COMMUNICATION FROM THE COMMISSION TO THE EUROPEAN PARLIAMENT, THE COUNCIL, THE EUROPEAN ECONOMIC AND SOCIAL COMMITTEE AND THE COMMITTEE OF THE REGIONS EU response to COVID-19: preparing for autumn and winter 2023
Date: 2022-09-02
Institutions: Directorate-General for Health and Food Safety, European Commission
Subjects: EU strategy, coronavirus disease, disease surveillance, epidemic, public health, vaccination, vaccine

EN 

  EN 

   EUROPEAN COMMISSION  Brussels, 2.9.2022  COM(2022) 452 final  COMMUNICATION FROM THE COMMISSION TO THE EUROPEAN PARLIAMENT, THE COUNCIL, THE EUROPEAN ECONOMIC AND SOCIAL COMMITTEE AND THE COMMITTEE OF THE REGIONS EU response to COVID-19: preparing for autumn and winter 2023  
 
 
1.  INTRODUCTION 

The COVID-19 summer wave, driven by Omicron BA.4 and BA.5, reminded us very clearly that the 
pandemic is not yet over. Between the beginning of June and the middle of July1, the EU/EEA saw a 
tripling  of  COVID-19  cases.  Since  then,  case  numbers  have  been  falling  again,  but  remain  high 
among people aged 65 years and over, with consequent increases in hospitalisation rates and intensive 
care unit (ICU) admissions in this age group2. Overall, more than 2 300 people still die every week 
in the EU/EEA of COVID-19.  

These  numbers  are  worrying  not  least  since  they  are  likely  to  be  an  underestimation  of  the  real 
situation and they do not account for repercussions such as long-COVID, as well as the impact of the 
pandemic  on  mental  health.  In  addition,  all  countries  have  lifted  most  restrictions  and  their 
populations are experiencing pandemic fatigue, which can lead to changes in behaviour. These factors 
make it easier for the virus to circulate rapidly in the EU and this opens the door to new variants 
emerging that could evade immunity, spread more easily or cause more severe disease. It is therefore 
possible  that  the  costly  gains  made  in  response  to  the  pandemic  could  be  lost  if  the  virus  is  not 
controlled and further infections are not prevented.  

Since the end of April this year, the uptake of COVID-19 vaccines in the EU has barely changed. 
Among people aged 60 years and over, 7.5 % are still unvaccinated and 16.3 % have not received 
their first booster. Looking at the vaccination rates in adults, 14.1 % of people aged 18 and over are 
unvaccinated and 35.5 % have not received their first booster. Additionally, while protection from 
vaccines continues to be high against severe outcomes (severe diseases, hospitalisation and death), 
protection is also waning, as most people received their last shot several months ago. The widespread 
exposure  to  Omicron,  the  varying  vaccination  coverage  across  and  within  countries,  and  waning 
protection from both natural infection and vaccines presents a complex landscape of immunity in the 
population. 

The past 2 years have shown that the EU could face another COVID-19 wave this autumn and winter. 
With people returning from holidays, schools reopening, and colder weather driving people indoors 
for social gatherings, infection rates could further spike. It is also likely that the EU will face a season 
with  an  active  circulation  of  other  respiratory  viruses,  including  influenza,  as  usual  in  the  winter 
season. This forecast presents challenge to the already overburdened national healthcare systems and 
their workforce across the EU.   

This Communication, building on the set of actions proposed in April3, urges Member States to put 
the necessary integrated  strategies and measures in place to help avoid a surge of COVID-19 this 
autumn and winter, and to put in place the necessary structures  that allow us to respond to future 
outbreaks in a sustained manner. Moreover, the Commission calls on Member States for continued 
coordination of preparedness  efforts across the EU, ahead of the next  wave and  further  rollout of 
vaccination programmes. Finally, by continuing to act now, we can limit the expected pressure on 
our healthcare systems, the disruption of our economies and challenges for our society.  

1 

2 

3 

By the end of week 22 of 2022, the 14-day COVID-19 case notification rate for the EU/EEA was 350 (country range: 8.1-3 303) 
per 100 000 population, which increased to 1 207 (country range: 43.0-4 945) per 100 000 by the end of week 28 of 2022. 
Hospital admission rates per 100 000 nearly doubled between early May and mid-July 2022, and current levels are at over 40% 
of the pandemic maximum. ICU admission and occupancy rates currently correspond to 16% and 18% (respectively) of the 
maximum rates reported since the start of the pandemic.  
Communication from the Commission to the European Parliament, the Council, the European Economic and Social Committee 
and the Committee of the Regions, COVID-19 – Sustaining EU preparedness and Response: Looking ahead (COM/2022/190 
final). 

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2.  COVID-19 VACCINE DEVELOPMENT AND AVAILABILITY FOR AUTUMN AND 

WINTER 

The development of COVID-19 vaccines can be considered a scientific triumph, and it is estimated 
that their successful roll-out has saved around 20 million lives worldwide during their first year4. In 
the context of the current resurging pandemic, driven by Omicron BA.4 and BA.5, it is important to 
reinforce  the  message  that  the  current  COVID-19  vaccines  (monovalent  vaccines  targeting  the 
original SARS-CoV-2 virus) continue to offer high levels of protection against hospitalisation, severe 
disease and death. Vaccination continues to be the most reliable way of avoiding severe disease and 
therefore reducing mortality from COVID-19. 

At the same time, vaccine manufacturers are developing adapted mRNA vaccines to be used as 
boosters  targeting  Omicron  variants.  Adapted  versions  of  the  Comirnaty  and  Spikevax  vaccines, 
targeting the original SARS-CoV-2 virus as well as the BA.1 Omicron subvariant were approved by 
the European Medicines Agency (EMA) and authorised in the EU at the beginning of September, 
under an accelerated process provided for by the Commission in 20215. The EMA has also started a 
rolling  review  for  a  version  of  Comirnaty  adapted  to  the  original  SARS-CoV-2  virus  and  to  its 
Omicron subvariants BA.4 and BA.5, for a potential accelerated authorisation in the autumn. The 
adapted mRNA vaccines are expected to offer increased, broader protection against current and future 
variants of concern.  

A second category of protein-based vaccines, awaited in the coming weeks, are expected to protect 
against  SARS-CoV-2  variants  and  complement  our  broad  vaccine  portfolio  and  choice  for 
vaccination strategies6. The Nuvaxovid and VLA2001 vaccines, currently available in the EU, use 
safe  and  effective  conventional  vaccine  platforms  that  have  the  potential  to  increase  COVID-19 
vaccination acceptability. In addition, the Vidprevtyn and PHH-1V vaccines, targeting other strains 
of COVID-19 variants of concern, will offer effective alternatives for heterologous boosters. The EU 
vaccines contracts ensure that Member States have access to these latest vaccines in quantities needed 
as soon as they become available. In August this year, the first Joint Procurement framework contract 
was signed for a COVID-19 vaccine with the company HIPRA. 

