Preparing Europe for the next cross-border health threats, COVID lessons unpacked
In 2022, the European Commission introduced a Regulation to develop a comprehensive prevention, preparedness and response plan at the EU and member state levels. And in a major step forward, WHO Member States recently took measures to strengthen global collaboration on prevention, preparedness and response to future pandemic threats.
Acknowledging that pandemics and epidemics remain significant threats to global public health, Shionogi, together with Euractiv, held a panel discussion on how to tackle the question of preparing Europe for emerging cross-border health threats, in particular, the 'slow pandemic' of antimicrobial resistance (AMR).
AMR occurs when germs no longer respond to antimicrobial treatments, and experts argue that further cooperation, transparency and improved procedures are needed to combat the deep-rooted problem.
Serious cross-border threats
Kicking off the discussion, Antonio Parenti, Director, Public Health, Cancer and Health Security, DG SANTE, European Commission, emphasised the critical role of the Regulation on serious cross-border threats to health (EU 2022/2371) which strengthens EU coordination and collaboration, prevention and preparedness, as well as beefing up different monitoring and surveillance mechanisms, serving as the backbone for future health security preparedness and cross-border health responses
He explained that DG SANTE is intensifying collaboration with the relevant internal and external stakeholders through simulation exercises and is intensively working on improving the EU's rapid reaction capabilities, and is addressing the growing threat of AMR with unprecedented co-financing through the EU4Health Programme.
Embedding health in the EU's Preparedness Strategy, where health is a vital societal function under the Union Preparedness Strategy, is essential, said Parenti 'Ensuring its resilience means boosting citizen readiness and strengthening civil-military health cooperation. A new Technical Working Group on civil-military collaboration under the Health Security Committee is paving the way for interoperable responses to crises, from pandemics to armed aggression and CBRN threats,' he added.
Fragmented approaches
Rohit Malpani, Senior Policy Advisor at the Global Antibiotic Research & Development Partnership (GARDP), called on the European Union to take a more proactive and integrated stance in addressing antimicrobial resistance (AMR), warning that current fragmented approaches may fall short in the face of future health crises.
Malpani argued that 'The EU should introduce an end-to-end model for which the EU coordinates funding across research, clinical development, manufacturing and access.'
He stressed that such a model would help avoid the pitfalls experienced during the COVID-19 pandemic, including shortages of medical technologies and counterproductive competition between member states.
'Instead of setting out incentives and hoping that the private sector will respond with what is required, it is critical that the EU and other countries take an active role in defining its needs and ensuring that those needs are met,' he added.
Malpani also emphasised the need for adaptable funding and research models.
'Responding to AMR requires flexible funding, models, and R&D approaches: No single push funding or pull incentive will address all needs,' he said.
Drawing on GARDP's experience, he advocated for a diversified strategy that includes developing new antibiotics, repurposing existing treatments, and testing combinations of older generics. He noted that the EU's Health Emergency Preparedness and Response Authority (HERA) is well-positioned to support such a tailored response.
Malpani urged the EU to maintain a global perspective.
'While it is critical for the EU to ensure that it can develop and ensure access to key medical technologies to address viral threats and bacterial pathogens of concern, it is also important that it is prioritising threats globally, including against AMR, and for underserved populations such as children and babies,' he said, underscoring the importance of ensuring that new technologies are tested and supported by robust data to effectively curb AMR both within Europe and globally.
Strategic and operational coordination
Laurent Muschel, Deputy Head of HERA, European Commission, agreed that the EU must adopt a toolbox to cross-border health threats - strengthening strategic and operational coordination through HERA and ensuring readiness via early warning systems, advanced research, stockpiles, and joint procurement. He explained that the upcoming MCM Strategy will focus on innovation, supply chain resilience, and equitable access to vaccines, therapeutics, and diagnostics.
Muschel also addressed concerns about AMR.
'AMR is treated with the same urgency as pandemics. HERA is investing in novel solutions like bacteriophage therapies and new classes of antibiotics and supporting SMEs through HERA Invest. I believe the EU must reduce dependency on global supply chains by investing in onshore manufacturing and modernising distribution mechanisms to ensure rapid and equitable access to medical countermeasures,' he said.
