The COVID‑19 pandemic has exposed vulnerabilities in European public health systems, highlighting the importance of strengthening crisis preparedness capacities to protect public health and minimise disruption. When asked about which risks they feel personally mostly exposed to in 2024, 27% of EU citizens reported feeling exposed to human health emergencies – the second-most frequently reported risk after extreme weather events (38%) (European Commission, 2021[1]). The pandemic has also raised awareness of the growing risks posed by global environmental changes, such as climate change, which in turn increase the likelihood of zoonotic infections spilling over from animals to humans. Strengthening crisis preparedness capacities is thus essential to bolster European countries’ response capacity to future pandemics and mitigate the impact of other looming threats.
In this context, the WHO International Health Regulations (IHR) serve as the cornerstone of global efforts to enhance public health emergency preparedness and response worldwide. Amended in 2022 in response to the pandemic, the IHR provide a legal framework for countries to build and maintain minimum capacities to detect, assess and respond to public health threats. Countries must annually assess their capacities using the IHR States Parties Self-Assessment Annual Reporting Tool (SPAR), which covers 15 core capacities for effective public health emergency management (WHO, 2021[2]).
In 2023, EU countries had on average a self-assessed IHR score of 75 out of 100, consistent with the average score reported in 2020. Capacity-specific scores showed that surveillance, laboratory capacity and human resources were the highest-ranked capacities on average across EU countries. Conversely, the lowest scores were recorded in risk communication and community engagement, radiation emergencies and chemical events. Compared to 2020, the average EU IHR score for human resource capacities improved significantly (+18%), while chemical events (‑23%), radiation emergencies (‑21%) and zoonotic diseases (‑16%) saw the largest average declines. Scandinavian countries reported the highest total IHR scores, indicating near full compliance with IHR standards. France, Lithuania and Germany followed closely, with average IHR scores of 85 out of 100 or higher. Conversely, Romania (61), Greece (60) and the Slovak Republic (50) self-reported the lowest IHR scores in the EU. Between 2020 and 2023, Poland reported the largest overall IHR score increase (+46%) followed by Czechia and Malta (+13%), while Italy (‑14%), Luxembourg (‑29%) and the Slovak Republic (‑31%) reported the largest declines (Figure 8.1). It is worth noting that these changes may not exclusively reflect actual changes in a country's capacities, but also be due to changes in reporting methodologies or the stringency of self-assessments.
Public trust in government institutions is a key determinant of the effectiveness of crisis preparedness and response efforts by countries. High levels of trust can promote public compliance with health measures and social cohesion during crises. Conversely, a lack of public trust can undermine the legitimacy and efficacy of public health interventions, leading to lower adherence to guidelines, increased social tensions and poorer health outcomes. The OECD Trust Survey 2023 provides insights into public perceptions of government institutions’ capacity to protect people’s lives. On average across the 19 EU countries with available data, more than half of survey respondents expressed confidence in their governments’ capacity to protect the population in the event of a large‑scale emergency, while 31% believed they would not be capable (Figure 8.2). Public trust in government institutions’ crisis management capacity was highest in Finland (82%), the Netherlands (68%) and Denmark (66%), and lowest in Latvia (35%), Portugal (33%) and Greece (30%). These large differences in trust levels can be attributed to several factors, including historical crisis management performance, the strength of social welfare systems, satisfaction with key public services, assessments of a country’s resources and cultural predispositions to trust institutions in general.