It is impossible to predict what variants will be predominant during the autumn and winter period, 
but the Union will continue to ensure access to a broad and flexible vaccines portfolio providing a 
very good level of immunity against SARS-CoV-2. 

Thanks  to  the  EU’s  Vaccines  Strategy7,  Member  States  are  equipped  to  plan  and  launch  their 
vaccination campaigns including adapted vaccines ahead of autumn, offering an additional booster 
as  needed,  according  to  the  characteristics  of  such  vaccines  and  national  recommendations.  The 
Commission continues its work with manufacturers to ensure that Member States will receive more 
adapted vaccines as a priority as they become available. In addition, the Commission continues to be 
in close contact with the suppliers of critical components that are needed throughout the production 
process. Furthermore, the EU-US joint COVID-19 manufacturing and supply chain task force8 has 
agreed  on  a  list  of  critical  materials  necessary  for  the  production  of  COVID-19  vaccines  that  are 

4 

5 

6 

7 
8 

lives  during 

The  Economist,  Covid-19  vaccines  saved  an  estimated  20  m 
https://www.economist.com/graphic-detail/2022/07/07/covid-19-vaccines-saved-an-estimated-20m-lives-during-their-first-
year?frsc=dg%7Ce.  
Commission Delegated Regulation (EU) 2021/756 of 24 March 2021 amending Regulation (EC) No 1234/2008 concerning the 
examination  of  variations  to  the  terms  of  marketing  authorisations  for  medicinal  products  for  human  use  and  veterinary 
medicinal products (OJ L 162, 10.5.2021, p. 1). 
In  addition  to  the  existing  contracts  with  Sanofi  and  Novavax,  the  EU  has  recently  put  in  place  a  contract  via  the  Joint 
Procurement Agreement to ensure Member States’ access to the HIPRA vaccine. 
https://ec.europa.eu/info/live-work-travel-eu/coronavirus-response/public-health/eu-vaccines-strategy_en. 
https://ec.europa.eu/commission/presscorner/detail/en/STATEMENT_21_4847. 

first  year,  7 July  2022, 

their 

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considered worth monitoring9. Such monitoring will serve as an early warning scheme and will help 
to identify possible bottlenecks in the supply chain at an early stage. 

Planning  for  the  medium-term,  the  Commission  is  engaging  with  international  partners  and 
developers of potential pan-coronavirus, or combination vaccines that elicit broader, stronger, and 
longer-lasting immune responses. Moreover, the Commission is closely following the development 
of  vaccines  with  intranasal,  intramuscular  and  intradermal  delivery  systems.  These  vaccines  are 
expected  to  be  easier  to  administer,  more  accessible  and  may  increase  vaccination  acceptance.  In 
addition, the EU vaccines contracts also ensure that companies keep Member States closely informed 
on the progress made in the development of these vaccines.  

Overall, funding for research and development, adapted regulatory pathways, and development of 
manufacturing and infrastructure capacities will be key to ensure access to safe and effective next-
generation vaccines. 

3.  ROLLING OUT THE NEXT COVID-19 VACCINATION STRATEGIES  

As  different  vaccines  will  be  made  available  at  different  times  in  the  coming  weeks  and  months, 
Member  States  should  consider  both  the  potential  protection  offered  by  adapted  vaccines  and  the 
benefits  of  vaccinating  people  in  particular  risk  groups  at  the  right  time.  National  vaccination 
strategies should be coordinated and consistent with each other to avoid any major differences across 
the EU/EEA and to provide clarity and coherent messages to the public. Moreover, they should be 
rolled out ahead of the next wave. 

The  priority  of  national  vaccination  campaigns  should  remain  improving  vaccine  uptake  of  the 
primary vaccination course and first booster dose among eligible individuals. This is of particular 
importance  for  population  groups  at  higher  risk  of  severe  outcomes  and  for  countries  with  lower 
vaccination rates. Significant gaps and disparities across countries and the population remain, and 
these should be tackled to strengthen protection.  

The following section puts forward suggestions for Member States regarding their national COVID-
19  vaccination  strategies,  including  priorities  and  factors  to  be  considered  when  preparing  and 
implementing them10.  

SUGGESTED ACTIONS FOR COVID-19 VACCINATION STRATEGIES FOR AUTUMN 
AND WINTER 2022-2023  

Overall objectives and priorities to implement at this stage of the pandemic 

  Continue national COVID-19 vaccination strategies using the currently available vaccines 

to reduce hospitalisations, severe disease and death. 

  Close vaccination coverage gaps. Improving vaccine uptake of the primary vaccination course 
and  first  booster  dose  among  eligible  individuals,  including  eligible  children  and  adolescents 
according to national vaccination schedules, remains a priority. This is of particular importance 
for population groups at higher risk of severe outcomes and for countries with lower vaccination 
rates.  

  Maintain  sufficient  vaccination  capacities,  either  by  reactivating  vaccination  centres  or  by 

using other resources, such as general practitioners. 

9  

10 

The compiled list is primarily based on experience incurred during upscaling of the production of COVID-19 vaccines. The list 
covers a wide range of products groups (44 essential items), such as enzymes and single-use and chromatography materials. 
These  recommendations  build  on  the  joint  statement  from  the  ECDC  and  the  European  Medicines  Agency  (EMA)  on  the 
administration of  a  fourth  dose  of  mRNA  vaccines  of  6 April  2022  as  well  as  Preliminary  public health  considerations  for 
COVID-19 vaccination strategies in the second half of 2022, published by the ECDC on 18 July 2022. 

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  Prioritise  the  administration  of  an  additional  booster  dose  (second  or  subsequent)  for 
specific population groups: people aged 60 years and over and individuals of any age at risk of 
severe disease (e.g. individuals with underlying comorbidities, immunocompromised individuals 
and pregnant women). The boosting of healthcare workers and long-term care facility personnel 
should also be considered. Subsequent boosters could be administered as early as 3 months after 
the previous one, and priority should be given to people who received their last booster more than 
6 months ago. 

  Ensure long-term care residents receive the recommended booster doses.  
  Combine  COVID-19  and  influenza  vaccination  campaigns  where  possible,  particularly 

targeting vulnerable groups and relevant age groups.  

Measures to take when adapted COVID-19 vaccines are available  

  Develop  national  vaccination  programmes  outlining  which  vaccines  should  be  used  for 
which  population  groups.  This  will  depend  on  the  characteristics  of  the  adapted  vaccines 
compared to first-generation ones, the epidemiological situation, and the possible emergence of 
new variants. Such strategies should be discussed in the appropriate EU forums11, to exchange on 
experiences and to ensure coordination among countries. 