Tomislav Sokol, MEP and member of the European Parliament's SANT Committee, has called for a comprehensive overhaul of the EU's approach to health innovation and preparedness, urging policymakers to focus on research, industrial resilience, and strategic autonomy.
Sokol stressed the importance of stimulating funding for basic research and incentivising pharmaceutical innovation, while also ensuring that companies developing new medical products remain anchored in Europe.
He welcomed recent EU initiatives, including the General Pharmaceutical Legislation (GPL) and the Critical Medicines Alliance (CMA), which he said are 'giving preferential treatment to production in Europe.' He also praised the establishment of the Health Emergency Preparedness and Response Authority (HERA) and its coordination efforts.
However, he argued that further steps are needed. 'I think we have to do some additional things like stronger or mandatory coordination of stockpiling,' he said. Concluding on an optimistic note, Sokol stated: 'If we understand that healthcare and public health should be one of the priority sectors now in the EU, we can really make a difference, and that Europe can be much better prepared for future health crisis and also much less dependent on imports than it is now.'
Central role of funding
Emmanuel André, Co-Chair of the European Commission's Advisory Committee on Public Health Emergencies (ACPHE) and Professor of Clinical Microbiology at KU Leuven, underscored the central role of funding in Europe's ability to respond to future health threats.
'Funding is the key. If you want to get new medical countermeasures, antibiotics or therapeutics or vaccines, it is, as we say in French, 'nerf de la guerre.' It's really the key,' André said.
He called for health to be prioritised in the EU's next Multiannual Financial Framework (MFF), urging the European Parliament, Council, and member states to ensure adequate budgetary support.
'We count on the European Parliament to help us on the Council and member states to make sure that we have sufficient budget to do what we're supposed to do,' he added.
However, André warned that Europe cannot shoulder the burden alone.
'Europe should not fund everything. I call for all of the funders to come into the game. It's always the same players – the Gates Foundation, the Wellcome Trust are always there. But it's always the same,' he said. Pointing to recent international engagement, he questioned the financial follow-through.
"Saudi Arabia held a nice ministerial meeting on AMR in Jeddah last November. Where is the money from Saudi Arabia? Where is the funding?' he asked.
Framing antimicrobial resistance (AMR) as a global challenge, André concluded: 'This is a global issue, and we are not the only ones who have high GDP per capita. There are some others. So it's really a global, worldwide issue, and others also need to play their game.'
Robust policy framework needed
Huw Tippett, CEO of Shionogi Europe and board member since 2019, has urged policymakers to elevate health on the political agenda and implement robust frameworks to support antimicrobial innovation. Speaking on the pharmaceutical industry's role in combating antimicrobial resistance (AMR), Tippett highlighted the economic and structural challenges that hinder progress.
'We need a robust policy framework, including the right funding mechanisms, as sometimes the business case doesn't add up for pharma companies. We need equity in terms of access. All in all, health needs to be higher up the political agenda,' he said.
Founded nearly 150 years ago in Osaka, Shionogi is one of the few major pharmaceutical firms maintaining a long-standing commitment to anti-infective research, with over six decades of experience in antimicrobial development.
Tippett pointed to the '100 Day Mission' as a strategic model for future preparedness. 'I think that's an excellent strategic framework. There's a lot that has to be done in it. We've said it already today, we need excellent R&D pipelines through funding and investment, attracting more people back to the space,' he noted.
He also stressed the importance of collaboration, particularly with organisations like the Global Antibiotic Research & Development Partnership (GARDP).
'Great funding mechanisms, working together, working as partners and getting to places in the world that you might not be able to get to yourself through great partnerships, such as Shionogi with GARDP. We're experts in the developed world, but GARDP are experts in the low and middle income world,' Tippett said, 'access to medicines is key.'
