Health security and health workforce preparedness in the EU: a qualitative comparative assessment

Background

Europe is facing unparalleled security threats that are testing the resilience of health systems and health and care workforce (HCWF) in maintaining essential services during crises. This study assesses health security and HCWF protection and preparedness in the EU with a focus on armed and hybrid conflicts, aiming to identify health security patterns and weaknesses and capacities for improvement.

Methods

A qualitative comparative methodology connects EU policy analysis with a country case study design, including Czechia, Finland, Germany, Netherlands, Poland, Portugal and Romania. Drawing on expert information and secondary sources, data was collected until April 2026 and thematic analysis undertaken.

Results

Across the seven countries a common pattern emerges: health security institutions have expanded considerably since COVID-19, but HCWs remain only partially integrated into preparedness planning. Firstly, all countries face persistent HCWF shortages that strongly limit surge capacities, particularly acute in Poland and Romania. Second, some dedicated reserve staffing mechanisms for wartime or mass-casualty scenarios exist but remain insufficient. Third, mental health support and occupational protection for HCWF are weak and equity and gender equality largely ignored, despite evidence from COVID-19 that this may threaten security. Fourth, countries with strong whole-of-government preparedness, most notably Finland, and those with high investment in military-centred security measures, with Poland on top, appear better positioned to connect HCWF policy with resilience agendas.

Conclusions

The polycrisis of HCWF fragility and health security threats affects all countries, calling for coordinated EU action to implement new health security measures and protect and prepare the HCWF effectively. A coherent governance framework is still lacking, but aligning EU’s emerging security landscape with HCWF strategy may strengthen health system resilience.

Key messages

• The health workforce must become a structural pillar and part of an emerging EU health and security landscape and an essential infrastructure for its implementation.

• Investment in health and care workforce stability and a coherent EU crisis strategy are needed to make use of new security measures and available resources.