  Identify which population groups should be prioritised for the adapted vaccines, in particular 
if these vaccines show greater effectiveness against variants circulating during autumn and winter.  
  Ensure  there  is  sufficient  capacity  to  administer  the  vaccines  when  adapted  vaccines  are 

delivered, so vaccination campaigns can start immediately.  

  Closely monitor the effectiveness and safety of the [new and] adapted vaccines once widespread 
rollout  commences.  If  needed,  national  vaccination  strategies  should  be  adapted  when  more 
evidence on the performance of these vaccines becomes available.  

Communication strategies related to the autumn and winter vaccination strategies  

  Implement  and, if possible, coordinate  effective  communication initiatives and strategies to 
promote uptake of additional vaccine doses, and promote completion of the primary series by 
those who have not yet done so. Clear information should be provided around the rationale for 
recommendations, and the benefits of the primary course and boosters for different population 
groups, including for those who already had the disease.  

  Ensure that capacity is in place to  regularly update public communication strategy, based on 
epidemiological developments, changes in the public’s perceptions and attitudes of the ongoing 
pandemic and COVID-19 vaccination, including the capacity to monitor and swiftly respond to 
false or misleading information. 

  Increase vaccine confidence by monitoring and addressing the public’s questions and concerns, 
explaining the science behind the recommendations and debunking mis- and disinformation in 
the  mainstream  media  and  on  social  media.  Clear,  consistent,  and  evidence-based  messaging 
demonstrating the continued safety and effectiveness of COVID-19 vaccines is key. Target hard-
to-reach population groups through tailored communication and draw on health professionals 
and community leaders as trusted sources of information.  

  Ensure pro-active communication once new and adapted vaccines will become available. 
Ahead of the deliveries of adapted vaccines, Member States should communicate clearly to the 
public to avoid confusion about how boosters will be given in the coming months, when and why 
it will happen, and who will have access to them.  

  Address the political dimension of vaccine hesitancy and disinformation campaigns linked 
to  anti-Western  and  anti-EU  narratives.  Particular  challenges  include  channels  where 
disinformation is circulating in relation to other crises, especially the Russian military aggression 
against Ukraine. 

11 

Such as the Health Security Committee.  

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4.  ESSENTIAL AREAS FOR INCREASED EFFORTS 

Surveillance of respiratory viruses 

The  current  testing  strategies  and  reduced  sequencing  efforts  in  some  countries  are  creating  a 
dangerous blind spot in our knowledge of how the virus is spreading and evolving. There is an urgent 
need  to  develop  and  sustain  resilient  population-based  integrated  surveillance  systems.  Such 
systems would monitor different diseases like influenza, COVID-19, and other respiratory virus 
infections12 in the EU in an integrated way. Data from such surveillance systems will enable countries 
to closely monitor the spread and intensity of circulating respiratory viruses and to detect changes in 
trends and the emergence of new variants of concern. This will, in turn, guide control measures and 
mitigate the impact of new variants. These systems will be a key element at this stage of the pandemic 
and for possible future cross-border health threats. 

Strategic prioritisation and sustained financing are required to further expand and develop ‘sentinel 
systems’  to  make  them  fit  for  purpose.  Sentinel  systems  have  been  commonly  used  for  the 
surveillance  of  respiratory  infections  (e.g.  influenza).  Instead  of  testing  the  whole  population,  a 
sentinel surveillance system takes samples from a number of representative cases from specific sites, 
such as general practices or hospitals, which are evenly spread across the country or region. A sentinel 
system  with  sufficient  sites  that  are  producing  sufficient  volumes  of  testing  and  that  are 
geographically  and  demographically  representative  of  the  whole  population  of  a  country,  is  an 
efficient and effective way to monitor the spread of a (respiratory) infection. 

Member States should aim to boost the number of sentinel sites, ensure that these sites represent the 
geographic  and  demographic  distribution  of  their  population,  and  increase  the  number  of  tests 
performed  in  sentinel  surveillance  sites.  They  should  also  plan  to  upscale  their  testing  capacity, 
particularly if required to respond to the emergence of a new variant of concern or influenza variant. 
A sufficient sequencing volume also needs to be maintained to monitor circulating viruses and detect 
new virus variants promptly.  

On  18 July  2022,  the  ECDC  and  the  World  Health  Organization  Regional  Office  for  Europe 
published guidance13 with practical advice for countries on setting up effective surveillance systems 
and ensuring continuity  of national  surveillance in the 2022-2023 winter  season and beyond. The 
guidance sets out the many advantages offered by population-based integrated surveillance systems, 
and  Member  States  are  strongly  encouraged  to  study  and  follow  up  on  its  recommendations. 
Following the guidance will improve comparability between Member States and produce more robust 
epidemiological data; analysing this data will enable more effective and timely responses, ultimately 
improving  the  EU’s  pandemic  preparedness.  Member  States  are  invited  to  periodically  share 
information with the ECDC about the status of their surveillance systems for respiratory viruses, for 
example by responding to short surveys when circulated. 

Wastewater-based surveillance has emerged during the COVID-19 pandemic as a complementary 
tool to gather information on large population groups. It has been included more systematically in 
national  surveillance  strategies  for  detecting  SARS-CoV-2  and  its  variants,  and  different  EU 
measures  have  been  implemented  to  support  countries  in  these  efforts.  For  example,  26  Member 
States have received direct action grants to support wastewater surveillance and related activities14. 

12 
13 

14 

2022, 

Such as respiratory syncytial virus (RSV) infections or new viral diseases of public health concern. 
in 
18 July 
https://www.ecdc.europa.eu/en/publications-data/operational-considerations-respiratory-virus-surveillance-europe.  
https://environment.ec.europa.eu/news/coronavirus-response-monitoring-wastewater-contributes-tracking-coronavirus-and-
variants-across-all-2022-03-17_en. 

ECDC,  Operational 

considerations 

surveillance 

respiratory 

virus 

for 

Europe, 

5 

 
 
                                                           
The forthcoming revision of the Urban Wastewater Treatment Directive15, planned to be adopted this 
autumn,  will  introduce  wastewater  surveillance,  with  the  monitoring  of  public  health  relevant 
parameters including the virus and its variants in urban wastewaters. Member States are encouraged 
to continue their efforts to systematically monitor SARS-CoV-2 in wastewater surveillance and to 
apply the actions set out in the related Commission recommendation16.  

Non-pharmaceutical interventions 

Vaccines  are  a  crucial  part  of  the  response  to  COVID-19.  However,  our  experience  with  this 
pandemic has shown that our efforts need to include non-pharmaceutical interventions to limit the 
virus’ spread, protect vulnerable groups and reduce the pressure on healthcare systems. Examples of 
highly  effective  non-pharmaceutical  interventions  include  wearing  masks  and  more  restrictive 
measures like limiting the size of gatherings. Particularly if such interventions are implemented ahead 
of or at the beginning of a next wave, their impact will be greatest. It is therefore possible that any of 
the non-pharmaceutical interventions will need to be reintroduced in the coming months.  

