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Brian Doherty: EU Action for Regional Health Security

THL
THL

Mr. Brian Doherty, Policy Officer, Crisis Management and Preparedness in Health, DG SANTE, the European Commission, at One Health Security Conference, 14-15 Oct 2019, THL, Helsinki

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EU Action for Regional Health Security:
Preparedness and response
to serious cross-border threats to health
Brian Doherty
DG SANTE C3 – Crisis management and preparedness in health
Decision 1082/2013/EU on serious
cross-border threats to health
 Strengthened EU Health Security Framework
 Integrated, coordinated and comprehensive approach
for preparedness, early warning, risk assessment and
crisis response
 Extended scope of cross-border health threats including
 communicable diseases, antimicrobial resistance and healthcare
associated infections and biotoxins
 chemical, environmental and unknown threats
EEA
Coordination under the EU health security framework
EU Member States
GHSI: Global Health Security Initiative
Structures and mechanisms
Network for
epidemiologic
surveillance
EWRS – alert
system
Health
Security
Committee,
and working
groups
Capacity
building and
technical
assistance
through
Health
Programme
Commission
internal
mechanisms
for crisis
coordination
and response
Preparedness
Article 4 of the Decision aims at
ensuring adequate coordination
between the Member States to achieve
a consistent level of preparedness
and interoperability between the
existing and future national
preparedness plans.
MS and Commission to consult each other for
coordinating efforts to develop, strengthen
and maintain capacities for monitoring, early
warning and assessment of and response to
serious cross-border health threats
MS to provide Commission updates on
preparedness and response planning for the
first time in 2014 and then every 3 years
Sharing best
practice and
experience in
preparedness and
response planning
Promoting
interoperability
of national
preparedness
plans
Addressing
intersectoral
dimension of
preparedness and
response planning
at Union level
Supporting
implementation
of core-capacity
requirements
for surveillance
and response (as
per Art. 5 and 13
of the IHR)
Epidemiological surveillance
 Communicable diseases are permanently monitored by the
European Centre for Disease prevention and Control (ECDC)
 Network for the epidemiological surveillance of CDs and of
related special health issues operated by the ECDC
• The network brings into permanent communication the Commission, the ECDC
and national authorities responsible for epidemiological surveillance.
• MS communicate comparable and compatible data on epidemiological
surveillance of notifiable communicable diseases and the progression of epidemics
by using the EU case definitions
• A new draft Commission Implementing Decision updating the list of communicable
diseases and relevant case definitions to be covered by epidemiological surveillance is
expected to be adopted in May 2018. This will include communicable diseases that have
recently emerged or re-emerged, such as Chikungunya, Dengue, Lyme
neuroborreliosis and Zika, and their corresponding case definitions, as well as revised
case definitions for several diseases and related special health issues.

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Brian Doherty: EU Action for Regional Health Security

