WP7 D7.2 Progress report on national sustainability plans implementation | UNITED4Surveillance

This report presents results from Work Package (WP) 7 Sustainability in implementing the EU4Health UNITED4Surveillance Joint Action (Grant Agreement Number 101102070) (https://united4surveillance.eu/project/) sustainability plan. The goal of this WP is to ensure that project outcomes, activities, and benefits extend not only during the project duration but also contribute to the long-term aim: strengthening integrated European health surveillance systems. The overarching objective is to strengthen communicable disease surveillance systems at the national level, with a focus on improving the integration, interoperability, and digitalization of data sources. We concentrate on outbreak detection/laboratory-based reporting, hospital surveillance, and One Health surveillance. The report is the further look at the planned national sustainability activities from 21 countries within the UNITED4Surveillance consortium. All sustainability actions proposed in the sustainability plans were described based on core work package activities. Most countries that submitted their national sustainability plans declared their intention to strengthen outbreak detection by utilizing tools developed during UNITED4Surveillance. Furthermore, activities related to foodborne diseases, zoonotic influenza, and vector-borne diseases surveillance are planned. The main key findings from the report: Funding strategies: Sustainable financing combines national health program budgets with other European funding sources (e.g. through the projects receiving grants under the call EU4H-2023-DGA-MS-IBA-01: Direct grants to Member States’ authorities: improving and strengthening national surveillance systems (Regulation of the European Parliament and of the Council on serious cross-border threats to health and repealing Decision No 1082/2013/EU) (CP-g-23-01) such as Strengthening infectious disease surveillance in the Netherlands (acronym Surveillance4NL), Strengthening surveillance systems in Denmark (acronym UpSurvDK), Integrating Data Sources to Improve Infectious Disease Surveillance In Finland (acronym FinSurveillance). The collaboration with national and regional health authorities and institutes to support infrastructure, tools, and stakeholder activities is the important focus of sustainability. Integration efforts: Most countries are strengthening horizontal and vertical integration through formal agreements, Memorandums of Understanding and cross-sector partnerships, aiming to enhance data sharing, surveillance capacity, and long-term sustainability. Stakeholder engagement: Engagement activities (defining roles, regular meetings, and trainings) have generally increased across lab-based reporting, outbreak detection, hospital surveillance, and One Health topics, though relevance varies by country. Monitoring indicators: While some countries have defined specific KPIs for system upgrades, stakeholder engagement, outbreak detection, and data quality, others have yet to do so due to recently set objectives, reliance on general metrics, resource constraints, or plans to address this in future projects. Sustainability planning: Most countries have formal sustainability plans, regularly assessing legislation, monitoring progress quarterly, and engaging stakeholders. Over half have identified potential risks to sustaining UNITED4Surveillance outcomes. Challenges: Persistent barriers include insufficient funding and human resources, competing stakeholder priorities, GDPR-related legal complexities, technical interoperability hurdles, and difficulties in maintaining engagement after the end of the UNITED4Surveillance. Overall, while there is clear commitment and positive momentum toward sustainability, continued support is needed to fill gaps in indicator development, secure long-term funding, and strengthen risk management and stakeholder coordination.