COMMUNICATION FROM THE COMMISSION TO THE EUROPEAN PARLIAMENT, THE COUNCIL, THE EUROPEAN ECONOMIC AND SOCIAL COMMITTEE AND THE COMMITTEE OF THE REGIONS Introducing the Union prevention, preparedness and response plan for health crises
Date: 2025-11-28
Institutions: Directorate-General for Health and Food Safety, European Commission
Subjects: EU Member State, EU action, European Health Union, crisis management, cross-border cooperation, disease prevention, disease surveillance, emergency aid, public health

EN 

  EN 

   EUROPEAN COMMISSION  Brussels, 28.11.2025  COM(2025) 745 final  COMMUNICATION FROM THE COMMISSION TO THE EUROPEAN PARLIAMENT, THE COUNCIL, THE EUROPEAN ECONOMIC AND SOCIAL COMMITTEE AND THE COMMITTEE OF THE REGIONS Introducing the Union prevention, preparedness and response plan for health crises {SWD(2025) 393 final}  
 
 
1. 

STRENGTHENING  THE  EUROPEAN  UNION’S  PREPAREDNESS  AND 
RESILIENCE AGAINST EMERGING CROSS-BORDER HEALTH THREATS 

The European Union is operating in an era of mounting uncertainty and multifaceted threats 
and  risks.  It  faces  a  complex  and  intensifying  threat  landscape  –  from  pandemics  and 
cyberattacks  to  disinformation,  climate-related  disasters  and  geopolitical  instability.  These 
challenges are no longer isolated; they are intertwined, amplifying one another and testing the 
resilience of societies, economies and democracies.  The  EU’s security, prosperity and unity 
depend on its ability to  prepare,  anticipate  and  react –  not  only  when crises strike, but  long 
before. 

Many of these intersecting threats have the potential to lead to a cross-border health crisis. In 
today’s volatile landscape, a large-scale health crisis could be profoundly damaging, affecting 
not only individual well-being but also the overall functioning of societies and economies. The 
magnitude  of  the  COVID-19  pandemic  bore  witness  to  this  and  taught  us  many  painful  yet 
invaluable lessons that we must continue to draw upon in our efforts to address future health 
crises.  Health  systems  that  are  unprepared,  fragmented  and  lack  resilience  can  become 
overwhelmed  during  a  health  crisis,  leading  to  disrupted  essential  services  and  diminished 
public confidence in institutions. However, health crises strike far beyond hospital walls and 
can disrupt economies,  exacerbate social inequalities, halt trade and shake public trust to its 
core. As health crises disproportionately affect different groups within society, ensuring that 
prevention, preparedness and response measures are designed and implemented in a way that 
is inclusive and accessible to all people is essential for strengthening trust, equity and resilience 
of the Union’s public health systems. Moreover, in an interconnected Europe, health crises can 
ripple across borders, straining solidarity and shared resources. These cross-border and cross-
sector  effects  clearly  demonstrate  the  importance  of  robust  coordination  between  Member 
States and the need for a strong toolbox of measures at both national and EU level. 

The  cost  of  inaction  in  the  face  of  foreseeable  threats  is  immense,  measured  not  only  in 
economic  losses  but  first  and  foremost  in  human  suffering  and  diminished  resilience.  By 
contrast, prevention and preparedness offer significant returns and are far more cost-effective 
than merely responding to a crisis (1). Societies that are well prepared recover faster, can better 
protect livelihoods and maintain greater stability. 

The lessons  from  recent years  are clear: preparedness  for  cross-border  health crises  is  not  a 
matter of choice, it is a necessity. The Commission, Member States and EU agencies and bodies 
have therefore taken decisive steps towards a stronger, more resilient European Health Union, 
aiming to strengthen the EU’s ability to prepare for and respond to health crises. Key building 
blocks include the adoption of the EU Regulation on serious cross-border threats to health 
(2),  the  strengthened  mandates  for  the  European  Centre  for  Disease  Prevention  and  Control 

1 

2 

A recent study shows that preventing viral pandemics costs just a fraction of what is lost when they strike: 
less than 5% of the value of lives lost and 10% of the economic damage from these types of outbreaks. 
A.S. 
Advances: 
https://www.science.org/doi/10.1126/sciadv.abl4183.  
Regulation (EU) 2022/2371, OJ L 314, 6.12.2022, p. 26.  

Bernstein 

Science 

2022, 

Feb 

al., 

et 

4 

1 

 
 
 
(ECDC) (3)  and  the  European  Medicines  Agency  (EMA)  (4),  and  the  creation  of  the 
Commission’s Health Emergency Preparedness and Response Authority (HERA) to improve 
preparedness  and  response  to  serious  cross-border  threats  in  the  area  of  medical 
countermeasures  (5).  Moreover,  the  Council  Regulation  on  a  framework  of  measures  for 
ensuring the supply of crisis-relevant medical countermeasures in the event of a public health 
emergency at Union level was adopted (6). 

