In responding to an emerging cross-border health threat, the first step is to assess its associated risks. It is important to know
- Origin: what is the disease or chemical causing the outbreak?
- Transmission: how it is spread (e.g. air-borne like influenza, foodborne like salmonella or spread by mosquitoes like Zika)?
- Consequences: what its consequences are for human health (e.g. causes pneumonia, etc.)?
- Lethality: what the severity of disease is, including the lethality?
The answers to these questions determine the possible options of response. In addition, as with COVID-19, we can be confronted by completely novel diseases, where we need to plan a response even before we have the answers to all these questions.
Decision 1082/2013/EU on serious cross border threats to health puts in place coordinated EU risk assessment mechanisms. This involves mobilising expertise from relevant EU and international bodies, to provide robust scientific advice to feed into the process of coordinating the response.
Which agencies perform a risk assessment?
At EU level, the risk assessment is carried out by:
- the European Centre for Disease Prevention and Control (ECDC), if the threat is of:
- biological origin and consists of infectious diseases or antimicrobial resistance and healthcare-associated infections
- unknown origin
- the European Food Safety Authority (EFSA), in the case of a serious cross-border threat to health falling under its mandate
- other relevant EU agencies which may be called upon in their respective area of expertise (e.g. the environment)
Where the risk assessment required is totally or partially outside the mandate of existing EU agencies, the Commission provides an ad hoc risk assessment. For example, the Scientific Committee on Health, Environmental and Emerging Risks (SCHEER) is mandated to provide public health risk assessment in case of serious cross-border chemical threats.
The risk assessment takes into account, if available, relevant information provided by other entities, in particular by the World Health Organization (WHO) in the case of a public health emergency of international concern.