ECDC Portfolio 
Steering Committee 
reporting 

● Project completed on 
time, within planned 
resources and scope 

ECDC annual report 

● 81% of KPIs results 
measured 

ECDC annual report 

● 73% of measured KPIs 
reach the target 

Project/programme 
documentation 

● Roadmap and its 
tranches defined, 90% of 
tranche 1 implemented. 

Action 
Area 
5.1 

5.1 

5.1 

5.1 

5.1 

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Objective 

Performance indicator 

Target 

Verification 

Result 2021 

Action plan implemented 
according to the proposed 
timeline 

Implementation according 
to project plan (schedule, 
resources and scope) 

Action plan as approved 
by the Management 
Board 

● 75% 
(Delays due to change of 
mandate) 

Implement the action 
plan stemming from 
ECDC third external 
evaluation 
Transform human 
resources 
management and 
provide effective and 
efficient Human 
Resources services 

Develop a 
comprehensive 
stakeholder 
engagement 
programme to 
identify, engage and 
mobilise institutional 
and non-institutional 
stakeholders 
Improve and further 
develop ECDC online 
presence strategically, 
ensuring that the 
content on its main 
website and its sub-
sites is driven by 
audience-oriented 
content strategy, 
improving the 
transparency, visibility 
and availability of 
ECDC outputs 
ECDC will redefine 
and enhance its social 
media presence and 
engagement 

Action 
Area 
5.1 

5.2 

5.3 

5.3 

5.3 

5.3 

- Proportion of organisational 

entities (units, sections, groups) 
covered by the Skills gap 
analysis 

- Timeliness of recruitment 

process 

100% 

Results of the skill gap 
analysis 

12 weeks as from vacancy 
notice deadline 

HR services statistics 

- Percentage of staff 

satisfaction/engagement 

- Number of sick leaves (short-

term and long-term) 

75% 

<2% (short-term) <3% 
(long-term) 

Average vacancy rate for 
Temporary Agent posts (post 
occupied) 

<5% 

Mapping of stakeholders: 
Implementation according to 
project plan (schedule, resources 
and scope) 

Less than 20% deviation 
from the duration, 
resources and scope of 
the initial baseline  

Biannual staff survey 

HR statistics  
(Short-term up to four 
weeks;  
long-term: four weeks 
and longer) 

% of authorised posts of 
the annual establishment 
plan (temporary agents) 
which are vacant at the 
end of the year, including 
job offers sent before 31 
December. 
Quarterly ECDC Portfolio 
Steering Committee 
reporting 

Website statistics 

● Visits -40% 
● Sessions -41% 

- Number of visitors and sessions 

- Number of downloads on the 

website (measures users re-use 
ECDC data and publications)  

Proportion of returning vs new 
visitors on the website (measures 
visitors’ loyalty and engagement) 

+10% 
+5% 

+7% 

Above 40% 

- Number of followers and rate of 
engagement and interaction with 
of ECDC social media channels 

+20% 

Social media statistics 

- Number of participants to online 

and offline events 

- Number of participants in online 
campaigns and discussions 

Number of multimedia content 
produced 

+20% 

+20% 

+20% 

Develop and 
implement a Public 
relations plan to foster 
ECDC’s reputation 
management 

Public relations plan: 
Implementation according to 
project plan (schedule, resources 
and scope) 

Less than 20% deviation 
from the duration, 
resources and scope of 
the initial baseline 

Quarterly ECDC Portfolio 
Steering Committee 
reporting 

● 100% of the entities 
are part of the project 
plan, and project will end 
in 2022. 

● 8 weeks. 

● 61% 

● Sick leave: 1.10% 
short term and 2.48% 
long term 

● 4.8% 

● The project was 
deprioritised because of 
COVID-19 work and high 
workload in the 
Procurement section. First 
phase planned to be 
implemented in 2022. 

● Downloads -29 

● Returning visitors 54% 

● Followers and 
engagement rate +20% 

● Not available. 

● Not available.  

● Multimedia content +20% 

● The project was 
deprioritised because of the 
COVID-19 work and high 
workload in the 
procurement section. The 
first phase is planned to be 
implemented in 2022. 

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Action 
Area 
5.3 

Objective 

Performance indicator 

Target 

Verification 

Result 2021 

Maintain and enhance 
the cooperation with 
key stakeholders at 
the EU-level, including 
relations with our host 
country 

Satisfaction of participants at 
Gastein seminar 

80% 

Participants’ survey 

● EFHG survey sent out 
to participants. 
Very positive feedback 
received on Community 
engagement session1. 

6. Support services 

6.1 Digital Transformation Services  

Digital Transformation plays an important role in enabling ECDC’s core missions such as disease surveillance, 
epidemic intelligence, and response. Some key information systems operated by ECDC are the EpiPulse portal, the 
Event and Threat Management Solution (ETMS), the European Surveillance System (TESSy), the ECDC web portal, 
and the EU’s Early Warning and Response System (EWRS) for public health threats, which the Centre operates on 
behalf of the European Commission. Developing, operating and maintaining these systems at all times requires 
highly secure, interoperable and robust infrastructures. In addition, ECDC depends on IT systems to support its 
administrative processes. 

Digital Transformation is strategically governed and enables ECDC’s mandate with fit-for-purpose, interoperable, 
sustainable, innovative and best-value-for-money services. 

During 2021, large scale IT projects in the area of surveillance were delivered. The Event and Threat Management 
Solution (ETMS) went live with improved support for events and threats detection and display of event-based 
surveillance information in the EpiPulse portal. The new system replaces the current Threat Tracking Tool and EPIS 
applications. Other major upgrades released in 2021 include the new SARMS, the SRM events module and several 
e-workflows in the administrative area. New projects have also been launched such as the Enterprise Content 
Management Platform and the new Planning and Monitoring System.  

The COVID-19 pandemic has put a high strain on TESSy, our surveillance system, with higher service requirements 
to support the higher volumes of data uploads. Urgent measures were implemented to improve TESSy’s capacity 
and a proof of concept for a full replacement based on state-of-the-art technology was initiated. ECDC also 
released frequent updates of its COVID-19 and Vaccine Tracker dashboards to cope with the evolving information 
needs of its stakeholders.  

With the increased number of new personnel to support the Centre’s activities, the Front Office team has 
onboarded 205 new persons throughout the year compared to an average baseline of 120 newcomers in previous 
years. With the increased need of working from home, ECDC has fully adopted MS Teams and all meeting rooms in 
the ECDC premises have been prepared to support hybrid meetings.  

The deployment of Microsoft 365 was completed, starting with a set of Data Protection Impact Assessments for 
Microsoft 365. This enabled to continue the rollout of Exchange Online, OneDrive, MS Defender, SharePoint Online, 
MS Teams and Dynamics CRM Online.  

2021 also paved the way for future work with a record number of 16 feasibility studies completed, the definition of 
the 2022 IT Work Programme, and the preparation of the Digital Roadmap 2027 which identifies the business 
objectives and digital outcomes needed to enable the ECDC Strategy 2021-2027. ECDC has initiated a feasibility 
study for the review of its IT Target Operating Model which will help prepare the procurement procedure for the 
next generation framework contracts. Finally, a study on Integrated Digital Surveillance System (IDSS) was 
initiated to understand how the ECDC application landscape must change to support the new mandate. 

1 https://www.ehfg.org/documents/EHFG2021/Outcomes/#page=1 
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Table 6. List of mission-relevant IT solutions (not exhaustive) 

System/application 

ECDC KM Systems 

Description 

From Q1 2022, Knowledge Management tools within the European Centre for Disease Prevention 
and Control (ECDC) will primarily leverage the forthcoming Enterprise Content Management Platform, 
which provides a unified portal for information held within the Centre’s electronic document 
repositories and the content management systems for ECDC’s ‘Intranet’ and ‘Extranets’. It provides a 
single, unified search interface (Enterprise Search) and functionality to ensure consistent metadata-
tagging and terminology management. 

Document Management System 

Supports the management of electronic formats of documents, providing a single point of controlled 
access for documents in the Centre, contributing to the reduction of paper-based processes. 

Early Warning and Response System 
(EWRS) 

ECDC data warehouse 

ECDC extranets 

ECDC Library 

ECDC Virtual Academy (EVA)  

ECDC web portal 

A rapid alert system that supports critical communication about serious cross border health threats, in 
accordance with Decision 1082/2013/EU, through a web-based platform used to exchange 
information on public health threats, between the European Union/European Economic Area 
(EU/EEA) Member States, the European Commission, other EU agencies and the World Health 
Organization (WHO). 

ECDC’s data warehouse hosts all indicator and event-based surveillance data along with 
determinants of health data. It covers information relevant for performing standard or specific 
epidemiological surveillance analysis and reporting, along with harmonised terminology between 
datasets for all the communicable diseases and related special health topics covered by ECDC. In 
addition, through its dataset management and storage, ECDC data warehouse supports the ECDC 
Open Data Framework.  

Support collaboration of public health networks, working groups and institutional bodies (Management 
Board and Advisory Forum). Currently ECDC manages >20 extranets. In 2016, a major migration took 
place to an updated platform, making new functionalities available and bringing improvements to the 
user interface. 

The Library provides information delivery services by making available tools to ease access to 
information. The Library is developing its collection (both electronic and print) and provides services 
both via the Library Intranet and the physical area. 

Launched in 2014, EVA is the learning management system that supports ECDC public health 
training activities. It provides access to e-learning, mixed courses and training materials, and 
facilitates the administration of face-to-face activities, including the ECDC Fellowship programme 
(EPIET, EUPHEM), MediPIET and continuous professional development activities designed, 
developed, and implemented with different ECDC teams and experts.  

Supports an important part of the external communication, e.g. making available outputs for public 
health professionals, information for the public. The current Portal, supported on a modern content 
management system, was launched in June 2017. 

ECDC Candidate Expert Directory 

ECDC Candidate Expert Directory is a roster of potential external experts, allowing ECDC - when 
deemed necessary - to expand the number of experts and areas of knowledge and skills beyond its 
own expert staff and expertise. 

European Surveillance Portal for 
Infectious Diseases 

European Federation Gateway Service 

Eurosurveillance website 

Online portal for European public health authorities and global partners to collect, analyse, share, and 
discuss infectious disease data for threat detection, monitoring, risk assessment and outbreak 
response. EpiPulse was launched in 2021 and integrates several surveillance systems that were 
previously independent (The European Surveillance System (TESSy), the five Epidemic Intelligence 
Information System (EPIS) platforms and the Threat Tracking Tool), providing new functionalities and 
seamless access to data in a single platform. The portal facilitates collection, analysis and 
dissemination of indicator- and event-based surveillance data on infectious diseases and associated 
health issues, including global epidemic intelligence, whole-genome sequencing, and health 
determinants.  

Component of the technical interoperability solution agreed by participating Member States in the 
eHealth Network to enable interoperability of approved mobile apps supporting contact tracing, as set 
out in the Commission Implementing Decision (EU) 2020/1023 of 15 July 2020 amending 
Implementing Decision (EU) 2019/1765 as regards the cross-border exchange of data between 
national contact tracing and warning mobile applications with regard to combatting the COVID-19 
pandemic. 

Supports the submission, edition and publication of Eurosurveillance, a European journal on 
communicable diseases ranking among the top-10 journals in its field. A modern publication platform, 
with some interactive features was launched in September 2017. 

Intranet 

Tool for internal communication and support of internal processes. 

Management Information System 

Internal system used to plan and monitor the implementation of ECDC’s annual work programme. 

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System/application 

Description 

Passenger Locator Form Exchange 
Platform  

Enables the secure, timely and effective exchange of data between the EWRS competent authorities 
of the Member States, by enabling them to transmit information from their national digital passenger 
locator form systems to other EWRS competent authorities in an interoperable and automatic manner. 

PHE Intranet (Emergency Operation 
Centre) 

Internal crisis management tool where response activities and resources are gathered, managed and 
maintained. 

Remote access to ECDC systems 

Allows the continuity of work by ECDC staff when away from the Centre's premises (e.g. during 
missions and when on stand-by duty.) 

SARMS 

ECDC Scientific Advice Repository and Management System supports the production of ECDC 
outputs with scientific content from registration to clearance and dissemination using electronic 
workflows and provides a repository of ECDC scientific outputs for reference and auditing purposes. 

Stakeholder Relationship Management 
(SRM) system 

A primary business system of contacts, relationships (internal and external) and interactions with 
ECDC stakeholders. Supports the centralised management of Member States and other external 
contacts. The system is a user-friendly one-stop-shop with the potential for evolution to meet growing 
business needs. 

Surveillance Atlas of Infectious Diseases 

Launched in 2014, this tool provides a highly interactive, graphical access to surveillance data. It is 
accessible via ECDC's web portal. The Atlas has been evolving, in particular by increasing the 
number of diseases covered. 

The European Surveillance System 
(TESSy) 

Supports collection and validation of data for public health surveillance, provided by EU Member 
States and other associated countries. TESSy will be gradually integrated into EpiPulse (󠆍2021−2023). 

Threat Reports Mobile App 

Free and open-access mobile application that gives direct access to key updates and reports on 
communicable disease threats of concern to the EU on mobile devices. 

6.2 Resource management 

Throughout 2021, the Resource Management Services (RMS) Unit provided significant support for operational 
requirements, with high-quality delivery in the areas of Corporate Services, Finance and Accounting, Human 
Resources management and Legal Services and Procurement. The PHE had a profound impact on resource 
management services, as 46 additional posts and an increase of EUR 106 million in the Centre’s budget were 
effectively accommodated in what is already a high-volume business. In addition to the operational support tasks, 
several notable projects were undertaken aimed at enhancing effectiveness and efficiency in future periods, 
including: 

• 

• 

• 

Corporate Services: Workplace assessment finalised, EMAS implementation project commenced, and 
development of Corporate Services strategy started; 
Finance and Accounting: e-commitments launched in Speedwell, and an asset management framework 
being developed; 
Legal Services and Procurement: further e-workflows developed and deployed (procurement), as well as 
improved (electronic) Declaration of Interests. 

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Figure 20. Budget execution  

Figure 21. Work programme implementation 

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6.1 

6.1 

6.1 

6.1 

6.2 

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Support services. Performance indicators 

Objective 

Performance indicator 

Target 

Verification 

Result 2021 

ECDC supports public health by 
providing digital solutions for 
the Commission, Member States 
and other stakeholders. In 
addition, the Centre’s operations 
are enabled with the necessary 
digital solutions for the steering 
and support of the Next 
Generation ECDC 

- Business owners’ 

satisfaction 

- Implementation of the IT 

work programme 
according to plan 
(schedule, resources and 
scope) 

- Quality of software 

products: Number of 
Critical and High severity 
defects for IT Products 
with high business impact 
(BIP = 1, 2) 

ECDC provides its staff with a 
digital workplace that addresses 
the needs for mobility, flexibility, 
communication and 
collaboration. Users can easily 
access the IT services they need 
via the front-office or self-
service. 

- End-users’ satisfaction 

surveys 

- Proportion of ICT Front-
Office requests and 
incidents resolved as per 
service level agreement 

57% (10% increase) 

Digital 
Transformation 
Services dashboard 

● N/A (satisfaction 
survey postponed for 
2023). 

Less than 20% deviation 
from the duration, resources, 
and scope of the initial 
baseline 

For IT products with BIP 1 or 
2: 0 Critical and 0 High 

● Resource deviation: 
7% 
Schedule deviation: 
14% 

●● Critical defects: 0; 
High severity: 1 

At least 78% 

Digital 
Transformation 
Services dashboard 

● N/A (satisfaction 
survey postponed for 
2023 due absence of IT 
QMO) 

Above 95% for requests and 
above 95% for incidents 

●● Request fulfilment: 
90% 
Incident resolution: 95% 

● Performed FS: 14 

● 99,9% 

● 157 out of 453 
procedures were 
delayed for launch = 
35%. This gives 65% 
launched on time. 

● In the original 
procurement plan there 
were 368 expenses. In 
the final plan there were 
453 expenses. This is a 
change of 23% 

● N/A The data is not 
extractable with our 
current tools. 
● Management Board 
members and 
alternates: 98% 
● AF members and 
alternates: 95% 
● RRA experts: 100% 
● Experts to meetings: 
97% 
● ECDC senior 
management: 100% 
● 100% of access to 
document requests 
dealt on time. 

Prepare ECDC for the future 
through technology foresight 
and innovation  

- Number of Feasibility 
Studies performed per 
year 

at least 10 

ECDC continuously improves its 
digital infrastructure so that its 
critical systems fulfil business 
needs. 
Provide effective and efficient 
procurement services 

- Availability of hosted 

applications under service 
level agreement 

- Percentage of 

procurement/grant 
procedures launched at 
planned launch date  

99% 

80% 

- Percentage of changes 

made in the procurement 
plan throughout the year 

<20% 

Digital 
Transformation 
Services dashboard 

Digital 
Transformation 
Services 
Dashboard 
Management 
information system 

Minimum timelines 
published on ECDC 
intranet per type of 
procedure 

- Percentage of 

procurement/grant 
procedures completed 
within indicative minimum 
procurement/grant 
timelines 

Proportion of reviewed 
annual and specific 
declarations of interest for: 

-  delegates to 

Governing Bodies; 
-  invited experts and 

ECDC staff members 
before participation to 
meetings with 
scientific outputs;  
-  invited experts and 

ECDC staff members 
before participation to 
Rapid Risk 
Assessments. 
- Proportion of replies to 
requests to document 
access within the legal 
deadline. 

85% 

100% for each category 

Report from the 
compliance officer 

Statistics from e-
workflow (K2) 

100% 

6.2 

Provide effective and efficient 
legal services 

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Action 
Area 
6.2 

Objective 

Performance indicator 

Target 

Verification 

Result 2021 

Provide effective and efficient 
corporate services 

- EU Eco-Management and 
Audit Scheme (EMAS): all 
milestones implemented 
as per project plan 

100% 

Project plan 

● 50% 

- ECDC’s greenhouse gas 

emissions (CO2) 

TBC 

- Percentage of meetings 
launched at planned 
launch date  

- Percentage of changes 

80% 

made in the meeting plan 
throughout the year  

- Proportion of issues 

resolved as per service 
level agreement 

<20% 

90% 

6.2 

Provide effective and efficient 
Financial Management services 

- Percentage of budget 
committed (C1) and 
percentage of payments 
executed (C1) in the same 
year as the commitment 

100% committed minimum 
80% paid minimum 

- Percentage of invoices 

paid within the time limits 
of ECDC’s Financial 
Regulation 

95% 

- Rate of cancellation of 
payment appropriations 

- Rate of budgetary outturn 

2% 

5% 

TBC – to be confirmed. 

Energy meters 
(electricity 
consumption), 
combined with 
consumption 
invoices 

Management 
Information System 

Management 
Information System 

● tbc 

● 92% 

● 17% 

● 99.6% 

Ivanti system 

ABAC 

● Commitment rate in 
2021: 99.4%; and 
payment execution rate: 
64.1%. The relatively 
low level of payments 
was primarily due to the 
European Health 
Emergency 
Preparedness and 
Response Authority 
Action Grants whose 
balances are planned to 
be paid in 2022. 
● 98% of invoices paid 
within the time limits. 
● Cancellation of 
payment appropriations: 
7.6% 
● Rate of budgetary 
outturn: 1.03% 

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Part 2a. Management 

Management Board 

As in the previous year, all Management Board meetings were held virtually in 2021 due to the COVID-19 
pandemic. An extraordinary Management Board meeting was held in May 2021 to discuss the European Health 
Emergency Preparedness and Response Authority Incubator Action Area 1 (Rapid detection of SARS-Cov-2 
variants) and its impact on the ECDC work plan.  

During the course of 2021, the Management Board approved Memoranda of Understanding between the ECDC and 
the Secretariat of Health of the United Mexican States, the Korea Disease Control and Prevention Agency, and the 
UK Health Security Agency respectively. The Board also endorsed the IAS Internal Audit Plan 2022-2024 and 
approved the ECDC Communication Policy 2022-2027.  

In 2021, the Management Board approved the Consolidated Annual Activity Report 2020 and endorsed the Final 
Annual Accounts 2020 in accordance with legal obligations. The Board also approved the ECDC Single 
Programming Document 2022-2024 and the Budget and Establishment Table 2022. The draft ECDC Single 
Programming Document 2023–2025 was discussed and endorsed by the Board members. 

No risks and control issues were brought to discussion to the Management Board in 2021. 

Major developments 

The main event impacting the work of ECDC in 2021 was the continuation of the COVID-19 pandemic. A large 
number of ECDC experts continued working in the PHE structures set in place in 2020. The implementation of 
some of the recommendations from the ‘Strategic and performance review of ECDC response to COVID-19 
pandemic’ carried out in 2020 helped ECDC to further improve its processes related to public health events (PHE). 
In 2021 ECDC carried out the revision of its PHE plan, based on the lessons learned from the pandemic and 
international benchmarking. However, due to the quickly changing course of the pandemic, its implementation was 
postponed. Throughout the year, ECDC conducted epidemiological surveillance related to COVID-19, provided 
numerous rapid risk assessments, published scientific guidance to support public health decision-making, and 
responded to a large number of ad-hoc requests from the European Institutions, Member States, and other 
stakeholders. During this time, ECDC continued close collaboration with other CDCs, the World Health Organisation 
and different global partners. 

In November 2020, the European Commission proposed the way towards a European Health Union to better 
protect the health of citizens, equip the EU and its Member States to better prevent and address future pandemics, 
and to improve resilience of health systems. In this context, the Commission proposed to strengthen ECDC’s 
mandate and put forward a proposal for an amended ECDC Founding Regulation, together with two other pieces of 
legislation, namely a proposal for an amended Founding Regulation of the European Medicines Agency, and 
Regulation on Serious Cross Border Threats to Health. In 2021 the proposed amended ECDC Founding Regulation 
went through its normal legislative process in the Council and the Parliament, and as requested, ECDC provided its 
technical expertise to the EU Institutions in support of this process. 

In 2021, the Commission continued to pursue the Health Union further by launching a new European Health 
Emergency Preparedness and Response Authority for health emergencies. In preparation of this structure, ECDC 
was requested to support EU Member States in setting up and/or expanding their WGS capacities and capabilities 
through grants. Setting up this ad-hoc grant programme and implementing it together with Member States 
represented a major cross-organisational effort, which will continue in 2022.  

In 2021, the implementation of the ECDC Strategy 2021-2027 was slow due to the pandemic. Due to this, and to 
the additional tasks entrusted to ECDC in relation with the establishment of European Health Emergency 
Preparedness and Response Authority, the annual work plan was amended several times during the year together 
with the financing decisions, approved by the Management Board. The efforts to enhance the monitoring of the 
implementation of the annual work plan and related resources were initiated in 2021. 

The COVID-19 pandemic increased ECDC’s visibility in different media platforms and raised the Agency’s 
institutional profile. Due also to the main developments described above, ECDC was represented in six informal or 
formal Health Council meetings, four hearings in the European Parliament, and five meetings with the Director of 
the WHO European Regional Office and other WHO entities in Europe. 

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Budgetary and financial management 

Fund source C1 (current year appropriations) 

Budget execution in terms of commitment appropriations at year-end reached 99.35%, equivalent to EUR 167 
million. 

Budget execution in terms of payment appropriations at year-end reached 64.08%, equivalent to EUR 107.7 
million. 

Information on transfers and amending budgets 

The Director exercised her right to amend the budget within the limitations of Article 26.1 of ECDC’s Financial 
Regulation and approved net budget transfers of EUR 8.6 million between several budget lines within the different 
titles to optimise the use of the budget. 

Level of appropriations carried forward to the following financial year 

ECDC carried forward the amount of EUR 59.3 million to 2022 (compared with EUR 13.5 million carried forward to 
2021). 

Implementation of appropriations carried forward from the previous 
financial year 

Budget execution in terms of payment appropriations for the fund source C8 at year-end reached 92.41%, EUR 12 
475 019 was paid from EUR 13 500 266 carried forward to 2021. 

Interest charged by suppliers for late payments: EUR 488. 

Procurement procedures 

During 2021 a total of 257 contracts and grant agreements were concluded with ECDC as a part: 

14 Direct Contracts with a total value of EUR 2 655 059. 

21 ECDC Framework Contracts with a combined budget ceiling of EUR 115 379 030. These contracts were the 
result of 15 procurement procedures.  

131 Specific Contracts (Signed Contracts under Framework Contracts) with a combined budget of EUR 21 823 372. 

27 Framework Partnership Agreements (Grant Procedures)  

24 Action Grants to National Public Health Authorities from EU and EEA Member States for enhancing Whole 
Genome Sequencing (WGS) and/or Reverse Transcription Polymerase Chain Reaction (RT-PCR) national 
infrastructures and capacities to respond to the COVID-19 pandemic in the European Union and European 
Economic Area. The Action Grants have a combined budget of EUR 77 087 704. 

40 Specific Grant Agreements with a total value of the ECDC contribution amounting to EUR 2 003 729. 

ECDC also joined 20 inter-institutional and inter agency contracts. These are contracts procured by other entities 
where ECDC may solicit under these contracts.  

Summary information on budgetary operations for the year 

The core budget of the Centre for 2021 (EUR 168.1 million) increased by 169% compared to 2020 (EUR 62.5 
million). The Centre paid in 2021, an interest of EUR 488, charged by suppliers through late payments (>30 days). 

For additional information see Annex VIII, Final annual accounts 2021. 