Since then, many  other  strategic EU initiatives  have been  adopted, aiming to strengthen  the 
EU’s resilience and boost its ability to anticipate, prevent, prepare for, respond to, and recover 
from  crises.  In  particular,  the  Preparedness  Union  Strategy  (7)  is  a  major  EU  initiative 
designed to address the interconnected threat environment by strengthening resilience across 
all  levels  and  sectors.  It  takes  a  proactive  approach  to  crisis  management  based  on  three 
mutually  reinforcing  principles:  (i)  all-hazards  (8);  (ii)  whole-of-government  (9);  and  (iii) 
whole-of-society  (10).  Moreover,  it  envisages  that  preparedness  and  security  considerations 
have to be integrated and mainstreamed across EU legislation, policies and programmes. The 
Preparedness Union Strategy seeks to build durable capacities that ensure the EU is strong on 
all fronts and at every level of society. 

The Strategy is accompanied by an Action Plan (11), outlining 30 key actions to be implemented 
by the Commission and Member States across the seven thematic areas of the Strategy. There 
is a need for a coherent and coordinated approach at EU level among the different actors and 
instruments  in  the  EU’s  reinforced  health  security  architecture.  Therefore,  the  Action  Plan 
includes, as one of the concrete actions, to deliver, by the end of 2025, the Union prevention, 
preparedness  and  response  plan  for  health  crises  (the  ‘Union  plan’),  already  a  legal 
requirement mandated in the Regulation on serious cross-border threats to health (12). 

Although the Union plan does not cover health crisis response outside the EU, it is aligned with 
the EU’s global health priorities and initiatives. Fostering cooperation with non-EU countries 
and international organisations in the field of public health is crucial for EU and global health 
resilience and security, as recognised by the Regulation on serious cross-border threats to health 
(13) and the Preparedness Union Strategy. The EU’s commitment in this area is guided by the 
principles and actions set out in the EU Global Health Strategy (14) and the Global Gateway 

3 
4 
5 
6  
7 
8 
9 

10 

11 
12 
13 
14 

Regulation (EU) 2022/2370, OJ L 314, 6.12.2022, p. 1.  
Regulation (EU) 2022/123, OJ L 20, 31.1.2022, p. 1. 
C(2021) 6712 final.  
Council Regulation (EU) 2022/2372, OJ L 314, 6.12.2022, p. 64. 
https://commission.europa.eu/topics/preparedness_en. 
The strategy takes an approach that prepares for a broad range of threats. 
The strategy includes taking a more proactive, whole-of-government approach to crisis management, 
across both civilian and military sectors 
The strategy’s whole-of-society approach means that local communities, civil society organisations, 
business and social partners, academics and other essential actors play a role in fostering a culture of 
preparedness across the EU. 
Annex to the Preparedness Union Strategy: https://commission.europa.eu/topics/preparedness_en. 
Article 5 of Regulation (EU) 2022/2371. 
Recital 38 of Regulation (EU) 2022/2371. 
https://health.ec.europa.eu/system/files/2023-10/international_ghs-report-2022_en.pdf. 

2 

 
 
 
(15). The recent announcement of the Global Health Resilience Initiative in President Ursula 
von der Leyen’s State of the Union address (16) in September 2025 reiterates this commitment. 

2. 

THE UNION PREVENTION, PREPAREDNESS AND RESPONSE PLAN FOR 
HEALTH CRISES 

The Union plan: a toolbox for crisis managers  

The  Union  plan,  accompanying  this  Commission  Communication,  is  the  EU’s  blueprint  for 
action on serious cross-border health threats, covering prevention, preparedness and response. 
It  is  a  comprehensive  toolbox  that  empowers  crisis  managers  to  prevent,  prepare  for  and 
respond to emergencies swiftly and effectively. It complements national efforts by describing 
how the EU coordinates prevention and preparedness, which joint capacities and resources can 
be mobilised, and how solidarity leads to action when it matters most. The Union plan also sets 
out  the  process  for  recognising  a  public  health  emergency  at  Union  level  and  outlines  the 
additional measures  and procedures that may be activated, ensuring the EU can act fast and 
with purpose. Equally important, it fosters a culture of learning and continuous improvement, 
helping Member States review, revise and strengthen their own systems. This enables the EU 
to recover quickly and emerge stronger after every crisis. 

The  Union  plan  is  designed  primarily  for  Member  States,  particularly  for  the  authorities 
responsible for crisis management and policy implementation in prevention, preparedness and 
response  planning.  However,  its  value  extends  much  further,  benefiting  EU  agencies  and 
bodies, international partners such as the World Health Organization (WHO) and key players 
across civil society, academia, the private sector, social partners and the media. 