At this stage of the pandemic, the epidemiological situation varies between Member States. As such, 
the best and most efficient public health response may also differ. Countries will need to assess their 
particular epidemiological situation in terms of impact on public health, healthcare capacity, and the 
social  acceptance  of  such  public  health  measures,  and  make  decisions  accordingly.  However, 
coordination  of  national  approaches  in  the  Council’s  integrated  political  crisis  response  (IPCR)17 
arrangements and the Health Security Committee18 was essential in the previous waves to encourage 
a coherent approach in the EU and single market. It is essential that this continues.  

The key indicators to assess when deciding on reintroducing non-pharmaceutical measures are set 
out below.  

Data and thresholds to assess for reintroducing non-pharmaceutical measures  

  Severity  indicators  to  be  used:  incidence  of  severe  acute  respiratory  illness  (SARI)  due  to 

COVID-19 or influenza by age; mortality attributed to COVID-19 or influenza by age.  

  Alternatively, specific COVID-19 or influenza hospital and ICU admissions and/or hospital 

and ICU occupancy rates can be used. These should ideally be broken down by age.  

  Severity  indicators  must  be  combined  with  data  on  healthcare  capacity  and  health  systems 
performance to be able to assess the epidemic impact. Such impact assessments should be carried 
out regularly and be triggered by increasing trends in severity indicators.  

  Data from previous years will help determine country-specific thresholds of epidemic severity, 
taking into account the different levels of severe disease and available healthcare capacity.  

In many Member States, the mandatory use of face masks in healthcare settings and long-term care 
facilities is still in place. Their use in closed public spaces, including public transport, can be a first 
option to limit community transmission.  Recent  evidence shows that FFP2 face masks, which are 
readily available in the EU/EEA, have a stronger protective effect than medical masks or cloth masks 
in the community. Member States are therefore strongly encouraged to consider their use in specific 
settings. Ensuring adequate ventilation indoors is a key measure for reducing the risk of transmission 

15 
16 

17  
18  

Council Directive 91/271/EEC of 21 May 1991 concerning urban waste-water treatment (91/271/EEC). 
Commission Recommendation of 17.3.2021 on a common approach to establish a systematic surveillance of SARS-CoV-2 and 
its variants in wastewaters in the EU, C/2021/1925, (OJ L 98, 19.3.2021, p. 3–8).  
https://www.consilium.europa.eu/en/policies/ipcr-response-to-crises/. 
https://health.ec.europa.eu/health-security-and-infectious-diseases/preparedness-and-response/health-security-committee-
hsc_en. 

6 

 
 
                                                           
of  SARS-CoV-2  and  other  respiratory  viruses19.  More  efforts  are  needed  to  improve  ventilation 
across  the  EU/EEA  Other  measures  such  as  working  from  home  or  limiting  the  size  of  mass 
gatherings  have  proved  effective  to  limit  transmission  of  the  virus. When  implemented  ahead  of 
increases in cases, these measures can avoid the need for more disruptive ones such as lock downs, 
closing  businesses  and  schools,  stay-at-home  recommendations  and  travel  restrictions.  Political 
commitment and  community  engagement are key  for the  success  and the effectiveness of non-
pharmaceutical measures. 

Reopening of schools 

As children return to school after the summer break, it is crucial to maintain safe school environments 
and minimise student and staff absences by preventing the transmission of SARS-CoV-2 alongside 
other respiratory viruses20.  Children of all ages are susceptible to  and can transmit  SARS-CoV-2. 
Children are often asymptomatic or present with mild symptoms of infection, but severe cases do 
occur, particularly among children with risk factors for severe outcomes. Post-COVID condition (or 
long COVID) has also been reported among children. 

Important  measures  such  as  promoting  the  vaccination  of  pupils  and  staff  against  COVID-19, 
encouraging good respiratory and hand hygiene, establishing improved ventilation systems in school 
premises, and issuing frequent reminders to stay home when experiencing respiratory symptoms, are 
vital tools to reduce virus transmission. The implementation of in-school mitigation measures should 
be adapted to the educational setting and age group of the students. In addition, such measures should 
take into account the need to provide children with an optimal learning and social environment. The 
guidance published by the ECDC in July 202121 and the recommendations from this document remain 
valid in this regard.  

The COVID-19 pandemic has disrupted the lives of children and adolescents affecting their everyday 
routines, education, health, development and overall well-being. It is therefore important to keep in 
mind  the  negative  impacts  of  school  disruptions  on  the  health  and  development  of  children.  The 
implementation of measures at schools should be aimed to be kept at a minimum and the further loss 
of learning should be prevented.  

Strengthening healthcare systems and capacity  

The  COVID-19  crisis  has  tested  the  resilience  and  agility  of  European  health  systems  in  an 
unprecedented way. In the summer of 2022, EU health systems continue to face challenges due to an 
increase in COVID-related hospital admissions and the need to clear the pandemic-induced backlog 
of non-COVID care. This pressure on healthcare systems is exerted against the backdrop of other 
longstanding challenges, such as the persistent shortages of health workers, which the COVID-19 
pandemic has aggravated. According to a survey by the ECDC, many Member States are reporting 
issues in retaining and recruiting a sufficient number of healthcare staff with the right competencies22. 
Healthcare systems risk having insufficient capacity for the winter of 2022 if healthcare funding and 
human resources are not increased. Furthermore, other respiratory viruses (e.g. influenza) might pose 
an additional burden on healthcare systems. The pandemic has shown that it is imperative to have a 
strong, resilient and well-staffed healthcare system.  

19 

20  
21  

22 

If adequate ventilation is not possible, the use of air-cleaning devices, such as those equipped with either HEPA (high-efficiency 
particulate  absorbing)  filters  or  filters  with  comparable  effectiveness  and  ultraviolet  germicidal  irradiation  (UVGI)  can  be 
considered. 
Such as influenza, respiratory syncytial virus (RSV) and norovirus. 
8  July  2021,  ECDC,  COVID-19  in  children  and  the  role  of  school  settings  in  transmission  -  second  update, 
https://www.ecdc.europa.eu/en/publications-data/children-and-school-settings-covid-19-transmission. 
3 August 2022, ECDC, Assessment of workforce capacity and training needs for the prevention and control of communicable 
diseases  -  report  on  2021  survey,  https://www.ecdc.europa.eu/sites/default/files/documents/ECDC-Assessment-Capacity-
Training-Needs-EUEEA-2021.pdf. 

