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Peer-reviewedCC BYHealthcare (Basel, Switzerland)

From Preparedness to Documented Operational Readiness: Mapping Public Evidence Across the EU/EEA Health-Security Architecture.

  • Krzysztof Goniewicz1
  • Henk van der Wal2,3
  • Markus Ries4,5,6,7
  • Amir Khorram-Manesh8,9,10
10 affiliations
  1. 1Department of Security Studies, Polish Air Force University, 08-521 Dęblin, Poland.
  2. 2Civil-Military Centre of Expertise for Trauma Care, Central Military Hospital, Ministry of Defence, 3584 EZ Utrecht, The Netherlands.
  3. 3Civil-Military Centre of Expertise for Trauma Care, Traumacenter, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands.
  4. 4Crisis and Disaster Management Unit, Heidelberg University Hospital, Heidelberg University, Im Neuenheimer Feld 430, 69120 Heidelberg, Germany.
  5. 5Center for Virtual Patients, Medical Faculty, University of Heidelberg, 69120 Heidelberg, Germany.
  6. 6Pediatric Neurology and Metabolic Medicine, Center for Pediatrics and Adolescent Medicine, Heidelberg University Hospital, 69120 Heidelberg, Germany.
  7. 7Rhine-Neckar Public Health Service, 69115 Heidelberg, Germany.
  8. 8Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, 405 30 Gothenburg, Sweden.
  9. 9Disaster Medicine Center, University of Gothenburg, 405 30 Gothenburg, Sweden.
  10. 10Gothenburg Emergency Medicine Research Group (GEMREG), Sahlgrenska Academy, Gothenburg University, 405 30 Gothenburg, Sweden.
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Abstract

Background/Objectives: Post-pandemic reforms have expanded the EU/EEA health-security architecture across surveillance, crisis coordination, medical countermeasures, workforce mobilisation, civil protection and cybersecurity. Preparedness structures do not themselves establish operational performance. We mapped publicly available documentary evidence of operationalisation across eight health-readiness domains. Methods: We applied structured qualitative documentary analysis and a capability-based Framework Method to 35 primary public sources dated or accessed between 1 January 2024 and 17 September 2026. We extracted 190 source-linked observations. Frequency estimates included 175 observations from 34 sources after excluding 15 potentially overlapping rows from an interim cross-country PHEPA synthesis. Evidence was coded using nonexclusive policy (P), mechanism (M), operational functionality (O), completed exercise (E) and real-world use (R) attributes, without deriving a readiness score. Results: Policy commitments and established mechanisms were documented more often than completed exercise testing or real-world use. Explicitly documented gaps occurred in 62 of 175 observations (35.4%), concerning formalisation and activation, interoperability and situational visibility, scalability and sustainability, exercise and event evidence, learning and corrective-action closure, and cross-sector or cross-border integration. Gap frequencies differed by source type, particularly between PHEPA reports and other documents, and do not indicate comparative readiness. Most observations did not specify hazard interaction; none met the revised strict thresholds for a hybrid campaign, compound crisis or cascading disruption. Conclusions: This study provides a traceable map of public evidence linking preparedness structures to reported operationalisation. Its findings identify documentary patterns and implementation challenges, not direct measures of capability, effectiveness or performance in complex crises.

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Cite

BibTeXRIS
BibTeX
@article{goniewicz2026from,
  title = {{From Preparedness to Documented Operational Readiness: Mapping Public Evidence Across the EU/EEA Health-Security Architecture.}},
  author = {Krzysztof Goniewicz and Henk van der Wal and Markus Ries and Amir Khorram-Manesh},
  journal = {Healthcare (Basel, Switzerland)},
  year = {2026},
  month = oct,
  doi = {10.3390/healthcare14203529},
  url = {https://europepmc.org/article/MED/42940574},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - From Preparedness to Documented Operational Readiness: Mapping Public Evidence Across the EU/EEA Health-Security Architecture.
AU  - Krzysztof Goniewicz
AU  - Henk van der Wal
AU  - Markus Ries
AU  - Amir Khorram-Manesh
PY  - 2026
DA  - 2026/10/20
JO  - Healthcare (Basel, Switzerland)
DO  - 10.3390/healthcare14203529
UR  - https://europepmc.org/article/MED/42940574
AB  - Background/Objectives: Post-pandemic reforms have expanded the EU/EEA health-security architecture across surveillance, crisis coordination, medical countermeasures, workforce mobilisation, civil protection and cybersecurity. Preparedness structures do not themselves establish operational performance. We mapped publicly available documentary evidence of operationalisation across eight health-readiness domains. Methods: We applied structured qualitative documentary analysis and a capability-based Framework Method to 35 primary public sources dated or accessed between 1 January 2024 and 17 September 2026. We extracted 190 source-linked observations. Frequency estimates included 175 observations from 34 sources after excluding 15 potentially overlapping rows from an interim cross-country PHEPA synthesis. Evidence was coded using nonexclusive policy (P), mechanism (M), operational functionality (O), completed exercise (E) and real-world use (R) attributes, without deriving a readiness score. Results: Policy commitments and established mechanisms were documented more often than completed exercise testing or real-world use. Explicitly documented gaps occurred in 62 of 175 observations (35.4%), concerning formalisation and activation, interoperability and situational visibility, scalability and sustainability, exercise and event evidence, learning and corrective-action closure, and cross-sector or cross-border integration. Gap frequencies differed by source type, particularly between PHEPA reports and other documents, and do not indicate comparative readiness. Most observations did not specify hazard interaction; none met the revised strict thresholds for a hybrid campaign, compound crisis or cascading disruption. Conclusions: This study provides a traceable map of public evidence linking preparedness structures to reported operationalisation. Its findings identify documentary patterns and implementation challenges, not direct measures of capability, effectiveness or performance in complex crises.
SN  - 2227-9032
ER  -