The Union plan was developed through cross-sectoral collaboration and in consultation with 
Member States and other stakeholders (17). It draws on and integrates the EU’s strengthened 
health security framework and recently published policy documents (18). 

Preventing, preparing for, responding to and recovering from a health crisis 

The  Union  plan  covers  a  wide  range  of  crises,  whether  natural,  accidental  or  intentional, 
including those of biological, chemical, environmental and unknown origin (19). It also applies 
to  ‘exceptional  emergency  situations’  that  require  an  EU  coordinated  response  (20),  such  as 
armed  conflicts  or  situations  where  existing  measures  have  proven  insufficient  to  protect 
people’s health. The Union plan takes an all-hazards, all-sectors, all-society approach, built on 

15 
16 
17 

18 

19 
20 

https://commission.europa.eu/topics/international-partnerships/global-gateway_en. 
https://commission.europa.eu/strategy-and-policy/state-union/state-union-2025_en. 
A public consultation (call for evidence) was open from 1 to 29 October 2025, which received 57 
responses, mainly from non-governmental organisations and business associations.  
e.g. https://commission.europa.eu/topics/defence/safer-together-path-towards-fully-prepared-union_en, 
https://home-affairs.ec.europa.eu/policies/internal-security_en and https://health.ec.europa.eu/latest-
updates/hera-review-taking-stock-reinforce-health-security-eu-2025-03-26_en. 
Article 2(1) of Regulation (EU) 2022/2371. 
Article 2(4) of Regulation (EU) 2022/2371.  

3 

 
 
 
the principles of One Health (21), whole-of-government and whole-of-society cooperation. This 
approach  is  essential,  as  complex  threats  and  risks  require  a  comprehensive  response  to 
effectively manage them. 

The Union plan covers the four phases of the health crisis management cycle: (1) prevention 
and  preparedness,  (2)  detection  and  assessment,  (3)  response,  and  (4)  recovery.  The  plan 
outlines the EU’s health crisis governance architecture, capacities and resources as well as the 
support mechanisms in place for each phase. 

Phase 1: Preventing and preparing for health crises  

The  EU  must  ensure  robust  prevention  and  preparedness  for  potential  serious  cross-border 
threats  to  health  to  be  able  to  protect  the  public  and  safeguard  public  health  security.  The 
following activities help achieve this:  

•  Member States report periodically on the planning and implementation of their national 

prevention, preparedness and response plans (22). 

•  Member  States  coordinate,  together  with  the  Commission,  in  the  Health  Security 
Committee (23) to  help  prepare their  national  prevention, preparedness  and response 
plans. 

•  The  ECDC  conducts  Public  Health  Emergency  Preparedness  Assessments  (24) 
(PHEPA)  to  assess  the  state  of  implementation  of  national  plans  and  makes 
recommendations to improve them. 

•  Member States strengthen healthcare systems and the health workforce so they can 
be more resilient under pressure; this includes promoting vaccination as one of the most 
powerful and cost-effective public health tools to prevent disease. 

•  The Commission, with the assistance and advice of Member States through the HERA 
the  development,  availability  and  distribution  of  medical 
Board,  supports 
countermeasures, ranging from vaccines to therapeutics, diagnostics, medical devices, 
and protective equipment, including related threat anticipation, threat assessment and 
intelligence gathering. 

•  As  a  risk  mitigation  in  the  event  of  future  health  emergencies,  the  Commission  has 
reserved vaccine manufacturing capacity through EU FAB to ensure constant readiness 
and appropriate supply of critical raw materials.   

•  EU  support  mechanisms,  such  as  the  EU  Health  Task  Force  and  the  Union  Civil 

Protection Mechanism, assist Member States in preparing for health crises.  

Preparedness in action: vaccine procurement and vaccination 

21  

22  
23   

24 

One Health is an approach that recognises the interconnection between human, animal, and 
environmental health, promoting collaboration across disciplines to prevent, detect, and respond to 
health threats. 
Article 7(1) of Regulation (EU) 2022/2371. 
https://health.ec.europa.eu/health-security-and-infectious-diseases/crisis-management_en#health-
security-committee. 
https://www.ecdc.europa.eu/en/about-ecdc/what-we-do/public-health-emergency-preparedness-
assessments. 

4 

 
 
 
The  outbreak  of  mpox  (formerly  known  as  monkeypox)  in  the  EU/EEA  in  2022  highlighted  the 
importance of EU-wide preparedness for serious cross-border health threats. First, the Health Security 
Committee (HSC) discussed the epidemiological situation. Then, the HERA Board met and helped the 
Commission secure over 109,000 vaccine doses in June 2022, which were donated to the Member States 
and EU4Health associated countries within a month of the outbreak.  

The Health Security Committee (HSC) also played an important role by adopting recommendations 
for  a  common  EU  approach  to  mpox  vaccination  policies  (25).  The  HSC  opinion  set  out  key 
considerations for Member States’ national mpox vaccination strategies, in line with guidance issued by 
the ECDC/WHO and taking into account their national epidemiological and public health circumstances, 
including vaccine availability. 