  • 1. EU Action for Regional Health Security: Preparedness and response to serious cross-border threats to health Brian Doherty DG SANTE C3 – Crisis management and preparedness in health
  • 2. Decision 1082/2013/EU on serious cross-border threats to health  Strengthened EU Health Security Framework  Integrated, coordinated and comprehensive approach for preparedness, early warning, risk assessment and crisis response  Extended scope of cross-border health threats including  communicable diseases, antimicrobial resistance and healthcare associated infections and biotoxins  chemical, environmental and unknown threats
  • 3. EEA Coordination under the EU health security framework EU Member States GHSI: Global Health Security Initiative
  • 4. Structures and mechanisms Network for epidemiologic surveillance EWRS – alert system Health Security Committee, and working groups Capacity building and technical assistance through Health Programme Commission internal mechanisms for crisis coordination and response
  • 5. Preparedness Article 4 of the Decision aims at ensuring adequate coordination between the Member States to achieve a consistent level of preparedness and interoperability between the existing and future national preparedness plans. MS and Commission to consult each other for coordinating efforts to develop, strengthen and maintain capacities for monitoring, early warning and assessment of and response to serious cross-border health threats MS to provide Commission updates on preparedness and response planning for the first time in 2014 and then every 3 years Sharing best practice and experience in preparedness and response planning Promoting interoperability of national preparedness plans Addressing intersectoral dimension of preparedness and response planning at Union level Supporting implementation of core-capacity requirements for surveillance and response (as per Art. 5 and 13 of the IHR)
  • 6. Epidemiological surveillance  Communicable diseases are permanently monitored by the European Centre for Disease prevention and Control (ECDC)  Network for the epidemiological surveillance of CDs and of related special health issues operated by the ECDC • The network brings into permanent communication the Commission, the ECDC and national authorities responsible for epidemiological surveillance. • MS communicate comparable and compatible data on epidemiological surveillance of notifiable communicable diseases and the progression of epidemics by using the EU case definitions • A new draft Commission Implementing Decision updating the list of communicable diseases and relevant case definitions to be covered by epidemiological surveillance is expected to be adopted in May 2018. This will include communicable diseases that have recently emerged or re-emerged, such as Chikungunya, Dengue, Lyme neuroborreliosis and Zika, and their corresponding case definitions, as well as revised case definitions for several diseases and related special health issues.
  • 7. Chemical threat surveillance  Network of European Poison Centres collaborates through the RasChem system • lower tier risk assessment/discussion platform • for EU Member States and competent authorities to exchange useful detailed technical information on emerging chemicals hazards. • helps to ensure that countries are aware of emerging chemical events and that the same technical information (e.g. case definition) is shared between them.
  • 8. Early Warning and Response System (EWRS) • A rapid alert system for notifying at Union level alerts in relation to serious cross-border threats to health. • The EWRS enables the Commission and the competent authorities responsible at national level to be in permanent communication for the purposes of alerting, assessing public health risks and determining the measures that may be required protect public health. • Commission Implementing Decision (EU) 2017/253 of 13 February 2017 on EWRS and for the information exchange, consultation and coordination of responses
  • 9. Risk Assessment The Commission shall, where necessary for the coordination of the response at EU level • where an alert is notified • upon request of the HSC • on its own initiative make promptly available to the national competent authorities and to the HSC, through the EWRS, a risk assessment of the potential severity of the threat to public health, including possible public health measures. Communicable diseases Food safety e.g. Chemical threats NATIONAL COMPETENT AUTHORITIES
  • 10. Rapid Risk Assessment SCIENTIFIC COMMITTEE ON HEALTH, ENVIRONMENTAL AND EMERGING RISKS Rapid Risk Assessment WG Made up of member state representatives • Chair (SCHEER member) • Expert Risk Assessor (SCHEER member or external expert) acting as a rapporteur • SCHEER members experienced in public health RRA • External experts from the pool of RRA experts. Create an ad-hoc working group to provide the RRA • Members of RRA WG as appropriate • Experts selected from the Pool of Experts on RRA • Based on expertise and availability
  • 11. Health Security Committee  Existed as informal group established on the basis of 2001 Council Conclusions on bioterrorism  Consists of MS representatives, with candidate countries as well as EFTA countries as observers, ECDC and WHO, plus other bodies when relevant  Chaired by Commission  Main task: to coordinate responses to serious health threats
  • 12. Coordination of response  MS to consult each other within the Health Security Committee and in liaison with the Commission with a view to coordinating:  national responses to serious cross-border threat to health  risk and crisis communication, aimed at providing consistent and coordinated information in the EU to the public and to healthcare professionals.  MS to inform about their intention to adopt measures unless so urgent that immediate adoption is necessary.
  • 13. Chemical and environmental threats Including heat wave (2003), volcanic ash clouds (2010), red aluminium sludge spill in Hungary and in Danube (2010), food poisoning linked to malathion etc Threats of biological origin Including alerts on chikungunya, malaria, dengue, hepatitis A, drug-resistant tuberculosis, salmonellosis, botulism, influenza, yellow and lassa fever, meningitis, legionellosis, poliomyelitis, cholera, histamine poisoning, etc; including major outbreaks such as Ebola, MERS CoV, poliomyelitis, Zika, measles
  • 14. Vaccination • Tackle vaccine hesitancy • Improve coordination on vaccine procurement • Support research and innovation • Strengthen EU cooperation on vaccine-preventable diseases
  • 15. State of Play •Global Vaccination Summit •Coalition for Vaccination •Joint Action on Vaccination
  • 17. Joint Actions- Vaccination [EU-JAV] • Immunization Information systems - strengthen surveillance, increase coverage • Supply and preparedness • Research and development prioritisation • Hesitancy and uptake
  • 18. Anti-Microbial Resistance One Health approach to: • Make the EU a best practice region • Boost research, development and innovation • Shape the global agenda
  • 19. Joint Actions - AMR and associated infections [EU-JAMRAI] • One Health national strategies and Action Plans • Prevention of Health-Care-Associated Infections • Appropriate use in human and animals • Awareness raising • Research and innovation
  • 20. Joint Actions • Preparedness and action at points of entry [Healthy GateWays] • Ground crossings • Air transport • Maritime Transport • Chemical Threats at PoE • Capacity Building • International Health Regulations [ShARP] • Terror Attacks (starting Q1 2020)
  • 21. Joint procurement of medical countermeasures (Article 5)  Joint Procurement Agreement, adopted in 2014, provides for a voluntary mechanisms for procuring jointly: 24 MS participate  A joint procurement procedure for pandemic influenza vaccines is underway, other medical countermeasures are under preparation. Rationale: purchase medical countermeasures, so that:  pandemic vaccines and other medical countermeasures are available in sufficient quantities;  access to pandemic vaccines or medical countermeasures is guaranteed for all participating Member States;  all Member States are treated equally and can benefit from correct contractual conditions.  a voluntary mechanism established, covering all countermeasures against cross-border health threats
  • 22. Joint procurement of medical countermeasures (Article 5)
  • 23. Exchange of Medical Countermeasures • Procedures and templates to facilitate and ensure the most timely exchange process for MCMs via EWRS • 2 formats: Requests for MCMs & Proposals to provide MCMs • Aim is to have their use systematized • Voluntary bi-lateral exchange • Terms and conditions responsibility of the nations involved
  • 24. Coordination within the Commission • Frameworks for food safety and animal health and for pharmaceutical productsDG SANTE • EU Civil Protection Mechanism, European Medical Corps, European Voluntary Aid CorpsDG ECHO • European Agenda on Security, Security Union; EU CBRN Action PlanDG HOME • EU Joint Framework on countering hybrid threatsDG GROW-EEAS • EU Framework Programme for Research and Innovation Horizon 2020DG RTD • Bilateral programmes - IHR implementation within health systems strengthening and promoting universal health coverage DG DEVCO • EU Action Plan on the Sendai Framework for Disaster Risk Reduction 2015-2030DG ECHO-JRC • Strategy on Foreign and Security Policy DG EEAS
  • 25. Thank you! Public Health Web site: http://ec.europa.eu/dgs/health_consumer/publichealth_en.htm EU Health portal http://ec.europa.eu/health-eu/index_en.htm
  • 26. Coordination under the EU health security framework EU Member States EEA & EFTA GHSI: Global Health Security Initiative