[Edited By Brian Maguire | Euractiv's Advocacy Lab ]
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For many, the COVID-19 pandemic is a fading memory, but for those working at the coalface of public health, the EU and national governments, it's been seared as an instructive reminder of the need for greater policy infrastructure to support better preparation for future cross-border health security threats. In 2022, the European Commission introduced a Regulation to develop a comprehensive prevention, preparedness and response plan at the EU and member state levels. And in a major step forward, WHO Member States recently took measures to strengthen global collaboration on prevention, preparedness and response to future pandemic threats. Acknowledging that pandemics and epidemics remain significant threats to global public health, Shionogi, together with Euractiv, held a panel discussion on how to tackle the question of preparing Europe for emerging cross-border health threats, in particular, the 'slow pandemic' of antimicrobial resistance (AMR). AMR occurs when germs no longer respond to antimicrobial treatments, and experts argue that further cooperation, transparency and improved procedures are needed to combat the deep-rooted problem. Serious cross-border threats Kicking off the discussion, Antonio Parenti, Director, Public Health, Cancer and Health Security, DG SANTE, European Commission, emphasised the critical role of the Regulation on serious cross-border threats to health (EU 2022/2371) which strengthens EU coordination and collaboration, prevention and preparedness, as well as beefing up different monitoring and surveillance mechanisms, serving as the backbone for future health security preparedness and cross-border health responses He explained that DG SANTE is intensifying collaboration with the relevant internal and external stakeholders through simulation exercises and is intensively working on improving the EU's rapid reaction capabilities, and is addressing the growing threat of AMR with unprecedented co-financing through the EU4Health Programme. Embedding health in the EU's Preparedness Strategy, where health is a vital societal function under the Union Preparedness Strategy, is essential, said Parenti 'Ensuring its resilience means boosting citizen readiness and strengthening civil-military health cooperation. A new Technical Working Group on civil-military collaboration under the Health Security Committee is paving the way for interoperable responses to crises, from pandemics to armed aggression and CBRN threats,' he added. Fragmented approaches Rohit Malpani, Senior Policy Advisor at the Global Antibiotic Research & Development Partnership (GARDP), called on the European Union to take a more proactive and integrated stance in addressing antimicrobial resistance (AMR), warning that current fragmented approaches may fall short in the face of future health crises. Malpani argued that 'The EU should introduce an end-to-end model for which the EU coordinates funding across research, clinical development, manufacturing and access.' He stressed that such a model would help avoid the pitfalls experienced during the COVID-19 pandemic, including shortages of medical technologies and counterproductive competition between member states. 'Instead of setting out incentives and hoping that the private sector will respond with what is required, it is critical that the EU and other countries take an active role in defining its needs and ensuring that those needs are met,' he added. Malpani also emphasised the need for adaptable funding and research models. 'Responding to AMR requires flexible funding, models, and R&D approaches: No single push funding or pull incentive will address all needs,' he said. Drawing on GARDP's experience, he advocated for a diversified strategy that includes developing new antibiotics, repurposing existing treatments, and testing combinations of older generics. He noted that the EU's Health Emergency Preparedness and Response Authority (HERA) is well-positioned to support such a tailored response. Malpani urged the EU to maintain a global perspective. 'While it is critical for the EU to ensure that it can develop and ensure access to key medical technologies to address viral threats and bacterial pathogens of concern, it is also important that it is prioritising threats globally, including against AMR, and for underserved populations such as children and babies,' he said, underscoring the importance of ensuring that new technologies are tested and supported by robust data to effectively curb AMR both within Europe and globally. Strategic and operational coordination Laurent Muschel, Deputy Head of HERA, European Commission, agreed that the EU must adopt a toolbox to cross-border health threats - strengthening strategic and operational coordination through HERA and ensuring readiness via early warning systems, advanced research, stockpiles, and joint procurement. He explained that the upcoming MCM Strategy will focus on innovation, supply chain resilience, and equitable access to vaccines, therapeutics, and diagnostics. Muschel also addressed concerns about AMR. 