To strengthen medium- and long-term preparedness for mpox,  the Commission also secured up to 2 
million doses of the mpox vaccine in 2023 and 2024 through a Joint Procurement Framework (26). This 
gave  participating  Member  States  the  option  to  build  stockpiles  and  plan  vaccination  strategies  in 
advance and prepared for response measures taken in 2024 such as coordinated vaccine donations. These 
efforts  demonstrate  how  the  EU  harnessed  pooled  purchasing  and  strategic  stockpiling  to  maintain 
equitable access, mitigate supply risk, and anticipate future health threats. 

These  mechanisms  go  beyond  reacting  to  a  single  outbreak  –  they  exemplify  a  structured,  forward-
looking  approach  to  preparedness,  enabling  the  EU  to  respond  more  effectively  to  emerging  health 
threats while strengthening cross-border cooperation, resource planning and evidence-based decision-
making for the future. 

Phase 2: Detecting and assessing health threats 

Effectively detecting and assessing health threats is critical in responding to health crises. The 
following activities help achieve this. 

•  The  Commission  improves  surveillance  and  detection  systems  through,  amongst 
others,  designating  EU  reference  laboratories  for  public  health,  and  by  integrating 
various surveillance approaches including the One Health framework, laboratory-based 
monitoring, wastewater analysis and vector surveillance and control.  

•  The Commission promotes information sharing and data interoperability to improve 

collective preparedness and response to health crises. 

•  The Commission supports national and EU-level comprehensive and integrated threat 
assessment, risk assessment and early warning to inform rapid and effective response 
measures.  

•  EU agencies, such as the ECDC, EMA and EFSA (27), help carry out rapid public health 
risk assessments to support data-driven and evidence-based coordination of response 
efforts at EU level. 

25           https://health.ec.europa.eu/publications/recommendations-common-eu-approach-regarding-vaccination-
policies-monkeypox-outbreak-response_en. 
26           https://ec.europa.eu/commission/presscorner/detail/en/ip_22_6766. 
27 

European Food Safety Authority. 

5 

 
 
 
Risk assessment in action: the EU’s rapid risk assessment carried out by a unique group of EU 
agencies 

When an EU Member State reports a serious cross-border threat to health, the Commission or the Health 
Security Committee can request one or more EU agencies and bodies to carry out a public health risk 
assessment.  These  assessments  aim  to  support  data-driven,  evidence-based  and  expert-advised 
coordination of the response to such threats.  

The ECDC, EMA, EFSA, ECHA (28), EEA (29), EUDA (30), and Europol each contribute to these public 
health risk assessments based on their respective mandates and expertise. The EU agencies assess the 
potential  severity  of  the  threat  to  public  health  and  consider  the  impacts  of  public  health  and  social 
measures. To support a comprehensive risk assessment, the Commission shares information related to 
medical  countermeasures  with  the  relevant  EU  agencies,  including  on  supply,  procurement  and 
deployment. 

Practical example: Salmonella outbreak response  

In October 2025, the ECDC and EFSA jointly published an updated rapid outbreak assessment of the 
prolonged cross-border outbreak of Salmonella Strathcona ST2559 (31), with 437 cases detected between 
2023 and 2025 across 15 EU/EEA countries. Tomatoes were found to be the primary vehicle of infection 
in several national investigations. The detection of S. Strathcona in irrigation water samples collected at 
a  tomato  production  site  confirmed  the  environmental  contribution  to  tomato  contamination.  These 
findings underline the need for a multidisciplinary strategy that integrates environmental assessments to 
mitigate the risk of Salmonella contamination. 

Phase 3: Responding to a health crisis 

Responding  to  a  serious  cross-border  threat  to  health  in  a  coordinated  and  complementary 
manner is critical. The following activities help achieve this: 

• 

In the Health Security Committee (HSC), chaired by the Commission, Member States 
coordinate response efforts with the Commission and EU agencies and bodies, including 
crisis management and public health and social measures. 

•  The  Commission,  with  the  support  of  the  HERA  Board  (32),  coordinates  efforts  on 
matters related to medical countermeasures to ensure their availability and accessibility 
in response to a serious cross-border threat to health. 

•  Member  States  ensure 

increased  situational  awareness,  risk  and  crisis 
communication,  and  the  necessary  emergency  research  and  funds  to  support 
response efforts. 

•  Depending on the severity of the threat and the need for and proportionality of additional 
measures,  the  Commission  may  decide  to  recognise  a  public  health  emergency  at 
Union  level,  which  unlocks  additional  capacities  and  resources,  including  extended 

28 
29 
30 
31  

European Chemicals Agency. 
European Environment Agency. 
European Drugs Agency. 
https://www.ecdc.europa.eu/sites/default/files/documents/ROA_%20S_%20Strathcona-ST2559_multi-
country.pdf. 