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Investments under the Recovery and Resilience Facility to strengthen health systems are now in full 
swing. More than EUR 42 billion in investments are earmarked for fostering better healthcare under 
adopted recovery and resilience plans, and almost one third of this amount is dedicated to investment 
and reforms to drive the digitalisation of health systems. Specific investment also aims to strengthen 
the public health capacity of national health systems. Continuous effort will be needed to bolster the 
resilience  of  health  systems,  from  the  short-term  to  the  long-term.  In  addition,  the  latest  country-
specific recommendations  – adopted in July 2022 as part of the European Semester – addressed 
healthcare systems in eight Member States and stressed the need for better prevention and primary 
healthcare, as well as tackling workforce shortages. 

The next edition of the biannual report Health at a Glance: Europe will be published by the end of 
2022. It will in particular assess the disruption of health services for non-COVID patients during the 
pandemic and look at strategies to overcome backlogs in healthcare. It will also examine the impact 
of the COVID-19 pandemic on child and youth health, notably mental health. 

Looking further ahead, health systems’ preparedness for infectious disease outbreaks and other types 
of shocks must be improved. Running resilience tests will enable Member States to regularly review 
health crisis preparedness and check their health systems’ resilience against specific high-pressure 
scenarios and long-term structural challenges. Resilience should also include resilience and efficiency 
of public procurement practices by hospitals and other purchasing bodies23. Given the burden of the 
pandemic on mental health, particularly of the health workforce, Member States should strengthen 
measures  to  support  good  mental  health  of  healthcare  workers  and  of  the  overall  population. 
Furthermore,  strengthening  the  health  workforce  will  make  health  systems  more  resilient.  The 
Commission supports training for health professionals through the EU4Health programme24, ESF+ 
and the EU Pact for Skills25. Several projects are ongoing to support countries in addressing retention 
of  staff,  task-shifting  and  personnel  shortages  in  ‘medical  deserts’  (areas  with  limited  access  to 
healthcare). Moreover, the Commission intends to launch a joint action on improved health workforce 
planning  and  forecasting  later  this  year.  In  addition,  the  Commission  supports  the  availability  of 
medical emergency teams, as well as of necessary personal protective equipment, medical items and 
therapeutics at national and EU level (e.g. via the Union Civil Protection Mechanism). 

Use of COVID-19 therapeutics  

The EU Strategy on COVID-19 therapeutics26 aims to build a broad portfolio of safe and effective 
therapeutics. In particular, antivirals and antiviral monoclonal antibodies play an important part in 
treating COVID-19 patients. To date, eight COVID-19 therapeutics of different categories have been 
authorised, including six antivirals, addressing different stages and severity of the disease. Between 
October 2020  and July  2022, four Joint Procurement Framework Contracts, including  extensions, 
were concluded to ensure the availability of antiviral medicines in a number of Member States27.  

The Commission  will continue to  work with  Member States to  identify priorities for further  joint 
procurements  for  therapeutics  and  strengthen  the  integration  with  established  national  and  EU 

23 

24 

25 

26  

27 

In September the following HERA call will be published: Call for proposals to support structured dialogue at national or regional 
level on public procurement in the health sector. 
EU4  Health  Programme,  Call  for  proposals  to  provide  training  for  health  workforce,  including  digital  skills, 
https://ec.europa.eu/info/funding-tenders/opportunities/portal/screen/opportunities/topic-details/eu4h-2022-pj-06. 
Erasmus+ project, EHMA,  Blueprint Alliance for a Future Health Workforce Strategy on Digital And Green Skills: BeWell 
project kicked-off, https://ehma.org/2022/07/22/blueprint-alliance-for-a-future-health-workforce-strategy-on-digital-and-green-
skills-bewell-project-kicked-off/. 
Communication from the Commission to the European Parliament, the Council, The European Economic and Social Committee 
and the Committee of the Regions, EU Strategy on COVID-19 therapeutics (COM/2021/355 final/2). 
These  cover  the  following  therapeutics:  remdesivir,  bamlanivimab  and  etesevimab,  casirivimab  and  imdevimab,  and 
xevudy/sotrovimab. 

8 

 
                                                           
processes. Increased cooperation and joint procurement strengthen solidarity by ensuring equitable 
access and the availability of therapeutics in participating Member States. As outlined in the 2014 
Joint Procurement Agreement signed by 37 countries, procuring jointly also strengthens purchasing 
power, especially for smaller Member States, allowing for better contractual terms and economies of 
scale. 

The need for multi-country clinical trials 

As of January 2022, with the entry into application of the Clinical Trials Regulation28, the assessment 
and supervision of clinical trials throughout the EU have been harmonised, notably via a  Clinical 
Trials  Information  System  (CTIS).  The  Clinical  Trials  Regulation  allow  swifter  authorisation  of 
clinical trials across Member States, thus improving the efficiency of clinical research as a whole. At 
the same time, the high quality and safety standards already set for such trials will be upheld.  

With  the  Regulation  and  the  CTIS,  commercial  and  non-commercial  sponsors  can  now  apply  for 
clinical trial authorisations in up to 30 EU/EEA countries at the same time. The new regulatory system 
and the platform improve information-sharing and collective decision-making on clinical trials. CTIS, 
whose use will be mandatory for the submission of the clinical trial applications by 31 January 2023, 
provides  also  a  public  searchable  database  for  healthcare  professionals,  patients  and  the  general 
public. On 31 January 2025, the Regulation will be fully applicable and all clinical trials will need to 
be compliant with the rules.  

Over the coming years, this new European regulatory environment for clinical trials will facilitate, 
streamline, speed up and increase transparency for multinational clinical trials also for possible new 
COVID-19 therapeutics and vaccines. Moreover, it will ensure that the EU offers an attractive and 
favourable environment  for carrying out  clinical  research on a large scale, with  high standards of 
public transparency and safety for clinical trial participants. 

The Emergency Task Force, established as part of the EMA’s revised mandate29, provides advice on 
clinical trial protocols, including joint clinical trials, to developers of clinical trials that are carried 
out in the Union. Ultimately, the advice will facilitate the timely development and authorisation of 
medical products such as vaccines and treatments and improve overall clinical trial coordination in 
Europe. This scientific advice by the Emergency Task Force should be taken into account by Member 
States when authorising a clinical trial application. 

Finally, two EU clinical trial networks have been established under Horizon 2020: one focusing on 
COVID-19  therapeutics  and  one  for  COVID-19  vaccines.  The  therapeutic  trials  network  includes 
large-scale adaptive platform trials carried out in intensive care populations, hospitalised patients and 
primary  care  patients30.  In  addition,  the  joint  access  advisory  mechanism  (JAAM)  supports  an 
efficient  use  of  resources  between  the  trials  and  avoids  duplication  of  efforts.  The  vaccine  trial 
network includes public health focused vaccine trials in the elderly, the general adult population and 
children31.  

