First Health Emergency Faced by the European Health Emergency Preparedness and Response Authority: War in Ukraine

The European Health Emergency Preparedness and Response Authority (HERA) was officially launched earlier this year. HERA forms part of the organisational structure of the European Commission. Its purpose is to coordinate the response to health emergencies, taking into account the design and remit of similar authorities at the international level, but drawing especially on the European Commission’s experience managing the response to COVID-19.

The European Commission played an active role in this crisis through the EU vaccine strategy adopted in 2020 and the joint procurement agreements for coronavirus vaccines. Although HERA was conceived during the coronavirus pandemic and, therefore, is focused especially on infectious diseases, the scope of its activity can encompass other health emergencies. Different functions are envisaged for HERA depending on the phase of a health emergency—preparedness phase or crisis phase—as agreed by the governments of the 27 Member States in the Council at the proposal of the European Commission.

Although HERA was conceived during the coronavirus pandemic and, therefore, is focused especially on infectious diseases, the scope of its activity can encompass other health emergencies

Although the “crisis phase” label has not yet been applied to the humanitarian situation caused by Russia’s invasion of Ukraine, there are a number of actions that HERA and other bodies within the European Commission can take under the rubric of preparedness. HERA director Pierre Delsaux confirmed last week that discussions had taken place between HERA and Ukraine to assess health needs, and between HERA and other Commission departments and Member States regarding the mobilisation of resources.

Comparative overview of competences of HERA, ECDC and EMA in the area of international engagement and reinforcement. Source: European Union. 

Health cooperation with Ukraine is nothing new for the European Union. In the fight against COVID-19 alone, the EU contributed €200 million to provide 3.7 million vaccine doses through Team Europe in addition to the more than 8.4 million doses channelled through the COVAX initiative.

HERA director Pierre Delsaux confirmed that discussions had taken place with Ukraine to assess health needs, and with other Commission departments and Member States regarding the mobilisation of resources

However, the humanitarian crisis created by Russia’s invasion will, in all likelihood, have a much greater impact on the EU budget, as it will require aid for the more than one million people who are currently displaced—most of them within Europe—and the provision of medical supplies and health care within Ukraine’s borders.

Regarding the situation of refugees in Member States bordering Ukraine, the European Centre for Disease Prevention and Control (ECDC) warns in its most recent bulletin that “situations of overcrowding could favour the emergence of outbreaks of infectious diseases, particularly of respiratory infections. This includes influenza, which is currently circulating in some of the reception countries, COVID-19 and TB.”

A Ukrainian girl who has fled Russian aggression in Przemyśl (Poland). February 27, 2022. Author: Mirek Pruchnicki / Wikimedia Commons.

Other immediate risks that have been publicly discussed include the risk of radiation exposure from hypothetical damage to civilian nuclear infrastructure and the interruption of treatment for chronic diseases, particularly HIV, given that Ukraine has one of the highest HIV prevalence rates in Europe and ensuring continuous access to antiretroviral therapy during an armed conflict may prove challenging.

On 15 February, Ukraine activated the European Union Civil Protection Mechanism in anticipation of the Russian invasion. This mechanism, managed by the Emergency Response Coordination Centre (ERCC), mobilises pre-committed resources, such as the European Civil Protection Pool and the European Medical Corps (a pool of medical and public health experts that can be quickly deployed for preparedness and response operations). In addition to these pre-committed resources, the mechanism also coordinates the mobilisation of additional resources, such as emergency and medical equipment.

Ukraine received the first shipment of medical supplies on 22 February, two days before Russian troops crossed the Ukrainian border

Ukraine received the first shipment of medical supplies on 22 February, two days before Russian troops crossed the Ukrainian border. One of the most recent upgrades to the Civil Protection Mechanism was the establishment of a dedicated stockpile of medical supplies, known as the rescEU reserve. Supplies from Germany, the Netherlands and Hungary—including ventilators, infusion pumps, patient monitors, masks and gowns, ultrasound devices, and oxygen concentrators—have already been mobilised to meet medical needs arising from the military conflict. The deployment of this equipment is made possible by the civil protection logistics centres in Poland, as well as those being set up in Romania and Slovakia. In addition to the Civil Protection Mechanism, the European Commission has also donated €90 million for humanitarian aid to help civilians in Ukraine and displaced people in Moldova and is coordinating unilateral contributions from Member States.

In this crisis, the European Union has acted swiftly and decisively with regard to health care. If the medical and economic situation were to deteriorate even further, additional measures—such as the declaration of the crisis phase in accordance with article 3 of the regulation on the emergency framework regarding medical countermeasures—are still available.