32            In accordance with Commission Decision of 16.9.2021 establishing a Health Emergency Preparedness 
and Response Authority (HERA), C(2021)6712. 

6 

 
 
 
 
• 

mandates  for  certain  EU  agencies  and  bodies.  The  EU’s  Advisory  Committee  on 
Public Health Emergencies supports the Commission, upon its request, by advising 
whether a threat constitutes a public health emergency at Union level. 
In the Health Crisis Board, co-chaired by the Commission and the rotating Presidency 
of  the  Council,  the  Council,  the  Commission,  the  relevant  EU  bodies,  offices  and 
agencies and Member States coordinate their efforts to ensure the supply of and access 
to  crisis-relevant  medical  countermeasures.  The  Health  Crisis  Board  shall  be 
established if a public health emergency at Union level is recognised, and if the Council 
activates the framework of emergency measures (33) 

•  Member States, with support from the Commission, safeguard continuity of care and 
assistance  across  borders,  from  medical  evacuations  to  providing  medical  in-kind 
assistance  (including  medical  countermeasures  and  equipment)  and  contact  tracing 
between  Member  States,  while  linking  up  with  broader  EU  crisis  management 
mechanisms  managed  by  the  Commission,  such  as  the  Union  Civil  Protection 
Mechanism (UCPM) and ReliefEU (34) as well as the Council’s Integrated Political 
Crisis Response (IPCR) (35). 

•  The Commission may, if the situation merits, introduce temporary travel restrictions 
and  internal  border  controls  in  line  with  the  revised  Schengen  Borders  Code  (36). 
Additional  measures  could  include  export  control  mechanisms  in  which  customs 
authorities  help  secure  the  supply  of  critical  medical  countermeasures  by  facilitating 
their import and, where necessary, restricting their export during a crisis. 

Response in action: the Integrated Political Crisis Response (IPCR) mechanism 

The IPCR of the Council of the European Union (the Council) is the central EU mechanism for rapid 
and coordinated decision-making at EU political level in response to major or complex crises. Chaired 
by the Presidency of the Council, the IPCR is scalable according to the gravity of the crisis. In a health 
emergency, the Health Security Committee (HSC) and the Health Crisis Board work closely with the 
IPCR  to  ensure  that  political  coordination  at  EU  level  is  supported  by  public  health  expertise  and 
operational input from Member States by, for example, sharing information, opinions and guidance. For 
example, during the COVID-19 pandemic, over 100 Integrated Situational Awareness and Analysis 
(ISAA) reports were produced by the Commission with input from Member States, EU agencies, EU 
representations and delegations, aiming to provide decision makers with a clear picture of the situation. 

Practical example: Alignment between the IPCR and HSC on the COVID-19 response 

During the COVID-19 pandemic, the Commission reported to the IPCR on a regular basis about the 
HSC’s deliberations. For instance, in January 2023, the IPCR adopted the same position as the HSC 
regarding the sudden increase in COVID-19 cases in China, as expressed in the Opinion of the HSC for 
a common EU approach in response to the COVID-19 situation in China (37). 

Council Regulation (EU) 2022/2372, OJ L 314, 6.12.2022, p. 64. 
https://civil-protection-humanitarian-aid.ec.europa.eu/what/humanitarian-aid/reliefeu_en. 
Council Implementing Decision (EU) 2018/1993, OJ L 320, 17.12.2018, pp. 28–34. 

33  
34  
35  
36            Articles 21a and 28 of the revised Schengen Borders Code (Reg 2016/399, as amended by 1717/2024) 
37 

https://health.ec.europa.eu/latest-updates/opinion-health-security-committee-common-eu-approach-
response-covid-19-situation-china-2023-01-05_en. 

7 

 
 
 
 
 
 
 
Phase 4: Recovering from a health crisis 

Recovering from health crises and learning lessons is essential for restoring communities and 
preventing future crises. This involves: 

•  conducting in-action and after-action reviews to learn from every health crisis; 
• 

turning lessons learnt into policy reforms, updated legal frameworks, and improved 
preparedness plans, including more resilient health systems; 

•  evaluating the effectiveness and impact of crisis response and recovery policies with the 
help  of  independent  experts  such  as  the  Scientific  Advice  Mechanism  (SAM)  and 
audits by the European Court of Auditors; 
fostering transparency and trust by communicating clearly about what worked, what 
can be improved and what needs to change; 

• 

•  considering the social and economic impacts on groups disproportionately affected by 
health crises and identifying ways to strengthen equity and an inclusive approach.  

