SHARP Joint Action calls for priority outcomes to be adopted by policymakers to minimise vulnerability to acute public health events

The implementation of the SHARP Joint Action (JA), designed to strengthen EU preparedness against serious cross-border health threats and support the implementation of the International Health Regulations (IHR), has been influenced by the Covid-19 pandemic. However, as a joint action aiming to enhance EU health security, it is positioned to contribute to the evolving health security framework that is emerging in the wake of the pandemic. This presents an opportunity to sustain the outcomes of SHARP.

To this end, ten key priority outcomes from SHARP JA have been identified: each with relevance to national, regional, and global priorities in terms of prevention, preparedness, and response:

  1. Work Package 5: Methodology, tools, and recommendations for improving IHR implementation and evaluation;

WP5 developed a methodology based on a peer-to-peer approach aimed at strengthening the implementation and evaluation of the IHR. As part of this methodology, a tool was created, offering strategic recommendations to enhance IHR implementation. This tool is adaptable to each country’s specific context and enables progress in certain key capabilities to be documented. This initiative is essential for assessing and strengthening core IHR capacities at the EU, regional, and global levels, aligning with EU directives regarding the reporting and assessment of national preparedness and response plans.

  1. Work Package 5: Template agreement of intention for cross-border multisectoral collaboration between neighbouring countries;

WP5 developed a template agreement of intention, inspired by the Nordic Public Health Preparedness Agreement, for cross-border multisectoral collaboration between neighbouring countries. This initiative aligns with EU, Pan-European, and global priorities for strengthening regional and international cooperation in response to health threats. Neighbouring countries can adapt and use this template, and it could be integrated into the EU Plan, encouraging cross-border collaboration among member states and neighbouring regions. This approach supports a more effective global response to health emergencies.

  1. Work Package 6: Consensus to determine core elements of a multisectoral preparedness and response plan and related tools;

WP6 used a RAND modified consensus procedure to identify sectors involved in pandemic preparedness and developed a Tabletop Exercise (TTX) and an all-hazards e-learning tool to promote multisectoral collaboration during public health emergencies. This addresses the need for clearer guidelines on multisectoral cooperation at national and global levels, aligning with EU regulations and global initiatives recognizing its importance. To ensure sustainability, Member States can integrate this approach into their national plans, while the EU and global efforts can incorporate these principles into their strategies and training programs.

  1. Work Package 7: The EMERGE laboratory network on highly pathogenic bacteria and viruses;

The EMERGE Laboratory Network, comprising 40 diagnostic laboratories across 25 European countries, focuses on high-risk pathogens. It provides surge capacity and expertise during outbreaks and conducts annual External Quality Assurance Exercises (EQAEs) to ensure readiness and best practices. The network’s consolidation at the EU level offers benefits such as alignment with IHR, support for low-income countries, improved risk assessments, and contributions to antimicrobial resistance efforts. Sustainability options include national-level contributions from network partners and potential EU designation as a Reference Laboratory Network for Highly Pathogenic Infectious Agents (HPAI). Collaboration with WHO can further strengthen global health security efforts.

  1. Work Package 8: Methodology to assess the cross-sectoral training needs for IHR strengthening across countries;

WP8 developed a multi-country methodology for assessing cross-sectoral training needs to strengthen IHR. The methodology integrated data from ECDC training needs assessments, voluntary Joint External Evaluations (JEEs), and mandatory Self-Assessment Annual Reporting (SPAR) to identify areas for improvement and capacity building.

  1. Work Package 8: Training tools for IHR strengthening, including training material, curricula, and an online platform;

WP8 worked with the other Work Packages within SHARP and relevant stakeholders including ECDC and WHO EURO, adapted and developed several training material and curricula to strengthen IHR core capacities. WP8 is also developing curricula for basic and advanced face-to-face and online training. Training material were translated into most EU language and are available on a dedicated training platform (SHARP JA Training Platform ( EduSHARP: All courses (

  1. Work Package 9: Recommendations to set up a European chemical laboratory network to respond to serious chemical health threats;

WP 9 worked on a report to evaluate the desirability and feasibility of establishing a European chemical laboratory network to respond to serious chemical health threats. This assessment involves a gap analysis of chemical capacities in European countries, an examination of existing relevant networks, and outlines the need for further study to assess the network’s size, scope, technical requirements, costs, and funding. Addressing chemical health threats is a priority at both EU and global levels, as evidenced by EU regulations and initiatives like the Joint Action TERROR and the Global Health Security Initiative. Options for sustainability include further exploration of the network’s feasibility at the EU and global levels.

  1. Work Package 9: Chemical safety and chemical threats: SOPs on chemical health threats;

To ensure a baseline competency among EU Member States in dealing with cross-border chemical health threats, WP9 developed Standard Operating Procedures (SOPs) on various chemical-related topics. The SOPs cover surveillance, risk analysis, multisectoral collaboration, decontamination, sampling and detection, and recovery. Addressing chemical health threats is a priority at both EU and global levels, making these SOPs crucial for preparedness and response.

  1. Work Package 10: Mapping existing High-Level Isolation Units likely to be dealing with rare or new high-consequence infectious diseases and for an expert clinical support service for high-consequence infectious diseases;

WP 10 undertook a mapping of clinical preparedness tools for hospital preparedness and capacity in dealing with high consequence infectious diseases. A referral network was proposed that would identify national centres as clinical referral units and as providers of remote clinical consultations. WP 10, in collaboration with WP5, aimed to define the characteristics of an expert clinical consultation, support service and to elaborate technical recommendations. A feasibility study was conducted which proposes the establishment of a permanent reference network of clinical experts on HCIDs recruited from HLIUs across Europe that would replace present informal networks

  1. Work Package 10: Recommendations on the implementation of a syndrome-based clinical protocol.

WP10 developed a “syndrome-based” approach for the early clinical management of highly contagious infectious diseases (HCID). This approach includes specific disease lists and protocols designed for HCID patient management in Emergency Departments. Its implementation aims to enhance healthcare personnel’s preparedness and response capabilities for HCID cases, focusing on efficient triage, standardized processes, effective isolation, and protection against occupational exposure risks. The protocol aligns with ECDC’s operational checklist for imported HCID cases, enhancing national preparedness. Integrating WP10’s protocol into WHO EURO’s Preparedness 2.0 framework at the Pan-European level would further strengthen regional preparedness and response for HCID outbreaks.


WP4 (Sustainability) elaborated a report as a guide for Member States and, where relevant, the EU and WHO EURO, aiming to integrate the JA-SHARP priority outcomes into national policies, EU or regional policies and plans through operational measures. The report seeks to ensure the sustainability of these priority outcomes through relevant national, EU, pan-European, or international bodies. Read the D4.2-Sustainability-report-final (PDF 609KB).

Building on this work, sustaining SHARP priority outcomes will further enhance national, EU, pan-European, and global endeavours in preparedness and response. This support aligns with common priorities identified at all levels, including the strengthening of preparedness and response evaluation, planning, and capacities; fostering cross-border collaborations; promoting a multisectoral approach; facilitating training and capacity building; and enhancing laboratory capabilities.

Read more on the experts involved, objective, outputs, activities and deliverables for each of these work packages under the SHARP work packages – SHARP Joint Action ( pages.