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

AI报告摘要

ECDC Public Health Emergency Preparedness Assessment for Iceland, 2025 Summary

Core Content

The ECDC Public Health Emergency Preparedness Assessment for Iceland, 2025 is conducted under Article 8 of Regulation (EU) 2022/2371 on serious cross-border threats to health. The assessment evaluates Iceland's preparedness for public health emergencies by reviewing 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 (Capacity 12), and Zoonotic Diseases and Environmental Threats (Capacity 10).

The assessment process included a desk review of relevant documents and a five-day country visit from 2 to 6 June 2025. It was led by an ECDC team in collaboration with European Commission and WHO experts, as well as national and regional stakeholders.

Main Findings

Health System Structure: Iceland has a state-centred, publicly funded health system with universal health coverage. Key decision-making bodies include the Parliament (Althingi), Ministry of Health (MoH), and Ministry of Finance and Economic Affairs (MoF).
Public Health Governance: The Chief Epidemiologist is directly accountable to the Minister of Health and oversees disease control and preventive measures.
Collaboration Culture: There is a strong collaborative culture within and across sectors, which enhances information sharing and public health decision-making, particularly in response to natural disasters.
Healthcare Regions: Iceland is divided into seven healthcare regions, each with its own healthcare institution and funding for administrative responsibilities.
Healthcare Infrastructure: While the national preparedness and response mechanisms are well-developed, healthcare services are less consistent in executing these tasks. There is a need for better-defined roles and responsibilities to avoid overlapping and ensure accountability.

Key Recommendations

Health Emergency Management (Capacity 6)

Formalise the response process and communication among stakeholders using checklists or SOPs.
Strengthen intersectoral collaboration by conducting stakeholder mapping and formalising their involvement in preparedness planning.
Ensure regular reviews of preparedness plans based on all-hazard risk prioritisation and cycles of simulation exercises.
Develop a rapid risk assessment methodology to improve communication of health risks to stakeholders.
Enhance situation awareness tools to track bed capacity, ICU coverage, workforce, cases, deaths, and tests.
Create tools to monitor supply and estimate demand for crisis-relevant medical countermeasures (MCMs).
Develop a specific methodology for compiling a strategic stockpile of MCMs.
Create a sustainable management plan for MCM stockpiles, including operational SOPs for deployment and reception.
Continue legislative efforts to ensure a six-month supply of critical MCMs.
Participate in EU-level and global procurement activities.

Laboratory (Capacity 3)

Support the designation of the National Reference Laboratory (NRL) at Landspítali University Hospital with appropriate legislation and budget.
Define the NRL's role in the national pandemic preparedness plan.
Establish a national laboratory network with a formal cooperation framework, ensuring harmonised quality standards, reliable diagnostics, and efficient information exchange.
Prioritise unification of electronic laboratory systems, including regional and animal sector laboratories.
Develop a national sequence database and mechanisms for sharing sequence data between the NRL and Chief Epidemiologist, with flexibility to expand to One Health sectors.

Surveillance (Capacity 4)

Develop standardised national reporting protocols aligned with EU surveillance requirements.
Create a comprehensive data infrastructure to support interoperability and integration between clinical notification systems, vaccination registries, vital statistics, electronic medical records, and One Health data.
Integrate a contact tracing platform into the surveillance system.
Establish a sentinel surveillance system for acute respiratory infections with microbiological surveillance of influenza, RSV, and SARS-CoV-2.
Continue monitoring of surveillance data quality and system evaluations when performance issues arise.
Reintroduce disease-specific thresholds and early warning indicators, especially for respiratory viruses.

Antimicrobial Resistance and Healthcare-Associated Infections (Capacity 12)

Secure sustainable multi-year funding for the One Health National Action Plan (NAP) for AMR.
Strengthen antimicrobial stewardship through accredited training programs, Prescription Medicines Database, and electronic feedback systems.
Expand HAI prevention and control programs, including sustainable e-surveillance for sample types such as blood.
Ensure IPC capacity at all healthcare facilities through face-to-face workshops and local adaptation of IPC guidance.
Increase acute care capacity, such as inpatient bed capacity, to support IPC at Landspítali and Akureyri hospitals.

Zoonotic Diseases and Environmental Threats (Capacity 10)

Establish One Health governance to coordinate surveillance, prevention, and control of zoonotic and environmental threats.
Enhance the Statutory Joint Committee for Epidemic Prevention (SSUS) by involving additional sectors such as the NRL, Icelandic Medicines Agency, and animal health.
Organise interdisciplinary training and exercises on surveillance, preparedness, risk assessment, and management.
Develop a comprehensive data infrastructure for food-, water-, vector-, and zoonotic disease surveillance, integrating data from public health, animal health, and environmental sectors.
Integrate health-related indicators into the Climate Atlas and assess the impact of extreme weather events on health services, proposing preventive measures and addressing special needs of vulnerable groups.

Conclusions

The assessment highlights Iceland's strong collaboration culture and robust national preparedness and response mechanisms, particularly for natural disasters. However, healthcare services are less consistent in executing public health functions, and roles and responsibilities need to be clearly defined to ensure operational efficiency.

The update of the national legal framework and the EU4Health program present opportunities to formalise critical collaborations, strengthen laboratory-based surveillance, and ensure sustainable funding for key public health priorities such as preventing healthcare-associated infections.

Key Factors for a Robust Public Health System

Stakeholder Engagement: Involving healthcare providers and district physicians in public health functions.
Workforce Development: Strengthening epidemiological and microbiological workforce through training and capacity-building.
Formalisation of Processes: Formalising informal collaborations, roles and responsibilities, and response procedures to improve accountability and efficiency.