欧洲疾控中心-国家报告_2025年拉脱维亚ECDC公共卫生应急准备评估（英）-2025_33页_1mb

ECDC Public Health Emergency Preparedness Assessment for Latvia, 2025 Summary

Core Content Overview

The ECDC Public Health Emergency Preparedness Assessment (PHEPA) for Latvia, conducted under Article 8 of Regulation (EU) 2022/2371, aims to improve prevention, preparedness, and response planning in the country. The assessment was carried out between 17–21 March 2025 and included a desk review and a country visit. The evaluation focused on 16 capacities, with five assessed in-depth:

• Health Emergency Management (Capacity 6)
• Laboratory (Capacity 3)
• Surveillance (Capacity 4)
• Antimicrobial Resistance (AMR) and Healthcare-Associated Infections (HAIs) (Capacity 12)
• Zoonotic Diseases and Environmental Threats (Capacity 10)

The assessment team comprised nine experts from ECDC, DG SANTE, DG HERA, and national experts from Croatia and Lithuania. The Latvian Ministry of Health, State Emergency Medical Service (SEMS), and Latvian Centre for Disease Prevention and Control (CDPC) coordinated the process. The report provides specific recommendations for Latvia to enhance its public health emergency preparedness and response capacities.

Key Findings

Health System and Governance

• Latvia has a centralised national health system with a strong state role.
• The National Disaster Medicine Plan (NDMP) is well-structured and updated regularly, covering multiple hazards at strategic and operational levels.
• Primary care providers do not have contingency plans for service disruptions, unlike other health sector institutions.
• The National Risk Assessment includes health risks and is complemented by sectoral risk assessments.

Emergency Management Structure

• The Incident Management System includes the State Operational Medical Commission (SOMC) and the Crisis Management Council (CMC).
• The SAIRIS system allows real-time monitoring of hospital resources and facilitates rapid information exchange during emergencies.
• A plan for critical medicine stockpiles is in place, and discussions are ongoing to strengthen supply chains with Estonia and Lithuania.

Laboratory Capacity

• A tier-based laboratory system exists, covering human and animal health sectors.
• BSL-3 facilities are available, but BSL-4 access is not formalised.
• Whole genome sequencing (WGS) is available, but limited sequencing is conducted in practice.
• Biosafety and biosecurity measures are in place, but further standardisation and routine development are needed.
• Sample transportation is sufficient for routine diagnostics but insufficient for outbreak situations.

Surveillance System

• The VISUMS system is outdated and relies on manual processes, limiting efficient outbreak detection.
• The EPID system, developed for COVID-19, functions well but cannot receive data for other diseases.
• Sentinel ILI/ARI/SARI surveillance is in place, but sample collection for ILI/ARI is missing, and linkage to patient data for SARI is not established.
• The CDPC does not follow a formalised procedure for daily threat assessments.

AMR and HAIs

• There is an epidemic of CRE in hospitals, with molecular evidence of cross-facility spread.
• The Standard Hygiene Plan is under revision, offering an opportunity to strengthen infection prevention and control (IPC) infrastructure.
• Progress has been made with the National Action Plan (NAP) for AMR and the establishment of the AMR Competence Centre in 2024.
• Antimicrobial stewardship activities have improved.

One Health and Zoonotic Diseases

• There is good cooperation between public health, animal health, and food safety sectors.
• However, a comprehensive One Health approach is lacking, and environmental sector links are limited.
• Cross-sectoral notifiable diseases are in place, but surveillance is project-based and funding-dependent.
• Resources for routine public health and One Health tasks are limited, particularly in human resources, technical infrastructure, and training.

Main Recommendations

Health Emergency Management (Capacity 6)

• Develop a multi-sectoral methodology for health emergency risk profiling.
• Include primary healthcare in emergency planning, exercises, and the State Operational Medical Committee.
• Create clear SOPs for roles and joint terminology in mixed scenarios involving health and military sectors.
• Establish a funding mechanism for training and exercises in emergency management.
• Evaluate options to support medical countermeasures (MCMs) production, including capacity reservation contracts and security of supply considerations.

Laboratory (Capacity 3)

• Define how to scale up laboratory capacity in emergency situations within the NDMP.
• Clarify the regulatory framework for biosafety and biosecurity.
• Ensure an efficient sample transportation system for outbreak situations, both domestic and international.

Surveillance (Capacity 4)

• Make the national surveillance system resilient and fit-for-purpose, with automated reporting across diseases, including genotyping and AMR data.
• Address human resources and competence for routine surveillance, outbreak response, and threat assessment.
• Strengthen ILI and ARI surveillance by ensuring sample collection and testing for these diseases.

AMR and HAIs (Capacity 12)

• Formalise the One Health Intersectoral Coordinating Mechanism (ICM) for AMR, including the secretariat and NAP monitoring.
• Implement clear actions, targets, and timelines to address carbapenem-resistant organisms (CRE).
• Strengthen laboratory and epidemiological capacities for outbreak detection and control.
• Ensure the Standard Hygiene Plan includes standards for the built environment in hospitals.
• Develop a national strategic plan for HAI surveillance.

Zoonotic Diseases and Environmental Threats (Capacity 10)

• Strengthen cooperation between public health, animal health, and environmental sectors.
• Establish a cross-sectoral priority list of zoonotic diseases for molecular surveillance.
• Integrate molecular surveillance and data-sharing mechanisms across sectors for priority zoonotic diseases.

Conclusions

The assessment confirmed that Latvia has a strong understanding of health emergency preparedness and a culture of preparedness planning. Collaboration among key stakeholders is functional but not always formalised. There is a need for further commitment to implement recommendations from lessons-learned exercises and the 2017 WHO Joint External Evaluation.

The PHEPA process was conducted in a collaborative atmosphere, with active discussions and insightful presentations. However, local-level representation was limited, which could have provided deeper insights into lower administrative capacities.

Latvia is requested to develop an action plan addressing the recommendations within nine months of receiving the report to improve prevention, preparedness, and response planning. The report highlights the importance of standardised procedures, intersectoral coordination, and resource allocation to enhance public health emergency response capabilities.