'AMR is treated with the same urgency as pandemics. HERA is investing in novel solutions like bacteriophage therapies and new classes of antibiotics and supporting SMEs through HERA Invest. I believe the EU must reduce dependency on global supply chains by investing in onshore manufacturing and modernising distribution mechanisms to ensure rapid and equitable access to medical countermeasures,' he said. Tomislav Sokol, MEP and member of the European Parliament's SANT Committee, has called for a comprehensive overhaul of the EU's approach to health innovation and preparedness, urging policymakers to focus on research, industrial resilience, and strategic autonomy. Sokol stressed the importance of stimulating funding for basic research and incentivising pharmaceutical innovation, while also ensuring that companies developing new medical products remain anchored in Europe. He welcomed recent EU initiatives, including the General Pharmaceutical Legislation (GPL) and the Critical Medicines Alliance (CMA), which he said are 'giving preferential treatment to production in Europe.' He also praised the establishment of the Health Emergency Preparedness and Response Authority (HERA) and its coordination efforts. However, he argued that further steps are needed. 'I think we have to do some additional things like stronger or mandatory coordination of stockpiling,' he said. Concluding on an optimistic note, Sokol stated: 'If we understand that healthcare and public health should be one of the priority sectors now in the EU, we can really make a difference, and that Europe can be much better prepared for future health crisis and also much less dependent on imports than it is now.' Central role of funding Emmanuel André, Co-Chair of the European Commission's Advisory Committee on Public Health Emergencies (ACPHE) and Professor of Clinical Microbiology at KU Leuven, underscored the central role of funding in Europe's ability to respond to future health threats. 'Funding is the key. If you want to get new medical countermeasures, antibiotics or therapeutics or vaccines, it is, as we say in French, 'nerf de la guerre.' It's really the key,' André said. He called for health to be prioritised in the EU's next Multiannual Financial Framework (MFF), urging the European Parliament, Council, and member states to ensure adequate budgetary support. 'We count on the European Parliament to help us on the Council and member states to make sure that we have sufficient budget to do what we're supposed to do,' he added. However, André warned that Europe cannot shoulder the burden alone. 'Europe should not fund everything. I call for all of the funders to come into the game. It's always the same players – the Gates Foundation, the Wellcome Trust are always there. But it's always the same,' he said. Pointing to recent international engagement, he questioned the financial follow-through. "Saudi Arabia held a nice ministerial meeting on AMR in Jeddah last November. Where is the money from Saudi Arabia? Where is the funding?' he asked. Framing antimicrobial resistance (AMR) as a global challenge, André concluded: 'This is a global issue, and we are not the only ones who have high GDP per capita. There are some others. So it's really a global, worldwide issue, and others also need to play their game.' Robust policy framework needed Huw Tippett, CEO of Shionogi Europe and board member since 2019, has urged policymakers to elevate health on the political agenda and implement robust frameworks to support antimicrobial innovation. Speaking on the pharmaceutical industry's role in combating antimicrobial resistance (AMR), Tippett highlighted the economic and structural challenges that hinder progress. 'We need a robust policy framework, including the right funding mechanisms, as sometimes the business case doesn't add up for pharma companies. We need equity in terms of access. All in all, health needs to be higher up the political agenda,' he said. Founded nearly 150 years ago in Osaka, Shionogi is one of the few major pharmaceutical firms maintaining a long-standing commitment to anti-infective research, with over six decades of experience in antimicrobial development. Tippett pointed to the '100 Day Mission' as a strategic model for future preparedness. 'I think that's an excellent strategic framework. There's a lot that has to be done in it. We've said it already today, we need excellent R&D pipelines through funding and investment, attracting more people back to the space,' he noted. He also stressed the importance of collaboration, particularly with organisations like the Global Antibiotic Research & Development Partnership (GARDP). 'Great funding mechanisms, working together, working as partners and getting to places in the world that you might not be able to get to yourself through great partnerships, such as Shionogi with GARDP. We're experts in the developed world, but GARDP are experts in the low and middle income world,' Tippett said, 'access to medicines is key.' [Edited By Brian Maguire | Euractiv's Advocacy Lab ]
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