Controls and control results 

A short description of the controls and the control results can be found below regarding the internal control 
objectives mentioned in the ECDC Financial Regulation, article 30.2. 

A number of control results are reported to the Director every year regarding ongoing and/or separate 
assessments to ascertain whether the components of internal control are present and functioning.  

The following assessments are prepared, and made available to the Director, at least annually: 

• 
• 
• 
• 

Overall self-assessment of internal control in ECDC, including main deficiencies reported; 
Self-assessment of the implementation of the ECDC Internal Control Framework; 
Results of the specific assessment(s) performed; 
Analysis of exceptions reporting, including action plans on possible remedial actions;  

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• 
• 
• 
• 

Status of internal control and quality weaknesses reported; 
Results of the ex-post controls for the grant verifications; 
Summary of the interactions with OLAF;  
Analysis of the audit observations/recommendations of the Internal Audit Service and of the European 
Court of Auditors to identify internal control deficiencies, including monitoring of ECDC's implementation of 
the corrective actions being implemented in a timely manner. 

Legality and regularity of the underlying transactions 

The ECDC budget is implemented through mainly four types of transactions: salaries and salary-related 
entitlements, reimbursements (to staff or external persons), procurement-related expenditure and grants. 

The main objective of the controls in place regarding budgetary implementation in ECDC is to ensure compliance 
with the regulations ensuring the legality and regularity of the underlying transactions.  

The main ex-ante controls to be performed are described mainly in the internal procedures (IP) in place. The most 
important being the IP on the Advisory Committee on Procurement, Contracts and Grants; the IP on Procurement 
and Contract Management; the IP on Grant Management, as well as the IPs on the Financial Workflows for 
Commitments and Payments (including the checklists for the ex-ante verifications to be performed). 

In addition to the ex-ante controls performed, ex-post controls are performed for grants.  

Ex-post verifications of grant agreements are performed every year by ECDC, in line with the ECDC Grant 
Verification Policy and the ECDC Grant Verification Plan. The verifications are performed by an external audit firm. 

In 2020, two grants were selected for verification and the results of the verifications were concluded upon in 2021. 
In 2021, another two grants were selected, and the results of the verifications have been received. The final 
results are expected to be established in the first quarter of 2022. 

The sample of verifications performed per year is not representative of the total population of grant agreements 
and not linked directly to the payments made for the year 2021. However, the result of the verifications does not 
indicate that the most likely average error regarding grant agreements in ECDC is above the materiality criteria of 
2%. 

Prevention, detection, correction and follow-up of fraud and 
irregularities 

ECDC has an Anti-Fraud Strategy in place. The current Anti-Fraud Strategy covers 2021-2023 and was approved by 
the Management Board in November 2020. It is based on a fraud risk assessment and includes a number of 
activities, i.e. internal fraud training activities, performing an annual review and refining the fraud risk assessment 
over time, and selecting an area annually in which to further analyse and potentially improve the controls in place. 
The fraud risk assessment was updated in 2021 and the implementation of the action plan is monitored.  

ECDC has an OLAF coordinator in place that is responsible for coordinating issues regarding fraud and irregularities 
and the contacts with OLAF. The OLAF coordinator reports to the Director at least once a year regarding the work 
performed and the status of fraud-related issues and investigations. 

Safeguarding of assets and information 

At the end of 2021, the total net value of the ECDC fixed assets was EUR 2.33 million. ECDC’s assets are managed 
in the ABAC Assets IT tool. A physical inventory is performed at minimum every two years. The latest physical 
inventory for both IT equipment and furniture was performed in 2020. Overall, it is concluded that the most likely 
error for assets is below the materiality threshold, however, some improvements are being implemented by ECDC 
to the procedures in place. 

Information at ECDC is safeguarded in the relevant IT systems, including the ECDC Document Management 
System. IT security is provided by the Digital Transformation Services Unit, which also has an IT Security Officer 
and IT Security Operation Specialist in place. In 2021, ECDC continued to be a subject of interest from cyber-
criminals and hacktivists which materialised in different types of cyber-attacks towards ECDC infrastructure and IT 
services. In response, additional cyber-security measures were implemented to safeguard the information, e.g., 
Microsoft Defender (on-prem and in cloud), forensic tools for deep analysis, Information Security Management 
System (ISMS), privilege access/identity management (PAM/PIM). 

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Reliability of reporting 

Financial reporting is provided by ECDC both internally and externally at regular intervals. Reports on budget 
implementation are provided monthly to the Director and Heads of Unit. External financial reporting is provided 
mainly through the annual accounts of the Centre and the annual report on budgetary and financial management, 
in accordance with the ECDC Financial Regulation. These external reports are audited by the European Court of 
Auditors and no material anomalies were noted for 2020. 

Effectiveness, efficiency, and economy of operations 

The effectiveness, efficiency and economy of operations is covered mainly by Part I of the Consolidated Annual 
Activity Report, but sound financial management is also an integral part of the ex-ante controls performed for the 
individual transactions authorised. 

Costs and benefits of controls 
The controls in place are designed to optimise their effectiveness and efficiency, by striking the right balance 
between the benefits of the controls regarding the legality and regularity of the underlying transactions, and the 
effectiveness and efficiency of the control taking into consideration the risks involved. 

Regarding the effectiveness of the controls, the European Court of Auditors has given ECDC an unqualified opinion 
on the 2020 accounts and had no comments at all regarding the legality and regularity of the underlying 
transactions. No other indications were found that the controls in place were not effective.  

Regarding the efficiency and economy of the controls, no serious anomalies were reported to indicate that the 
efficiency and economy were under question. However, in order to better measure the efficiency and economy of 
the controls, ECDC is working on introducing some more detailed indicators. 

The estimated costs of control for ECDC in 2021 is included in the following table: 

Table 7. Estimated costs of control 2021 

The table is split by relevant control systems, which are based on how ECDC implements the budget, and by ex-
ante and ex-post controls. 

The table and calculation method has been inspired by the approach used in the European Commission. The 
estimated costs of control include the estimated salary costs (including social charges) of the staff directly involved 
in the relevant control systems. 

The staff included as staff directly involved are those working in the Resource Management Services Unit with 
accounting and financial management issues in the Finance and Accounting Section; the staff working with 
managing salaries in the Human Resources Section; the staff working with controls of reimbursements in mainly 
the Missions and Meetings Group in the Corporate Services Section; the staff working with procurements and 
grants in the Legal Services and Procurement Section; as well as the operational staff working directly with grants 
mainly in the Fellowship Programme Group in the Public Health Training Section and in the Microbiology and 
Molecular Surveillance Group in the Surveillance Section in the Public Health Functions Unit. In addition, an 
estimation has been made for the amount of time spent by the operational staff involved in the procurement 
related expenditure.  

The estimated costs of control do not include any direct or indirect information technology costs, any staff costs for 
general control-related activities (e.g., planning, quality management, internal control coordination, anti-fraud 
related work) or any other overhead costs (e.g., costs for office space). 

The costs of control are compared to the funds managed (defined as funds paid as C1 or C8 credits in 2021), 
which makes it possible to establish a ratio.  

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The ex-post costs of control include the staff costs for the coordination and monitoring of the grant verifications 
and the costs of the external audit firm performing the actual verifications. 

ECDC will further refine the methodology used, and closely follow the development of the cost of controls and the 
ratios, over the coming years. The cost of controls and the ratios are difficult to compare to other organisations. 
However, they are indicators to be used over time to monitor the development of the efficiency of the controls in 
place. 

As seen in the table, the ratio for the costs of ex-ante control for salaries and other entitlements is relatively low, 
due mainly to the rather large amount of total salary payments. The ratio is very similar to last year. The ratio for 
the costs of ex-ante control is a lot higher regarding reimbursements than for other types of transactions. 
Reimbursements are clearly more time consuming than other types of transactions, due to the rather large number 
of small individual payments made. The costs of control for reimbursements have gone down significantly in 2021 
due to the reduction in meeting reimbursements, but the ratio remains similarly high as in 2020. The ratio for the 
costs of ex-ante control for procurements is closely linked to the number and types of procurements performed in 
the year in question. This year the costs of control are similar to those of 2020, but the total value of 
procurements has gone up significantly leading to a lower ratio (6.81% in 2021, as compared to 10.13% in 2020). 
Finally, the ratio for the costs of control for grants is highly impacted in 2021 by the fact that ECDC has managed a 
high amount of relatively large new grants for the European Health Emergency preparedness and Response 
Authority incubator programme. Due to this, the costs of control for grants have almost doubled in 2021, although 
the ratio has been reduced from 20.12% in 2020 to 1.83% in 2021. 

Delegation and sub-delegation of the powers of budget 
implementation to agency’s staff 

The Director of ECDC, as authorising officer (AO), has delegated financial responsibility to the five Heads of Unit, 
as authorising officers by delegation (AOD).  

The Heads of Unit in turn delegate responsibility – but only in their absence – to the Deputy Heads of Unit 
(Authorising Officers by Sub-Delegation (AOSD)).  

Should the Deputy Head of Unit be unavailable, the authority returns to the Director. Thereby, a very limited 
number of persons act as authorising officers in ECDC.  

The authorising officers by delegation can enter into budgetary and legal commitments and authorise payments. 
During the first part of the year, all commitments above EUR 250 000 required the signature of the Director. Since 
the second half of July 2021, the threshold has been changed to EUR 500 000 for budgetary and legal 
commitments and unlimited for the authorisation of payments. 

For the expenditure of 2021, the AODs signed a Declaration of Assurance to the AO for the area for which they 
were delegated responsibility. No reservations were raised by the AODs. 

Human resources management 

Human Resources management aims at supporting the Centre’s management and staff by providing continuous HR 
services in areas such as recruitment, working conditions, pay and entitlements, learning and development, and 
staff health and well-being. The objective of the Centre’s learning and development activities is to offer 
professional growth for the individual and maintain and further strengthen the Centre’s organisational 
performance. 

As part of the review of the ECDC mandate, the Centre received an additional 73 posts (both Temporary Agents 
and Contract Agents) in the beginning of 2021 for the years 2021 – 2024, of which 31 posts were allocated for 
2021. Considering the impact of the large European Health Emergency Preparedness and Response Authority grant 
that ECDC received in spring 2021, ECDC obtained the approval to recruit an additional 15 posts initially foreseen 
for 2022, already in 2021. Hence the total number of additional posts in 2021 amounted to 46. As a consequence 
of the new posts allocated to the Centre, the 20 short term Contract Agent posts assigned to ECDC in 2020 are 
expected to be phased out by 2023. Additionally, the Centre received 21 Contract Agent posts for externally funded 
projects for which the recruitments started in 2020 and continued in 2021.  

Moreover, during this growth phase and in combination with the workload due to the pandemic, HR reinforced the 
organisation with short term staffing (interims). Other HR activities continued to focus on supporting staff with 
regards to the extraordinary situation (e.g. adjusted modalities linked to teleworking and time management) as 
well as continued support in the area of staff wellbeing, with stress prevention activities, extended support of in-
house doctor’s phone consultation and ergonomic sessions. The learning and development activities continued to 
be offered online, and support was provided to managers and teams in view of the new ways of working. A project 
on Respect at the workplace was also launched with a survey carried out in autumn 2021 and an action plan to be 
developed in 2022. 

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The majority of the Centre’s jobs (78.4%) are related to the implementation of activities linked to the Centre’s 
operational work. 14.5% of the jobs belong to ‘administrative support and coordination’, while 7.1% of the jobs are 
defined as neutral (i.e., primarily in the area of finance/accounting and internal control) (see Annex IV, 
Establishment plan and additional information on Human Resources management). 

Strategy for efficiency gains 

In 2021, ECDC continued its efforts towards delivering efficiency gains. The Integrated Management Framework 
(IMF) Working Group was established to support, among other tasks, the preparation of the implementation 
roadmap for the IMF. This roadmap will be finalised in the beginning of 2022. The introduction of new 
methodologies, including the automation of support and operational processes as critical aspects to reach and 
sustain further efficiency gains, continued in 2021. In 2021 five new administrative processes were automated 
through electronic workflows and four of these were to automate all internal procurement preparation steps. A 
feasibility study was undertaken to find a more sustainable and cost-effective solution for the platform for 
electronic workflows. An overall analysis of the use of the electronic workflows already shows a significant 
adoption by users and a clear reduction of process time, due to the elimination of unnecessary steps or waits, 
while ensuring legal compliance. ECDC is also engaged in a number of joint procurements with other EU agencies 
and is using shared IT services (such as the disaster recovery centre of EUIPO). 

As mentioned in this document, ECDC is also implementing a number of operational programmes and actions, such 
as the re-engineering of its surveillance systems, or the implementation of an automated tool for early detection of 
public health threats, for increased efficiency. 

Assessment of audit and ex-post evaluation results during 
the reporting year 

Internal Audit Service (IAS) 

ECDC is audited by its internal auditor, the Internal Audit Service of the European Commission (IAS). The audit 
work is defined in the risk-based IAS strategic internal audit plan. A new plan was developed by the IAS in 2021, 
which covers the period 2022-2024.  

All observations and recommendations are taken into account and appropriate action plans are developed. The 
implementation of these actions is regularly followed up and presented to the Audit Committee of the Management 
Board. 

In 2021, the IAS performed a limited review on the implementation of the new internal control framework in ECDC. 
The audit made four recommendations, all classified as important. An action plan was developed by ECDC, and its 
implementation will be carefully monitored by ECDC and the Audit Committee and reported upon to the IAS. 

Internal Audit Capability (IAC)  

Not applicable. 

European Court of Auditors (ECA) 

The ECDC annual accounts are audited by the European Court of Auditors (ECA). The audit provides a Statement 
of Assurance as to the reliability of the accounts of the Centre and the legality and regularity of the underlying 
transactions. 

ECDC received an unqualified opinion for 2020, indicating that the accounts are reliable and the transactions 
underlying the accounts are legal and regular. The ECA made no other comments in its final report for 2020 for the 
second year in a row. 

The ECA audit of the 2021 annual accounts is ongoing. The first part of the audit was performed in November 
2021. The audit will be finalised during spring 2022, and a draft report will be available by June 2022. 

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Follow-up of recommendations and observations 

Follow-up of recommendations and action plans for audits and 
evaluations 

Audits 
At the end of January 2021, all IAS recommendations had been implemented by ECDC and reported to the IAS for 
review. The IAS review performed in 2021 confirmed that they could be formally closed. In 2021, ECDC agreed the 
action plans for the four recommendations from the audit on human resource management and ethics and the four 
recommendations from the limited review on the implementation of the new internal control framework. The target 
dates for those eight recommendations were set as: six to be implemented by Q4 2021, one by Q1 2022 and one 
by Q2 2022. The six recommendations with target dates to be implemented by Q4 2021 have been partly 
implemented, but none of them has been fully implemented yet. ECDC will carefully be following up to ensure that 
they are fully implemented as soon as possible. 

The outstanding issue with the ECA was regarding two payments for meeting events, where the auditors found 
weaknesses in the structure and documentation of checks and reconciliations on order forms, deliverables and 
invoices and recommended that the Centre should strengthen these aspects of its control system, in particular with 
respect to large and complex meeting events. This has been resolved by ECDC, and closed by the ECA, in 2021. 
Thereby, there are no open issues regarding the ECA. 

Evaluations 
In an effort to continuously improve its performance, the Centre commissioned an external assessment of its 
response to the COVID-19 pandemic for the period January - September 2020. This analysis grounded its 
conclusions and recommendations on desk research, a comprehensive stakeholder consultation, and a 
benchmarking and learning exchange with other similar organisations. The aim was to obtain a good evidence 
base to propose practical recommendations related to the support ECDC provides to Member States and the 
European Commission, the collaboration with key partners and the internal organisation of the COVID-19 
operations. The report resulted in 17 recommendations. During 2021, the Centre incorporated a series of 
improvements in its response to COVID-19 addressing the ten prioritised recommendations of this report. 
Comprehensive information on the way ECDC addresses each prioritised recommendation is provided in Part II (b). 
External evaluations, of this document. 

Follow-up of recommendations issued following 
investigations by the European Anti-Fraud Office1 
As ECDC did not have any open European Anti-Fraud Office (OLAF) recommendations from previous years or 
receive any new ones in 2021, no follow-up of actions was required or taken in this regard. No reports impacting 
the accounts were received in 2021. 

Follow-up of observations from the discharge authority 

Article 110 (2) of the ECDC Financial Regulation states: ‘At the request of the European Parliament or the Council, 
the director shall report on the measures taken in the light of those observations and comments’. 

This report provides an overview of the measures taken by the European Centre for Disease Prevention and 
Control (ECDC) in the light of observations and comments made by the Discharge Authority on 28 April 2021 in 
respect of the implementation of the budget of the Centre for the financial year 2019. 

1 Article 11 Regulation (EU/Euratom) 883/2013 of the European Parliament and of the Council concerning investigations 
conducted by the European Anti-Fraud Office (OLAF) 

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Table 8. European Parliament’s observations and measures taken by ECDC 

Reference 

Observation of the Discharge Authority 

Response and measures taken by ECDC   Status/Reference 

Performance 

P9_TA(2021)0187 
paragraph 3 

Observes that the Centre describes the status as 
‘ongoing’ in relation to the discharge authority’s 
recommendation from last year on the Centre’s role 
in developing tools for the digitalisation of 
healthcare in the Union, in particular in the 
context of tackling a pandemic; calls on the 
Centre to inform the discharge authority in a 
timely manner on the action plan’s status, 
especially in the context of the current 
pandemic and mitigation of its negative effects; 

ECDC is currently carrying out digital 
surveillance of severe respiratory infections 
using data from electronic health records in 
seven EU Member States. In 2022 this will 
be extended to additional countries and 
diseases. 

Furthermore, in 2021 ECDC operationalised 
the automatic monitoring of social media for 
the rapid detection and assessment of 
threats. This tool will be further enhanced in 
scope and automation during 2022. 

An entirely new European Surveillance 
System is being developed, and it will start 
hosting COVID-19 data in the fall of 2021. In 
2022 it will progressively cover all other 
diseases and health conditions under 
EU/EEA surveillance. The new system 
adopts new technologies and ensures 
automation of data validation and analysis, 
thus reducing the reporting burden for 
Member States.  
In 2021, ECDC launched a new surveillance 
portal called EpiPulse, through which the 
Centre allows its stakeholders to rapidly 
exchange data and information on ongoing 
disease trends and events.  

Several technology assessment projects are 
ongoing to ensure that the Centre takes 
advantage of technical innovations in the 
most cost-effective manner.  

During 2020 and 2021, through automation 
of web-searching, the Centre was able to 
retrieve and disseminate COVID-19 
epidemiological data worldwide. 
Furthermore, ECDC will represent a node in 
the EHDS. For this purpose, ECDC 
prepared a pilot study so assess the 
feasibility of using the EHDS to monitor 
antimicrobial resistance. 

Ongoing 

Implemented 

Ongoing 

Implemented 

Ongoing 

Implemented 

ECDC action plan to implement the 
recommendation of the third external 
evaluation was presented to the ECDC 
Management Board (Management Board) in 
March 2021. ECDC Management Board 
approved the proposed actions and their 
timing. ECDC Management Board will be 
informed regularly on the implementation of 
this plan. 

Plan developed and 
approved by the ECDC 
Management Board 
Implementation ongoing  

P9_TA(2021)0187 
paragraph 5 

Notes that an external evaluation for the period 
2013-2017 was concluded in 2018-2019 and the 
recommendations from the evaluation were 
adopted in 2020; welcomes the fact that the 
evaluation concluded that the Centre successfully 
provided support in the Union and national policy 
priority areas and demonstrated the capacity to 
successfully adapt to policy developments; notes 
with satisfaction that the Centre was positively 
evaluated regarding the coherence of its actions 
and coordination with other relevant bodies; calls 
on the Centre to report to the discharge 
authority on the status of the development of an 
action plan for the implementation of the 
recommendations stemming from the 
evaluation; is, however, of the opinion that the 
evaluation of the Centre’s work should be done by 
the Commission instead of by the Centre’s 
management board; 

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Reference 

Observation of the Discharge Authority 

Response and measures taken by ECDC   Status/Reference 

Staff Policy 

P9_TA(2021)0187 
paragraph 13 

Sustainability 

P9_TA(2021)0187 
paragraph 16 

Procurement 

P9_TA(2021)0187 
paragraph 18 

Is concerned about the large number of 
members on the Centre’s management board, 
which makes decision making difficult and 
generates considerable administrative costs; 

Regrets that the Centre has not set CO2 
reduction targets; welcomes, however, the efforts 
made by the Centre to create an environment-
friendly workplace and all the measures taken by 
the Centre to reduce its carbon footprint and its 
energy consumption, and to develop a paperless 
workflow; 

Notes that two out of three observations of the 
Court have been implemented, one regarding ex-
ante controls performed as regards the IT 
framework contract and one regarding conference 
and multimedia equipment service contracts; calls 
on the Centre to report on the status of the 
actions taken to respond to the third 
observation, namely regarding the structure 
and documentation of checks and 
reconciliations as regards order forms, 
deliverables and invoices; 

Prevention and management of conflicts of interest, and transparency 

Notes with concern the absence of some 
declarations of interest and CVs of the 
management board and of the advisory forum; 
calls on the Centre to publish the declarations 
of interest and the CVs of all the members of 
the management board and of the advisory 
forum and to report to the discharge authority 
on the measures taken in this regard; notes that 
the Centre has adopted an independence policy 
that routinely requires the collection and inspection 
of declarations of interests by its senior 
management team, key staff members and external 
experts who participate in the Centre’s scientific 
activities; 

Notes that the Centre registered and closed one 
whistleblowing case in 2019 and that the 
appropriate measures have been put in place, and 
notes that, as a result, a written reminder was 
issued to members of staff about their duties under 
the Staff Regulations; notes that 29 relevant 
potential conflicts of interest were identified and 
further investigated in 2019, and that mitigation 
measures were applied in relation to 21 of those 
conflicts of interest; notes that the Centre has 
registered meetings with lobbyists and that they are 
made public upon request; stresses that the 
Centre must further improve its ethics 
framework by adopting whistleblower 
protection measures; 

P9_TA(2021)0187 
paragraph 19 

P9_TA(2021)0187 
paragraph 20 

62 

The composition of the ECDC Management 
Board is defined in the ECDC Founding 
Regulation, and members are representing 
EU Member States, European Commission, 
and European Parliament.  
The Management Board has approved its 
updated Rules of Procedure in 2018, and 
these further define the procedures for the 
Management Board decision making. 

ECDC is currently in the implementation 
phase of its Environmental Management 
System based on EMAS, which will include 
CO2 reduction targets. 

Ongoing 

Implemented 

Ongoing 

Ongoing 

ECDC developed a set of internal 
documents to ensure efficient meeting 
documentation processing in two key areas: 
meeting organisation and reimbursements. 
The internal guidelines are live documents 
and are periodically reviewed based on the 
need to address new emerging issues or 
process changes. The structure of the 
meetings folders has also been reviewed 
and improved to allow more efficient 
retrieving of meeting documents. 
Based on the action taken, the ECA closed 
the observation in the ECDC 2020 annual 
report received in May 2021 

In comparison to previous years, the 
submission rates continue to improve. In 
early 2020, ECDC adopted further 
measures to increase the submission rate, 
which were 95% for the Management Board 
and 93% for the AF in 2020. 

Since the beginning of 2020, members / 
alternates of the Management Board and 
AF are not able to access the meeting 
documents in the extranet before they 
submit their Annual DoI. Should there be a 
need to implement further measures that 
would mean that in the case of non-
compliance the Management Board and AF 
members/alternates/observers would not be 
able to attend the meetings in 2022.  
In 2020, the IAS performed an audit 
on Human Resource Management 
and Ethics in ECDC in accordance 
with the strategic internal audit plan. 
The final report was received in 
January 2021. The audit made four 
recommendations, two of them were 
classified as very important and two 
as important. An action plan was 
developed by ECDC, and its 
implementation will be carefully 
monitored by ECDC and the Audit 
Committee and reported upon to the 
IAS. 

Following the IAS audit, ECDC is in 
the process of creating a function of 
“Ethics Officer”, that will promote and 
advocate the highest level of ethical 
standards within the agency, 
including organising training and 
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Reference 

Observation of the Discharge Authority 

Response and measures taken by ECDC   Status/Reference 

P9_TA(2021)0187 
paragraph 21 

Underlines the fact that the current ethical 
framework applying to Union institutions and 
agencies suffers from considerable drawbacks due 
to its fragmentation and the lack of consistency 
between existing provisions; highlights that these 
issues should be addressed by setting up a 
common ethical framework, ensuring the 
application of high ethical standards for all Union 
institutions and agencies;  

P9_TA(2021)0187 
paragraph 22 

Underlines that certain officials fill in declarations of 
absence of conflicts of interest and provide self-
assessments with regard to respect for ethical 
standards; highlights, however, that such self-
declarations and self-assessments are not 
sufficient and that additional scrutiny is 
therefore needed;  

Internal controls 

P9_TA(2021)0187 
paragraph 23 

Other comments 

P9_TA(2021)0187 
paragraph 26 

Notes that the Centre’s current audit plan covers 
the 2018 to 2020 period; notes that all previous 
observations and recommendations have been 
taken into account and appropriate action plans 
have been developed; notes that, following the 
2019 audit of the Internal Audit Service on 
‘Preparedness and Response in the ECDC’, five 
recommendations were issued, two classified as 
very important and three as important, of which one 
very important and one important recommendation 
have already been implemented; calls on the 
Centre to report to the discharge authority on 
the status of the remaining recommendations; 

Welcomes the fact that the Centre has developed a 
comprehensive strategy aimed at achieving cost-
effectiveness and at environmental protection; calls 
on the Centre to pay due attention to the energy 
mix of its sources of electricity and encourages 
the Centre to procure electricity generated by 
renewable energy; 

Ongoing 

In 2020, the IAS performed an audit 
on Human Resource Management 
and Ethics in ECDC in accordance 
with the strategic internal audit plan. 
The final report was received in 
January 2021. The audit made four 
recommendations, two of them were 
classified as very important and two 
as important. An action plan was 
developed by ECDC, and its 
implementation will be carefully 
monitored by ECDC and the Audit 
Committee and reported upon to the 
IAS. 

