Norwegian Institute of Public Health, Postboks 222 Skøyen, Oslo, 0213, Norway.
Global Health. 2023 Oct 28;19(1):79. doi: 10.1186/s12992-023-00977-y.
Improving response capacities in the EU requires a good overview of capacities at both country and Union level. The International Health Regulations (2005) Monitoring and Evaluation framework assesses capacities in countries. It includes semi-quantitative tools such as State Parties Annual Report (SPAR) and Joint External Evaluation (JEE). After Action Reviews (AAR) and Simulation Exercises (SimEx) were included to identify weaknesses in the functionality of capacities which are not addressed bySPAR and JEE. This study presents an analysis of the use of qualitative tools at regional level, in Europe. It aims to identify their added value by comparing them to standardised monitoring tools and lessons learned from COVID-19, and considers ways to improve their use in assessing capacities in the EU.
We included 17 SimEx and 2 AAR organised by the European Commission between 2005 and 2018. We categorised a total of 357 recommendations according to the IHR (2005) core capacities and to the target audience of the recommendation. We analysed the data using language analysis software. Recommendations to countries were compared to SPAR and JEE indicators. Recommendations to EU agencies were compared to the current mandates of the EU agencies, and to lessons learnt during COVID-19.
Of all extracted recommendations from the exercises, 59% (211/357) targeted EU agencies, 18% (64/357) targeted countries, and 16% (57/357) targeted both. Recommendations mainly addressed areas of IHR coordination (C2), heath emergency management (C7) and risk communication (C10), and not low scoring areas. Recommendations complement SPAR indicators by identifying gaps in functionality. Eight out of ten early lessons learnt during the COVID-19 pandemic had been raised earlier as recommendations from exercises. Exercise reports did not include or result in action plans for implementation, but COVID-19 has accelerated implementation of some recommendations.
SimEx/AAR provide valuable insight into public health preparedness at EU level, as they assess functionality of preparedness and response mechanisms, point out gaps, and provide training and awareness on for participants, who often have key roles in public health emergencies. Better follow-up and implementation of recommendations is key to improve the regional preparedness for international public health incidents such as pandemics.
提高欧盟的应对能力需要对国家和欧盟层面的能力有一个很好的了解。《国际卫生条例（2005 年）监测和评估框架》评估各国的能力。它包括半定量工具，如缔约国年度报告（SPAR）和联合外部评估（JEE）。事后审查（AAR）和模拟演习（SimEx）被纳入其中，以确定 SPAR 和 JEE 未涵盖的能力功能中的弱点。本研究介绍了在欧洲区域层面使用定性工具的情况。它旨在通过将其与标准化监测工具进行比较，并从 COVID-19 中吸取经验教训，来确定其附加值，并考虑如何改进在评估欧盟能力方面的使用。
我们纳入了欧盟委员会在 2005 年至 2018 年期间组织的 17 次 SimEx 和 2 次 AAR。我们根据《国际卫生条例（2005 年）》的核心能力和建议的目标受众，对总共 357 项建议进行了分类。我们使用语言分析软件对数据进行了分析。针对国家的建议与 SPAR 和 JEE 指标进行了比较。针对欧盟机构的建议与欧盟机构的现行任务和 COVID-19 期间吸取的经验教训进行了比较。
从演习中提取的所有建议中，59%（211/357）针对欧盟机构，18%（64/357）针对国家，16%（57/357）针对两者。建议主要涉及《国际卫生条例》协调（C2）、卫生应急管理（C7）和风险沟通（C10）领域，而不是低评分领域。建议通过确定功能方面的差距，补充了 SPAR 指标。在 COVID-19 大流行期间，十大早期经验教训中有八项是更早作为演习建议提出的。演习报告没有包括或导致实施行动计划，但 COVID-19 加速了一些建议的实施。
SimEx/AAR 提供了对欧盟层面公共卫生准备情况的宝贵见解，因为它们评估了准备和应对机制的功能，指出了差距，并为参与者提供了培训和意识，而参与者通常在公共卫生紧急情况下发挥关键作用。更好地跟踪和实施建议是改善区域应对国际公共卫生事件（如大流行）的关键。
