International and multisectoral cooperation are critical for effective response to serious cross-border threats to health

EU member states have made efforts to encourage sectors other than health to contribute to assessments, planning and interventions aimed at strengthening capacities under the IHR (2005).  Nevertheless, effective multisectoral collaboration remains a challenge in most, if not all, countries. 

Importantly, lack of capacity in this respect will make it difficult to meet the demands of the new regulation (EU) 2022/2371 on serious cross-border threats  (SCBT) which came into effect on 23 November 2022.

Some useful lessons can be found in a recent review by Instituto de Salud Carlos III,  partner in work package 6 of the SHARP Joint Action.  The review analysed the success and fail factors relating to three public health events that affected EU countries between 2010 and 2014 – one biological in origin, one chemical, and one environmental.   

Existing European-level structures should be used to effectively respond to health threats

One of the main lessons learnt concerns the utilisation of existing international cooperation structures. The review demonstrates how EU mechanisms that aim to monitor, share information, and strengthen cooperation in relation to public health threats were utilised to best effect. These structures include the EU Early Warning and Response System (EWRS), the Rapid Alert System for Food and Feed (RASFF), EpiPulse – the European surveillance portal for infectious diseases, and the EU Civil Protection Mechanism.

Overall, best practice examples underline the success of multidisciplinary and intersectoral approach in preparedness and response. Whilst reinforced cooperation between relevant agencies and authorities – both locally and nationally – allows more effective response in a timely fashion.

Further, the scenarios reviewed showed the usefulness of risk assessments and preparedness plans that detailed relevant authorities’ roles, responsibilities and the clear operating procedures.

It concludes that countries should also work to strengthen capacities in risk assessment and incorporate preparedness and response plans at all levels to be better prepared for future threats.

Training and simulation exercises offer a way to build capacity

The review emphasises the role of personnel training and simulation exercises in capacity building – a core SHARP Joint Action priority.

Elements of this review are being used by WP6 lead, the RIVM, in collaboration with WP8  in the development of  a tabletop exercise (TTX).  This aims to enhance awareness on which sectors are currently involved, and which should be involved, in the initial phase of public health emergency response (M23).  It’s designed to inspire public health professionals to think about multisectoral collaboration in their existing national, (in)formal, all hazards preparedness and response plans.

Read the entire review here. Here author, Carmen Varela Martínez, Centro Nacional de Epidemiología, Instituto de Salud Carlos III present the highlights from this review.

The TTX and an “All hazards e-learning tool” (MS21) will be made available for all SHARP JA partners at a workshop in Spring 2023.

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The review is part of the work of SHARP Joint Action’s Work Package 6. WP6 supports in the development of an integrated multisectoral preparedness and response plan which Member States can incorporate into their national Preparedness and Response plans.  Read more about Work Package 6

Read more on how regular simulation exercises are a way to test preparedness plans in a report from SHARP Joint Action WP5, Simulation Exercises and After Action Reviews are effective tools to evaluate EU-level crisis preparedness – SHARP Joint Action (

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