Recovery in action: Strengthening EU health security based on lessons learnt from the COVID-
19 pandemic 

Building on the lessons learnt from the COVID-19 pandemic, the Commission updated the legislation 
on  serious  cross-border  health  threats.  This  puts  in  place  a  more  robust  system  for  prevention, 
surveillance, early warning and response at both EU and national levels and ensure faster coordination, 
improved  information  sharing  and  joint  action  in  times  of  emergency.  HERA  was  set-up  as  a 
Commission service to strengthen the EU’s ability to prevent, detect, and rapidly respond to cross-border 
health  emergencies  by  ensuring  the  development,  manufacturing,  procurement,  and  equitable 
distribution of key medical countermeasures. The mandates of key EU agencies were also strengthened: 
(i) the ECDC now has enhanced powers in surveillance, risk assessment, and the creation of a network 
of EU reference laboratories for public health, supporting better preparedness and response planning 
across Member States; and (ii) the EMA plays a central role in preventing and managing shortages of 
essential medicines and medical devices. Further, a framework of measures for ensuring the supply of 
crisis-relevant medical countermeasures in the event of a public health emergency at Union level was 
established. Moreover, the reinforced Union Civil Protection Mechanism (UCPM) legal framework 
has  enabled  the  Commission  to  expand  the  rescEU  reserves.  This  includes  creating  over  20  rescEU 
strategic  stockpiles  located  in  16  Member  States,  containing  essential  items  such  as  medical 
countermeasures,  intensive  care  medical  equipment,  chemical,  biological,  radiological  and  nuclear 
(CBRN) response equipment and personal protective equipment. 

Following these legislative reforms, the EU continued to refine its health security framework  on the 
basis of post-pandemic evaluations. The Scientific Advice Mechanism (SAM) provided independent, 
evidence-based  guidance  on  pandemic  preparedness,  vaccine  strategies  and  public  trust  in  science. 
Moreover, the European Court of Auditors carried out a series of  reviews and audits  on the EU’s 
response to the COVID-19 pandemic (38). In particular, the Court of Auditors assessed the ECDC’s and 
the  EMA’s  preparedness  for  and  response  to  the  COVID-19  pandemic,  auditing  the  two  agencies’ 
performance in times of a health crisis (39). In general, within the limits of their respective powers and 
capacities, the audit concluded that the two agencies generally responded well to the COVID-19 crisis. 

38 
39 

https://www.eca.europa.eu/en/covid19. 
https://www.eca.europa.eu/en/publications?ref=SR-2024-12. 

8 

 
 
 
More  recently,  the  operations  of  the  Commission’s  service  HERA  were  reviewed  (40),  highlighting 
HERA’s achievements in strengthening EU-level preparedness and response capacities. However, these 
reports  also  identified  shortcomings  in  specific  areas  and  shed  light  on  areas  where  further  work  is 
needed.  Additionally,  an  evaluation  of  the  UCPM,  adopted in  2024, recommended  strengthening its 
operational response capabilities to more effectively mitigate large-scale, cross-border risks (41). 

Insights from these audits and reviews help strengthen the EU’s capabilities in health crisis prevention, 
preparedness and response. Together, these measures show how the EU  has transformed the  lessons 
from the pandemic into lasting improvements in health security – building a healthier, safer and more 
resilient Europe for the future. 

3. 

STRENGTHENING  NATIONAL 
ENSURING  A 
COORDINATED  EU-LEVEL  RESPONSE:  A  COHESIVE  APPROACH  TO 
HEALTH SECURITY 

PLANS  WHILE 

The Union plan takes inspiration from the national prevention, preparedness and response plans 
that Member States have been developing and updating since the adoption of the Regulation on 
serious cross-border threats to health in  2022 (42). In turn, Member States should  align their 
national plans with the Union plan to the largest extent possible, fostering a cohesive approach 
to health security. By integrating EU and national plans, a robust and inclusive health security 
framework  can  be  put  in  place  across  the  EU.  The  Union  plan  therefore  serves  as  both  a 
guiding document  and a  catalyst for unity: empowering national  authorities to  strengthen 
their own national plans while ensuring a coordinated EU-level response to health crises.  

Every three years, Member States report to the Commission on their prevention, preparedness 
and  response  planning  and  implementation  at  national  level,  providing  an  overview  of  their 
national  governance structures,  capacities and resources in place  dedicated  to ensuring  their 
readiness and response to cross-border health crises. The Health Security Committee (HSC) 
(43) plays an important role in this self-reporting exercise and in discussions on the EU’s overall 
state of preparedness. The HSC brings together Member States, the Commission and relevant 
EU agencies and bodies to discuss  and share best practices, promote  alignment between the 
national plans and the Union plan, and foster a culture of collaboration (44).  