28 

29 

30 
31 

Regulation (EU) No 536/2014 of the European Parliament and of the Council of 16 April 2014 on clinical trials on medicinal 
products for human use, and repealing Directive 2001/20/EC (OJ L 158, 27.5.2014, p. 1). 
Regulation  (EU)  2022/123  of  the  European  Parliament  and  of  the  Council  of  25  January  2022  on  a  reinforced  role  for  the 
European Medicines Agency in crisis preparedness and management for  medicinal products and medical devices  (OJ  L 20, 
31.1.2022, p. 1–37). 
REMAP-CAP trial, EU SolidAct trial and ECRAID-Prime trial. 
EU-COVAT-1 AGED, EU-COVAT-2 BOOSTAVAC and EU-COVPT-1 CoVacc. 

9 

 
                                                           
Focusing on addressing post-COVID condition (“long-COVID”) 

Emerging  evidence  suggests  that  as  many  as  1  in  8  people  who  recover  from  COVID-19  will 
experience debilitating symptoms lasting much longer than expected, leading to an impaired quality 
of life32.  

Although the risk of developing post-COVID condition appears to be greater among older individuals 
with  pre-existing  conditions  who  were  admitted  to  hospital  because  of  COVID-19,  studies  have 
shown how it is also prevalent among previously healthy, young people who experienced mild to no 
symptoms when they first contracted the virus33. People with post-COVID condition can experience 
a  wide  range  of  symptoms,  including  respiratory,  cardiovascular,  gastrointestinal,  cognitive, 
musculoskeletal, and neurological symptoms. These symptoms can be intermittent, affect several of 
the body’s systems and range from mild to incapacitating, frequently impairing people’s ability to 
return to work. Against the backdrop of this long list of symptoms, to date there are no validated 
therapies to treat this condition.  

This novel class of patients will require specific care, often from different medical specialisations. 
This is expected to add a substantial burden on European healthcare systems and can exacerbate the 
large  backlog  of  non-COVID-related  care  accumulated  throughout  the  pandemic.  These 
considerations  highlight  the  urgency  of  stepping  up  research  efforts  aimed  at  understanding  the 
biological  basis  of  post-COVID  condition.  Achieving  a  better  understanding  of  the  pathology 
underlying  post-COVID  condition  will  enable  researchers  to  identify  candidate  therapies  and 
ultimately develop large-scale clinical trials to verify their benefit.  

In this context, the EU’s Horizon Europe work programme 2021- 2022 has provided funding for six 
research projects focused on post-COVID condition. These projects aim at better characterising post-
COVID condition, as well as investigating risk factors for its development across different SARS-
CoV-2  variants  and  population  groups,  with  a  view  to  identify  potential  biomarkers  and  inform 
treatment options. 

The EU Strategy on COVID-19 therapeutics34 refers to post-COVID condition in its framework of 
research,  development  and  innovation  actions.  The  strategy  acknowledges  that  post-COVID 
condition requires a different therapeutic approach to acute COVID-19. Equally, and in keeping with 
the emerging hypothesis that persistent viral reservoirs may be one cause of post-COVID condition35, 
therapeutics used to treat COVID-19 (such as antivirals) could also be tested as a potential treatment 
for post-COVID condition.  

To provide expert guidance on how healthcare systems should design and develop appropriate health 
services for patients affected by post-COVID condition, the Commission has tasked the Expert Panel 
on effective ways of investing in health36 to provide an opinion, due at the end of 2022, on the impact 
of post-COVID condition on health systems. Moreover, the European Agency for Safety and Health 
(EU-OSHA)  has  published  a  report  on  the  impact  of  post-COVID  condition  on  workers  and 

32 

The Lancet, volume 400, issue 10350, P452-461, 6 August 2022, A.V. Ballering et.al., Persistence of somatic symptoms after 
COVID-19  in  the  Netherlands:  an  observational  cohort  study,  https://www.thelancet.com/journals/lancet/article/PIIS0140-
6736(22)01214-4/fulltext. 

33   Daugherty, Sarah E., et al. "Risk of clinical sequelae after the acute phase of SARS-CoV-2 infection: retrospective cohort study." 

34  

35  

36 

BMJ 373 (2021). 
Commission Communication, EU Strategy on COVID-19 therapeutics (COM/2021/355 final/2), https://eur-lex.europa.eu/legal-
content/EN/TXT/?uri=CELEX:52021DC0355R(01). 
Brodin, P., Casari, G., Townsend, L. et al., Studying severe long COVID to understand post-infectious disorders beyond COVID-
19, Nat Med 28, 879–882 (2022), https://www.nature.com/articles/s41591-022-01766-7. 
Expert  Panel  on  effective  ways  of  investing  in  health,  https://health.ec.europa.eu/expert-panel-effective-ways-investing-
health_en. 

10 

 
                                                           
workplaces37  and  has  issued  related  guidance  for  workers38  and  managers39.  Member  States  are 
encouraged to join forces to gather up-to-date evidence on post-COVID condition and to increase 
training of health workforce in the recognition and management of post-COVID condition, especially 
in primary care. It should be recalled that the best way to prevent the post-COVID condition is to 
avoid being infected with SARS-CoV-2 in the first place. 

Transport, mobility, travel  

Since  August  2022,  all  measures  affecting  free  movement  of  persons  in  the  EU  have  been  lifted, 
including the requirement for travellers to hold an EU Digital COVID Certificate.  

Continued efforts to facilitate free movement in the EU during the COVID-19 pandemic remain 
crucial, both for people and goods. It remains our shared goal to enjoy unrestricted free movement, 
if the epidemiological situation allows so. To respond to the specific challenges affecting the transport 
sector and disruption of the supply chain, the Commission and EU Member States should rely on the 
tools already developed so far, in particular Green Lanes40, Contingency Plan for Transport  41, and 
appropriate health protocols. 

Travel restrictions should only be introduced or reintroduced where they are absolutely necessary and 
proportionate  for  the  protection  of  public  health.  For  example,  certain  non-pharmaceutical 
interventions, such as mask-wearing, should be considered before introducing or reintroducing any 
travel restrictions. Any new measures should be communicated to key stakeholders, such as transport 
operators, so they can prepare and avoid any negative potential impacts. Should Member States wish 
to  activate  contact  tracing  of  cross-border  passengers,  common  tools,  such  as  the  EU  Passenger 
Locator Form, are available to exchange passenger data to enhance their contact tracing capabilities 
while limiting burdens on passengers and transport operators.  

Member  States  can  make  use  of  the  EU  Digital  COVID  Certificate  in  case  the  epidemiological 
situation this autumn and winter makes it necessary for countries to temporarily reintroduce travel 
restrictions.  The  EU  Digital  COVID  Certificate  Regulation,  which  has  been  extended  until  June 
202342, provides the necessary framework to manage the impact of restrictions on free movement and 
to  facilitate  travel.  It  ensures  that  citizens  can  benefit  from  interoperable  and  mutually  accepted 
certificates of COVID-19 vaccination, test and recovery. In principle, holders of valid EU Digital 
COVID Certificates should not be subject to any additional restrictions when travelling within the 
EU. 