Following the IAS audit, ECDC is in 
the process of creating a function of 
“Ethics Officer” that will promote and 
advocate the highest level of ethical 
standards within the agency, 
including organising training and 
awareness-raising in this area.  

Ongoing 

ECDC has developed and is in the process 
of implementing its Internal Procedure on 
Conflict of Interest for Staff. This will provide 
an opportunity to further develop processes 
to facilitate additional scrutiny, for example, 
ex post checks are envisaged. The 
Compliance Officer function, Legal Services 
and Procurement Section and Human 
Resources Section shall collaborate on 
developing this issue.  

ECDC has implemented all the 
recommendations from the IAS audit on 
“Preparedness and Response in the ECDC” 
and submitted them to the IAS for review. 
The IAS has reviewed the implementation 
and ECDC is currently awaiting the final 
conclusions. 

Ongoing1 

Implemented 

100% of the ECDC electricity is provided by 
hydro powered energy. ECDC has been 
operating in its new premises since March 
2018. The premises have been 
environmentally certified as a “Green 
building” since 2008. The ECDC building 
has received in 2020 the environmental 
certification ‘BREEAM Very Good in use’. 
Building Research Establishment 
Environmental Assessment Method 
(󠆍BREEAM) is the world’s leading 
sustainability assessment method for 
master planning projects, infrastructure, and 
buildings. 

P9_TA(2021)0187 
paragraph 27 

Welcomes the Centre’s new measures on the 
dissemination of the results of its research to the 
public, and to reach out to the public via the social 
media and other media outlets; welcomes the 
website changes for the various stakeholders; 
notes that the Centre does not have a specific 
cyber-security policy, but does have several 
security policies in place which include a policy on 
cyber-security 

Cyber-security is already extensively 
covered in the current ECDC information 
security policy (ECDC/IP/63 Information 
Security Policy) and IT security rules. Still, a 
new and updated ECDC cyber-security 
policy is currently under preparation in 
anticipation of the EU Regulation on 
common Cybersecurity rule which is 
expected to be adopted before end of 2021. 

Ongoing 

1 At the time of preparing this report, the IAS has formally closed all the recommendations, therefore the status of the 
observation is Implemented 

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Reference 

Observation of the Discharge Authority 

Response and measures taken by ECDC   Status/Reference 

As part of its effort to strengthen cyber-
security, ECDC is furthermore considering 
investment in an information security project 
and a cyber-security awareness and training 
program from 2022 onwards. 

Environment management 

ECDC is implementing an Environmental Management System based on EMASand is subsequently working on 
achieving EMAS certification. In addition, the ECDC premises have been environmentally certified as a ‘Green 
building’ since 2018. In December 2020, the ECDC building received the environmental certification ‘BREEAM Very 
Good’. 

Assessment by management 

2021 was the second consecutive year ECDC worked under circumstances we have never faced before in this 
magnitude, and thus, many experts were diverted from their core tasks. ECDC changed its annual work plan 
several times over the year to accommodate tasks needed for COVID-19 response. Despite this, the Agency was 
able to deliver most of its prioritised core activities. ECDC has tried to implement the lessons learned of this 
experience while working in the response mode, and this learning will continue after the pandemic. 

ECDC conducts its operations in compliance with relevant legal requirements in an open manner to maintain its 
scientific independence and to reach high professional standards. The Agency regularly monitors the 
implementation of the action plans based on ECA and IAS audit recommendations. In 2021 ECDC closed all the 
audit recommendations from previous years, and the review carried out on the ECDC Internal Control Framework 
did not raise any significant deficiencies. 

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Part 2b. External evaluations 

ECDC’s Founding Regulation requires the Centre to organise external evaluations every five years to assess how it 
performs its mission. The third Independent External Evaluation of ECDC, conducted by Price Waterhouse Cooper, 
was concluded in 2018–2019. The report looked at the period 2013–2017. The evaluation provides insights into the 
progress made since the previous evaluation and points out areas for further improvements. The evaluation 
concluded that ‘ECDC has successfully supported the EU and national policy priority areas and demonstrated the 
capacity to successfully adapt to policy developments, confirming the relevance of its activities’. ECDC’s coherence 
and coordination with other relevant bodies was also evaluated positively. 

In response to the evaluation, the Management Board adopted a set of recommendations in its March 2020 
meeting. Based on the recommendations of the Board, ECDC developed an action plan for the implementation of 
actions and presented a progress update to the Management Board in March 2021. Another update will be 
presented to the Management Board in March 2022. 

During the first phase of the COVID-19 pandemic, the Centre contracted externally a ‘strategic and performance 
analysis of ECDC response to COVID-19 pandemic’ which resulted in 17 recommendations. During 2021, the 
Centre incorporated a series of improvements in its response to COVID-19 addressing the ten prioritised 
recommendations of this report. The improvements are related to the adjustments in the governance and the 
structure of the response team, the use of criteria for prioritisation of requests, improved key messages and 
summary of our outputs, strengthening the role of the strategic analyst to ensure a more forward-looking 
approach in the management of the pandemic, a revised PHE Plan using the good practices and lessons learnt 
from other international actors and defining core outputs to ensure easier deployment of resources. 

A short progress update on the implementation of the summarised Management Board recommendations is 
presented below. The full text of the recommendations of the third external evaluation and the recommendations 
of the Management Board are available on the ECDC website1: 

Management Board Recommendation 1: The Management Board suggests that gaps identified in Member 
States public health systems should be shared with the Member State and the European Commission to support 
Member States in the most appropriate way. 

ECDC should develop country knowledge to advise the European Commission on priorities for national capacity 
strengthening and measures which could be supported by EU instruments described above, including surveillance, 
preparedness, training, and control of CDs. 

ECDC has been working intensively in 2021 to put in place the foundations of a solid targeted country support 
approach and to execute the first country missions. The Steering committee on Targeted Country Support 
developed an internal procedure for ECDC country missions, which was used in the organisation of missions to 
three Member States in the end of 2021. ECDC also organised several consultations on the content and 
visualisation tools to be used in the compilation and presentation of data. This work will continue in 2022, 
developing a methodology to analyse vulnerabilities, needs and strengths. More information on the actions 
implemented is available in Part I. Policy Achievements, Strategic Objective 2, of this report. 

Recommendation 2: ECDC’s mandate under Decision 1082/2013/EU 

2A. The Management Board recommends that the European Commission and ECDC examine how the allocation of 
preparedness tasks between these different stakeholders could be more clearly communicated and described, in 
particular, in relation to the terms of reference of HSC Working groups, expected deliverables and their timeline, as 
well as the processes for their validation.  

The European Commission and ECDC should prepare information packages for ECDC stakeholders as well as HSC 
members to clarify roles and responsibilities in the area of preparedness. 

Preparedness is an important element in strengthening the ECDC mandate. Preparedness-related tasks and 
outputs are clearly defined (Art. 5b). Once the ECDC mandate and the new regulation on serious cross-border 
health threats are adopted, the Centre will develop specific information packages on the role of the European 
Commission, the HSC and ECDC for key stakeholders. 

2B. The Management Board invites ECDC to install a systematic feedback system on the use and relevance of rapid 
risk assessments (RRAs). The Management Board endorses the further involvement of the CCBs in the preparation 
of RRAs, as this can be expected to increase the relevance of the assessments, stakeholders’ buy-in to their results 
and follow-up.  

1 Available from https://www.ecdc.europa.eu/en/publications-data/third-external-evaluation-ecdc-2013-2017 

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Following this recommendation, the Centre has been involving the Advisory Forum and relevant networks in the 
preparation of RRAs since February 2021. Moreover, ECDC will request input from Member States in the 
preparatory phase of RRAs to ensure that all aspects on which our stakeholders need advice are considered. 

Recommendation 3: ECDC’s international activities 

The Management Board calls upon the European Commission to develop a substantiated process to ensure a long-
term and structural agreement on the use of ECDC resources in support of external requests. 

The Management Board is committed to taking a stronger role in evaluation, monitoring and validation of ECDC’s 
international activities to ensure that the strategic priorities are met. 

The European Commission’s legal proposal to strengthen the ECDC mandate expands its international dimension. 
Currently, three actions funded by the European Commission (Directorate-General for Neighbourhood and 
Enlargement Negotiations and the Directorate-General for International Partnerships) are being implemented by 
ECDC: ‘Preparatory measures for the participation of the Western Balkans and Turkey in the ECDC with special 
focus on One-Health against AMR and enhanced SARI surveillance, 2020 – 2024’, ‘EU Initiative on Health Security’ 
and ‘EU for Health Security in Africa: ECDC for Africa CDC’. In 2021, ECDC almost completed the recruitments for 
all three projects. A discussion on the long-term sustainability aspects for the continuation of these projects and 
collaboration with third countries is planned to take place during the final year of these projects. 

Recommendation 4: Collection, validation, analysis, and dissemination of data 

4A. The Management Board agrees that it would be important for ECDC to better understand the root causes for 
the low reporting, to be able to provide the right type of support to Member States. ECDC should, therefore, take 
action to gather the information on the matter from the Member States. 

Surveillance systems descriptors have been defined and will now be used to develop surveillance standards. In 
2021, ECDC worked on surveillance standards for pandemic prone diseases. The work is still ongoing, but part of it 
has been published as part of the COVID-19 surveillance guidance (October 2021). 

ECDC is planning the evaluation of surveillance systems as part of the implementation of the new mandate 
(priority diseases and timing to be agreed with Member States). From 2022, special focus will be given to 
implementing and evaluating surveillance systems based on the direct use of electronic health information.  

4B. Concerning the involvement of Member States experts in the analysis of TESSy data and other ECDC outputs, 
the Management Board view was that Member State involvement is beneficial, especially on products that add 
greatest value, while being careful with aspects such as conflict of interest. 

In 2021, the main surveillance effort was on COVID-19. Member States have been involved extensively through 
regular calls with the COVID-19 surveillance network, including on improving data quality, and the interpretation of 
surveillance findings. 

Recommendation 5: Awareness and utility of ECDC’s outputs 

The Management Board stated that raising awareness and communication to national audiences is the primary 
responsibility of Member States. A key for success for ECDC is to continue providing Member States with evidence-
based and objective information. 

The Management Board considers that reaching out to media stakeholders can be most effective and successful in 
the context of existing global public health campaigns such as European Antibiotic Awareness Day (and WAAW), 
European Immunisation Week, TB day, AIDS Day. As far as RRAs are concerned, they are promoted at the HSC to 
facilitate the coordination of measures between Member States. 

The Management Board invites ECDC to present an analysis of its Communication strategy and adapt it, and 
supports the monitoring of communication activities.  

Recommendation 7A. Recommendation related to translation of certain documents published on the ECDC website 
in different languages ‘to make ECDC and its contribution to communicable disease prevention and control in 
Europe more visible to the general public and known as an objective and reliable source of information’. 

The latest ECDC Communication Policy was developed and approved by the Management Board in 2021. This 
policy defines the actions for the period 2022-2027 and the Centre’s target audiences, stakeholders, as well as 
internal and external priorities. It also reflects the needs and media use of its target audiences and stakeholders, 
as well as the current trends and innovations in e.g., risk communication, crisis communication, and 
behavioural/social science research, amongst others.  

Throughout 2021, ECDC supported overall COVID-19 communication activities and delivered several awareness 
days such as World Tuberculosis Day, World Hepatitis Day, World Hepatitis Day, World Hand Hygiene Day, World 
Field Epidemiology Day, Flu Awareness Week, European Immunisation Week, World AIDS Day, and European 
Antibiotic Awareness Day, with a variety of communication actions, some of which were translated and shared with 
partners and stakeholders across the EU. 

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Recommendation 6: Coordination and complementarity 

6A. The Management Board recommends that, under the MoU between ECDC/WHO Euro, areas for improvements 
are addressed by the Joint Coordination Group and reported back to the Management Board. 

6B. The Management Board recommends that the ECDC should be fully involved in both the planning and 
implementation of all Joint Actions that impact on, or could benefit from, the Centre’s activities to ensure they are 
more efficient. ECDC should be invited systematically by the European Commission to participate in the planning 
stage of the Joint Actions and integrate them into its planning process. 

ECDC continued its active collaboration with WHO, defining a list of actions annually, most of which were 
successfully implemented in 2021 despite the high workload related to the pandemic (85% implementation rate). 
More information is available in Part I. Policy Achievements, Strategic Objective 4, of this report. 

Dialogue was maintained with the Directorate-General for Research and Innovation/the Directorate-General for 
Health and Food Safety on future research actions and ECDC role in 2021, including in the context of the 
discussion on revisions to the ECDC mandate and the legislative proposals for revision to cross border health 
threats and the establishment of the European Health Emergency preparedness and Response Authority. 

Recommendation 7: Implementation of the Common Approach on EU Decentralised Agencies and its 
Roadmap 

(7A covered with recommendation 5) 

7B. Recommendation to provide more systematic feedback to the Management Board on the Advisory Forum’s 
meetings and its annual report, and to communicate earlier the budget and human resources allocated to the 
activities (e.g., prioritisation, planned projects and highlight of new activities). 

The planned discussion on the type of systematic feedback requested by the Management Board (e.g. information 
on new projects, KPIs) will take place in 2022 with a concrete proposal on broadening the scope of the 
Management Board Audit Committee.  

The Centre already presents its Single Programming Documents twice to the Management Board: in November 
year N-2 (draft SPD) and in November N-1 (final SPD), and will incorporate highlights of the new activities from 
now on. 

Recommendation 8: Efficiency 

Several specific recommendations were made to improve the efficiency of ECDC in terms of its organisation and 
process. They covered the cooperation between the Management Board and Advisory Forum, the systematic 
review and reporting ensuring prioritisation mechanisms are put in place, the effort to use more outcome-level 
indicators and ensuring strong follow-up of recommendations resulting from evaluations. 

The Centre is continuing the efforts to ensure enhanced collaboration between the Management Board and the AF. 
As per 2022 the Chief Scientist will share it annual report not only with the AF but also with the Management 
Board. 

As part of its IceCube programme, a feasibility study to identify options for a new planning and monitoring tool 
was finalised in 2021, and two tools are currently piloted. In 2021 the Centre automated five additional processes 
with K2, thus reaching a total of 15 automated processes and prepared an implementation plan for the Integrated 
Management Framework of the Centre. 

The Centre started the measurement of its strategic key performance indicators, reviewed its procedure for 
evaluation and strengthened the mechanism for implementation of recommendations, as demonstrated with the 
full implementation of the actions resulting from the ‘Strategic and performance analysis of ECDC response to 
COVID-19 pandemic’. 

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Part 3. Assessment of the effectiveness of 
the internal control systems 

Effectiveness of internal control systems 

Methodology applied for the assessment of effectiveness of the 
internal control system 

ECDC assesses the effectiveness of the internal control system at least annually by assessing the implementation 
of the internal control framework, including the implementation of the indicators defined, and by assessing the 
main deficiencies noticed by ECDC itself or reported by others, including the Internal Audit Service and the 
European Court of Auditors. 

Internal control framework 

The Management Board adopted the new internal control framework at its 43rd meeting in November 2018. 
Starting in 2019, the internal control framework forms the basis for ECDC’s internal control system. 

ECDC’s internal control framework is designed to provide reasonable assurance regarding the achievement of the 
five objectives set in Article 30 of the ECDC Financial Regulation: 

• 
• 
• 
• 
• 

effectiveness, efficiency and economy of operations; 
reliability of reporting; 
safeguarding of assets and information; 
prevention, detection, correction and follow-up of fraud and irregularities; 
adequate management of the risks relating to the legality and regularity of the underlying transactions, 
taking into account the multiannual character of programmes as well as the nature of the payments 
concerned. 

The framework supplements the ECDC Financial Regulation and other applicable rules and regulations, with a view 
to align ECDC standards with the highest international standards. The framework implemented by the European 
Commission served as a basis for defining principles and their characteristics. 

The internal control system at ECDC is based on the five internal control components: 

• 
• 
• 
• 
• 

the control environment 
risk assessment 
control activities 
information and communication 
monitoring activities. 

These are the building blocks that underpin the framework’s structure and support the Agency in its efforts to 
achieve its objectives. The five components are interrelated and must be present and effective at all levels of the 
organisation for internal control over operations to be considered effective. 

Each component of the internal control system adheres to several principles which facilitate the system’s 
implementation and make it possible to assess the system’s operability at the management level. Working with 
these principles helps provide reasonable assurance that the organisational objectives are met. The principles 
specify the actions required for internal control to be effective. 

The internal control framework moves away from a purely compliance-based to a principle-based system, whereby 
the managers are offered the necessary flexibility to adapt to specific situations, characteristics and circumstances 
while ensuring robust internal control and consistent assessment throughout the Agency. This approach aims at 
helping the organisation to achieve its objectives and sustain operational and financial performance by establishing 
diverse and objective-based managerial processes that meet each entity’s specific needs. 

Ongoing monitoring of the effective functioning of internal control is built into business processes and performed 
on a real-time basis at all levels of the organisation. This enables the entities to react timely to changing conditions 
and correct deviations from intended performance and effectiveness levels. 

The Agency must be able to demonstrate not only that controls are in place but also that these controls are 
effective in controlling risks and that they work as intended. Internal control principle 16 states that the 
assessment of internal control is founded both on ongoing (continuous) monitoring and on specific (periodical) 
assessments to ascertain whether the internal control systems and their components are present and functioning. 
ECDC must carry out an overall assessment of the presence and functioning of all internal control components at 
least once a year. 

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In 2019 the internal control framework was further reinforced with detailed indicators that were approved by the 
Management Board in November 2019, with a revision of the indicators performed in June 2020 as agreed with the 
Board. 

The implementation of the internal control framework is assessed annually and reported to the Audit Committee of 
the Management Board. The assessment of the internal control framework for 2021 was performed in January–
February 2022 and is presented to the Audit Committee in March 2022. 

The main conclusions were as follows: 

• 

• 

• 

• 

The self-assessment performed regarding the implementation of the internal control framework showed 
that the internal control system is present and functioning, but some improvements are needed.  
On the component level, one component (Monitoring Activities) is in place and functioning well, with no or 
only minor improvements needed, and four components are present and functioning, but with some 
improvements needed.  
On the principles level, nine principles are in place and functioning well with no or only minor improvements 
needed, while eight principles are present and functioning, but with some improvements needed.  
Overall, 37 characteristics were rated as ‘the characteristic is in place and functioning well, with no or only 
minor improvements needed’, 12 characteristics were rated as ‘the characteristic’s control system is present 
and functioning, but some improvements are needed’, 1 characteristic was rated as ‘the characteristic is 
partially present and functioning, major improvements are needed’ and none were rated as ‘the 
characteristic is not present and functioning’.  

The major improvement needed and the proposed deadline is as follows: 

• 

• 

Characteristic 14.1, internal communication: internal communication is performed on several subjects and 
through various channels, however, an internal communications policy is to be developed based on the 
overall ECDC communication policy 2021-2027, including communication on the objectives and 
responsibilities of internal control.  
Deadline: Q4 2022. 

Implementation and monitoring of the agency’s policies for 
the prevention and management of conflict of interest 

It is important that ECDC’s products and communications are scientifically correct and impartial. As ECDC relies on 
many internal and external experts who together shape the Centre’s scientific position, ECDC introduced an 
independence policy in 2016 that ensures transparency and identifies risk of conflicts of interest. The policy has 
since been split into two documents, with one document covering non-staff, including Management Board and 
Advisory Forum (AF), and the other covering ECDC staff, including the ECDC Director and the Heads of Unit. A 
compliance officer oversees the implementation of this policy. An electronic system for the submission of 
declarations of interest minimises the amount of errors in the submitted documents. This facilitates the 
implementation of the independence policy and increases the compliance rate. 

ECDC continued to apply and strengthen its independence policy for non-staff and for staff members. In 2021, the 
Centre lacked only a very small percentage of declarations: 2% of the appointed Management Board 
members/alternates did not file their Annual Declaration of Interest (ADoI), 5% of the appointed AF 
members/alternates failed to submit and all external experts consulted for Rapid Risk Assessment (RRA) declared 
their interests before publication of the RRA. It should be noted that all members of the Management Board and 
Advisory Forum attending the meetings and thus contributing to the discussions had valid ADoIs. The Director and 
Heads of Unit filled their ADoI and 97% of external experts participating in ECDC meetings that required a conflict-
of-interest check submitted an ADoI. 

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Figure 22. Percentage of declarations of interest received, by group 

Conclusions of assessment of internal control systems 

Given the fact that the control system in place, the information obtained from the building blocks of assurance 
mentioned below and the lack of critical findings from the Court of Auditors and the Internal Audit Service at the 
time of the declaration, there is no reason to question the effectiveness of the internal control system. However, 
some improvements are needed regarding the implementation of the internal control framework (as explained in 
paragraph 1.2 Internal Control Framework above). 

The overall conclusion is that internal control system is present and functioning, but that some improvements are 
needed. 

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Statement of the manager in charge of risk management 
and internal control 

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Part 4. Management assurance 

Review of the elements supporting assurance 

The main building blocks of the Director’s Declaration of Assurance are:  

• 
• 
• 
• 
• 
• 
• 
• 
• 
• 
• 
• 
• 
• 
• 

The Director’s own knowledge of the management and control system in place; 
The declarations of assurance made by each Authorising Officer by Delegation to the Director; 
The results of the self-assessment of internal control; 
The results of the self-assessment of the implementation of the Internal Control Framework; 
The results of the specific assessment performed; 
The results of the risk self-assessment exercises; 
The analysis and list of recorded exceptions; 
The status on the internal control and quality weaknesses reported; 
The results of the grant verifications known at the time of the declaration; 
The summary of OLAF activities; 
The summary of the implementation of the ECDC Independence Policy; 
The report from the Data Protection Officer 2021; 
The observations of the European Ombudsman known at the time of the declaration; 
The observations of the Internal Audit Service known at the time of the declaration; 
The observations of the European Court of Auditors known at the time of the declaration. 

There were no significant weaknesses reported from these building blocks of assurance that are of such a significance that they 
would have an impact on the Director’s Declaration of Assurance. 

Reservations 

Materiality criteria used regarding reservations 

The concept of materiality provides the authorising officer with a basis for determining if an identified weakness should be 
subject to a formal reservation to the declaration of assurance or not.  

When defining whether an identified weakness is material, ECDC assesses both qualitative and quantitative aspects: 

Qualitative criteria  

Weaknesses leading to critical operational damage 
A detected weakness in the design or operation of ECDC’s internal controls (affecting the Director’s Declaration of Assurance) 
that would lead to critical operational damage.  

The severity of the operational damage is assessed mainly through the size and sensitivity of the issue and area concerned and 
the potential damage on ECDC and its operations. 

Weaknesses leading to critical reputational damage 
A detected weakness in the design or operation of ECDC’s internal controls (affecting the Director’s Declaration of Assurance) 
that would lead to critical reputational damage.  

The severity of the reputational damage is assessed mainly through the size and sensitivity of the issue and area concerned and 
the potential damage on ECDC’s reputation, including the level of public interest.  

Critical observations by auditors or OLAF  
A critical observation made by the European Court of Auditors, the Internal Audit Service or OLAF could lead to a reservation. 

ECDC especially considers if the observation is made in an area covered by the Director's Declaration of Assurance, if the issue 
was not solved immediately during the reporting period, and if the impact is potentially material. 

Quantitative criteria 
A quantifiable weakness in the control system is defined as material when ex-ante or ex-post controls detect errors regarding the 
legality and regularity of the underlying transactions of 2% or more (financial impact).  

Thereby, if the most likely error affecting the underlying transactions for the internal control system/area in question is 2% or 
more, a reservation should be made.  

However, only if the internal control system/area affected by the potential reservation represents 2% or more of the total 
payments made by ECDC for the year in question (for 2021 set at a minimum of €1.6 million), otherwise no financial reservation 
is made (without prejudice to a reservation for qualitative reasons). 

The rate of 2% is based on the materiality rate applied by the European Court of Auditors.  
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Reservations for 2021 

None. 

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Part 5. Declaration of assurance 

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Annex 1. Core business statistics 2021 

In 2021, ECDC delivered 74% of the outputs planned in its Single Programming Document 2021–2023. Nine per cent of the 
planned outputs were postponed to 2022, while 16% were delayed or had not yet started at year-end 2021. 

The following table provides the detail on the implementation of the 2021 work programme by SPD objective and related 
outputs. 

