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International collaboration between authorities during crisis report, authored by experts from the Norwegian Directorate of Health (Helsedirektoratet), proposes a framework for collaboration between health authorities during crises.

This timely publication support countries to meet the on-going requirements of the EU cross-border threats to health legislation. This requires coherence with the EU-level ‘prevention, preparedness and response plan

The regulation demands member states liaise with each other when drawing up their national plans. A key element of such inter-state liaison is the operationalisation of obligations related to responses from health systems, cross-sectoral efforts and effective assistance between member states when needed.

The Nordic health agreement provides an example of how this may be achieved.

An all-hazards template agreement on cross-border multisectoral support should be made available for European countries

A rigorous approach captured the key challenges experienced by SHARP Joint Action partner countries in national and international collaboration between governments and authorities during health crises. 

Drawing on the existing, proven Nordic Public Health Preparedness Agreement for cooperating in providing healthcare and social welfare in the case of emergencies or disasters, this insight on the various factors was then used to refine a proposed template agreement of intention. 

If adopted, it could facilitate the process of inter-state collaboration in preparedness and response planning at the regional, and subsequently EU level. All in line with fulfilling obligations under the International Health Regulations (IHR) (2005).

To maintain and further develop the proposed agreement of intention, the report recommends the establishment of a co-operative body composed of authorities of the participating countries. Using the template as a guide, the main obstacles to effective cross-border collaboration would be identified and resolved to arrive at detailed operational plans to best respond to emergencies.

Who should use the reports

• Those experienced in national preparedness and response,across health, diagnostic laboratory, citizen engagement and governmental institutions.
• Competent authorities and contact points in your organisation/National focal points (NFPs) for the International Health Regulations (2005).
• Individuals involved in the development and implementation of policies, guidelines, etc. who can take these recommendations into consideration, when they adjust their national preparedness and response plans.

IHR core capacities strengthened in focus countries over the course of the Joint Action

The IHR Core Capacity Strengthening and Assessment report looks at the knowledge, practices and added value of strengthening of selected core capacities in the EU and neighbouring countries.

This summarises the activities of Work Package 5 Task 5.1 workstream aimed to improve IHR implementation in twelve focus (low GNI) countries by strengthening selected core capacities through a series of annual workshops and corresponding work between them. The focus countries were Bosnia and Herzegovina, Croatia, Greece, Latvia, Lithuania, Malta, Moldova, Poland, Portugal, Serbia, Slovenia and Spain.

Led by the Public Health Agency of Sweden (FOHM), the bulk of the work was done between the annual workshops that gathered participants from the different countries to share barriers, plans for improvements and perspectives.

The experience was enhanced by the involvement of ECDC, WHO EURO and DG SANTE.

Qualitative analysis concludes that IHR core capacities did strengthen in the focus countries whilst managing the pandemic – particularly in the areas of laboratory capacity, surveillance, and risk communication. Comparison of 2019 to 2022 SPAR reports supports this experience. 

Why this evidence is important

The IHR are legally binding upon each WHO Member state’s government, rather than upon a single ministry, agency, office or sector. This means a multisectoral approach is central to the IHR (2005), with collaboration across all relevant national sectors to detect, assess and respond to a variety of potential public health emergencies of international concern.

It is well recognized that the capacity to address cross-border threats requires that countries first have the capability and capacity to control local, regional and national level health threats.

At the EU level, a decision to authorise the opening of negotiations for an international agreement on pandemic prevention, preparedness and response has been made. 10 incentives and benefits of an international treaty on pandemics – Consilium (europa.eu.