The EU Digital COVID Certificate has been a major success in providing the public with a tool that 
is accepted and trusted across the EU (and in several third countries) and in avoiding fragmentation 
of  multiple  national  systems.  As  of  1  August  2022,  75  countries  and  territories  from  across  5 
continents are connected to the EU Digital Certificate system (30 EU/EEA Member States and 45 
non-EU countries and territories), and several more countries have expressed interest in joining the 

37 

38 

39 

40 

41 

42 

6 

6 

and 

July 

July 

long 

2021, 

2021, 

infection 

the  role  of  OSH, 

Impact  of  Long  Covid  on  workers  and  workplaces  and 

EU-OSHA,  20  May  2022, 
https://osha.europa.eu/en/publications/impact-long-covid-workers-and-workplaces-and-role-osh. 
EU-OSHA, 
– 
COVID-19 
https://osha.europa.eu/en/publications/covid-19-infection-and-long-covid-guide-workers. 
COVID 
COVID-19 
EU-OSHA, 
https://osha.europa.eu/en/publications/covid-19-infection-and-long-covid-guide-managers. 
Communication from the Commission on the implementation of the Green Lanes under the Guidelines for border management 
measures to protect health and ensure the availability of goods and essential services 2020/C 96 I/01 (C(2020) 1897) 
Communication from the Commission to the European Parliament, the Council, the European Economic and Social Committee 
and the Committee of the Regions A contingency plan for transport (COM(2022) 211) 
Regulation (EU) 2022/1034 of the European Parliament and of the Council of 29 June 2022 amending Regulation (EU) 2021/953 
on  a  framework  for  the  issuance,  verification  and  acceptance  of  interoperable  COVID-19  vaccination,  test  and  recovery 
certificates (EU Digital COVID Certificate) to facilitate free movement during the COVID-19 pandemic (OJ L 173, 30.6.2022, 
p. 37). 

for  managers, 

infection 

workers, 

COVID 

guide 

guide 

long 

and 

for 

– 

11 

 
                                                           
gateway or are already engaged in technical discussions with the Commission. This makes the EU 
Digital COVID Certificate a global standard.  

The EU Digital  COVID  Certificate system  is sufficiently flexible to  adapt  to  the evolution  of the 
COVID-19  response.  Possible  adaptations  to  the  validity  period  of  certificates  issued  for  the  first 
booster  may  become  necessary  in  light  of  further  scientific  evidence  and  the  evolution  of  the 
pandemic.  

If the use of the EU Digital COVID Certificate were to be reintroduced, it remains important to ensure 
that  everyone  can  obtain  a  valid  EU  Digital  COVID  Certificate.  This  means  that  Member  States 
should  continue  to  ensure  that  sufficient  testing  and  vaccination  capacity  is  available  and  easily 
accessible. Member States should also inform citizens who underwent a SARS-CoV-2 infection of 
their right to receive a recovery certificate if they have done a PCR or antigen test.  

In addition, Member States should do their utmost to ensure that passengers are well-informed about 
possible travel restrictions they may face when entering another EU/EEA Member State. The Re-
Open  EU  web  platform43  remains  a  key  point  of  reference  for  anyone  travelling  in  the  EU.  The 
Commission reiterates the continued importance of timely updates44 by Member States on possible 
travel restrictions, public health and safety measures, so that European citizens can continue to rely 
on the platform to plan their travel with confidence.  

The emergency brake procedure agreed  in that Council Recommendation  2022/10745 continues to 
ensure a coordinated approach among Member States in response to the emergence of potential new 
variants of concern. 

The current ECDC colour-coded country categorisation has been discontinued in light of the evolving 
approaches and decreasing trends in testing volumes in Member States, which in turn did not allow 
the ECDC to draw up an adequate depiction of the epidemiological situation. 

Furthermore,  in  the  context  of  travel  from  third  countries,  in  June  2020,  the  Council  adopted  a 
coordinated approach to travel to the EU+ area, which has since then been amended three times46. 
The  Commission  intends  to  propose  a  revision  of  the  Recommendation  shortly,  in  order  to  take 
account  of  the  changed  epidemiological  situation  and  the  developments  of  the  practices  in  the 
Member States, notably concerning the list of countries in Annex 1 to Council Recommendation (EU) 
2020/912  that  no  longer  reflect  the  current  situation.  Such  a  revision,  that  will  be  consulted  with 
Member States, aims to provide a common framework for the coming months, ensuring a coordinated 
approach.  

5.  THE GLOBAL DIMENSION  

In order to  control and end the pandemic, world-wide efforts  and support for fighting  COVID-19 
globally are essential. This is why, since the onset of the COVID-19 crisis, the EU, as Team Europe47, 
has played a central role in the multilateral response for the rapid development, scale-up and equitable 
distribution of COVID-19 vaccines worldwide. The EU remains the biggest donor of COVID-19 
vaccines globally, considering doses shared by Member States via COVAX (COVID-19 Vaccines 
Global Access) and as bilateral donations. In total, Team Europe has now shared almost 482 million 

43 
44 

45 

46 

47 

https://reopen.europa.eu/. 
To ensure that the Re-Open EU web platform provides up to date information, Member States should inform the Commission 
about possible updates before introducing possible restrictions and measures. 
Council Recommendation (EU) 2022/107 of 25 January 2022 on a coordinated approach to facilitate safe free movement during 
the COVID-19 pandemic and replacing Recommendation (EU) 2020/1475 (OJ L 18, 27.1.2022, p. 110) 
Council Recommendation (EU) 2020/912 of 30 June 2020 on the temporary restriction on non-essential travel into the EU and 
the possible lifting of such restriction (OJ L 208I 1.7.2020, p. 1). 
https://europa.eu/capacity4dev/wbt-team-europe. 

12 

 
                                                           
doses  with  countries  in  need  and  remains  committed  to  donation  and  exportation  efforts  in  the 
upcoming  months,  should  there  be  an  increased  interest  for  original  formulations  and  adapted 
vaccines.  Even  though  the  global  COVID-19  vaccines  supply  has  stabilised,  many  countries, 
especially in Africa, are still very far from achieving sufficient vaccination rates. The lack of primary 
vaccination  also  creates  a risk of missing out  on the benefits  of boosters, including boosters with 
adapted vaccines. 