No.  Action Area 

SPD Objective 

Expected outputs 2021  Status 

Comments 

Strategic objective 1. Strengthen and apply scientific excellence in all ECDC’s activities and outputs to inform public health policy and practice 

1 

1.1 Standards  1.1.1. Operationalise 

the results of the 
EPHESUS project 
and the lessons 
learnt from the 
COVID-19 pandemic 

2 

1.1 Standards  1.1.2. Identify and 

define existing 
methods that should 
be used to establish 
standards for 
scientific processes 
and outputs to 
identify, assess, 
prevent and control 
infectious disease 
threats to public 
health 

3 

1.1 Standards  1.1.3. Ensure and 

demonstrate scientific 
independence in all 
ECDC activities in 
consultation with 
relevant stakeholders 
(on standards for 
safeguarding and 
demonstrating 
scientific 
independence)" 
1.2.1. Ensure timely 
and effective 
monitoring of 
potential threats from 
infectious diseases  

1.2.1. Ensure timely 
and effective 
monitoring of 
potential threats from 
infectious diseases  
1.2.2. Carry out 
routine indicator-
based surveillance, 
including generation 
of high quality, 
relevant, and timely 
outputs 

4 

1.2 Evidence 

5 

1.2 Evidence 

6 

1.2 Evidence 

Proposal for EU 
surveillance standards 

Postponed 
to 2022 

Focus on standards for surveillance of pandemic-prone respiratory 
viruses 

List of defined methods for 
establishing standards to 
be adopted in relevant 
ECDC policies and 
procedures 

Delayed 

In the context of the new mandate, ECDC initiated the work on 
revising its scientific advice processes and outputs 

Draft position paper for 
Advisory Forum 

Implemented  The draft ECDC Policy on Scientific Integrity and Independence was 
discussed and endorsed by the Advisory Forum and will be submitted 
to the Management Board (March 2022) for approval  

Implemented  Daily Round Table report and weekly Communicable Diseases Threat 

Report delivered according to schedule. 

Implemented  Transfer from all EPIS modules to EpiPulse took place in July 2021 

and has been functioning well since then. 

Implemented   

Daily Round Table report 
and weekly CDTR 
available on EpiPulse. 

Stakeholders access real 
time information on current 
signals, events and threats 
via EpiPulse and the 
ETMS. 
Data on reportable 
diseases collected in a 
consistent way, according 
to implementing decision 
2018/945 

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No.  Action Area 

SPD Objective 

Expected outputs 2021  Status 

Comments 

7 

1.2 Evidence 

1.2.2. Carry out 
routine indicator-
based surveillance, 
including generation 
of high quality, 
relevant, and timely 
outputs 

AER published for all 
diseases under 
surveillance 

Delayed 

ARHAI: AER published for antimicrobial consumption (2020 data). 
AER for AMR (2020 data) to be published Q1 2022. AER chapters for 
HAIs postponed to 2022 due to reallocation of resources to COVID-19 
work. 
SBT: AER published for Hepatitis B and C and TB (2019 data), AER 
for HIV infection and AIDS, Chlamydia, Gonorrhoea, 
Lymphogranuloma venereum, Syphilis (2019 data) delayed. AER 
2020 data delayed.  
CAI Zoonotic and seasonal influenza reports published in 2021 
EVD: postponed to 2022 due to reallocation of resources to COVID-19 
work 
FWD: delayed, postponed due to reallocation of resources to COVID-
19 work 
LEG: AER 2020 for 2019 data published 24 May 2021, AER 2021 on 
2020 data prepared for publication. 
VPI: postponed to 2022 due to reallocation of resources to COVID-19 
work 

Atlas of infectious 
diseases updated with 
newest data 

Stand-alone surveillance 
reports (including 
HIV/AIDS report, TB 
surveillance and 
monitoring report, Euro 
GASP report, weekly 
FluNewsEurope bulletin 
(incorporating COVID-19), 
regular influenza and 
coronavirus 
characterisation reports, 
Monthly Measles and 
Rubella monitoring report, 
monthly ELDSNet report, 
Zoonoses and zoonotic 
AMR monitoring reports, 
AMR, antimicrobial 
consumption, HAIs  

Implemented  ARHAI: 2020 data available for AMR. Antimicrobial consumption data 

(2020) available in stand-alone database. 
SBT: 2020 data available for Chlamydia, Gonorrhoea, Hepatitis B and 
C, Lymphogranuloma venereum, Syphilis, Tuberculosis  
VPI: 2021 data to be published in the Atlas in March 2022 
CAI: 2021 data available for Influenza and RSV  
EVD: 2020 data published in the Atlas 25 October 2021. 
FWD: 2020 data published in the Atlas 5 October 2021 
LEG: 2020 data published 5 July 2021 

Implemented  ARHAI and FWD: 3rd report on Joint Interagency Antimicrobial 

Consumption and Resistance Analysis (JIACRA III, jointly with EFSA 
and EMA) covering 2016-2018 data, published June 2021  
ARHAI: 1st ECDC- WHO Regional Office for Europe joint report on 
AMR surveillance (2020 data) published on 26 January 2022. HAI: 
report on surveillance of COVID-19 in long-term care facilities 
published on 29 November 2021. All other HAI surveillance. Other HAI 
reports postponed to 2022 due to COVID-19. CaI: FluNewsEurope on 
schedule. COVID-19 weekly surveillance reports published and 
COVID-19 dashboard updated daily. Quarterly Avian Influenza 
overview published. European Mortality Monitoring website available 
and updated weekly  
EFVED: The European Union One Health 2019 and 2020 Zoonoses 
Report published 9 Dec 2021 
FWD AMR: on schedule 
LEG: monthly reports for TALD data published for 10 of 12 months.  
SBT HIV/ AIDS report published. TB report published. EUROGASP 
reports with 2019 and 2020 data published. 
VPI: Monthly Measles and Rubella monitoring report on schedule 

EU protocol for the use of 
WGS and exposure data in 
surveillance of listeriosis in 
EU/EEA 

Implemented   

Seasonal, real-time 
surveillance of vector-
borne diseases to support 
blood safety measures 

Implemented  EVD: Seasonal surveillance on West Nile virus infection and reporting 

(human and animal cases) was implemented between June and 
November 2021. 

8 

1.2 Evidence 

9 

1.2 Evidence 

1.2.2. Carry out 
routine indicator-
based surveillance, 
including generation 
of high quality, 
relevant, and timely 
outputs 

1.2.3. Coordinate EU 
level surveillance of 
all EU notifiable 
diseases and special 
health issues (incl. 
coordinated lab 
support) 

10  1.2 Evidence 

11  1.2 Evidence 

1.2.3. Coordinate EU 
level surveillance of 
all EU notifiable 
diseases and special 
health issues (incl. 
coordinated lab 
support) 
1.2.3. Coordinate EU 
level surveillance of 
all EU notifiable 
diseases and special 
health issues (incl. 
coordinated lab 
support) 

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Expected outputs 2021  Status 

Comments 

12  1.2 Evidence 

1.2.4. Provide 
evidence to support 
Member States to 
increase public health 
microbiology capacity 

EQA reports (Euro GASP, 
Legionella EQA-report, 
EVD-LabNet activities, 
AMR for European 
Antimicrobial Resistance 
Surveillance Network 
(EARS-Net) participating 
laboratories, and in the 
area of vaccine-
preventable diseases with 
specific focus on 
diphtheria, pertussis, 
invasive bacterial 
diseases, as well as 
schemes of Salmonella, 
Campylobacter, Listeria 
monocytogenes, and 
STEC) 

On schedule  Direct support to WGS capacity building provided through ECDC 

grants with 24 Member States (value 77.1 million Euros): Implemented 
Direct support to SARS-CoV2 sequencing provided to 13 countries 
with limited capacity: On schedule 
CaI: Influenza and COVID-19 EQAs On schedule 
ARHAI: no report in 2021 (AMR EQA for EARS-Net 2020 was 
cancelled due to COVID-19).  
EFVED: on schedule 
EVD: EVD-LabNet EQAs on rodent-borne infections and on emerging 
alphaviruses are delayed due to hight workload on network 
laboratories in SARS CoV-2 diagnosis. Contract amendment in 
progress. Delivery expected in 2022. 
LEG: Annual report for the EQA Legionella scheme 2020/2021 
prepared for publication. 
SBT: EUROGASP EQA reports 2019 and 2020 results published. 
VPI: EQA on Pertussis performed, results to be published in February 
2022. 
In consultation with Member States it was decided that the EULabCap 
tool is to be updated and that next survey will be run in 2022.  

EU Laboratory Capability 
Monitoring System 
(EULabCap) reports 

Not started 

13  1.2 Evidence 

14  1.2 Evidence 

1.2.4. Provide 
evidence to support 
Member States to 
increase public health 
microbiology capacity 
1.2.4. Provide 
evidence to support 
Member States to 
increase public health 
microbiology capacity 

Public Health microbiology 
training sessions (EVD-
LabNet activities, ERLI-Net 
activities) 

Implemented  CaI: ERLI-net webinars conducted as planned during 2021 (Annual 

Influenza and COVID19 meeting in October 2021, start of season 
webinar with the surveillance network in October 2021). 
Wetlab training for influenza postponed to Q2 2022 due to the 
pandemic and travel constraints in 2021.  
Finalisation of an online training on assay validation to be published in 
EVA in 2022. Course delivered in 2021 
EFVED: on schedule 
EVD: EVD-LabNet Webinar conducted as scheduled and online 
training on emerging alphaviruses is planned on 28-30 March 2022 
(on schedule) 
VectorNet Webinar Vector Control Practices and Strategies 15 Oct 
2021 
Microbiology: Training sessions as part of COVID-19 response have 
been executed 

15  1.2 Evidence 

1.2.4. Provide 
evidence to support 
Member States to 
increase public health 
microbiology capacity 

Other outputs (e.g. 
Technical Reports and 
Handbooks)  

16  1.2 Evidence 

1.2.5. Produce 
consistently high-
quality scientific work 
and advice within 
agreed deadlines to 
support evidence-
informed decision 
and policy making 

High-quality ECDC 
scientific advice outputs 
published on the Centre’s 
website and/or as open 
access publication if 
published in peer-review 
scientific journals 

On schedule  CaI: on schedule 

EVD: EVD-LabNet Technical report on the use of urine as a matrix for 
diagnostic is delayed due to hight workload on contractor in SARS 
CoV-2 diagnosis. Delivery expected in 2022. VectorNet - Technical 
report Organisation of vector surveillance and control in Europe (13 
December 2021) 

On schedule  ARHAI: Multiple scientific outputs including peer-reviewed manuscripts 

published 
CaI: Multiple scientific outputs including peer-reviewed manuscripts 
published  
EFVED: Multiple scientific outputs including peer-reviewed 
manuscripts published 
VPI: mostly COVID-19 related outputs 
SBT: delayed, postponed due to reallocation of resources to COVID-
19 work  

17  1.2 Evidence 

1.2.6. Ensure that all 
Public Health related 
ECDC actions, are 
reviewed through the 
IRIS instrument for 
consultation on 
priority setting 

IRIS proposals and the 
Advisory Forum 
assessments 

Postponed 
2022 

Agreed that this will not be done in 2021, due to focus of AF business 
on COVID-19 

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No.  Action Area 

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Expected outputs 2021  Status 

Comments 

Not started 

Postponed 
2022 

Extension of repository beyond current ARHAI repository postponed to 
2022 

On schedule  EFVED: on schedule 

Microbiology: AMR, FWD and COVID-19 sequencing ongoing. 
SBT: delayed, postponed due to reallocation of resources to COVID-
19 work 
SARS-CoV-2: On Schedule 

Implemented  New improved version of SARMS launched  

On schedule  Update and further improvement of current templates and guidelines is 

ongoing 

Implemented   

On schedule  Guidance was developed. Publication in 2022 

Minutes of first 
consultation meeting, 
including listing of scientific 
advice and knowledge 
output priorities for 
national Competent Bodies 

1.2.7. Establish 
formalised 
mechanism for 
engagement with 
national Competent 
Bodies in establishing 
priorities for scientific 
advice and 
knowledge outputs  
1.2.8. Establish a 
repository for 
collation of quality-
assured guidance 
developed by national 
authorities and 
professional bodies in 
EU Member States  
1.2.9. WGS services  National isolates 

Repository available and 
the procedures (including 
quality standards) for 
inclusion of documents 
agreed with Advisory 
Forum 

sequenced by ECDC in 
the context of multinational 
outbreaks. 

The Scientific Advice 
Repository and 
Management System 
(SARMS) is the sole 
support platform for the 
production and clearance 
of all scientific outputs of 
the Centre 

SARMS contains 
templates and guidelines 
for the production of 
scientific outputs and 
supports the production 
and clearance process 
with e-workflows.  

SARMS provides a 
comprehensive overview 
of the Centre’s scientific 
outputs, supports peer-
review and quality 
assurance, ensures 
compliance with ECDC 
policies, standards and 
processes/procedures and 
monitors responsiveness 
to external requests to the 
Centre. 

Guidance document on 
statistical methods for 
trend analysis 

1.3.1. Develop and 
assess standards and 
processes that 
support the 
transparent, 
consistent and 
efficient production 
and clearance of 
scientific work and 
advice. 
1.3.1. Develop and 
assess standards and 
processes that 
support the 
transparent, 
consistent and 
efficient production 
and clearance of 
scientific work and 
advice. 
1.3.1. Develop and 
assess standards and 
processes that 
support the 
transparent, 
consistent and 
efficient production 
and clearance of 
scientific work and 
advice. 

1.3.2. Develop 
guidance on options 
and application of 
enhanced statistical 
methods for trend 
analysis of 
surveillance data  
1.3.3. Further 
develop and deliver 
advice and support 
on evidence-based 
public health methods 

18  1.2 Evidence 

19  1.2 Evidence 

20  1.2 Evidence 

21  1.3 

Methodologies 

22  1.3 

Methodologies 

23  1.3 

Methodologies 

24  1.3 

Methodologies 

25  1.3 

Methodologies 

78 

Training course in 
evidence-based public 
health methods 

Delayed 

The last face-to-face training workshop took place in January 2020 
Adaptations ongoing for virtual live workshop and/or transition to self-
paced e-learning modules 

 
ECDC CORPORATE 

Consolidated Annual Activity Report 

No.  Action Area 

SPD Objective 

Expected outputs 2021  Status 

Comments 

26  1.4 Knowledge 
transfer 

27  1.4 Knowledge 
transfer 

28  1.4 Knowledge 
transfer 

29  1.4 Knowledge 
transfer 

30  1.4 Knowledge 
transfer 

31  1.4 Knowledge 
transfer 

32  1.4 Knowledge 
transfer 

1.4.1. Pilot 
knowledge 
management 
approaches for 
strengthening the 
community of practice 
within and outside 
ECDC  
1.4.1. Pilot 
knowledge 
management 
approaches for 
strengthening the 
community of practice 
within and outside 
ECDC  
1.4.2. Organise the 
annual European 
Scientific Conference 
on Applied Infectious 
Disease 
Epidemiology 
(ESCAIDE), in 
cooperation with 
Member States, the 
European 
Commission 
(including SANTE, 
CHAFEA, JRC) and 
other EU agencies, 
and include a 
""knowledge for policy 
and practice"" track at 
the conference 
1.4.2. Organise the 
annual European 
Scientific Conference 
on Applied Infectious 
Disease 
Epidemiology 
(ESCAIDE), in 
cooperation with 
Member States, the 
European 
Commission 
(including SANTE, 
CHAFEA, JRC) and 
other EU agencies, 
and include a 
""knowledge for policy 
and practice"" track at 
the conference 
1.4.3. Ensure 
production and wide 
dissemination of 
Eurosurveillance as a 
high quality journal 
with good visibility 
1.4.3. Ensure 
production and wide 
dissemination of 
Eurosurveillance as a 
high quality journal 
with good visibility 
1.4.3. Ensure 
production and wide 
dissemination of 
Eurosurveillance as a 
high quality journal 
with good visibility 

Inventory of existing 
practices 

On schedule  Knowledge management practices reviewed as part of the work of the 

IKM Steering Committee in developing the knowledge management 
framework for the Centre 

Pilot initiated 

On schedule  Public Health Emergency output toolkit, including guidance and 

templates to further improve the ECDC PHE outputs and in particular 
the summary/green box that is included in all Rapid Risk Assessments 
and other key scientific outputs 

ESCAIDE track on 
knowledge for policy and 
practice 

Implemented  ESCAIDE conference took place November 16-19 

2021 edition of ESCAIDE 
to be hosted in Warsaw, 
Poland 

Implemented  ESCAIDE conference took place November 16-19 as an online event 

due to the COVID-19 pandemic. 

Scientific seminar with 
focus on 25th anniversary 

Implemented  Seminar took place on 19 November 2021: 

https://www.eurosurveillance.org/seminar#2021 
https://www.youtube.com/watch?v=hql7nLxxOkg  

Board meeting with action 
points for 2022 

Implemented  Board meeting including three preparatory meetings held on 22, 20,15 
and 13 October; final minutes sent on 29 October 2021.  

50 issues of 
Eurosurveillance 

Implemented  Weekly issues since week 1 2021 with a mix of rapid communications 

and regular articles; regular social media posts 

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No.  Action Area 

SPD Objective 

Expected outputs 2021  Status 

Comments 

33  1.4 Knowledge 
transfer 

34  1.4 Knowledge 
transfer 

35  1.4 Knowledge 
transfer 

36  1.4 Knowledge 
transfer 

1.4.4. Promote 
transparency and 
reproducibility in 
generating scientific 
information among 
Eurosurveillance 
contributors/audience 
through respective 
editorial policies 
1.4.4. Promote 
transparency and 
reproducibility in 
generating scientific 
information among 
Eurosurveillance 
contributors/audience 
through respective 
editorial policies 
1.4.5. Develop 
communication 
formats and tools for 
effective delivery of 
information and 
evidence to specific 
audiences 
1.4.6. Strengthen the 
dissemination and 
communication of 
ECDC key scientific 
outputs to ensure 
they reach their target 
audience, and are 
accessible at no cost 
for the user 

Up-to-date editorial 
policies, further increased 
completeness of articles 

Implemented  Revision of instructions for authors, policy on how articles from board 

members are handled and published, more authors submitting 
checklists also voluntarily, new policy on publishing ADoI from board 
members and on preprints. 

Implemented  Contribution as facilitator in EPIET/EUPHEM PRM, presentations for 
MedIPIET end August and September, respectively. Presentation at 
seminar at Santé publique France in November. 

Workshop on the margins 
of ECDC-organised events 
(ESCAIDE, ECDC summer 
school, traineeship project 
review module) or at 
national Public health 
institutes 

Proposal for one tailored 
communication model 
piloted with a selected 
audience 

On schedule  Public Health Emergency output toolkit, including guidance and 

templates to further improve the ECDC PHE outputs and in particular 
the summary/green box that is included in all Rapid Risk Assessments 
and other key scientific outputs 

All ECDC scientific outputs 
published on the website 

On schedule  CaI: on schedule 
SBT: on schedule 
VPI: on schedule 
ARHAI: on schedule 

Strategic objective 2. Support the countries to strengthen their capacities and capabilities to make evidence-based decisions on public health 
policies and practices 

37  2.1 Country 
focus 

2.1.1. Networks 
Interactions 

Diseases Network 
meetings and Public 
Health functions Network 
meetings  

38  2.1 Country 
focus 

2.1.1. Networks 
Interactions 

Disease Network and 
Public Health Functions 
Network Coordination 
Committees meetings  

80 

Implemented  ARHAI: joint information meeting for the ARHAI networks, 21-22 April 

2021. No network meetings were planned for 2021. 
CaI: Network meeting held: 7th Joint WHO EURO and ECDC 
European Influenza and COVID-19 Surveillance Meeting (virtual).  
EVD: EVD Network Annual meeting (virtual) 19-20 May 2021 
FWD: European Food- and Waterborne Diseases and zoonoses 
network AMR: implemented on 19-20 April 
LEG: ELDSNet network business meeting 9 June  
ELDSNet 2021 annual meeting 18-19 October 
NFP meeting Microbiology organised in March and April 2021. 
Surveillance NFP meeting held in October 2021. 
NFP Training/TSF meeting held quarterly since 26 March 2021. 
Fellowship Training Site Forum (TSF) meetings, monthly since 30 
April. 
VPI: No network meeting IMD this year 
SBT: TB and Hepatitis network meeting held virtual. STI and HIV 
network meeting postponed till 2022. 

Implemented  ARHAI: achieved (DNCC meetings for EARS-Net, ESAC-Net and the 
Healthcare-Associated Infections Surveillance Network took place as 
planned);  
CaI: DNCC nominations completed in June 2021 
EVD DNCC Meeting implemented on 21st May and 21st October 
FWD DNCC meeting scheduled for 23 November 
LEG: ELDSNet DNCC meeting 14 June and Annual Meeting October  
VPI: Regular NITAG network webinars on COVID-19 
vaccine/vaccination issues 
SBT: Achieved (All DNCC meetings took place as planned).  
NFPT Coordination Committee and TSF Chairs met on 23 April. 

 
ECDC CORPORATE 

Consolidated Annual Activity Report 

No.  Action Area 

SPD Objective 

Expected outputs 2021  Status 

Comments 

39  2.1 Country 
focus 

2.1.1. Networks 
Interactions 

Other meetings (inter-
sectoral meeting(s) with 
key stakeholders) 

Implemented  CaI: weekly meetings with COVID-19 Network and subnetworks held. 
Weekly meetings with WHO-European Regional Office on COVID-19 
and Influenza  
FWD: ECDC-EFSA joint meeting postponed to 2022 due to 
moratorium on face-to-face meetings. 
SBT: Different meetings/webinars with TB, hepatitis and HIV disease 
networks and the WHO Regional Office for Europe held. 
EVD: 
FAO-IAEA ZODIAC Senior/Expert Animal Health Consultant Meeting 
(virtual) to discuss and formulate the ZODIAC Coordinated Research 
Projects, 22, 24, 26 February 2021 
Workshops of the European Reference Laboratories for EVA and 
arthropod-borne encephalitis viruses (WNV, JEV, EEEV, WEEV and 
VEEV), 15-16 April 2021. 
EFSA-IZSAM Crisis Preparedness Exercise - Rift Valley fever, 06-08 
July, 2021 
Society of Vector Ecology (SOVE): Webinar Series I – Topic Vector-
borne Disease Preparedness and Response, 23 July 2021 
FAO-IAEA Consultancy Meeting on Development of Tools for the 
Mining, Monitoring and Tracing of Zoonotic Pathogens in Europe and 
Central Asia, 03 September 2021. 
COHESIVE One Health EJP – End symposium, 08-10 November 
2021 
EFSA’s annual internal crisis preparedness training, 11. November 
2021 
ERINHA - High Consequence Infectious Diseases in Central Eastern 
Europe: Gaps & Cooperation Opportunities, 25 November 2021 

40  2.1 Country 
focus 

2.1.2. Country 
Support 

IT requirements defined 
and finalized. Visualization 
tool selected. Content 
under development.  

On schedule 

Not started 

First release gradually to be done in 2022, for internal ECDC use 

On schedule 

Possible alternatives to incorporate unstructured data in the country 
overviews were identified 
Internal procedure in place but tool not fully functional 

On schedule 

Delayed 

Delayed 

The HAI outbreak investigation course was postponed due to COVID-
19. 

Procurement done. Work on training needs, existing courses, existing 
projects done.  

Country visits, with a focus 
on after-/in-action reviews 
in relationship with Covid-
19 response, conducted 

Unstructured data 
compilation and 
visualization, including 
from network meetings 
and country mission 
reports  

Internal procedure for 
country missions adopted. 
Tool set up and functional 
so ECDC and host country 
can work at the same time 
on related document and 
access the country mission 
reports. 

Healthcare-associated 
infections (HAI) outbreak 
investigation course 
delivered 

Training course for 
frontline healthcare 
professionals 

41  2.2 Prevention 
and control 
programmes 

2.2.1. Develop 
scientific advice on 
communicable 
disease prevention 
and control measures 

Expert Opinions 

On schedule  CaI: ESCMID clinical management guidelines for Influenza delayed 

due to COVID-19 pandemic 

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No.  Action Area 

SPD Objective 

Expected outputs 2021  Status 

Comments 

42  2.2 Prevention 
and control 
programmes 

2.2.1. Develop 
scientific advice on 
communicable 
disease prevention 
and control measures 

43  2.2 Prevention 
and control 
programmes 

2.2.1. Develop 
scientific advice on 
communicable 
disease prevention 
and control measures 

Public Health Guidance 
(Public health guidance on 
prevention of infections in 
PWID (jointly with 
European Monitoring 
Centre for Drugs and Drug 
Addiction) 
Technical reports (e.g., on 
a core EU vaccination 
schedule; piloted case 
studies on vaccination 
coverage) 

Delayed 

SBT: PWID joint guidance with EMCCDDA delayed, due to reduced 
staff and delays with Contractor. Publication of the guidance 
postponed till 2022. 

Implemented  VPI: Interim technical guidance on the benefits of full vaccination 

against COVID-19 for transmission and implications for non-
pharmaceutical interventions 
VPI: Six technical reports on COVID-19 vaccine deployment plans 
VPI: COVID-19 vaccine tracker dashboard and weekly rollout 
overview reports 
VPI: Interim public health considerations for the provisions of 
additional COVID-19 vaccine doses 
VPI: Partial COVID-19 vaccination, vaccination following SARS-CoV-2 
infection and heterologous vaccination schedule: summary of 
evidence 

SBT: Publication of technical guidance on HIV pre-exposure 
prophylaxis (PreP) in EU/EEA and the UK: implementation, standards 
and monitoring 

Technical report on countering online vaccine misinformation in the 
EU/EEA 
Technical report on facilitating COVID-19 vaccination acceptance and 
uptake in the EU/EEA 
Technical report on Behavioural Insights research to support the 
response to COVID-19 in the EU/EEA. 