In parallel, also in a three-year cycle, Member States’ prevention, preparedness and response 
capacities  are  assessed  by  the  ECDC.  Following  these  Public  Health  Emergency 
Preparedness  Assessments  (45)  (PHEPA),  the  ECDC  makes  tailored  recommendations  to 

40 
41 
42 
43   

44 
45 

COM(2025) 147 final. 
COM(2024) 212 final. 
As part of the implementation of Regulation (EU) 2022/2371, see Articles 6-8.  
https://health.ec.europa.eu/health-security-and-infectious-diseases/crisis-management_en#health-
security-committee. 
Article 10 of Regulation (EU) 2022/2371. 
https://www.ecdc.europa.eu/en/about-ecdc/what-we-do/public-health-emergency-preparedness-
assessments. 

9 

 
 
 
 
Member States, outlining areas for improvement and suggesting ways to improve their national 
plans and strengthen their capacities (46). 

The following figure illustrates the interlocking reporting and assessment cycles of Member 
States’  prevention,  preparedness,  and  response  (PPR)  planning.  The  left  side  depicts  the 
reporting cycle, in  which Member States report on their national PPR plans, which are then 
discussed in the Health Security Committee and summarised by the Commission in an overview 
report.  The  right  side  depicts  the  assessment  cycle,  starting  with  the  PHEPA,  followed  by 
ECDC  recommendations,  and  concluding  with  Member  States  developing  action  plans  in 
response. Feedback from both cycles feed into the Commission’s integrated overview of EU 
preparedness for the European Parliament and the Council, supporting continuous improvement 
of EU health security.  

Figure  1.  The  interlocking  Reporting  and  Assessment  cycles  of  Member  States’  prevention, 
preparedness and response planning.  

To date, all 30 EU/EEA countries have national prevention, preparedness and response plans 
in place and reported on their capacities in the first self-reporting exercise in 2023 (47). In 2024 
and 2025, 19 EU/EEA countries participated in the PHEPA run by the ECDC. 

Using the information collected through the national self-reporting exercise and the results of 
the PHEPA, the Commission, in cooperation with the ECDC, prepares an overview report on 
the state of preparedness in the EU (48), highlighting gaps and areas for improvement. 

46 
47 

48 

reporting 

Article 8 of Regulation (EU) 2022/2371. 
https://eur-lex.europa.eu/legal-
The 
content/EN/TXT/?uri=CELEX:32023R1808)  and  will be  repeated  in  2026  and  every  three  years  after 
that.  
Article 7(2) of Regulation (EU) 2022/2371. 

questionnaire 

based 

(see: 

on 

is 

a 

10 

 
 
 
 
Insights into EU/EEA countries’ preparedness capacities from the 2023 self-reporting exercise 

All  EU/EEA  countries  have  legislative  frameworks  for  health  crisis  management,  but  gaps  in 
implementation persist. To effectively tackle serious cross-border health threats, Member States need to 
adopt a comprehensive approach that emphasises collaboration, equal opportunities, financial resilience 
and robust coordination at all levels.  

On  the  One  Health  approach,  most  EU/EEA  countries  have  incident  management  systems  that  link 
public  health  to  other  sectors.  However,  coordination  mechanisms  across  different  sectors  and 
governance levels are rarely tested and revised. To better identify risks early on, Member States should 
regularly assess all types of threats and incorporate them into comprehensive, One Health and all-hazard 
health crisis plans, involving all relevant sectors of society. These plans should also integrate medical 
countermeasures, ensuring that stockpiles and manufacturing capacities are ready to support a rapid and 
effective response when health crises hit. 

Most EU/EEA countries have plans to ensure the availability of their health workforce during health 
crises, but few review these plans on a regular basis, and many struggle to adequately forecast human 
resource needs. Systems for deploying medical personnel across borders in an emergency are not yet 
well established. To manage surges in demand in an emergency, Member States should have plans in 
place to mobilise additional personnel, including students and retired professionals. They should also 
set out clear procedures for redeploying health workers across regions and between EU/EEA countries 
in high demand situations, including in potential conflict scenarios. In general, the operationalisation of 
mutual  assistance  and  cooperation  arrangements  is  needed  to  facilitate  the  movement  of  personnel, 
medical equipment, medical countermeasures and patients  across borders during emergencies and to 
enhance host-nation support. 

The development and implementation of the national plans, as well as the planning of required 
capacities within Member States for prevention, preparedness and response for health crises, 
are  therefore  a  dynamic  process  which  are  also  influenced  by  Member  States’  political 
priorities,  available  resources,  and  the  constantly  changing  threat  and  risk  landscape.  The 
Commission  and  EU  agencies  support  Member  States  by  providing  technical  guidance, 
organising trainings (37), simulation exercises, and providing expertise (38). Continued dialogue 
in the Health Security Committee is crucial in this regard.  

4. 

IMPLEMENTING AND FURTHER DEVELOPING THE UNION PLAN 

The Union plan, strongly linked to and building on the national plans, will inevitably evolve. 
Similar to the national plans, political developments, outbreaks, changes in EU legislation and 
the adoption or implementation of relevant EU initiatives need to be reflected in subsequent 
versions of the plan. Therefore, when updating the Union plan, it will be crucial to take into 
account feedback from simulation exercises, lessons learnt from real health crises, evaluations 
of EU legislation and initiatives, implementation experience and available financial resources. 

