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ECDC Public Health Emergency Preparedness Assessment for Luxembourg, 2024 Summary

Core Content

The ECDC Public Health Emergency Preparedness Assessment (PHEPA) for Luxembourg, conducted in 2024 under Article 8 of Regulation (EU) 2022/2371, evaluates the country's readiness to manage public health emergencies. The assessment includes 16 capacities, with five assessed in depth: Laboratory, Surveillance, Health Emergency Management, Antimicrobial Resistance (AMR) and Healthcare-Associated Infections (HAI), and Zoonotic Diseases and Environmental Threats.

The report highlights both strengths and areas for improvement in Luxembourg's public health infrastructure, offering actionable recommendations to enhance preparedness and response planning.

Key Findings

Strengths

• High adaptability: Luxembourg can reallocate resources, scale up laboratory and surveillance capacities, and coordinate activities across sectors during health crises.
• Legal framework updates: Provisions exist to update the legal basis for response mechanisms during emergencies.
• Strong laboratory system: Includes private, hospital, and national laboratories, with high capacity and flexibility in testing and data reporting.
• Effective surveillance system: Provides routine data for diseases like SARS-CoV-2, measles, and mpox, with real-time reporting capabilities.
• Interdisciplinary collaboration: The country has shown a willingness to engage multiple sectors and stakeholders during health emergencies.

Weaknesses

• Limited interoperability: Databases and digital systems lack integration, which could hinder data sharing during major crises.
• Few experienced staff: A shortage of highly qualified public health personnel may affect response effectiveness.
• Lack of formal procedures: Written procedures for cross-sector collaboration and risk assessment are not fully established.
• Inadequate legal framework: No formal agreement exists for accessing BSL-4 laboratory services, which are crucial for certain pathogens.
• Inconsistent public health measures: Decisions on public health and social measures are not standardised, making evaluation and learning difficult.

Main Recommendations

Health Emergency Management (Capacity 6)

• Develop a comprehensive Preparedness and Response Plan with strategic and operational components, as well as generic and topic-specific modules.
• Create Standard Operating Procedures (SOPs) for public health risk analysis and independent scientific assessment of serious threats.
• Establish a Public Health Emergency Operations Centre with corresponding procedures to manage health crises effectively.
• Formalise the process for collecting and analysing data on Medical Counter-Measures (MCM) and develop a business continuity plan.
• Define a methodology for listing critical MCMs and ensure the availability of written agreements for BSL-4 services.

Laboratory (Capacity 3)

• Include laboratory scaling-up procedures in the general preparedness plan.
• Implement protocols for transferring isolates from private to national laboratories and link them with epidemiological data.
• Improve the description of laboratory diagnosis processes, including typing, for outbreak management.
• Finalise and implement an updated laboratory reporting system to support molecular typing and sequencing data.

Surveillance (Capacity 4)

• Enhance the case reporting system to support better epidemiological data collection by clinicians.
• Develop a plan to monitor healthcare capacity and continue digitalisation efforts, especially for Severe Acute Respiratory Infections (SARI), bloodstream infections (BSI), and sexually transmitted infections (STI).
• Identify and implement tools to improve the collection of vaccination and immunisation data.

Antimicrobial Resistance and Healthcare-Associated Infections (Capacity 12)

• Strengthen intersectoral and interdisciplinary collaboration through regular exchanges on AMR strategies.
• Focus the next National Action Plan (NAP) for AMR on a few clear targets and translate them into actionable steps across human, animal, and environmental sectors.
• Develop a national strategy for HAI and IPC and document it for stakeholder engagement and programme evaluation.
• Implement multidisciplinary MDRO alert and response mechanisms, with special attention to carbapenem resistance.
• Explore strategies for antibiotic prescriber feedback to reduce misuse and improve AMR management.

Zoonotic Diseases and Environmental Threats (Capacity 10)

• Strengthen intersectoral and cross-border collaboration through the One Health Working Group.
• Embed the One Health approach into relevant legal frameworks and operational plans.
• Include a One Health perspective in climate change adaptation strategies and ensure the implementation and monitoring of the 2025–2035 plan.

Cross-Cutting Recommendations

• Improve communication with neighboring countries to streamline information sharing.
• Enhance interoperability of information systems if cost-effective.
• Clarify the process for adapting international risk assessments to the national context.
• Document crisis management procedures without compromising the agility and flexibility of the current system.
• Continue efforts to address human resource shortages and ensure the implementation of business continuity plans.

Conclusions

Luxembourg's public health authorities demonstrated a clear understanding of their preparedness and response mechanisms, and they have outlined a plan for continued improvement. The recommendations in this report aim to guide further development of the country's emergency preparedness framework, ensuring it aligns with EU standards and enhances the effectiveness of response actions.