44  2.2 Prevention 
and control 
programmes 

2.2.1. Develop 
scientific advice on 
communicable 
disease prevention 
and control measures 

Systematic reviews 

On schedule  CaI: three SRs on schedule 

EFVED: on schedule 
EVD: “Systematic review on tick-borne encephalitis virus transmission” 
– manuscript submitted for clearance in December 2021. 
VPI: ongoing LIVE SR on efficacy, effectiveness, safety of COVID-19 
vaccines in the context of NITAG collaboration 

SBT: one SR on schedule 

45  2.2 Prevention 
and control 
programmes 

2.2.1. Develop 
scientific advice on 
communicable 
disease prevention 
and control measures 

46  2.2 Prevention 
and control 
programmes 

2.2.1. Develop 
scientific advice on 
communicable 
disease prevention 
and control measures 

Other scientific outputs 
(vaccine effectiveness and 
impact analyses on 
COVID-19 and seasonal 
influenza, vaccine 
coverage estimates for 
COVID-19 and influenza) 
Training materials (in the 
field of vaccine hesitancy, 
training curriculum 
targeting HCPs on 
communications with 
hesitant members of the 
public) 

On schedule  CaI: on schedule including Influenza VE 

VPI: on schedule with focus on COVID-19 vaccine tracker and related 
outputs 
VPI: initiation of procured COVID-19 vaccine effectiveness studies 
(VEBIS project) 

Delayed 

VPI: Ongoing study on vaccine misinformation and strategies to 
address these 
VPI: Launch of study to develop training curricula for HCPs as to 
increase vaccine acceptance 
An online training on vaccine misinformation is being prepared. 
Development of the content is ongoing with the contractor.  

47  2.2 Prevention 
and control 
programmes 

48  2.2 Prevention 
and control 
programmes 

2.2 Prevention 
and control 
programmes 

2.2.1. Develop 
scientific advice on 
communicable 
disease prevention 
and control measures 

2.2.1. Develop 
scientific advice on 
communicable 
disease prevention 
and control measures 
Strengthen whole 
genome sequencing 
and RT-PCR capacity 
in the EU/EEA 

Reporting on WGS 
framework for invasive 
meningococcal disease 

Postponed 
2022 

VPI: This is postponed to 2022 

Scoping Reviews 
(Literature review of 
available influenza antiviral 
treatment options) 

Postponed 
2022 

Postponed due to COVID-19 

National WGS and/or RT-
PCR infrastructure support 
projects initiated 

Implemented   

82 

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Consolidated Annual Activity Report 

No.  Action Area 

SPD Objective 

Expected outputs 2021  Status 

Comments 

2.2 Prevention 
and control 
programmes 

Strengthen whole 
genome sequencing 
and RT-PCR capacity 
in the EU/EEA 

Framework contract for 
WGS and RT-PCR cross-
border capacity-building 
activities signed 

Implemented   

On schedule  On 26 March, TSF/NFPT and WGs consultation to present and 

discuss the roadmap. 
Roadmap presented and discussed with AF in May and presented to 
Management Board in June. 
Administrative Decision updated and published including some 
improvements for Cohort 2022. 
Working groups for operationalising the roadmap initiated in quarterly 
TSF/NFPT meetings.  

Implemented 

The update of the applied epidemiology competencies project was 
completed. The final version and the accompanying tools will be 
available in Q1 2022. 

Catalogue with CPD training offer published on EVA and ECDC web 
site. 

COVID-19 WGS workshops on training needs assessment are being 
run 

Launched in EVA: 
• 
• 
• 
• 
After-action review e-learning published  

How to design a functional exercise e-learning  
How to design a table-top e-learning  
Epidemic intelligence published  
Antimicrobial stewardship e-learning published  

Implemented  Train-the-trainers module delivered as part of the Winter workshop 

ECDC will start 
implementing the roadmap 
for an improved 
programme, by launching 
the call for applications for 
Cohort 2022. The first 
changes will be 
incorporated in the 
Administrative Decision. 
Curricular updates will be 
reflected in the 
Administrative Decision for 
cohort 2024. 
Offer presented in annual 
catalogue and delivered 
including on RRAs, WGS 
Vaccine preventable 
diseases, preparedness, 
e-health… 

Two key training to trainers 
modules on Emergency 
Preparedness delivered 
with participation of at 
least ten Member States 

CPD offer is further 
developed, and reflects the 
new needs identified, 
targeting professionals in 
the CCB networks and 
supervisors of the ECDC 
Fellowship Programme 

Implemented  The summer school was specifically targeted to the supervisors of the 
Fellowship Programme, who could also join an e-learning course and 
the Winter workshop on After Action Reviews. 
The WG Training Needs Assessment has identified priorities for SPD 
2022 through contacts with DP/CCB networks, for discussion with 
PHT Steering Committee. 

49  2.3 Training 

2.3.1. Improvements 
of the Fellowship 
Programme, based 
on the results of the 
2019 external 
evaluation 

50  2.3 Training 

51  2.3 Training 

52  2.3 Training 

2.3.2 Offer a 
Continuous 
Professional 
Development (CPD) 
that responds to the 
needs identified by 
the ECDC networks, 
and provide tools and 
support for the 
transfer of knowledge 
at European, national 
and sub-national 
levels, with special 
attention to COVID-
19 related needs 

2.3.2 Offer a 
Continuous 
Professional 
Development (CPD) 
that responds to the 
needs identified by 
the ECDC networks, 
and provide tools and 
support for the 
transfer of knowledge 
at European, national 
and sub-national 
levels, with special 
attention to COVID-
19 related needs 
2.3.2 Offer a 
Continuous 
Professional 
Development (CPD) 
that responds to the 
needs identified by 
the ECDC networks, 
and provide tools and 
support for the 
transfer of knowledge 
at European, national 
and sub-national 
levels, with special 
attention to COVID-
19 related needs 

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No.  Action Area 

SPD Objective 

Expected outputs 2021  Status 

Comments 

2.3.3. Keep 
continuous quality 
improvement 
activities, 
accreditation and 
evaluation as an 
essential part of 
ECDC training 
programmes and 
activities. 

2.3.3. Keep 
continuous quality 
improvement 
activities, 
accreditation and 
evaluation as an 
essential part of 
ECDC training 
programmes and 
activities. 
2.3.4 Maintain the 
ECDC Virtual 
Academy (EVA) as a 
learning system that 
includes training 
materials, and the 
administration of all 
ECDC training offer 
(face-to-face, online 
and blended) for the 
different training 
programmes and 
activities 
2.3.5. Identify country 
capacity gaps and 
training needs 
through the triennial 
assessment surveys 
(CCBs and NFPT), to 
tailor trainings and 
reduce inequalities in 
capacity across 
Europe 
2.3.5. Identify country 
capacity gaps and 
training needs 
through the triennial 
assessment surveys 
(CCBs and NFPT), to 
tailor trainings and 
reduce inequalities in 
capacity across 
Europe 
2.4.1. Provide 
technical support in 
the three phases of 
the preparedness and 
response cycle: 
anticipation, 
response, recovery  
2.4.1. Provide 
technical support in 
the three phases of 
the preparedness and 
response cycle: 
anticipation, 
response, recovery  

53  2.3 Training 

54  2.3 Training 

55  2.3 Training 

56  2.3 Training 

57  2.3 Training 

58  2.4 Emergency 

preparedness 

59  2.4 Emergency 

preparedness 

84 

Courses in ECDC training 
programmes, accredited 

On schedule  The following e-learning courses applied for accreditation from APHEA 

• 
• 
• 

After-action review e-learning (accredited) 
Epidemic intelligence e-learning (accredited) 
How to design a functional exercise e-learning (application 
submitted, pending decision)  

How to design a table-top e-learning (application submitted, pending 
decision) 

Accreditation of the ECDC 
Virtual Academy itself, 
explored 

Postponed 
2022 

Interactive catalogue of all 
CPD activities for 2022 
available in EVA Q4 

Implemented  The Catalogue is published in two formats: through EVA available 

here https://eva.ecdc.europa.eu/totara/catalog/index.php 
 and a document available on ECDC Webpage 
https://www.ecdc.europa.eu/en/publications-data/continuous-
professional-development-training-activities-course-listings-2022 
There are currently 21 courses available in EVA, 8 of which were 
launched in 2021. 

Tools for ECDC annual 
network meetings 
available, and their use 
promoted 

Postponed 
2022 

Tools for EU/EEA CCBs will be developed under outsourced 
mechanism (procurement) in 2022 

On schedule  New survey to CCB launched in October (Q4) 

Survey conducted, 
following the 
recommendation from the 
internal audit service (IAS) 
of the European 
Commission 

Simulation exercises 

On schedule  Off the shelf exercise for Legionella outbreaks. Contract awarded and 

programme underway for delivery early 2022 
Stress-test on logistical aspects of COVID-19 vaccination deployment 
plans organised for the EU/EEA member states and for the Western 
Balkans.  

After action reviews 

On schedule  Contract on the protocol for AAR on decision making is completed. A 

new Framework contract for the guidance on AAR is under 
preparation. 

A contract on AAR on decision making in LTCFs in ongoing with three 
countries. 

A contract on AAR on decision making in Schools is in preparation. 

 
ECDC CORPORATE 

Consolidated Annual Activity Report 

No.  Action Area 

SPD Objective 

Expected outputs 2021  Status 

Comments 

60  2.4 Emergency 

preparedness 

61  2.4 Emergency 

preparedness 

62  2.4 Emergency 

preparedness 

63  2.4 Emergency 

preparedness 

64  2.4 Emergency 

preparedness 

2.4.1. Provide 
technical support in 
the three phases of 
the preparedness and 
response cycle: 
anticipation, 
response, recovery  

2.4.1. Provide 
technical support in 
the three phases of 
the preparedness and 
response cycle: 
anticipation, 
response, recovery  
2.4.1. Provide 
technical support in 
the three phases of 
the preparedness and 
response cycle: 
anticipation, 
response, recovery  
2.4.1. Provide 
technical support in 
the three phases of 
the preparedness and 
response cycle: 
anticipation, 
response, recovery  
2.4.1. Provide 
technical support in 
the three phases of 
the preparedness and 
response cycle: 
anticipation, 
response, recovery  

65  2.4 Emergency 

preparedness 

66  2.4 Emergency 

preparedness 

67  2.4 Emergency 

preparedness 

2.4.1. Provide 
technical support in 
the three phases of 
the preparedness and 
response cycle: 
anticipation, 
response, recovery  

2.4.1. Provide 
technical support in 
the three phases of 
the preparedness and 
response cycle: 
anticipation, 
response, recovery  
2.4.1. Provide 
technical support in 
the three phases of 
the preparedness and 
response cycle: 
anticipation, 
response, recovery  

Case studies Public Health 
Emergency Preparedness 
(PHEP) plans assessment 

On schedule  Three countries agreed to participate in the case studies – specific 

contract to be signed 

Literature reviews 

Implemented  All literature reviews are underway or completed 

Expert meetings on 
emerging topics 

Implemented  Monthly webinars with the national focal points for preparedness and 

response organized on a monthly basis in 2021 

Outbreak investigation 
protocols and tools ready 
and available 

Implemented  Contact tracing guidance updated in October 2021.  

In collaboration with VPI, protocols to assess vaccine effectiveness in 
closed and semi-closed settings were developed 

Field deployments upon 
requests from the Member 
States, the European 
Commission (Directorate 
General for European Civil 
Protection and 
Humanitarian Aid 
Operations, Directorate-
General for Health and 
Food Safety) and WHO 
Global Outbreak Alert and 
Response Network 
Collaboration agreement 
with Directorate General 
for European Civil 
Protection and 
Humanitarian Aid 
Operationsto provide 
expertise and facilitate 
field deployments in 
response to requests from 
the Member States and 
the European Commission 

EWRS properly functioning 
and further improved 
according to the needs of 
the Commission and 
Member States 

Implemented  One mission to participate in the Joint external evaluation for Ukraine 

in Nov-Dec 2021 was completed 

On schedule  Draft concept note on the future EU health task force deployment in 
collaboration with Directorate General for European Civil Protection 
and Humanitarian Aid Operations, developed on the basis of previous 
documents elaborated with Directorate General for European Civil 
Protection and Humanitarian Aid Operationsand considering new 
humanitarian assistance mechanisms of Directorate General for 
European Civil Protection and Humanitarian Aid Operations 

Implemented  Weekly coordination with SANTE C-3 to follow up and monitor EWRS. 

Evaluation of the EWRS during the pandemic 

Preparedness indicators  On schedule  Five countries participated in the project covering 4 areas: lab testing, 
surveillance, risk communication, health/hospital system coordination. 
Deliverables received from the contractors in Q4 and will be published 
in Q2 2022 

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No.  Action Area 

SPD Objective 

Expected outputs 2021  Status 

Comments 

68  2.4 Emergency 

preparedness 

2.4.2. Provide 
support for 
strengthening 
competencies in the 
area of preparedness 
and response 

Preparedness and 
response training modules 
in ECDC virtual academy 
(EVA) 

On schedule  Competency based training modules cancelled due to reprioritization 

of activities 
Training modules on preparedness updated in EVA: two e-learning 
modules were launched, one on Epidemic intelligence and one on 
After-Action reviews. A training needs analysis was performed and will 
serve as a basis for the development of future trainings.  

69  2.4 Emergency 

preparedness 

2.4.2. Provide 
support for 
strengthening 
competencies in the 
area of preparedness 
and response 

Use of ECDC tools – risk 
ranking, Health 
Emergency Preparedness 
Self-Assessment, SIMEX 
handbook in work with key 
stakeholders 

Implemented  Risk ranking and Health Emergency Preparedness Self-Assessment 
tools used in the HSI and Africa CDC projects. SIMEX performed and 
under planning 

SIMEX handbook completed with relevant EVA web-learning activity 
accredited by APHEA 

70  2.4 Emergency 

preparedness 

71  2.4 Emergency 

preparedness 

72  2.4 Emergency 

preparedness 

73  2.4 Emergency 

preparedness 

74  2.4 Emergency 

preparedness 

75  2.4 Emergency 

preparedness 

76  2.4 Emergency 

preparedness 

2.4.2. Provide 
support for 
strengthening 
competencies in the 
area of preparedness 
and response 

2.4.3. Produce and 
disseminate Rapid 
Risk Assessments, 
and response related 
duties 

2.4.3. Produce and 
disseminate Rapid 
Risk Assessments, 
and response related 
duties 
2.4.4. Managing 
requests for technical 
and scientific 
assistance to support 
EU response actions 
in the field 

2.4.5. Maintain and 
network for the 
Emergency Operation 
Centre and Public 
Health Emergency 
(PHE) tools 
2.4.5. Maintain and 
network for the 
Emergency Operation 
Centre and Public 
Health Emergency 
(PHE) tools 

2.4.5. Maintain and 
network for the 
Emergency Operation 
Centre and Public 
Health Emergency 
(PHE) tools 

Bio-risk awareness 
workshops 

Postponed 
to 2022  

Due to COVID-19 the bio-risk workshops planned within joint actions 
have been postponed 

RRAs and Joint ECDC-
EFSA public health risk 
assessments (rapid 
outbreak assessments), 
including joint notification 
summaries  
Response related rosters 
functional 

Reviewed set of processes 
for managing requests for 
technical and scientific 
assistance to support EU 
response actions in the 
field 

Emergency Operation 
Centre equipment 
upgraded 

Implemented   

RRA and Rapid Outbreak Assessment being regularly delivered. 
Training activities on RRA planned and delivered 

Implemented  Response rosters organized and delivered as planned 

On schedule  Draft concept note on the future EU Health Task Force in collaboration 

with Directorate-General for Health and Food Safety ongoing. 
Draft concept note on joint field deployment with Directorate General 
for European Civil Protection and Humanitarian Aid Operations. 

On schedule  Emergency Operation Centre fully operational and functional  

PHE plan and PHE tools updated and under review  
The equipment of the EOC regularly renewed and upgraded 

Organisation of an 
international Emergency 
Operation Centre meeting 

Not started  Envisaged for Q1 2023 

PHE training internal and 
external 

Implemented  A PHE internal training for newcomers was developed and is available 

Strategic objective 3. Future outlook: Prepare for the future through foresight and innovation assessments 

77  3.1 Foresight 

78  3.1 Foresight 

3.1.1. Prediction 
modelling for 
foresight programme 
initiated  

3.1.2. Expert 
consultation on 
simulation models 
developed by ECDC 

Data content for priority 
public health infectious 
diseases drivers 

Delayed 

Scenario modelling for COVID-19 conducted, with outputs presented 
to the Advisory Forum, the Health Security Committee, and published 
in a peer review journal paper 

Meeting report 

Delayed 

ECDC coordinated an European COVID-19 Forecast Hub as part of its 
COVID-related modelling activities 

86 

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Consolidated Annual Activity Report 

No.  Action Area 

SPD Objective 

Expected outputs 2021  Status 

Comments 

79  3.1 Foresight 

80  3.2 Engage 

81  3.2 Engage 

82  3.2 Engage 

83  3.2 Engage 

84  3.3 Support 

transformation 

85  3.3 Support 

transformation 

86  3.3 Support 

transformation 

3.1.3. Develop a 
mechanism for 
identifying evidence-
synthesis needs and 
knowledge gaps 
3.2.1. Develop a way 
for identifying and 
communicating 
research priorities 
relevant to the 
prevention and 
control of infectious 
disease  
3.2.2. Contribute to 
EU Joint Actions and 
EU Research projects 

3.2.3. Establish 
stronger links with EU 
research initiatives, 
through appropriate 
engagement with EU 
research 
commissioning 
bodies in priority-
setting and evaluation 
of research proposals  
3.2.4. Collaborate 
with other EU 
Agencies, through the 
EU Agency Network 
on Scientific Advice 
(EU-ANSA), to 
develop: 
- Identification and 
communication of 
need for research in 
areas of mutual 
interest,  
- Innovative 
approaches to 
address issues of 
mutual interest 
through scientific 
collaboration and 
sharing of expertise 
in research clusters" 
3.3.1. Explore the 
feasibility and added 
public health value of 
surveillance, based 
on electronic health 
records for few 
diseases in selected 
countries 
3.3.1. Explore the 
feasibility and added 
public health value of 
surveillance, based 
on electronic health 
records for few 
diseases in selected 
countries 
3.3.2 Modernise and 
integrate EU/EEA 
surveillance platforms 

Protocol established for 
the mechanism 

On schedule  Aligned with SPD Objective #: 1.2.7. Being addressed partially through 

input to the stakeholder survey planning.  

Protocol 

Delayed 

Meeting with Directorate-General for Health and Food Safety and DG 
RTD to discuss mechanisms for ECDC to provide input to research 
priority setting and/or planning, and for contributing to EU Joint Actions 
and Research projects, held on 11/03/2021. Protocol developed for 
collating knowledge gaps and research priorities in the field of 
infectious disease prevention and control as perceived by experts 
working in ECDC, in national public health institutes, and in other 
ECDC collaborating partner organisations.  

ECDC contributions to 
ongoing projects, including 
expert advice, data, and 
technical support (subject 
to resource availability and 
concordance with ECDC 
mandate) 
Report to ECDC Advisory 
Forum and Management 
Board on conclusions of 
consultation 

On schedule  Meeting with Directorate-General for Health and Food Safety and DG 

RTD to discuss mechanisms for ECDC to provide input to research 
priority setting and/or planning, and for contributing to EU Joint Actions 
and Research projects, held on 11/03/2021 
EFVED: on schedule 
CaI: on schedule 

On schedule  Meeting with Directorate-General for Health and Food Safety and DG 

RTD to discuss mechanisms for ECDC to provide input to research 
priority setting and/or planning, and for contributing to EU Joint Actions 
and Research projects, held on 11/03/2021. Regular participation of 
ECDC in DG RTD “research to policy action” meetings to facilitate the 
dialogue between the research community and the public health policy 
makers, and to ensure the timely translation of research into policy 
aims to bring together the different initiatives. 

Statement on shared 
priorities for research 

On schedule  ECDC to organise and chair EU-ANSA meeting in May 2021. ECDC 

led an initiative with its partners in EU-ANSA to develop a scientific 
seminar series to increase awareness of scientific activities between 
Agencies, to stimulate cross-Agency projects, and to offer a ‘shared 
service’ model for continuing professional development of scientific 
staff in all EU-ANSA affiliated agencies. ECDC co-organised the first 
seminar in partnership with the Joint Research Centre, on the topic of 
COVID-19 and mathematical disease modelling 

On schedule  Specific activities taking place in a subnetwork of the SARI 

surveillance project 

Initial assessment on 
obstacles and limitations 
for the use of electronic 
health information systems 
for infectious disease 
surveillance 

Initial Proof of Concept 
results delivered to ECDC 

On schedule  Done for SARI surveillance in seven countries 

Plans in place to provide financial and technical support to MS in 
2022-2025 

EpiPulse and new data 
warehouse up and running 

Delayed 

Delay caused by COVID-19 work and other factors. EpiPulse Events 
and Docs (except for TALD) and Molecular Typing live since July 
2021.  

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No.  Action Area 

SPD Objective 

Expected outputs 2021  Status 

Comments 

87  3.3 Support 

transformation 

3.3.2 Modernise and 
integrate EU/EEA 
surveillance platforms 

Smooth Atlas update and 
AER production 

On schedule 
(Atlas) 

AER deprioritised due to pandemic 

88  3.3 Support 

transformation 

3.3.2 Modernise and 
integrate EU/EEA 
surveillance platforms 

Long-term surveillance 
framework 2021-2027 

Delayed 
(AER) 
Delayed 

Management Board endorsement pending new ECDC mandate and 
cross-border health threat legislation 

89  3.3 Support 

transformation 

3.3.2 Modernise and 
integrate EU/EEA 
surveillance platforms 

Blueprint for the future of 
EU/EEA surveillance 

On schedule  Completed, with main developments agreed with MS during the JSM. 

To be implemented from 2022.  

90  3.3 Support 

transformation 

91  3.3 Support 

transformation 

92  3.3 Support 

transformation 

3.3.3. Assess the 
potential impact on 
public health key 
functions of recent 
advances in digital 
technology and 
microbiological 
diagnostics to guide 
the future technical 
direction of the 
Centre" 
3.3.3. Assess the 
potential impact on 
public health key 
functions of recent 
advances in digital 
technology and 
microbiological 
diagnostics to guide 
the future technical 
direction of the 
Centre" 
3.3.4. Implement the 
molecular 
surveillance strategic 
framework 

Roadmap for gradual 
integration of new 
technologies in routine 
practice 

On schedule  Assessment of the new technologies, including the consultation 

performed in 2021 and the final report will be taken into account when 
finalizing the Digital roadmap in 2022 

Mapping of technologies 
that have the potential to 
impact public health key 
functions 

Implemented  Scoping reviews and mapping exercises performed. Stakeholder and 

expert consultation meetings took place. 

Ongoing molecular typing 
surveillance for all 
diseases planned for 
implementation in 2021 

Delayed 

Major efforts into the development of COVID-19 molecular 
surveillance. Other diseases to be resumed according to plan from 
2022, depending on pandemic evolution.  

93  3.3 Support 

transformation 

3.3.5. Automate 
signal detection from 
social networks 

Tool for detecting and 
monitoring events from 
social networks 

Implemented  Further development of EpiTweetr ongoing. 