To ensure that the Union plan continues to meet its aims and objectives, it will  be regularly 
tested through simulation exercises, the first of which is scheduled for 2026. These exercises 
will test the Union plan’s content in response to various types of emerging threats. Additionally, 

11 

 
 
 
other  simulation  exercises,  training  sessions  and  workshops  are  planned  that  will  focus  on 
specific aspects of prevention, preparedness and response to health crises49.  

If a health crisis emerges, the Commission will carry out in-action and after-action reviews with 
Member States. Capturing insights from these reviews and incorporating them into the Union 
plan  will  be  crucial.,  This  will  help  the  plan  to  remain  fit-for-purpose  and  to  be  the  most 
effective toolbox possible in all phases of the prevention, preparedness and response cycle. 

The results of the ongoing evaluations  of two key building  blocks of the  European Health 
Union must also be considered: (i) the implementation of the Regulation on serious cross-
border threats to health; and (ii) the ECDC in light of its revised mandate. The outcomes of 
these evaluations are expected to be published in Q1-2026 and Q2-2026, respectively. 

The roll-out of various key actions listed in the Action Plan annexed to the Preparedness Union 
Strategy would need to be taken into account in future revisions of the plan. These include: (i) 
developing  an  EU  Crisis  Coordination  Hub,  planned  for  2027;  (ii)  drawing  up  a 
comprehensive  EU  risk  and  threat  assessment  (2026);  (iii)  adopting  minimum 
preparedness  requirements  (2026);  and  (iv)  setting  out  comprehensive  civil-military 
preparedness arrangements (2027).  

The Action Plan annexed to the Preparedness Union Strategy also includes two strategies that 
were  adopted  in  2025.  The  Medical  Countermeasures  Strategy  (50)  aims  to  reinforce  the 
Union’s preparedness and response capacities for the next health emergency, irrespective of its 
origin,  by  ensuring  access  to  and  availability  of  medical  countermeasures  like  vaccines, 
medicines, diagnostics and other medical tools at all times. The Stockpiling Strategy (51) aims 
to build and maintain strategic reserves of essential medical supplies  for quick mobilisation.  
Both strategies’ implementation will focus on specific measures relevant to the Union plan.  

Proposals under the next Multiannual Financial Framework, currently being examined by the 
co-legislators,  will  also  have  important  implications  for  the  content  of  the  Union  plan.  In 
particular, the Commission’s proposal for a European Competitiveness Fund (52) focuses on 
fostering innovation and competitiveness in the health sector while ensuring supply security 
and boosting industrial capacity and capability to address future serious cross-border threats to 
health in line with the One Health approach. 

Moreover, the Commission’s proposal to strengthen the Union Civil Protection Mechanism 
and Union support for health emergency preparedness and response (53) aims to reinforce 
EU crisis prevention, preparedness and response.   

49 

50 
51 
52 
53 

For  example,  exercises  dedicated  to  the  management  of  medical  countermeasures  or  civil-military 
cooperation.  
COM(2025) 529 final of 9 July 2025.  
COM(2025) 528 final of 9 July 2025.  
COM(2025) 555 final of 16 July 2025. 
COM(2025) 548 final of 16 July 2025. 

12 

 
 
 
In addition, the European partnership on pandemic preparedness (BE READY), a research 
partnership funded under Horizon Europe (54), is set to launch in January 2026 and will bring 
together a sustainable pan-European research network that can quickly and effectively respond 
to future health crises (55).  

The  Union  plan’s  successful  implementation  and  future  updates  will  be  driven  by  a 
collaborative effort between the Commission, other EU Institutions, agencies and bodies, and 
Member States. The Health Security Committee will  continue to be the platform for regular 
coordination  on  the  Union  plan’s  implementation.  At  the  same  time,  the  Commission  will 
actively share knowledge and best practices with all stakeholders, including Member States’ 
competent  authorities,  through  a  range  of  communication  channels  including  key  events. 
Together, we will work towards a stronger, more inclusive and more resilient European Union 
in which no one is left behind, and by fostering a culture of cooperation and collective action 
to protect the public’s health and well-being. 

54  

55 

https://ec.europa.eu/info/funding-tenders/opportunities/portal/screen/opportunities/topic-
details/horizon-hlth-2024-disease-17-
01?order=DESC&pageNumber=1&pageSize=50&sortBy=startDate&isExactMatch=true&status=3109
4501,31094502&programmePeriod=2021%20-
%202027&frameworkProgramme=43108390&callIdentifier=HORIZON-HLTH-2024-DISEASE-17. 
https://beready4pandemics.eu/.  

13