The current situation is marked by more supply of vaccines relative to demand: the global availability 
of vaccines has not been matched by a corresponding increase in vaccine uptake in some countries. 
The challenge has clearly shifted to ‘getting shots into arms’ or administering the vaccines received. 
This is why, for instance, the EU has put forward a Vaccine Support Package for its African partners, 
which covers supply, ancillary material, and delivery support. The EU has announced additional EUR 
375 million support to countries with the lowest vaccination rates through the COVID-19 Delivery 
Support mechanism of the COVAX Facility48. This funding supports national governments in service 
delivery, health workforce, demand generation, vaccination campaigns, supply chain systems, cold 
chain and rapid UCC capacity following a country needs-based approach. The funding also supports 
countries  to  sustain  equitable  access,  reach  marginalized  populations,  integrated  COVID-19 
vaccination and routine immunisation and strengthen immunisation systems. 

The capacity of local healthcare systems needs to be further developed to ensure communities get 
vaccinated; local vaccine development and production should also be strengthened. The Commission 
supports  strengthening  of  national  healthcare  systems  in  Africa,  for  example  by  engaging  at  the 
regional  level  to  improve  health  security  through  a  One  Health  approach,  digitalisation  of  health 
systems and by supporting public health institutes. 

The EU will also continue working through the Team Europe initiative on manufacturing and access 
to vaccines, medicines and health technologies in Africa (MAV+)49. This initiative began in 2021 
and  is  contributing  to  increase  local  and  regional  manufacturing  capacity,  diversify  African 
pharmaceutical  supply  chains  and  to  address  bottlenecks  in  the  international  supply  chain.  Team 
Europe  has  mobilised  so  far  more  than  EUR  900  million  to  support  building  capacities  in  South 
Africa, Senegal, Rwanda and Ghana and at regional level for regulatory strengthening and the African 
Medicines  Agency  (AMA),  the  African  Union  Development  Agency  (AUDA-NEPAD)  and  the 
Partnership for African Vaccine Manufacturing. Within the framework of matchmaking events, the 
EU has been enhancing collaboration between African and European companies concerning the value 
chains of the pharma and medical technology industry. The EU has also launched a new initiative on 
local manufacturing of vaccines and medicines to support efforts in Latin-America and the Caribbean. 

The  EU  also  pledged  EUR  150  million  to  the  Global  Fund’s  COVID-19  Response  Mechanism 
(C19RM)50  for  ensuring  access  to  medical  countermeasures  in  partner  countries  (including 
diagnostics, tests, oxygen and personal protective equipment). 

Moreover,  the  EU  is  actively  contributing,  alongside  the  US  and  other  global  partners,  to  the 
successful implementation of the Global Action Plan to beat the pandemic. The objective is to help 
coordinate actions and mobilise resources in six priority areas in relation to the  global COVID-19 
response. COVID-19 has taught us that only a united and multilateral response can effectively tackle 
a global pandemic.  

48 

49  
50 

As well as the EUR 100 million of support from the humanitarian budget to roll out vaccines that has been implemented since 
2021. 
The first support packages for Senegal, Rwanda, South Africa and Ghana have been mobilised. 
https://www.theglobalfund.org/en/covid-19/response-
mechanism/#:~:text=The%20COVID%2D19%20Response%20Mechanism,formal%20and%20community%20health%20syst
ems. 

13 

 
                                                           
The  fight  against  anti-vaccination  mis-  and  disinformation  should  be  continuously  addressed 
globally. Tackling foreign information manipulation and interference requires a specific response. 
The  European  External  Action  Service  (EEAS),  in  close  cooperation  with  the  Commission  and 
Member States, has been developing the EU’s toolbox to tackle foreign information manipulation 
and interference (FIMI Toolbox).  

Lastly, the EU believes it is vitally important to build on the lessons learned from the COVID-19 
pandemic and to strengthen the global health architecture – with a reinforced WHO at its centre. The 
EU is determined to be a driving force in the negotiations on a new, legally binding, international 
agreement on pandemic prevention, preparedness and response and on targeted amendments to 
strengthen  the  International  Health  Regulations  2005.  These  complementary  processes  are  a 
priority  for  the  EU  and  provide  a  historic  opportunity  to  find  multilateral  solutions  to  common 
challenges,  based  on  the  principles  of  collective  solidarity,  equity,  fairness,  inclusiveness  and 
enhanced  transparency.  Moreover,  the  new  Financial  Intermediary  Fund  (FIF)  for  Pandemic 
Prevention, Preparedness and Response51, to which Team Europe has already pledged at least52 
EUR 588 million, will provide funding to support pandemic prevention, preparedness and response, 
including  the  implementation  of  the  amended  International  Health  Regulations  and  the  new 
international agreement on pandemic prevention, preparedness and response. 

COVID-19  has  demonstrated  that  the  international  aspect  of  EU  health  policy  has  become  more 
important  than  ever.  We  are  learning  these  lessons  and  taking  coordinated  steps  to  protect  and 
promote health globally and to strengthen the EU’s leadership in, and contribution to, global health. 
The  forthcoming  EU  global  health  strategy  will  provide  the  political  framework  with  priorities, 
governance and tools, enabling the EU to speak with one influential voice and making the most of 
Team Europe’s capacity to protect and promote health globally. 

6.  CONCLUSION 

While the evolution of the pandemic is unpredictable, the EU needs to prepare itself – for the third 
time in a row – for a challenging autumn and winter. But the future of the pandemic does not only 
depend on new variants that may emerge and outcompete older strains. It is also greatly determined 
by  human  behaviour  and  how  much  immunity  can  be  built  up  in  the  population.  Minimising  the 
number of new cases also decreases the chances of new variants appearing. These are factors that can 
be  influenced,  and  Member  States’  healthcare  systems  and  society  must  continue  to  adapt  their 
collective response to this virus until the threat of COVID-19 is no longer acute.  

As we have seen during the peaks of the COVID-19 pandemic, working together is essential. Now 
that a political agreement has been reached on the new EU regulation on serious cross-border threats 
to health, which is the final legislative piece of the European Health Union Package53, the Union will 
soon  have  a  new  set  of  tools  to  finish  the  revision  of  the  EU  health  security  framework  and  to 
strengthen the required infrastructure and processes for implementing COVID-19 preparedness and 
response measures.  

The pandemic has reminded us very clearly of the importance of collaboration. Through  working 
together, we can make a  real  difference and strengthen  the EU’s capacity to  prevent,  prepare and 
respond to health crises – in the upcoming months as well as in the future. We are stronger, more 
resilient and more effective when we work together on a sustained management of the pandemic. 

51 

https://unfoundation.org/blog/post/inside-the-new-fund-to-bolster-global-pandemic-prevention-preparedness-and-
response/#:~:text=This%20new%20fund%2C%20which%20is,before%20the%20next%20pandemic%20occurs. 

52   More EU Member States are considering to contribute or are preparing their pledge. 
53 

https://ec.europa.eu/info/strategy/priorities-2019-2024/promoting-our-european-way-life/european-health-union_en. 

14