Expansion to monitoring of more data sources planned for 2022 

Strategic objective 4. Increase the health security in the EU through strengthened cooperation and coordination between ECDC and partners in 
non-EU countries 
94  4.1 

Delayed 

Technical cooperation 
activities initiated on the 
One-Health approach 
against AMR 

Initiation of WS2 of ECDC-IPA6 project on advancing One Health 
approach against AMR in Western Balkans delayed due pending 
allocation of expert FTEs in technical area; necessary experts have 
been assigned, so planning of procurement procedure resumed now 

4.1.1. Gradually 
integrate Western 
Balkans and Turkey 
into ECDC systems 
and networks via 
enhanced technical 
cooperation and 
support their 
preparations for 
participation in ECDC 
activities; their 
advancement on 
‘One-Health’ 
approach against 
AMR; and enhancing 
SARI surveillance in 
Western Balkans 

Neighbourhood 

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ECDC CORPORATE 

Consolidated Annual Activity Report 

No.  Action Area 

SPD Objective 

Expected outputs 2021  Status 

Comments 

ECDC pre-accession 
assistance activities to 
prepare Western Balkans 
and Turkey for their 
participation in ECDC 

On schedule  Enhancing SARI surveillance in Western Balkans have been added as 

of 2021; implementation initiated as planned 

ENLabCap surveys as well as regional meeting on adaptation of the 
tool to align with EULabCap revision is on halt 

On schedule  Work programme is being implemented according to the planned 

schedule (with some adaptations) 

- Development of work 
plan to deliver Epidemic 
intelligence, risk 
assessment, preparedness 
and response capacity 
building activities 

- Develop criteria for 
integration of ENP partner 
countries into ECDC 
systems and networks 

Delayed 

Integration framework – the task will be performed with the support of 
external remunerated experts. The selection of experts is delayed  

95  4.1 

Neighbourhood 

96  4.1 

Neighbourhood 

97  4.1 

Neighbourhood 

4.1.1. Gradually 
integrate Western 
Balkans and Turkey 
into ECDC systems 
and networks via 
enhanced technical 
cooperation and 
support their 
preparations for 
participation in ECDC 
activities; their 
advancement on 
‘One-Health’ 
approach against 
AMR; and enhancing 
SARI surveillance in 
Western Balkans 
4.1.2. Support the 
progressive 
integration of ENP 
partner countries into 
ECDC activities and 
enhance health 
security through 
improving public 
health systems 
capacities and 
capabilities, including 
training through the 
continuation of 
MediPIET to respond 
to health threats 
related to 
communicable 
diseases and 
enhancing regional 
cooperation 
4.1.2. Support the 
progressive 
integration of ENP 
partner countries into 
ECDC activities and 
enhance health 
security through 
improving public 
health systems 
capacities and 
capabilities, including 
training through the 
continuation of 
MediPIET to respond 
to health threats 
related to 
communicable 
diseases and 
enhancing regional 
cooperation 

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No.  Action Area 

SPD Objective 

Expected outputs 2021  Status 

Comments 

- Perform baseline 
measurement on 
vulnerabilities and needs 
of ENP countries 

Implemented  In June 2020, ENP partner countries were invited to participate in the 

capacities self-assessment process to respond to public health 
emergencies (aka measurement on vulnerabilities and needs). So far, 
9 ENP partner countries Georgia, Moldova, Armenia, Egypt, Libya, 
Palestine*, Azerbaijan, Lebanon, and Ukraine provided requested 
information. 
Draft reports have been prepared and now ECDC is holding bilateral 
consultations with the countries. 
 * This designation shall not be construed as recognition of a State of 
Palestine and is without prejudice to the individual positions of the 
Member States on this issue. 

Technical assessment 
reports and initiation of 
national post-assessment 
action plans 

On schedule  The progress of WB and Turkey, including implementation of existing 

action plans reported to Directorate-General for Health and Food 
Safety on the occasion of annual sub-committee meetings on time 
(this encounters Albania, Bosnia and Herzegovina, Kosovo, 
Montenegro, North Macedonia, and Turkey. The sub-committee 
meeting with Serbia postponed by the EC to 2022). No green light to 
assess Bosnia and Herzegovina. 

Annual meeting of steering 
committee 

Implemented  Since June 2021 ECDC is officially responsible for the management of 

MediPIET 

Fourth Cohort of 
MediPIET, selected and 
training started, with on the 
job projects and modules 
implemented 

Implemented  On 7 June, Kick off meeting with MediPIET NFP (under nomination by 

MOH, with support of respective EU Delegations) 
Cohort 4 to be selected in Q3 to start IC in Sept/Oct 2021 
Cohort 4 is selected with 16 onboard. The cohort started on time in 
September 

On schedule 

This project will be implemented in December 2021-June 2022 

On schedule 

On schedule  The proposal of this output will be part of the evaluation project that 

will be implemented in December 2021-June2022 

Cooperation with CDCs 
having formal bilateral 
arrangements with ECDC 
(MoU, administrative 
arrangements) evaluated 

Joint Action Plans, based 
on the MoUs 

Establishment of 
processes and procedures 
for the rapid exchange of 
information in outbreak 
situations explored and 
taken forward 

4.1.2. Support the 
progressive 
integration of ENP 
partner countries into 
ECDC activities and 
enhance health 
security through 
improving public 
health systems 
capacities and 
capabilities, including 
training through the 
continuation of 
MediPIET to respond 
to health threats 
related to 
communicable 
diseases and 
enhancing regional 
cooperation 
4.1.3. Following the 
request from 
European 
Commission, 
continue assessment 
of partner non-EU 
countries and finalise 
and follow-up the 
assessment of 
Western Balkans and 
Turkey and ENP 
partner countries 
4.1.4. Manage 
MediPIET, under the 
ECDC action on 
strengthening health 
security in EU 
neighbourhood 
financed by the 
European 
Commission 
4.1.4. Manage 
MediPIET, under the 
ECDC action on 
strengthening health 
security in EU 
neighbourhood 
financed by the 
European 
Commission 
4.2.1. Strengthen the 
bilateral and 
multilateral 
collaboration with 
major CDCs for which 
cooperation 
agreements are 
signed and with 
potential new bilateral 
cooperation partners  

4.2.1. Strengthen the 
bilateral and 
multilateral 
collaboration with 
major CDCs for which 
cooperation 
agreements are 
signed and with 
potential new bilateral 
cooperation partners  

98  4.1 

Neighbourhood 

99  4.1 

Neighbourhood 

100  4.1 

Neighbourhood 

101  4.1 

Neighbourhood 

102  4.2 Major 
CDCs 

103  4.2 Major 
CDCs 

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ECDC CORPORATE 

Consolidated Annual Activity Report 

No.  Action Area 

SPD Objective 

Expected outputs 2021  Status 

Comments 

Implemented   

Regular exchange of 
information and practices 
through face- to-face 
meetings and 
teleconferences 

Regular exchange of 
information and practices 
through face- to-face 
meetings or 
teleconferences 

Assessment of the added 
value of multilateral 
collaboration among major 
CDCs 

Consolidation and further 
expansion of the Network 
to other CDCs explored 

Good practices/control 
options in outbreak 
situations or approaches in 
the prevention and control 
of infectious diseases 
threats identified 
Agreed cooperation 
framework between ECDC 
and Africa CDC for 
implementation of 
technical partnership over 
defined period of time 

Implemented   

On schedule  This output will be part of the evaluation project that will be 
implemented in December 2021-June 2022 

On schedule  This output will be part of the evaluation project that will be 
implemented in December 2021-June 2022 

Not started  This output will be part of the evaluation project that will be 
implemented in December 2021-June 2022 

On schedule  Project Steering Committee established, technical discussions on 

priorities started; inception phase planning ongoing, four independent 
external experts to support mapping of opportunities and needs 
contracted for activities under WP1 and WP3, 75% of project staff 
recruited (6 out of 8 planned). Workshops to share experiences and 
methodologies in various technical areas were organised. 

104  4.2 Major 
CDCs 

105  4.2 Major 
CDCs 

106  4.2 Major 
CDCs 

107  4.2 Major 
CDCs 

108  4.2 Major 
CDCs 

109  4.2 Major 
CDCs 

4.2.1. Strengthen the 
bilateral and 
multilateral 
collaboration with 
major CDCs for which 
cooperation 
agreements are 
signed and with 
potential new bilateral 
cooperation partners  

4.2.2. Evaluation and 
consolidation of 
cooperation within the 
network of major 
CDCs and expansion 
of the network 
4.2.2. Evaluation and 
consolidation of 
cooperation within the 
network of major 
CDCs and expansion 
of the network 

4.2.2. Evaluation and 
consolidation of 
cooperation within the 
network of major 
CDCs and expansion 
of the network 
4.2.2. Evaluation and 
consolidation of 
cooperation within the 
network of major 
CDCs and expansion 
of the network 
4.2.3. Initiate the 
implementation of a 
technical partnership 
project ‘ECDC4Africa 
CDC’ to contribute to 
health security in 
Africa by sharing EU 
practices and 
strengthening Africa 
CDC capacities in 
preparedness, 
surveillance, and 
response to health 
threats 

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No.  Action Area 

SPD Objective 

Expected outputs 2021  Status 

Comments 

Implemented  Close collaboration with regular meetings and several hearings have 
taken place with ECDC and the EU Institutions mentioned in 2021, in 
particular in relation to the ongoing COVID-19 pandemic and the 
proposal of a new ECDC mandate 

Enhanced channels of 
close collaboration for 
effective coordination and 
interaction with the 
European Commission, 
the, the European 
Parliament and the Council 
Secretariat 

Identification of potential 
areas of collaboration and 
joint work with other EU 
Agencies 

On schedule  EFVED: on schedule 

CaI: on schedule 

110  4.3 

Coordination 

111  4.3 

Coordination 

4.3.1. Nurture the 
collaboration and 
coordination with the 
EU Institutions and 
bodies particularly the 
European 
Commission 
(Directorate-General 
for Health and Food 
Safety, Directorate 
General for European 
Civil Protection and 
Humanitarian Aid 
Operations, 
Directorate-General 
for Neighbourhood 
and Enlargement 
Negotiations, DG 
DEVCO) and the 
European External 
Action Service and 
other EU agencies in 
particular with the 
European Food 
Safety Authority 
(EFSA) and the 
European Medicines 
Agency (EMA) 
4.3.1. Nurture the 
collaboration and 
coordination with the 
EU Institutions and 
bodies particularly the 
European 
Commission 
(Directorate-General 
for Health and Food 
Safety, Directorate 
General for European 
Civil Protection and 
Humanitarian Aid 
Operations, 
Directorate-General 
for Neighbourhood 
and Enlargement 
Negotiations, DG 
DEVCO) and the 
European External 
Action Service and 
other EU agencies in 
particular with the 
European Food 
Safety Authority 
(EFSA) and the 
European Medicines 
Agency (EMA) 

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Consolidated Annual Activity Report 

No.  Action Area 

SPD Objective 

Expected outputs 2021  Status 

Comments 

112  4.3 

Coordination 

113  4.3 

Coordination 

114  4.3 

Coordination 

115  4.3 

Coordination 

116  4.3 

Coordination 

117  4.3 

Coordination 

4.3.1. Nurture the 
collaboration and 
coordination with the 
EU Institutions and 
bodies particularly the 
European 
Commission 
(Directorate-General 
for Health and Food 
Safety, DG ECHO, 
Directorate-General 
for Neighbourhood 
and Enlargement 
Negotiations, DG 
DEVCO) and the 
European External 
Action Service and 
other EU agencies in 
particular with the 
European Food 
Safety Authority 
(EFSA) and the 
European Medicines 
Agency (EMA) 
4.3.2. Invest in 
maintaining 
appropriate 
relationships with the 
European Parliament, 
in particular with the 
Committee ENVI 

4.3.2. Invest in 
maintaining 
appropriate 
relationships with the 
European Parliament, 
in particular with the 
Committee ENVI 
4.3.2. Invest in 
maintaining 
appropriate 
relationships with the 
European Parliament, 
in particular with the 
Committee ENVI 
4.3.3. Enhance 
further collaboration 
with WHO to ensure 
complementarity of 
actions and avoid 
duplication of efforts 
4.3.3. Enhance 
further collaboration 
with WHO to ensure 
complementarity of 
actions and avoid 
duplication of efforts 

On schedule  EFVED: on schedule 

CaI: on schedule 

- Optimisation of ECDC’s 
strategic communication 
and capacity building to 
relevant policy 
stakeholders in the EU 
Institutions 

ECDC Director’s annual 
exchange of views with the 
ENVI Committee and 
hearings before 
Parliamentary Committees 
upon request 

Provision of scientific 
opinions as requested by 
EP 

Implemented  Regular contacts with the ENVI Committee and with individual MEPs 

are taking place, as well as with other Committees in the European 
Parliament. 
The ECDC Director’s annual exchange of views took place on 16 
March 2021. 
Several hearings and exchanges of views in the various EP 
Committees (mainly ENVI) have taken place throughout the COVID-19 
pandemic with the ECDC Director and ECDC experts. 

Implemented  ECDC is regularly responding to scientific requests by the EP 

Committees and individual MEPs 

On schedule   

Information of ECDC 
activities and of the 
Centre’s disease specific 
areas in a format useful for 
making decisions 

Reviewed set of processes 
for joint activities under the 
bilateral administrative 
arrangements and 
finalising the publications 
agreement 
- Revision of the 
Administrative 
arrangement between 
ECDC and The WHO 
Regional Office for Europe 

On schedule   

Postponed 
to 2022 

Starting of revision process was approved by ECDC senior 
management in July. First draft is expected to be ready in March 2022 

Strategic objective 5. Transform the organisation to the next generation ECDC 

118  5.1 Integrated 
management 
framework 

5.1.1. Review and 
optimise a subset of 
ECDC key processes 

- Library of optimised 
ECDC key processes  

Postponed 
2022 

- Two key processes re-
engineered and digitalised 

Delayed due to high workload of process owners due to COVID19 
pandemic and the foreseen amended mandate of ECDC, as the 
process landscape will be reviewed in 2022 and optimization and 
implementation project carried out in the following years.  

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No.  Action Area 

SPD Objective 

Expected outputs 2021  Status 

Comments 

5.1.2. Introduce an 
integrated 
management 
framework (including 
frameworks for 
governance, 
performance 
management quality 
management system 
and internal controls) 
and a learning culture 

5.1.2. Introduce an 
integrated 
management 
framework (including 
frameworks for 
governance, 
performance 
management quality 
management system 
and internal controls) 
and a learning culture 

5.1.2. Introduce an 
integrated 
management 
framework (including 
frameworks for 
governance, 
performance 
management quality 
management system 
and internal controls) 
and a learning culture 
5.1.2. Introduce an 
integrated 
management 
framework (including 
frameworks for 
governance, 
performance 
management quality 
management system 
and internal controls) 
and a learning culture 
5.1.2. Introduce an 
integrated 
management 
framework (including 
frameworks for 
governance, 
performance 
management quality 
management system 
and internal controls) 
and a learning culture 
5.1.2. Introduce an 
integrated 
management 
framework (including 
frameworks for 
governance, 
performance 
management quality 
management system 
and internal controls) 
and a learning culture 
5.1.3. Initiate the 
implementation of the 
selected Quality 
Management system 
at ECDC 

119  5.1 Integrated 
management 
framework 

120  5.1 Integrated 
management 
framework 

121  5.1 Integrated 
management 
framework 

122  5.1 Integrated 
management 
framework 

123  5.1 Integrated 
management 
framework 

124  5.1 Integrated 
management 
framework 

125  5.1 Integrated 
management 
framework 

94 

Agreed system for 
instructional documents 

Implemented   

Identified areas for 
improvement through a 
gap analysis 

Implemented   

Improved monitoring 
system 

On schedule  Feasibility study on planning and monitoring system finalized and 

proof of concept studies will take place 2022. 

IT support in place 

On schedule  Proof of concept study (POCs) on the planning and monitoring tool 

ongoing, selection of the tool foreseen mid-2022. 

Postponed 
2022 

Baseline for administrative 
services strategy and 
goals defined, agreed 
service levels with clients, 
and assessment of current 
services and gap analysis 
performed 

Postponed 
2022 

Learning culture 
framework introduced to 
increase the acceptance 
and use of different 
assessments (e.g. 
evaluations, audits, 
lessons learned etc.) 

Implemented  Implementation plan for the QM is part of the IMF implementation 

roadmap. 

- Gap analysis of ECDC 
current practices versus 
the selected standard 
- Approach for the 
implementation of the QM 
standard 

 
 
ECDC CORPORATE 

Consolidated Annual Activity Report 

No.  Action Area 

SPD Objective 

Expected outputs 2021  Status 

Comments 

- KPI tree based on ECDC 
intervention logic 
- Scorecard concept, with 
graphical representation of 
the different levels of 
reporting. 
- IT tool to manage multi-
annual and annual KPIs. 
Document describing the 
applications architectural 
roadmap for integrated 
steering and support 
systems at ECDC 

Skills gaps analysis 
supporting the strategy 
2021-2027 with specific 
focus on the expert 
competencies finalised (to 
be used for recruitment 
and training plans) 
Management training as 
well as targeted 
management coaching to 
support the development 
of the concept 
management by objectives 
Internal mobility framework 
taking into account the 
Centre’s strategic 
priorities, staff 
development and the 
applicable regulatory 
context. 
Stress Prevention 
Programme – further 
activities accomplished to 
build up staff resilience in 
view of the Next 
Generation ECDC (linked 
to new strategy) 
Timely adoption of new 
implementing rules 

Postponed 
2022 

Postponed to 2022 due to foreseen amended mandate of ECDC. 

Implemented  The Roadmap approved and its implementation has commenced. 

Delayed 

Project kicked-off in Q4/2021 and will be finalized in 2022. 

Implemented  Management training as well as coaching were in place and offered 

throughout the year. 

Postponed 
2022 

Project will be part of the “People Strategy” and commenced in 2022. 

Implemented  Continuation of the activities that commenced in 2020 throughout 

2021 

Implemented  The Commission did not adopt any new implementing rules in 2021. 

Stakeholder Engagement 
Programme 

Postponed 
to 2022-
2023  

Project initiation request ready, including timelines, milestones and 
specific deliverables. This work is planned for 2022-2024.  

Improved ECDC website  On schedule  Continuous work enhancing our website, ensuring that it is audience-
oriented and that our outputs are available in a clear and transparent 
way.  

126  5.1 Integrated 
management 
framework 

127  5.1 Integrated 
management 
framework 

128  5.2 Engaged 

staff 

129  5.2 Engaged 

staff 

130  5.2 Engaged 

staff 

131  5.2 Engaged 

staff 

132  5.2 Engaged 

staff 

133  5.3 

Stakeholders 
and external 
communication 

134  5.3 

Stakeholders 
and external 
communication 

5.1.4. Implement 
integrated system of 
Key Performance 
Indicators to support 
the achievement of 
Strategic Objectives 

5.1.5. Gradual 
implementation of the 
roadmap for the IT 
Integrated 
Management 
Systems 
5.2.1. Transform 
human resources 
management and 
provide effective and 
efficient Human 
Resources services  

5.2.1. Transform 
human resources 
management and 
provide effective and 
efficient Human 
Resources services  
5.2.1. Transform 
human resources 
management and 
provide effective and 
efficient Human 
Resources services  

5.2.1. Transform 
human resources 
management and 
provide effective and 
efficient Human 
Resources services  

5.2.1. Transform 
human resources 
management and 
provide effective and 
efficient Human 
Resources services  
5.3.1. Develop a 
comprehensive 
stakeholder 
engagement 
programme to 
identify, engage and 
mobilise institutional 
and non-institutional 
stakeholders 
5.3.2. Improve and 
further develop 
ECDC online 
presence 
strategically, ensuring 
that the content on its 
main website and its 
sub-sites is driven by 
audience-oriented 
content strategy, 
improving the 
transparency, 
visibility and 
availability of ECDC 
outputs 

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No.  Action Area 

SPD Objective 

Expected outputs 2021  Status 

Comments 

Enhanced Social Media 
presence, activities and 
engagement 

Implemented  Continued increase of social media impact, focusing on KPIs related 

to engagement and followers/likes.  

Rise of the ECDC brand 
knowledge, familiarity and 
reliability 

Implemented  Continuous work towards a more homogeneous brand in our 

communication outputs, following feedback from different stakeholder 
groups.  

Recognition of ECDC’s 
communication online and 
offline 

Implemented  Continuous work towards a more homogeneous brand in our 

communication outputs, following feedback from different stakeholder 
groups. 

Production of multimedia 
content 

Implemented  Increased production of videos, infographics and images aimed at 

making information more understandable and at increasing the 
outreach towards our target audiences.  

Public relation plan 
developed 

Postponed 
2022 

The start of the project has been postponed to 2022. Actions to put in 
place a call for tender for the full project are in progress. 

Session organised by 
ECDC at the European 
Health Forum Gastein 
2021 

Implemented  ECDC’s session at the EHFG focussed on the importance of 

community engagement in light of the ongoing COVID-19 pandemic 
took place on 28 September 2021. Feedback from participants was 
very positive. An ECDC podcast was also produced on the topic. 

Liaison and actions as per 
the agreement regarding 
strategic co-operation 
between ECDC and the 
Swedish Government, 
including sharing of 
experiences, and expertise 
with the Swedish 
authorities 

New IT solutions and 
further development of IT 
products (incl. takeover of 
the EFGS) 

Implemented  A webinar on EU’s vaccine strategy took place in the House of Europe 
on 4 May 2021 with the ECDC Director in the panel. The session was 
organised by the European Commission Representation in Sweden 
and Paneuropa Sweden. 
A visit to ECDC by the new Head of European Commission 
Representation in Sweden took place on 29 November 2021. 
Regular contacts are taking place with the liaison at the Swedish 
Ministry of Health and the contact person in EICS at ECDC. 

Implemented  Procurement for digital solutions further development 2022 is in 

progress (initial offer has been received). Enterprise Content 
Management Platform, PHE Intranet procurement has been 
completed and developments are in progress. EFGS takeover is in 
progress. The MoU between Directorate-General for Health and Food 
Safety, DG CNECT, DG DIGIT and ECDC is in the signature loop and 
procurement for external services under preparation. An internal team 
has been working on the takeover activities aiming to complete 
takeover by end of March 2022. 

135  5.3 

Stakeholders 
and external 
communication 

136  5.3 

Stakeholders 
and external 
communication 

137  5.3 

Stakeholders 
and external 
communication 

138  5.3 

Stakeholders 
and external 
communication 

139  5.3 

Stakeholders 
and external 
communication 

140  5.3 

Stakeholders 
and external 
communication 

141  5.3 

Stakeholders 
and external 
communication 

5.3.3. ECDC will 
redefine and enhance 
its social media 
presence and 
engagement 

5.3.3. ECDC will 
redefine and enhance 
its social media 
presence and 
engagement 
5.3.3. ECDC will 
redefine and enhance 
its social media 
presence and 
engagement 
5.3.3. ECDC will 
redefine and enhance 
its social media 
presence and 
engagement 
5.3.4. Develop and 
implement a Public 
relations plan to 
foster ECDC’s 
reputation 
management 
5.3.5. Maintain and 
enhance the 
cooperation with key 
stakeholders at the 
EU-level, including 
relations with our host 
country 
5.3.5. Maintain and 
enhance the 
cooperation with key 
stakeholders at the 
EU-level, including 
relations with our host 
country 

6. Support services 

142  6.1 Digital 

Transformation 
Services 

6.1.1. ECDC supports 
public health by 
providing digital 
solutions for the 
Commission, Member 
States and other 
stakeholders. In 
addition, the Centre’s 
operations are 
enabled with the 
necessary digital 
solutions for the 
steering and support 
of the Next 
Generation ECDC. 

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ECDC CORPORATE 

Consolidated Annual Activity Report 

No.  Action Area 

SPD Objective 

Expected outputs 2021  Status 

Comments 

143  6.1 Digital 

Transformation 
Services 

144  6.1 Digital 

Transformation 
Services 

145  6.1 Digital 

Transformation 
Services 

146  6.1 Digital 

Transformation 
Services 

147  6.1 Digital 

Transformation 
Services 

148  6.1 Digital 

Transformation 
Services 

6.1.1. ECDC supports 
public health by 
providing digital 
solutions for the 
Commission, Member 
States and other 
stakeholders. In 
addition, the Centre’s 
operations are 
enabled with the 
necessary digital 
solutions for the 
steering and support 
of the Next 
Generation ECDC. 
6.1.1. ECDC supports 
public health by 
providing digital 
solutions for the 
Commission, Member 
States and other 
stakeholders. In 
addition, the Centre’s 
operations are 
enabled with the 
necessary digital 
solutions for the 
steering and support 
of the Next 
Generation ECDC. 
6.1.2. ECDC provides 
its staff with a digital 
workplace that 
addresses the needs 
for mobility, flexibility, 
communication and 
collaboration. Users 
can easily access the 
IT services they need 
via the front-office or 
self-service 
6.1.3. Prepare ECDC 
for the future through 
technology foresight 
and innovation 

6.1.4. ECDC 
continuously 
improves its digital 
infrastructure so that 
its critical systems 
fulfil business needs. 
6.1.4. ECDC 
continuously 
improves its digital 
infrastructure so that 
its critical systems 
fulfil business needs. 

IT product basic 
maintenance  

Implemented  All IT Products and systems have been maintained during 2021. 

IT quality, PMO, enterprise 
architecture and IT 
security services are 
provided with high quality  

Implemented  The IT quality, PMO, Enterprise Architecture and IT security services 
have been provided with high quality, despite the challenges in 2021 
related to the lack of IT Quality Management Officer.  

Continuation of O365 
rollout, including OneDrive 
and Exchange online 

Implemented  Data Protection Impact Assessment (DPIA) for Office 365 finalized. 

Migration to Exchange Online and Onedrive has been completed. 

IT studies and advice 

Implemented  Studies relevant to the IceCube project such as those for the new 

planning and monitoring system have been completed. The study on 
the low code/ workflow development platform has been completed. 
The study on Country Support tool has been completed. Moreover, 
additional studies for new IT solutions and further improvements have 
been completed (more than 12 studies in total). 

Completion of a feasibility 
study for the review of 
ECDC Identity and Access 
Management 

Implemented  An IAM Feasibility Study has been finalised resulting in a new target 

architecture and an associated high level implementation roadmap 
covering the period 2022-2024. 

Initiation of the 
implementation of an 
Information Security 
Management System 

Implemented  Three groups of risk assessments on specific products were 

concluded and presented to the Director and the Director Consultation 
Group for approval on the “Microsoft 365 cloud security risks” as part 
of the ISMS project: 

1.  MS 365 core: fundamental services required to run the 

Microsoft 365 cloud services. 

2.  MS 365 applications: business applications required by 

3. 

ECDC to run its normal business. 
Communication tools: cooperation and communication 
services among ECDC staff and its stakeholders. 

The project scope for 2021 was delivered in accordance with the plan. 
The project itself will continue in 2022 and beyond. 

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No.  Action Area 

SPD Objective 

Expected outputs 2021  Status 

Comments 

IT operations and 
infrastructure services 

Implemented  The Centre’s activities have been supported and enabled by digital 
workplace, enterprise infrastructure and IT security services during 
2021. 

