欧洲疾控中心-国家报告_2024年芬兰ECDC公共卫生应急准备评估——根据条例（欧盟）2022_2371第8条（英）-2025_32页_2mb

AI报告摘要

ECDC Public Health Emergency Preparedness Assessment for Finland, 2024

Core Content

The ECDC Public Health Emergency Preparedness Assessment (PHEPA) for Finland, conducted in 2024 under Article 8 of Regulation (EU) 2022/2371, evaluates the country's preparedness for public health emergencies across 16 capacities. The assessment focuses on five capacities in depth: Laboratory (3), Surveillance (4), Health Emergency Management (6), Zoonotic Diseases and Environmental Threats (10), and Antimicrobial Resistance (AMR) and Healthcare-Associated Infections (HAIs) (12). The findings and recommendations are based on a desk review and a five-day in-country mission from 10 to 14 June 2024.

Main Findings

National Preparedness Planning: Finland's preparedness planning is based on legislation and the National Risk Assessment (NRA), covering a wide range of risks beyond communicable diseases.
Health Reform: Finland has undergone significant health reform, including the restructuring of social and healthcare services from 300 municipalities to 21 wellbeing services counties and five collaborative areas. This reform is ongoing and expected to be completed by 2025.
Intersectoral Collaboration: Strong intersectoral collaboration exists between public health, animal health, and environmental sectors, with coordination happening at all levels, from local to national.
Legal and Regulatory Framework: The Communicable Diseases Act (2016) and other relevant legislation are being revised, which may affect the alignment of preparedness capacities.
Impact of Budget and HR Cuts: The ongoing budget and human resource reductions from 2024 to 2027 may affect the sustainability of public health preparedness and response functions.
NAPHS and Joint External Evaluation: The National Action Plan for Health Security (NAPHS), developed following the WHO Joint External Evaluation (JEE) in 2017, has not been fully implemented since the pandemic, and its relevance needs to be reassessed.

Key Recommendations

Cross-Cutting Recommendations

Develop Operational Plans: Create plans to clarify coordination structures between administrative levels and sectors, and define leadership and roles for cross-institutional/sectoral collaboration.
Clarify Methodology and Roles: Develop methodologies and instruments to define roles and responsibilities for cross-sectoral risk assessment, such as Standard Operating Procedures (SOPs).
Enhance Intersectoral Simulations: Conduct inter-sectoral and cross-administrative level simulation exercises.
Revisit NAPHS: Reassess the National Action Plan for Health Security (NAPHS) to determine if its activities and strategies are still relevant.
Retest Redefined Roles: Ensure that roles redefined due to organizational changes are retested to maintain effectiveness.
Align New Legislation: Ensure that new legislative acts under revision are aligned, particularly with respect to the health sector.

Capacity-Specific Recommendations

Capacity 3. Laboratory

Strengthen the testing capacity strategy for public health emergencies and ensure it is part of the preparedness plan.
Document the use of whole genome sequencing (WGS) and other methodologies (e.g., metagenomic approaches) for pathogen characterization.
Ensure smooth transition to the new licensing system for clinical laboratories, maintaining quality and safety.
Develop automated reporting systems for new pathogens to avoid delays in testing implementation.
Ensure methodological support for the validation of new diagnostic tests and registration with Fimea.

Capacity 4. Surveillance

Establish an integrated clinical and laboratory sentinel system for monitoring mild acute respiratory infections.
Implement a mechanism for laboratory reporting of diagnostic test numbers.
Define clear responsibilities for surveillance and outbreak investigation between THL and wellbeing services counties.
Ensure timely and secure access to enhanced clinical information for informed decision-making.

Capacity 6. Health Emergency Management

Develop a risk and vulnerability analysis that addresses health sector-specific needs and complements the National Risk Assessment (NRA).
Ensure alignment of health preparedness plans with other sectors and define clear mandates and responsibilities.
Include expertise from communicable disease control staff in the situation awareness group during plan revisions.
Create an exercise plan to test and assess the National Pandemic Preparedness Plan in line with ongoing reforms and updated legislation.

Capacity 10. Zoonotic Diseases and Environmental Threats

Strengthen collaboration and communication between animal, human, and environmental sectors.
Formalize joint risk assessments and outbreak investigations as part of the preparedness strategy.

Capacity 12. AMR and HAIs

Ensure adequate resources for addressing AMR and HAIs at the national and regional levels.
Identify priority projects and potential funding mechanisms for AMR surveillance, prevention, and control.
Consider the role of the National Expert Group on AMR in determining these priorities.

Conclusions

Finland has a holistic whole-of-society preparedness approach and a strong collaborative culture that helps mitigate challenges in public health emergency management. However, the ongoing healthcare reform, budget cuts, and human resource reductions pose uncertainties regarding the long-term effectiveness of preparedness functions. The high scores in the Article 7 questionnaire may have been influenced by the recent testing opportunities during the COVID-19 pandemic, and the short planning phase of the assessment may have affected the completeness of responses.

Legal Basis

The SCBTH Regulation (EU) 2022/2371 mandates that ECDC, in coordination with Union agencies, conducts PHEPA assessments every three years to evaluate national preparedness for public health emergencies. The assessment is based on the 16 capacities outlined in the Article 7 template, which includes legal, organizational, and operational aspects of preparedness planning.

Assessment Process

The assessment team consisted of 14 experts from ECDC, DG SANTE, and HERA, along with national experts from Norway and Sweden.
The mission included a desk review and a five-day visit to Helsinki, where discussions focused on cross-cutting themes such as communication, coordination, and risk assessment.
The assessment was conducted in a pilot mode, with a shorter planning period (two months) compared to the standard six months.
The responses are considered as of December 2023, as the situation may have changed since the completion of the Article 7 questionnaire.