Strengthening our collective health security architecture is an urgent task

Thank you, dear Sandra, for the opportunity to speak to you today, another example of our productive collaboration.

I am sorry that I am unable to be with you in person. I’m calling in from Ukraine, on my fourth mission this year, currently on the road to Dnipro. The temperature here right now is hovering around the freezing point, but over the coming months it could fall to minus 20 degrees Celsius.

For the people of Ukraine, this winter will be about survival on many fronts as they face a devastating energy crisis, a deepening health emergency, a lack of access to health services and supplies, and the risk of viral infections.

It puts into sharp focus our agenda today, and the fact that we, the pan-European region and the world, must take effective steps to manage this so-called permacrisis – of pandemics, wars, new emerging diseases and the climate emergency.

Strengthening our collective health security architecture is an urgent task for all of us. So, in the short time I have with you today, I would like to touch on 3 areas:

• to provide an update and share some reflections on the global pandemic treaty and revisions to the International Health Regulations (IHR);
• to explain the actions we are taking in the pan-European region to advance health security; and
• to consider how these developments complement the action you are taking at the European Union (EU) level as part of the health security framework.

COVID-19 underlined known, and revealed new, failures in our global health security landscape, including limitations in the existing IHR, last updated in 2005. Reporting delays, a lack of accountability, and weak mechanisms for intercountry collaboration and access to countermeasures hampered the pandemic response, and cost lives.

To address this, in May 2022 the WHO Director-General set out 10 proposals to strengthen the global architecture for health emergency preparedness, response and resilience, built on more than 300 recommendations from various independent reviews.

In addition, 2 key Member State-led processes have been launched:

• the Working Group on Amendments to the IHR (WGIHR); and
• the Intergovernmental Negotiating Body (INB) to draft and negotiate a WHO convention, agreement or other international instrument on pandemic prevention, preparedness and response.

The WGIHR met for the first time last week, and is set to present its outcome at the World Health Assembly in 2023, with a view to adopting their recommendations by consensus in 2024.

One proposal that has received significant interest is the introduction of a new global target called 7-1-7, meaning that every suspected outbreak is identified within 7 days of emergence, reported to public health authorities with initiation of investigation and response efforts within 1 day, and effectively responded to – as defined by objective benchmarks – within 7 days.

Its proponents argue that this target would strengthen global accountability, enable countries to assess their performance easily and see where to improve, and direct action and donor support to areas of need.

The second process began almost a year ago, when WHO Member States agreed to establish the INB to draft and negotiate a WHO convention, agreement or other international instrument on pandemic prevention, preparedness and response – the so-called pandemic treaty.

Its rationale is to cover areas beyond the scope of the IHR. Some of the proposed topics – subject to negotiation – include the global supply chain and logistics, access to technology, increased research and development, the health workforce, community engagement, One Health, and public health literacy.

In the past year, the INB has made impressive progress, including agreeing that the new instrument should be legally binding, with non-legally binding elements. Based on the extensive consultations held so far, a conceptual zero draft was shared last week, and it is anticipated that this conceptual draft can be turned into an actual zero draft by the end of February next year. Again, a proposal will be put to the World Health Assembly in 2024.

These global Member State-driven processes rightly require extensive consultation and consensus building. This takes time, and requires extra effort to make sure that all countries play an active role.

Which brings me to what we are doing across the 53 countries of the WHO European Region – covering Europe and central Asia – to strengthen health security. Our approach is to play a leading role in advancing the global health security agenda, and to move forward simultaneously with our own pan-European plans. To help our Member States engage in the global processes, we have established a regional secretariat. This also serves to avoid duplication and speed progress.

I have spoken on many occasions about the Pan-European Commission for Health and Sustainable Development, led by Professor Mario Monti, which I convened to rethink policy priorities in the light of the pandemic. At the request of our Member States, we are now taking several of its specific recommendations forward.

One of these is to establish a Pan-European Network for Disease Control. The Network will share critical capacities and knowledge across the Region through collaborative operational research projects, professional exchanges and twinning programmes that will culminate in a regular conference.

We hope to launch this Network during the second part of 2023. I thank those Member States who have reached out to WHO in support of this initiative – we will count on your support, as well as that of the EU health institutions.

As part of our efforts to deliver the European Programme of Work, we are now also kick-starting a process to design a new strategy and action plan to strengthen health emergency preparedness, response and resilience for 2024 to 2029. We call it Preparedness 2.0.

Informed by the extensive lessons learned from recent health emergencies, and comprehensive consultation, the aim of Preparedness 2.0 is to create a European Region with the required capabilities and pan-European networks to rapidly detect, verify and notify one another of new and evolving health threats, and to effectively respond to emergencies caused by any hazard.

With an all-hazard, multisector, One Health approach as its backbone, the strategy will be structured around identified gaps and Member States’ priorities, including:

• addressing the threat of antimicrobial resistance
• creating a regional health emergencies workforce
• tackling infodemics and building community trust
• advancing the work of the Pan-European Network for Disease Control. 

All these developments illustrate that the European Commission’s Directorate-General for Health and Food Safety and WHO/Europe have a shared vision to provide a stronger health security architecture for our citizens, grounded in the principles of solidarity, transparency and accountability.

We welcome your leadership to bolster EU health security through proposed changes within all 4 elements of the health security framework, including new regulations, updated mandates for the European Centre for Disease Prevention and Control and the European Medicines Agency, and the creation of the European Health Emergency Preparedness and Response Authority (HERA).

We appreciate that the new framework underscores the value of the IHR and the role of WHO, and we are keen to explore how the Pan-European Network could catalyse these reforms beyond the EU’s borders.

We stand ready and committed to accelerate our collaboration with you and support your initiatives. Our tools, methodologies and technical competence could prove invaluable for working at the national level with Member States within the European Union and the wider pan-European region to ensure that their national preparedness plans and capacities are fit for purpose.

Dear colleagues and friends, in today’s complex world, we cannot know what health threats lie ahead, or when and where they will come from. But what is absolutely certain is that to tackle our permacrisis effectively, we must work in the same direction, strive for pan-European unity, and never leave any country or any person behind.