149  6.1 Digital 

Transformation 
Services 

150  6.2 Resource 
management 

6.1.4. ECDC 
continuously 
improves its digital 
infrastructure so that 
its critical systems 
fulfil business needs. 
6.2.1. Provide 
effective and efficient 
Procurement services 

All internal procurement 
approvals paperless 
(including contract 
signature) 

Implemented  Internal decisions have been moved to embedded e-workflows using 

word and excel as per the Administrative Decision on temporary 
measures to allow for paperless routing and approval of documents 
due to the COVID-19 outbreak. Administrative Decision is being 
prepared and will be finalised during Q1/2002. Qualified Electronic 
Signature (QES) is used by AOs and AODs for replacing the blue ink 
signature on reciprocal legal documents such as contracts and 
amendments.  
Due to competing work priorities, ECDC was unable to perform an 
assessment of how and where to reduce procedures. 

151  6.2 Resource 
management 

6.2.1. Provide 
effective and efficient 
Procurement services 

Number of negotiated 
procedures/direct 
contracts reduced 

Delayed 

152  6.2 Resource 
management 

6.2.2. Provide 
effective and efficient 
Legal services 

Legal Intranet page with 
key information available 

Delayed 

The project has started and will be finalized in 2022. 

153  6.2 Resource 
management 

6.2.2. Provide 
effective and efficient 
Legal services 

154  6.2 Resource 
management 

6.2.2. Provide 
effective and efficient 
Legal services 

155  6.2 Resource 
management 

6.2.2. Provide 
effective and efficient 
Legal services 

156  6.2 Resource 
management 

6.2.3. Provide 
effective and efficient 
Corporate services 

157  6.2 Resource 
management 

6.2.3. Provide 
effective and efficient 
Corporate services 

158  6.2 Resource 
management 

6.2.3. Provide 
effective and efficient 
Corporate services 

159  6.2 Resource 
management 

6.2.3. Provide 
effective and efficient 
Corporate services 

Update existing 
Memoranda of 
Understanding (MoU) with 
other Agencies to 
comprehensively regulate 
areas of cooperation 
Full compliance and 
establishment of routines 
for the implementation of 
the new Independence 
Policy for Staff  
Development of an 
effective ex-post control 
strategy for the application 
of the Independence 
Policy and the Data 
Protection Regulation and 
dissemination of the 
results in the Technology 
watch reports 
- Define a corporate 
services strategy or 
framework that aligns the 
Corporate Services 
structure and framework of 
services with ECDC long-
term plan for enhancing 
efficiency and 
effectiveness. 
Establish service level 
agreements for facilities 
management services;  

Improve efficiency of 
registration of travel 
participants to ECDC 
events; 

Reduce ECDC 
environmental footprint 
according to set 
objectives; 

98 

Ongoing 

Collection and review of all third-party agreements is an ongoing task, 
and the agreements are updated together with partners as and when 
required. 

Delayed 

The Policy has been approved and will be implemented through 
revised routines in 2022. 

Delayed 

Delayed due to IT delays 

Delayed 

The project to define the future strategy for Corporate Services 
commenced in Q4/2021 and is planned to be concluded end of 
Q2/2022. 

Delayed 

Service levels to be developed as part of the new contract for works 
and maintenance activities in 2022. 

On schedule  Physical meetings will resume in 2022. 

On schedule  EMAS certification project on-going.  

Interinstitutional contract to be established in 2022 to cover offsetting 
of Co2 emissions 

ECDC CORPORATE 

Consolidated Annual Activity Report 

No.  Action Area 

SPD Objective 

Expected outputs 2021  Status 

Comments 

160  6.2 Resource 
management 

6.2.3. Provide 
effective and efficient 
Corporate services 

Develop building analytics, 
intelligent buildings and 
remote monitoring; 

Postponed 
2022 

Activity was moved to 2022 due to other priorities 

161  6.2 Resource 
management 

6.2.3. Provide 
effective and efficient 
Corporate services 

Increase the digitalisation 
of mailroom and archives. 

On schedule  Upgrade of the mail IT tools underway 

162  6.2 Resource 
management 

163  6.2 Resource 
management 

164  6.2 Resource 
management 

6.2.4. Provide 
effective and efficient 
Financial 
Management 
services 
6.2.4. Provide 
effective and efficient 
Financial 
Management 
services 
6.2.4. Provide 
effective and efficient 
Financial 
Management 
services 

Consolidation of the use of 
electronic commitments in 
Speedwell; 

Further on-boarding 
suppliers into e-invoicing; 

Enhance the financial 
reporting, forecasting and 
monitoring of the budget 
implementation throughout 
the Centre 

Implemented  Commencing in June 2021, ECDC gradually moved all budgetary 

commitments for processing into Speedwell  

Implemented  New suppliers on boarded when contracted by ECDC – recurring 

process 

Implemented  *First Supplementary and Amending Budget 2021 approved by 

Management Board 
* Second Supplementary and Amending budget 2021 approved by 
Management Board through written procedure 05/2021 
* Monthly implementation report presented to the Director Consultation 
Group  
*Provisional annual accounts 2020 delivered on 1 March 2021 and 
audited by external audit firm from 25-30 March 2021 
* Third Supplementary and Amending budget 2021 approved by 
Management Board during June 2021 meeting (MB52/05) 
* Final annual accounts 2020 drawn up and submitted to EC, EP and 
Council 
* Court of Auditors report 2020 on Agencies and in particular on ECDC 
published on 29 October 2021 

165  6.2 Resource 
management 

6.2.4. Provide 
effective and efficient 
Financial 
Management 
services 

Further support and 
monitor the decrease of 
payment delays 
throughout the Centre 

Implemented  Payments monitored as part of the monthly implementation report 

presented to the Director Consultation Group, with an overall 
achievement of 98% invoices paid on time in 2021 

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Annex 2. Statistics on financial management 

Budget outturn (in EUR) 
Revenue actually received (+) 
Payments made (-) 
Carry-over of appropriations (-) 
Cancellation of appropriations carried over (+) 
Adjustment for carry-over of assigned revenue 
appropriations from previous year (+) 
Exchange rate differences (+/-) 
Adjustment for negative balance from previous year (-) 
Total 

2019 
60 316 000 
48 441 000 
11 671 000 
880 000 
259 000 

+126 000 

1 469 000 

2020 
70 708 000 
47 139 000 
22 533 000 
1 155 000 
1 118 000 

-238 000 

3 071 000 

2021 
172 749 000 
109 153 000 
71 428 000 
1 025 000 
9 089 000 

-543 000 

1 739 000 

Descriptive information and justification of: 

Budget outturn 
First estimate of the 2021 surplus to be reimbursed to the EU budget (as assigned revenue): EUR 1 739 880.22. 

The Centre cashed its budget of EUR 168 115 000 in 2021. 

The expenditure of 2021, including the carry-forward to 2022, equals to EUR 180 582 255.98. 

The amount of cancelled unused payment appropriations carried forward from previous year (2020) of EUR 1 025 247.08, the 
adjustment for carry-over from the previous year of appropriations available at 31/12 arising from assigned revenue of  

EUR 9 089 576.87 and the exchange rate loss for the year 2021 of EUR -542 570.47 have resulted in a positive budget outturn in 
2021. 

In 2021, ECDC reimbursed the budgetary positive balance from 2020 of EUR 3 071 478.28 to the EU.  

As a result of the above, EUR 1 739 880.22 will be reimbursed during 2022 to the EU budget (as assigned revenue) related to 
the Centre’s 2021 budget implementation. 

Cancellation of commitment appropriations 
The total implementation of commitment appropriations in 2021 reached 99.35% with a total of EUR 1 085 863.33 cancelled, 
compared to EUR 2 016 923.65 cancelled in 2020. As a result, the reductions of the EU contribution of 2% for the 
implementation of commitment appropriations and 2% for the cancellation of payment appropriations are not applicable for the 
2023 budget of ECDC. The commitment of appropriations for the operational expenditure on Title 3 reached 99.69% in 2021. 

Cancellation of payment appropriations for the year and payment appropriations carried 
over 
The Centre carried forward EUR 13 500 266 from 2020 to 2021, of which EUR 12 475 019 was paid (fund source C8). 

This corresponds to 92.41% of the amount carried forward. 

Report on budget and financial management 2021 of the European Centre for Disease Prevention and Control.  

For details, see: https://ecdc.europa.eu/en/about-usour-key-documents/financial-documents 

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Consolidated Annual Activity Report 

Annex 3. Organisational chart 

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Annex 4. Establishment plan and additional 
information on human resources 
management 

ECDC establishment table 2021 

Category and grade 

Establishment plan in voted EU budget 2021 

Officials 

TA 

AD 16 
AD 15 

AD 14 
AD 13 
AD 12 

AD 11 
AD 10 

AD 9 
AD 8 
AD 7 
AD 6 

AD 5 
Total AD 

AST 11 
AST 10 

AST 9 

AST 8 
AST 7 
AST 6 

AST 5 
AST 4 
AST 3 
AST 2 

AST 1 
Total AST 
AST/SC6 
AST/SC5 

AST/SC4 
AST/SC3 
AST/SC2 
AST/SC1 

Total AST/SC 
Total 

1 

2 
3 
7 

8 
25 

24 
24 
29 
18 

3 
144 

1 

2 

3 
11 
10 

15 
 10 
7 

59 

5 

5 
208 

102 

 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
  
 
  
 
 
  
 
  
 
  
 
 
  
 
  
 
 
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Recruitment grade/function group for each type of post - indicative 
table 

Key functions (examples – 
terminology should be adjusted to 
each agency’s job titles) 

Head of Unit (level 2) 

Deputy Head of Unit (level 3) 

Head of Section (level 3) 

Principal Expert 

Expert 

Scientific Officer 

Administration (e.g. HR, Procurement/ 
Finance)/ IT Officers 

Officers in support functions (e.g. 
Communication, IT, Legal) 

Assistants/ Specialists in support 
functions (e.g. HR, Finance, 
Procurement, IT) 

Administrative Assistants 

Office Assistants 

Type of contract (official, TA or 
CA) 

Function group, grade 
of recruitment* 

Indication whether the function is dedicated to 
administrative support or operations [subject 
to definitions used in screening methodology] 

TA 

TA 

TA 

TA 

TA 

CA 

TA 

CA 

CA 

TA 

CA 

AD 11/ AD 12 

Depending on function: operational or administrative 

AD 10 

AD 8 

AD 8 

AD 5 

FG IV 

AST 4 

FG IV 

FG III 

Depending on function: operational or administrative 

Depending on function: operational or administrative/ 
neutral 

operational 

operational 

operational 

Depending on function: operational or administrative/ 
neutral 

Depending on function: operational or administrative/ 
neutral 

Depending on function: operational or administrative/ 
neutral 

AST/SC 1 

FG II 

Depending on function: operational or administrative 

Depending on function: operational or administrative 

Job screening/benchmarking against previous year results1 

Job Type (sub) category 

Administrative support and Coordination 

Administrative Support 

Coordination 

Operational 

Top level Operational Coordination 

Programme management and 
Implementation 

Evaluation & Impact assessment 

General operational 

Neutral 

Finance/ Control 

Linguistics 

16.2 

14.5 

1.6 

77.8 

2.8 

65.8 

0.0 

9.3 

6.0 

6.0 

0.0 

Implementing rules adopted in 2021 

Management Board Decisions on Implementing Rules 

None 

Year N-1 (%) 

Year N (%) 

14.5 

13.6 

0.9 

78.4 

3.3 

66.0 

0.0 

9.1 

7.1 

7.1 

0.0 

1 Table as per Methodology for Agencies job screening (2014) 

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Annex 5. Human and financial resources by 
activity 

The activity-based costing provides an overview of human and financial resources used by activity in 2021. It 
reflects the structure of the presentation of the Consolidated Annual Activity Report. ECDC staff members record 
their working time per activity in the Human Resources system Allegro, reflected in the first column (Total FTE). 
The column ‘Administrative staff’ reflects the administrative support for operations, considered as operational work 
following the benchmarking exercise (see also Annex IV). 

This line reflects time underreported by staff, sick leave, medical part-time, part-time work, parental leave 

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Annex 6. Contribution, grant and service level agreements - Financial 
Framework Partnership Agreements 

General Information 

Financial and HR impacts 

Actual or 
Expected date of 
signature 

Framework 
Partnership 
Agreement signed 
in 2018 

Framework 
Partnership 
Agreements signed 
in 2020 

Framework 
Partnership 
Agreements signed 
in 2019, 2020 and 
2021 

Direct grant 
agreements, Action 
Grants without a 
call for proposal 

Grant Agreements 

1. ERLTB-Net  

2. Scientific coordination of 
ECDC Fellowship Programme 

 3. ECDC Fellowship 
Programme: hosting of fellows 

4. Action Grants for enhancing 
WGS and/or Reverse 
Transcription Polymerase Chain 
Reaction (RT-PCR) national 
infrastructures and capacities to 
respond to the COVID-19 
pandemic in the European Union 
and European Economic Area 

Total grant agreements 

Contribution Agreements 

 None 

Total contribution agreements 

Total amount 

Duration 

Counterpart 

Short Description 

N-1 (2020) 

N (2021) 

200 000 
EUR/year 

4 years 

Consortium led by 
Ospedale San Raffaele 

Implementation of lab coordination activities, including lab 
network coordination, EQA, training, strain collection, typing, 
scientific advice & technical guidance on lab issues as well 
as methods harmonisation and network meeting. 

Amount 

Nr of FTEs 

Nr of SNEs 

575 000 
EUR/year 

4 Years 

1 950 000 
EUR/year 

4 Years 

77 087 704 EUR 
for 2021 

1 Year 

12 specific agreements 
with different public health 
institutes over the period 
of two years 

Scientific Coordination of ECDC Fellowship Programme 
(Epidemiology (EPIET) and Public Health Microbiology 
(EUPHEM) paths). To ensure the availability of highly 
qualified scientific coordinators for the Fellowship 
programme. 

39 specific agreements 
(for hosting cohorts 2019, 
2020 and 2021) with 
different public health 
institutes 

24 grants to National 
Public Health Authorities 
from EU and EEA 
Member States 

ECDC Fellowship Programme (Epidemiology (EPIET) and 
Public Health Microbiology (EUPHEM) paths) hosting of 
fellows at Training Sites.  

Supporting activities via the award of grants for action that 
directly lead to enhanced and/or improved national public 
health WGS and RT-PCR capacity 

Amount 

Nr of FTEs 

Nr of SNEs 

Amount 

Nr of FTEs 

Nr of SNEs 

Amount 

Nr of FTEs 

Nr of SNEs 

199 981 EUR 

199 969 EUR 

0.15 

0.20 

495 274 EUR 

233 909 EUR 

3.08 

2.41 

1 777 738 EUR 

1 675 984 EUR 

1.04 

n/a 

n/a 

 1.16 

77 087 704 EUR 

3 

Amount 

2 472 993 EUR 

79 197 566 EUR 

Nr of FTEs 

4.27 

6.77 

Amount 

Nr of FTEs 

Nr of SNEs 

Amount 

Nr of FTEs 

Nr of SNEs 

105 

   
   
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
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Service-Level Agreements 

 None 

Total service-level agreements 

Contribution Agreements where ECDC is recipient of funds 

IPA6 Contribution agreement 

10 December 2019  2 500 000 EUR 

5 years 

Preparatory measures for the participation of the Western 
Balkans and Turkey in ECDC with special focus on One-
Health against AMR and enhanced SARI surveillance, 2020-
2024 

ECDC4Africa CDC Contribution 
agreement 

19 October 2020 

9 000 000 EUR 

4 years 

The ECDC for Africa CDC action aims to: 

• 

• 

Strengthen capacities of Africa CDC in preparedness, 
risk assessment, rapid response, and emergency 
operations. 
Improve continental harmonised indicator- and event-
based surveillance of infectious diseases, including 
platforms for data sharing and early detection of threats 
as well as foundations for sustainable trained public 
health workforce. 

Amount 

Nr of FTEs 

Nr of SNEs 

Amount 

Nr of FTEs 

Nr of SNEs 

Amount 

Nr of FTEs 

Nr of SNEs 

Amount 

Nr of FTEs 

Nr of SNEs 

2 042 EUR 

0.6 

0 EUR 

0.21 

583 467 EUR 

0.52 

242 644 EUR 

3.31 

EU Initiative on Health Security 
Contribution agreement 

18 December 2020  9 000 000 EUR 

4 years 

Total Contribution Agreements where ECDC is recipient of funds 

The EU Initiative on Health Security aims to set up a regional 
competent workforce for the prevention and control of 
challenges posed by communicable diseases and to enhance 
regional cooperation to tackle cross-border health security 
threats in EU candidate and potential candidates (EU 
Enlargement) countries and European Neighbourhood Policy 
(ENP) partner countries. 

Amount 

Nr of FTEs 

Nr of SNEs 

900 EUR 

1.27 

1 227 699 EUR 

3.52 

Amount 

2 942 EUR 

2 053 810 EUR 

Nr of FTEs 

2.08 

7.35 

106 

  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
  
 
 
 
 
 
 
 
 
 
 
 
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Annex 7. Environmental management 

ECDC measures to ensure cost-effective and environment- 
friendly working place 

ECDC premises are environmentally certified as a ‘Green building’ since 2018. In December 2020, the ECDC 
building received the environmental certification ‘BREEAM Very Good’. Building Research Establishment 
Environmental Assessment Method (BREEAM) is the world’s leading sustainability assessment method for master 
planning projects, infrastructure, and buildings.  

ECDC started the implementation of EMAS in October 2019, when ECDC performed its first environmental 
assessment. In 2021, ECDC has from then on subsequently worked on achieving EMAS certification. The 
environmental assessment established that travel related to missions, meetings, recruitment, and trainings 
represented the major source of CO2 emissions for ECDC. Due to the COVID-19 pandemic, and the reduction of 
staff missions and meetings, ECDC CO2 emissions related to travels were reduced to a non-relevant environmental 
significance factor in 2021. 

ECDC measures to reduce the environmental impact of its 
operations 

In 2021, 100% of the ECDC electricity continued to be provided by hydro powered energy. The ECDC premises are 
equipped with energy-efficient glass windows optimising daylight admission and reducing solar heat. Light sources 
are mostly of LED with occupancy sensors and daylight control systems. In 2021, ECDC introduced touchless taps 
helping to reduce up to 70% of the water consumption. 

ECDC continues to improve its new recycling system, with separation of waste into paper, plastic, glass, organic, 
metal, e-waste, toners, light and bulbs, batteries, corrugated cardboard and boxes. In addition, ECDC requests 
from some of its suppliers to provide environmentally friendly documentation and purchases eco-labelled products 
(such as stationery and cleaning detergents).  

To reduce the environmental impact of transport, ECDC encourages its staff to use sustainable ways of commuting 
by providing facilities for bicycles and encouraging use of good connections by public transport. Moreover, 
videoconferencing is encouraged to limit the environmental impact of missions. 

ECDC environmental objectives 

As an agency of the European Union, ECDC recognises its responsibility towards the environment and the 
importance of implementation of measures to control and lower the environmental impact of its operations. In the 
year 2021, the agency continued its efforts towards a more environmentally friendly profile, focusing on selected 
areas for further improvement. 

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Annex 8. Final annual accounts 2021 

See final annual accounts 2021 and report on budget and financial management 2021 of the European Centre for 
Disease Prevention and Control (MB document MB55/06). 

For details, see: https://ecdc.europa.eu/en/about-usour-key-documents/financial-documents  

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Annex 9. ECDC MB/AF/Coordinating 
Competent Bodies 

Members and Alternates of the ECDC Management Board 

Austria 

Belgium 

Bulgaria 

Croatia 

Cyprus 

Czechia 

Denmark 

Estonia 

Finland 

France 

Germany 

Greece 

Hungary 

Ireland 

Italy 

Latvia 

Lithuania 

Luxembourg 

Malta 

Netherlands 

Poland 

Portugal 

Romania 

Slovakia 

Dr Sigrid Kiermayr1 
Nomination pending 
Mr Lieven De Raedt 
Dr Dirk Wildemeersch2 
Dr Angel Kunchev 
Ms Nataliya Spiridonova 
Dr Bernard Kaić 
Assistant Professor Krunoslav Capak 
Dr Irene Cotter 
Ms Maroussa Konnari Jeronymides 
Dr Jozef Dlhý3  
Nomination pending 
Ms Bolette Søborg 
Ms Stine Ulendorf Jacobsen 
Ms Heli Laarmann 
Ms Mari-Anne Härma 
Dr Anni-Riitta Virolainen-Julkunen 
Dr Taneli Puumalainen 
Professor Geneviève Chêne 
Ms Anne-Catherine Viso 
Dr Hans-Ulrich Holtherm 
Dr Gesa Lücking 
Professor Theoklis Zaoutis4 
Ms Aggeliki Dreliozi 
Ms Ágnes Dánielisz 
Ms Krisztina Biró 
Dr Colette Bonner 
Mr Daniel Shine 
Dr Francesco Maraglino 
Dr Sandro Bonfigli 
Ms Jana Feldmane 
Professor Dzintars Mozgis 
Dr Audrius Ščeponavičius 
Dr Loreta Ašoklienė5 
Dr Jean-Claude Schmit 
Dr Thomas Dentzer 
Dr Patricia Vella Bonanno 
Dr Mariella Borg Buontempo 
Ms Ciska Scheidel 
Mr Bas Joost Lambert Derks6 
Mr Dariusz Poznański 
Mr Michał Ilnicki 
Mr Rui Portugal 
Ms Cristina Abreu Santos 
Mr Andrei Baciu 
Mr Paul Daniel Iordache 
Dr Ján Mikas 

1 Appointed Member in replacement of Dr Bernhard Benka as of November 2021 
2 Appointed Alternate in replacement of Dr Carole Schirvel as of February 2021 
3 Appointed Member in replacement of Ms Jarmila Rážová as of June 2021 
4 Appointed Member in replacement of Mr Panagiotis Arkoumaneas as of November 2021 

5 Appointed Alternate in replacement of Dr Saulius Čaplinskas as of April 2021 
6 Appointed Alternate in replacement of Ms Francine L'Ortye as of December 2021 

Member 
Alternate 
Member 
Alternate 
Member 
Alternate 
Member 
Alternate 
Member 
Alternate 
Member 
Alternate 
Member 
Alternate 
Member 
Alternate 
Member 
Alternate 
Member 
Alternate 
Member 
Alternate 
Member 
Alternate 
Member 
Alternate 
Member 
Alternate 
Member 
Alternate 
Member 
Alternate 
Member 
Alternate 
Member 
Alternate 
Member 
Alternate 
Member 
Alternate 
Member 
Alternate 
Member 
Alternate 
Member 
Alternate 
Member 

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Alternate 
Member 
Alternate 
Member 
Alternate 

Member 
Alternate 
Member 
Member 
Alternate 
Member 
Member 
Alternate 
Alternate 
Member 
Alternate 
Member 
Alternate 
Member 
Member 
Alternate 

Member 
Alternate 
Member 
Alternate 
Member 
Alternate 
Member 
Alternate 
Member 
Alternate 
Member 
Alternate 
Member 
Alternate 
Member 
Alternate 
Member 
Alternate 
Member 
Alternate 
Member 
Alternate 
Member 
Alternate 
Member 
Alternate 

Slovenia 

Spain 

Sweden 

European Parliament 

European Commission 

Iceland (EEA/EFTA)  

Liechtenstein (EEA/EFTA) 
Norway (EEA/EFTA) 

Ms Lucia Paulíková1 
Dr Mojca Gobec 
Mr Mario Fafangel 
Dr Pilar Aparicio Azcárraga 
Dr Manuel Cuenca Estrella 
Dr Johan Carlson 
Mr Andreas Johansson  

Ms Zofija Mazej Kukovič 
Ms Maria Eleni Koppa 
Mr Antonio Fernando Correia de Campos 
Mr Pierre Delsaux2Mr John F Ryan 
Ms Isabel de la Mata Barranco 
Ms Ingrid Keller3Ms Barbara Kerstiëns 
Ms Catherine Berens4  

Ms Ásthildur Knútsdóttir 
Ms Áslaug Einarsdóttir 
Dr Silvia Dehler 
Mr Øystein Riis 
Dr Siri Helene Hauge5 

Members and Alternates of the ECDC Advisory Forum 

Austria 

Belgium 

Bulgaria 

Croatia 

Cyprus 

Czechia 

Denmark 

Estonia 

Finland 

France 

Germany 

Greece 

Hungary 

Professor Dr Petra Apfalter 
Dr Bernhard Benka6 
Professor Dr Herman Van Oyen 
Dr Koen Blot7 
Nomination pending 
Dr Radosveta Filipova 
Dr Sanja Kurečić Filipović 
Dr Aleksandar Šimunović 
Dr Linos Hadjihannas 
Dr Costas Constantinou8 
Dr Jan Kynčl 
Dr Kateřina Fabiánová 
Professor Henrik Ullum9 
Dr Tyra Grove Krause 
  Nomination pending  
Dr Natalia Kerbo 
Dr Mika Salminen 
Dr Carita Savolainen-Kopra 
Dr Bruno Coignard10 
Ms Isabelle Bonmarin11 
Dr Osamah Hamouda 
Dr Ute Rexroth12 
Dr Sotirios Tsiodras 
Dr George Panagiotakopoulos13 
Ms Zsuzsanna Molnár 
Ms Ágnes Hajdu 

