Improving capacity to send and receive public health assistance across member states during crises

SHARP Joint Action contributes to this vision for health security by strengthening the internal activities of member states for preparedness and IHR implementation; and to improve the coordination across sectors and across countries of the EU/EEA and partner countries.

What we understand of trans-country coordination

Stella Kyriakides, EU Commissioner for Health and Food Safety. “The COVID-19 pandemic has taught us some crucial lessons – about the foundational importance of our health, about how fragile our societies are, about existing vulnerabilities in our health systems – and, perhaps most powerfully of all, about the value of collaboration.

As the Covid-19 pandemic showed, public health emergencies might be of a magnitude that exceeds the national capacities. In these cases, obstacles to effective international cooperation and support are evident.

The health sector often underestimates the complexity of intersectoral and inter-state cooperation to be able to move health personnel, share specialized services/capacities, or medevac of patients in large scale emergencies.  A key element of inter-state liaison is the operationalisation of obligations related to response from health systems; cross-sectoral efforts and delivering effective assistance between member states when needed.

The Nordic Health Preparedness agreement signed on the 14 June 2002 provides an example of how this may be achieved.  This agreement between the governments of Denmark, Finland, Iceland, Norway and Sweden commits the countries to provide assistance to one another upon request, and  promote cooperation and as far as possible remove obstacles in national legislation and regulations.  Since its establishment, the countries in the Nordic Health Preparedness agreement have been continually working to support one another across the borders, participated in cross-border exercises and have established active mechanisms to increase preparedness for treating patients.—engelska.pdf

Managing the changes  in the IHR (2005)

Such intra-EU, memoranda of understanding also complement and contribute to a country’s plans to manage  the changes  in the IHR State Party Self-Assessment Annual Report (SPAR) and Joint External Evaluation (JEE).  Details of the changes can be read in the presentation on Monitoring & Evaluation, Country Health Emergency Preparedness & IHR, WHO Health Emergencies Programme delivered at the workshop on IHR core capacity strengthening and assessment 19-20 September 2022 in Ljubljana, Slovenia.

SHARP Joint Action Work package 5, IHR core capacity strengthening and assessment addresses the gaps that exist in the IHR core capacities of countries. I.e., those essential public health functions that each country needs to have in place to effectively prevent, detect and control and manage health threats – such as legislation and regulation, surveillance systems, water and food safety functions, outbreak investigation, etc.

Improving trans-country coordination capacity in response to major health threats

SHARP JA is acting as a catalyst to facilitate the establishment of bilateral and/or multilateral service agreements between member states. 

The first step is to capture the up to date insight into the challenges of international collaboration between governments and national authorities via this 20 minute survey EUSurvey – Survey (  Twenty countries have already responded, and the deadline has been extended to 31 January 2023.

Co-production of a template agreement for trans-country collaboration that meets your practical needs

Having an effective agreement on international collaboration between authorities during crises will help country’s manage the new cross-border threats to health legislation which demands inter-state liaison.

Join us to elaborate on a template for a legal framework agreement for trans-country operationalisation of obligations related to response from health systems, cross-sectoral efforts and effective assistance between member states when needed. 

Workshop 5.2:  Creating a template agreement for trans-country collaboration between authorities during crises, 27 and 28 February 2023, Lux Lisboa Park Hotel, Lisbon & online

During this workshop, we will share the survey findings and table recommendations for discussion.

Click to Register to attend in person by 17 February 2023

Registrations to participate online will be accepted until 23 February 2023

Working language: English

Who should attend?

  • The competent authorities working with preparedness plans in SHARP partner countries.
  • Professionals from local, intermediate and national level competent authorities and public health agencies in countries participating in the SHARP Joint Action
  • National focal points (NFPs) for the International Health Regulations (2005)

This event is free to attend. However, participants will need to arrange and cover their travel, accommodation and subsistence costs from their own budget.

Venue and accommodation options

Final Agenda

Guidance on travel budgets for partners, affiliated entities and collaborating partners of SHARP Joint Action – SHARP Joint Action (

  • These partners have WP5 travel funds: THL, MCA, CIPH, MOH-FR, SEMS, MOHLT, MFH, HD, FHI, NIZP, MS, IPHS, NIJZ, ISCIII, FOHM, UKHSA and NAPH.
  • The RKI, INMI, BMSGPK, SUJCHBO, SSI, NNK and RIVM partners could apply to use WP8 travel funds.  Email:
  • EODY can use WP3 funds, and PHW WP2 funds.
  • Affiliated entities: e.g., MoH Italy, has WP5 funds.  Health Board Estonia has WP8 funds.
  • Collaborating partner MoH Spain has their own funds.

For specific advice, please email

Further reading

Dimitri Eerens, Rok Hrzic, Timo Clemens, The architecture of the European Union’s pandemic preparedness and response policy framework, European Journal of Public Health, 2022; ckac154,

European Court of Auditors. Dealing with serious cross-border threats to health in the EU: important steps taken but more needs to be done . Luxembourg, 2016:1–78.

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View the achievements and plans for IHR core capacity strengthening and assessment WP5