1 Appointed Alternate in replacement of Mr Peter Zsapka as of October 2021 
2 Appointed Member in replacement of Ms Sandra Gallina as of April 2021 
3 Appointed Alternate in replacement of Mr Wolfgang Philipp as of April 2021 
4 Appointed Alternate in replacement of Dr Karim Berkouk as of April 2021 
5 Appointed Alternate in replacement of Mr Eirik Rødseth Bakka as of February 2021 
6 Appointed Alternate as of October 2021 in replacement of Professor Dr Franz Allerberger 
7 Appointed Alternate as of October 2021 in replacement of Dr Sophie Quoilin 
8 Appointed Alternate as of May 2021 in replacement of Dr Ioanna Gregoriou 
9 Appointed Member as of January 2021 in replacement of Dr Kåre Mølbak 
10 Appointed Member as of March 2021 in replacement of Dr Jean-Claude Desenclos 
11 Appointed Alternate as of March 2021 
12 Appointed Alternate as of March 2021 in replacement of Dr Ole Wichmann 
13 Appointed Alternate as of March 2021 

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Ireland 

Italy 

Latvia 

Lithuania 

Luxembourg 

Malta 

Netherlands 

Poland 

Portugal 

Romania 

Slovakia 

Slovenia 

Spain 

Sweden 

Dr Lorraine Doherty 
Dr Derval Igoe 
Dr Silvia Declich 
Dr Giuseppe Ippolito 
Dr Jurijs Perevoščikovs 
Nomination pending 
Ms Jugita Pakalniškienė1 
Ms Rolanda Valintėlienė2 
Dr Isabel De La Fuente Garcia  
Professor Friedrich Muehlschlegel 
Dr Charmaine Gauci 
Dr Tanya Melillo Fenech 
Prof Dr Jaap van Dissel 
Dr Susan van den Hof 
Dr Malgorzata Sadkowska-Todys 
Dr Magdalena Rosińska 
Mr Carlos Matias Dias 
Dr Ana Maria Correia 
Dr Florin Popovici 
Nomination pending 
Dr Mária Avdičová 
Professor Henrieta Hudečková 
Dr Irena Klavs 
Dr Marta Grgič-Vitek 
Dr Fernando Simón 
Dr Marina Pollan Santamaria 
Dr Anders Tegnell 
Dr Birgitta Lesko  

Observers 
Albania (candidate country)  
Iceland (EEA/EFTA) 
Liechtenstein (EEA/EFTA) 

Montenegro (candidate country) 
Norway (EEA/EFTA) 

Serbia (candidate country) 
North Macedonia (candidate country) 
Turkey (candidate country) 
Non-governmental organisations 
European Institute of Women's Health 
European Public Health Association 
Association of Schools of Public Health in the European Region 
European Liver Patients’ Association  
European Society for Blood and Marrow Transplantation 
Steering Committee AIDS Action Europe 
European Association of Hospital Pharmacists 

Nomination pending 
Dr Thorolfur Gudnason 
Nomination pending 
Nomination pending 
Nomination pending 
Dr Frode Forland 
Dr Line Vold 
Nomination pending 
Nomination pending 
Professor Mustafa Gokhan Gozel3 
Mr Rebecca Moore 

Dr Aura Timen 
Mr John Duncan Middleton4 
Mr Marko Korenjak5 
Mr Jose Rafael De la Camara De Llanza6 
Mr Aigars Ceplitis7 
Ms Inese Sviestina 

1 Appointed Member as of April 2021 in replacement of Dr Loreta Ašoklienė 
2 Appointed Alternate as of April 2021 in replacement of Ms Nerija Kuprevičienė 
3 Appointed Member from January to October 2021, nomination pending 
4 Appointed Member as of July 2021 
5 Appointed Alternate as of July 2021 
6 Appointed Alternate as of July 2021 
7 Alternate from January to July 2021 

Member 
Alternate 
Member 
Alternate 
Member 
Alternate 
Member 
Alternate 
Member 
Alternate 
Member 
Alternate 
Member 
Alternate 
Member 
Alternate 
Member 
Alternate 
Member 
Alternate 
Member 
Alternate 
Member 
Alternate 
Member 
Alternate 
Member 
Alternate 

Member 

Alternate 
Member 
Observer 
Member 
Alternate 

Observer 
Member 

Member 
Member 
Alternate 
Alternate 
Alternate 
Alternate 

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ECDC Coordinating Competent Bodies 

In 2010, ECDC decided to strengthen and simplify its way of working with the Member States. A new process was 
introduced in 2011 with the nomination of one national Coordinating Competent Body (CCB) in each EU/EEA 
Member State. 

Austria 

Belgium 

Bulgaria 

Croatia 

Cyprus 

Czechia 

Denmark 

Estonia 

Finland 

France 

Germany 

Greece 

Hungary 

112 

Federal Ministry of Social Affairs, Health, Care and Consumer Protection 
Radetzkystrasse 2 
1031 Vienna  
http://www.bmg.gv.at 
+431711004637 
Sciensano 
Rue Juliette Wytsman  
14 1050 Brussels  
https://www.sciensano.be/en 
+3226425111 
National Center of Infectious and Parasitic Diseases 
Yanko Sakazov Blvd. 26  
1504 Sofia  
http://www.ncipd.org 
+35929442875 
Croatian Institute of Public Health 
Rockefellerova 7 
10000 Zagreb  
http://www.hzjz.hr 
+38514683010 
Ministry of Health 
Directorate Medical and Public Health Services  
1 Prodromou 
1449 Nicosia  
http://www.moh.gov.cy 
+35722605650 
National Institute of Public Health 
Šrobárova 48 
10042 Prague 10 
 http://www.szu.cz 
+420267082295 
Danish Health Authority 
Axel Heides Gade 1  
2300 Copenhagen 
http://sundhedsstyrelsen.dk 
+4572227400 
Health Board 
Tartu road 85 
10115 Tallinn  
http://www.terviseamet.ee 
+3726943500 
National Institute for Health and Welfare 
Mannerheimintie 166 
00271 Helsinki 
http://www.thl.fi 
+358295246000 
French Public Health Agency 
12 rue du Val d'Osne 94415 
Saint-Maurice 
http://www.santepubliquefrance.fr 
+33141796700 
Robert Koch Institute 
Nordufer 20 
13353 Berlin  
http://www.rki.de 
+4930187540 
National Public Health Organization 
Agrafon Street 3-5 
15123 Marousi 
https://eody.gov.gr/eody/  
+302105212000 
National Public Health Center 
Albert Flórián út 2-6  
1097 Budapest 
https://www.nnk.gov.hu 
+3614761100 
+3614761279 

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Iceland 

Ireland 

Italy 

Latvia 

Liechtenstein 

Lithuania 

Luxembourg 

Malta 

Netherlands 

Norway 

Poland 

Portugal 

Romania 

Slovakia 

Slovenia 

Centre of Health Security and Communicable Disease Prevention 
Austurströnd 5 
170 Seltjarnarnes 
 http://www.landlaeknir.is 
+3545101900 
Health Protection Surveillance Centre 
25-27 Middle Gardiner Street 
Dublin 
http://www.hpsc.ie 
+35318765300 
Ministry of Health  
Via  Giorgio  Ribotta  5 
00144 Rome 
http://www.salute.gov.it 
+390659946115 
Centre for Disease Prevention and Control 
Duntes 22 
1005 Riga http://spkc.gov.lv 
+37167501590 

Principality of Liechtenstein 
Äulestrasse 51 
9490 Vaduz http://www.ag.llv.li 
+4232367334 

Ministry of Health 
Vilniaus 33 
01506 Vilnius http://www.sam.lt 
+37052661466 

Directorate of Health 
13a rue de Bitburg 
1273 Luxembourg 
http://www.ms.public.lu 
+35224785550 
Superintendence of Public Health 
Ministry for Energy and Health 
St Luke's Hospital, Pjazza San Luqa 
MRS9010 Pieta 
https://deputyprimeminister.gov.mt/en/sph/Pages/Superintendence-of-Public- Health.aspx 
+35623266109 
National Institute for Public Health and the Environment 
Antonie van Leeuwenhoeklaan 9 3720 BA 
Bilthoven http://www.rivm.nl 
+31302742767 

National Institute of Public Health 
PO BOX 4404 Nydalen 0403 
Oslo http://www.fhi.no 
+4721077000 

National Institute of Public Health – National Institute of Hygiene 
24 Chocimska Street 
00791 Warsaw 
http://www.pzh.gov.pl 
+48228497612 
Directorate-General of Health 
Ministry of Health 
Alameda D. Afonso Henriques 45 1049-
005 Lisbon 
www.dgs.pt 
+351218430500 
National Institute of Public Health 
Dr Leonte Anastasievici 1-3, Sector 5 
050463 Bucharest 
http://www.insp.gov.ro/ 
+40213183612 
Public Health Authority of the Slovak Republic 
Trnavská cesta 52 
82645 Bratislava 
http://www.uvzsr.sk 
+421244372906 
National Institute of Public Health 
Trubarjeva cesta 2 
1000 Ljubljana http://www.nijz.si 
+38612441400 

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Spain 

Sweden 

Ministry of Health, Social Services and Equality 
Paseo del Prado 18–20, 7 planta 
28071 Madrid http://www.msssi.es 
+34915962062 

Public Health Agency of Sweden 
Nobels väg 18 
17182 Solna http://folkhalsomyndigheten.se/ 
+46102052000 

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Annex 10. ECDC outputs published in 2021 

Risk assessments 

January 

Risk Assessment: Risk related to the spread of new SARS-CoV-2 variants of concern in the EU/EEA – first 
update 

February 

Risk assessment: SARS-CoV-2 - increased circulation of variants of concern and vaccine rollout in the EU/EEA, 
14th update 

Risk assessment: Ebola virus disease outbreak in North Kivu, Democratic Republic of the Congo, 2021 

Ebola virus disease outbreak in Guinea, 2021 

Threat Assessment Brief: First identification of human cases of avian influenza A(H5N8) infection 

Multi-country outbreak of Salmonella Enteritidis sequence type (ST)11 infections linked to poultry products in 
the EU/EEA and the United Kingdom 

March  

Risk Assessment: Emergence of hypervirulent Klebsiella pneumoniae ST23 carrying carbapenemase genes in 
EU/EEA countries 

May 

Threat Assessment Brief: Dengue epidemic in Réunion, 2021 

Threat Assessment Brief: Emergence of SARS-CoV-2 B.1.617 variants in India and situation in the EU/EEA 

June 

Rapid risk assessment: Assessing SARS-CoV-2 circulation, variants of concern, non-pharmaceutical 
interventions and vaccine rollout in the EU/EEA, 15th update 

Threat Assessment Brief: Implications for the EU/EEA on the spread of the SARS-CoV-2 Delta (B.1.617.2) 
variant of concern 

July 

Rapid Outbreak Assessment: Multi-country outbreak of Salmonella Braenderup ST22, presumed to be linked to 
imported melons 

Rapid risk assessment: Increase in OXA-244 -producing Escherichia coli in the European Union/European 
Economic Area and the UK since 2013, first update 

Rapid Risk Assessment: COVID-19 outbreaks in long-term care facilities in the EU/EEA in the context of current 
vaccination coverage 

Rapid Risk Assessment: Extreme rainfall and catastrophic floods in western Europe 

August 

Risk assessment: The risk of variant Creutzfeldt-Jakob disease transmission via blood and plasma-derived 
medicinal products manufactured from donations obtained in the United Kingdom 
September 

Rapid Risk Assessment: Assessing SARS-CoV-2 circulation, variants of concern, non-pharmaceutical 
interventions and vaccine rollout in the EU/EEA, 16th update 

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October 

Rapid Outbreak Assessment: Multi-country outbreak of multiple Salmonella enterica serotypes linked to 
imported sesame based products 

November 

Assessment of the current SARS-CoV-2 epidemiological situation in the EU/EEA, projections for the end-of-year 
festive season and strategies for response, 17th update 

Threat Assessment Brief: Implications of the emergence and spread of the SARS-CoV-2 B.1.1. 529 variant of 
concern (Omicron) for the EU/EEA 

December 

Threat Assessment Brief: Implications of the further emergence and spread of the SARS-CoV-2 B.1.1.529 
variant of concern (Omicron) for the EU/EEA – first update 

Assessment of the further emergence of the SARS-CoV-2 Omicron VOC in the context of the ongoing Delta 
VOC transmission in the EU/EEA, 18th update 

Technical reports 

January 

ECDC rapid assessment of laboratory practices and needs related to COVID-19 

February 

Integrated COVID-19 response in the vaccination era 

Stress test on logistical aspects of COVID-19 vaccination deployment plans: final report 

Laboratory standard operating procedure for detecting sporadic Creutzfeldt-Jakob disease using Real-Time 
Quaking-Induced Conversion (RT-QuIC) assay 

Infection prevention and control and preparedness for COVID-19 in healthcare settings - sixth update 

European surveillance of COVID-19 in long-term care facilities in the EU/EEA: aggregate data reporting - 
Surveillance protocol version 1.1 

Using face masks in the community: first update - Effectiveness in reducing transmission of COVID-19 

Detection and characterisation capability and capacity for SARS-CoV-2 variants within the EU/EEA 

Behavioural Insights research to support the response to COVID-19: a survey of implementation in the EU/EEA 

March  

Methods for the detection and identification of SARS-CoV-2 variants 

Technologies, strategies and approaches for testing populations at-risk for sexually transmitted infections in 
the EU/EEA 

Guidance for COVID-19 quarantine and testing of travellers 

One-day in-action review (IAR) protocol in the context of COVID-19 

Considerations on the use of self-tests for COVID-19 in the EU/EEA 

Introducing a coherent European framework for tuning COVID-19 response measures 

Stress test on logistical aspects of COVID-19 vaccination deployment plans for the Western Balkans: final 
report 

116 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
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Consolidated Annual Activity Report 

Joint ECDC, EFSA and EURL Lm report: European Listeria typing exercise (ELiTE) 

Hepatitis B and C testing in the EU/EEA: progress in reaching the elimination targets 

Risk of SARS-CoV-2 transmission from newly-infected individuals with documented previous infection or 
vaccination 

Overview of the implementation of COVID-19 vaccination strategies and vaccine deployment plans in the 
EU/EEA 

The sustainable development goals and hepatitis B and C in the EU/EEA 

Rollout of COVID-19 vaccines in the EU/EEA: challenges and good practice 

Assessment tool for joint One Health country visits in relation to antimicrobial resistance 

April 

Reinfection with SARS-CoV-2: implementation of a surveillance case definition within the EU/EEA 

Interim guidance on the benefits of full vaccination against COVID-19 for transmission risks and implications 
for non-pharmaceutical interventions 

Objectives of vaccination strategies against COVID-19 

May 

Guidance for representative and targeted genomic SARS-CoV-2 monitoring 

Considerations for the use of saliva as sample material for COVID-19 testing 

Considerations on the use of rapid antigen detection (including self-) tests for SARS-CoV-2 in occupational 
settings 

Data collection on COVID-19 outbreaks in closed settings with a completed vaccination programme: long-term 
care facilities 

Overview of the implementation of COVID-19 vaccination strategies and vaccine deployment plans in the 
EU/EEA 

Overview of EU/EEA country recommendations on COVID-19 vaccination with Vaxzevria, and a scoping review 
of evidence to guide decision-making 

Public health impact of SARS-CoV-2 variants of concern: scoping review protocol 

The use of antibody tests for SARS-CoV-2 in the context of Digital Green Certificates 

Fourth external quality assessment on antimicrobial susceptibility testing and detection of ESBL‐, acquired 
AmpC-, and carbapenemase‐production of Salmonella, 2018 

Tenth external quality assessment scheme for Salmonella typing 

June 

Interim public health considerations for COVID-19 vaccination of adolescents in the EU/EEA 

Suspected adverse reactions to COVID-19 vaccination and the safety of substances of human origin 

Reducing COVID 19 transmission and strengthening vaccine uptake among migrant populations in the EU/EEA 

Seventh external quality assessment scheme for Listeria monocytogenes typing 

Overview of the implementation of COVID-19 vaccination strategies and deployment plans in the EU/EEA 

117 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
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Indicator framework to evaluate the public health effectiveness of digital proximity tracing solutions 

External quality assessment (EQA) schemes to support European surveillance of Legionnaires’ disease 
2019−2020 - Western Balkans and Turkey 

Countering online vaccine misinformation in the EU/EEA 

July 

COVID-19 in children and the role of school settings in transmission - second update 

Partial COVID-19 vaccination, vaccination following SARS-CoV-2 infection and heterologous vaccination 
schedule: summary of evidence 

August 

HIV Continuum of care: Monitoring implementation of the Dublin Declaration on partnership to fight HIV/AIDS 
in Europe and Central Asia (2020 progress report) 

September 

Interim public health considerations for the provision of additional COVID-19 vaccine doses 

Data collection on COVID-19 outbreaks in closed settings with a completed vaccination programme: long-term 
care facilities, version 2.0 

Protocol for a focused after-action review on evidence-based decision-making for selected COVID-19 response 
measures 

Overview of the implementation of COVID-19 vaccination strategies and vaccine deployment plans in the 
EU/EEA 

October 

Interim analysis of COVID-19 vaccine effectiveness against Severe Acute Respiratory Infection due to 
laboratory-confirmed SARS-CoV-2 among individuals aged 65 years and older, ECDC multi-country study 

Core protocol for ECDC studies of COVID-19 vaccine effectiveness against hospitalisation with Severe Acute 
Respiratory Infection laboratory-confirmed with SARS-CoV-2, version 1.0 

Facilitating COVID-19 vaccination acceptance and uptake in the EU/EEA 

COVID-19 surveillance guidance - Transition from COVID-19 emergency surveillance to routine surveillance of 
respiratory pathogens 

Response plan to control and manage the threat of multi- and extensively drug-resistant gonorrhoea in Europe 
– Indicator monitoring 2019 

Eleventh external quality assessment scheme for Salmonella typing 

Options for the use of rapid antigen detection tests for COVID-19 in the EU/EEA - first update 

Contact tracing in the European Union: public health management of persons, including healthcare workers, 
who have had contact with COVID-19 cases – fourth update 

November 

Overview of the implementation of COVID-19 vaccination strategies and vaccine deployment plans in the 
EU/EEA 

Digital technologies for key public health functions: results of an ECDC expert consultation - May/June 2021 

Digital technologies for the surveillance, prevention and control of infectious diseases - A scoping review of the 
research literature 

118 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
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Consolidated Annual Activity Report 

Assessment of electronic health records for infectious disease surveillance 

Surveillance of COVID-19 in long-term care facilities in the EU/EEA 

Tenth external quality assessment scheme for typing of Shiga toxin-producing Escherichia coli 

December 

Interim public health considerations for COVID-19 vaccination of children aged 5-11 years 

Euro-GASP external quality assessment scheme for Neisseria gonorrhoeae antimicrobial susceptibility testing - 
2019 

Euro-GASP external quality assessment scheme for Neisseria gonorrhoeae antimicrobial susceptibility testing – 
2020 

Organisation of vector surveillance and control in Europe 

Generic protocol for COVID-19 vaccine effectiveness studies during outbreaks in semi-closed settings in the 
EU/EEA 

Rapid assessment of antigenic characterisation capability and capacity for SARS-CoV-2 viruses in EU/EEA 
laboratories 

Methods for the detection and characterisation of SARS-CoV-2 variants - first update 

Surveillance reports 

March 

Tuberculosis surveillance and monitoring in Europe 2021 –2019 data 

June 

JIACRA III - Antimicrobial consumption and resistance in bacteria from humans and animals 

November 

Gonococcal antimicrobial susceptibility surveillance in the European Union/European Economic Area, 2019 

Surveillance of antimicrobial resistance in Europe, 2020 data 

HIV/AIDS surveillance in Europe 2021 (2020 data) 

Technical guidance 

February 

Sequencing of SARS-CoV-2: first update 

March 

HIV Pre-Exposure Prophylaxis in the EU/EEA and the UK: Implementation, standards and monitoring 

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Corporate publications 

January 

Strategic and performance analysis of ECDC response to the COVID-19 pandemic 

Single programming document 2021-2023 

ECDC Strategy 2021–2027 

June  

Consolidated Annual Activity Report 2020 

Regular publications  

Influenza virus characterisation, summary Europe 

Measles and rubella monitoring 

Communicable disease threats report 

Annual Epidemiological Report series on communicable 
diseases in Europe  

New chapters are published as they become available. 

Overview table 

January 

Smallpox - Annual Epidemiological Report for 2019 

Rabies - Annual Epidemiological Report for 2019 

Congenital toxoplasmosis - Annual Epidemiological Report for 2018 

Rift Valley fever - Annual Epidemiological Report for 2019 

Plague - Annual Epidemiological Report for 2019 

Leptospirosis - Annual Epidemiological Report for 2016 

Lassa fever - Annual Epidemiological Report for 2019 

Yersiniosis - Annual Epidemiological Report for 2019 

February  

Diphtheria - Annual Epidemiological Report for 2018 

Crimean-Congo haemorrhagic fever - Annual Epidemiological Report for 2019 

Yellow fever - Annual Epidemiological Report for 2019 

Ebola and Marburg virus diseases - Annual Epidemiological Report for 2019 

Tularaemia - Annual Epidemiological Report for 2019 

Mumps - Annual Epidemiological Report for 2018 

Q fever - Annual Epidemiological Report for 2019 

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March 

West Nile virus infection - Annual Epidemiological Report for 2019 

Tick-borne encephalitis - Annual Epidemiological Report for 2019 

Zika virus disease - Annual Epidemiological Report for 2019 

April  

Dengue - Annual Epidemiological Report for 2019 

Chikungunya virus disease - Annual Epidemiological Report for 2019 

Malaria - Annual Epidemiological Report for 2019 

Hantavirus infection - Annual Epidemiological Report for 2019 

May 

Shiga toxin-producing Escherichia coli (STEC) infection - Annual Epidemiological Report for 2019 

Legionnaires’ disease - Annual Epidemiological Report for 2019 

July  

Hepatitis C - Annual Epidemiological Report for 2019 

Hepatitis B - Annual Epidemiological Report for 2019 

August 

Zoonotic influenza - Annual Epidemiological Report for 2020 

Seasonal influenza - Annual Epidemiological Report for 2020-2021 

September 

Tuberculosis - Annual Epidemiological Report for 2019 

Poliomyelitis - Annual Epidemiological Report for 2018 

October 

Cryptosporidiosis – Annual Epidemiological Report for 2018 

Cholera - Annual Epidemiological Report for 2019 

November 

Antimicrobial consumption in the EU/EEA (ESAC-Net) - Annual Epidemiological Report for 2020 

Trichinellosis - Annual Epidemiological Report for 2019 

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Annex 11. Negotiated procedures without 
prior publication of a contract notice 
conducted in 2021 

Reference 

Title 

NP/2021/SMS/23702 

Biostatistics Services 

NP/2020/DPR/23653 

ECDC training in the area of 
vaccination and vaccine 
hesitancy for primary 
healthcare professionals 

Type of procedure: Art. 11.1. of 
the Financial 
Regulation 

Annex 1 - 11.1 ( e ) - New 
services/works consisting in the 
repetition of similar services/works 

Annex 1 - 11.1 (a) - Follow-up of an 
open/restricted procedure where 
no (or no suitable) 
tenders/requests to participate 
have been submitted 

173,000.00 

Amount 

Contractor 

Contract reference 

1,050,000.00 

EPICONCEPT 
SAS* 

ECDC/2019/015 

THE 
ASSOCIATION 
OF SCHOOLS 
OF PUBLIC 
HEALTH IN THE 
EUROPEAN 
REGION ASB 

TEAM WORK 
SAS 

ECDC/2021/005 

ECDC/2017/015 

BILBOMATICA 
SA 

ECDC/2019/004 

EUROPEAN 
DYNAMICS 
LUXEMBOURG 
SA 

SWECO 
SVERIGE AB 

ECDC/2019/005 

ECDC/2019/006 

48,200,000.00 

EUROFINS 
GENOMICS AS 

ECDC/2021/004 

3,285,000.00 

TEMPEST 
SECURITY 
SVERIGE AB 

ECDC/2018/036_03 

NP/2020/ SMS/12295  

ESCAIDE 

Annex 1 - 11.1 ( e ) - New 
services/works consisting in the 
repetition of similar services/works 

150,000.00 

NP/2021/PHF/23670 

Data management services  Annex 1 - 11.1 ( e ) - New 

1,200,000.00 

services/works consisting in the 
repetition of similar services/works 

NP/2021/PHF/23670 

Data management services  Annex 1 - 11.1 ( e ) - New 

1,200,000.00 

services/works consisting in the 
repetition of similar services/works 

NP/2021/PHF/23670 

Data management services  Annex 1 - 11.1 ( e ) - New 

1,200,000.00 

NP/2021/PHF/23685 

COVID-19 high-capacity, 
high-priority WGS support 

NP/2021/RMS/24808 

Security Services 

services/works consisting in the 
repetition of similar services/works 

Annex 1 - 11.1 ( c ) - Extreme 
urgency caused by unforeseeable 
events not attributtable to the 
contracting authority 

Annex 1 - 11.1 ( e ) - New 
services/works consisting in the 
repetition of similar services/works 

122 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
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European Centre for Disease 
Prevention and Control (ECDC)

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