The risk of epidemics and pandemics is severe in Europe, as the COVID-19 pandemic has demonstrated. Potential risks originate from novel, emerging diseases, like COVID-19, however the re-emergence of known diseases also poses a significant risk of causing epidemics and pandemics.
An epidemic is a widespread occurrence of an infectious disease. A pandemic is a widespread occurrence of an infectious disease over an entire region, or the entire world, such as COVID-19.
Statistics from the last 40 years show that infectious diseases have the highest mortality rates of all of the risks discussed in the report, and that this mortality rate has been on the rise for several decades before the COVID-19 pandemic began.
The EU is concerned about monitored infectious diseases that pose a risk of causing mass infection, like COVID-19. The EU is also concerned about the emergence of novel diseases that pose a risk to human life in Europe, and the re-emergence of known diseases such as measles (which is rising due to vaccine hesitancy) as well as diseases that can mutate potentially into more deadly variants or more easily transmissible variants (such as the COVID-19 Delta and Omicron variants).
According to the World Health Organization (WHO) Tracking SARS-CoV-2 variants, data published by, as of May 2022, there have been over 520 000 000 confirmed cases of COVID-19, over 6 260 000 confirmed deaths from COVID-19,and over 11.6 billion COVID-19 vaccinations administered.
Vector-borne diseases are infections that are transmitted through being bitten by an infected vector such as a tick or mosquito.
The European Health authorities are giving increased attention to emerging vector-borne diseases like Lyme disease and encephalitis. Both diseases are transmitted by tick bites and are the most common vector-borne diseases in Europe.
Vector-borne diseases are more common in other regions of the world than in Europe, such as malaria in sub-Saharan Africa and South Asia. However, vector-borne diseases are on the rise and their distribution is spreading.
The COVID-19 pandemic is the most destructive health crisis in the EU’s history in terms of deaths, cases of extended illness, global disruption, and overwhelming economic damages. The COVID-19 pandemic has proved that diseases can spread quickly between countries and develop into global health emergencies. Although the pandemic is still ongoing, with severe and lasting impacts, it is not the only disease that poses a risk of an epidemic or a pandemic to Europe or the world.
Approximately 85 000 cases of Lyme disease are reported each year, and there are an increasing number of cases being witnessed in northern Europe. Climate change is one of many factors that influence vector habitat (European Centre for Disease Prevention and Control) and milder winter temperatures due to climate change may enable the expansion of vector-borne diseases.
Zoonotic diseases are infections that are transmitted from animals to humans. The most recent and relevant example of a zoonotic disease is COVID-19, or SARS-Cov-2, a novel coronavirus not known to previously infect humans. Zoonotic diseases have long been the subject of concern due to their potential to cause an epidemic. They are increasingly likely to emerge as global population increases, humans intrude into natural ecosystems and intensive agriculture continues. This is because these factors increase the frequency of human-animal contact and put pressure on the natural environment.
Other viral diseases such as avian and pandemic influenza, Middle East respiratory syndrome, Ebola, Zika, Dengue, Chikungunya, and West Nile virus are being considered as possible causes of future epidemics in Europe. Measles is an example of an ‘old’ disease that has made a resurgence primarily due to a less than ideal uptake of the readily available vaccine. Measles is now recognised as a major threat to health across Europe, with 150 000 cases of measles reported in the EU/EEA over the last decade.
Emerging and re-emerging infectious diseases are defined by the European Commission as ‘infections that have newly appeared in a population or have existed previously but are rapidly increasing in incidence or geographic range.’ (EUROPA website). The COVID-19 pandemic is a typical example.
New pathogens continuously emerge and, since the 1970s, 1 500 new pathogens have been discovered, a large proportion of which are zoonotic.
HIV/AIDS is an re-emerging disease. Since its discovery in the 1980s, HIV/AIDS remains a public health concern in EU/EEA countries, with around 25 000 new diagnoses reported each year. Although HIV is preventable, and effective treatment of HIV now exists, there is no cure yet. Despite its overall decline in the EU as a whole, in one third of EU/EEA countries the rates of HIV infection continue to increase.
Foodborne diseases also pose risk to the EU public. They are contracted through eating foods contaminated with bacteria, parasites, viruses, or bacteria-produced toxins. The bacterial E. coli infection of 2011 killed 55 people and caused illness in nearly 4 000 people over 16 EU countries. 350 000 cases of infections from Campylobacter, Salmonella, Yersinia, E. coli,Listeria and monocytogenes are reported each year in the EU, though the true number is likely higher. In 2018, listeriosis and salmonellosis caused nearly 350 deaths. The EU is concerned about foodborne bacteria with antibiotic-resistant strains present because antimicrobial treatments are becoming less effective to treat these infections.
Europe is vulnerable to potential epidemics caused by anti-microbial resistant bacteria (Antimicrobial resistance), WHO page). Antimicrobial resistance occurs when microorganisms like bacteria, viruses, fungi and parasites adapt to withstand the action of antimicrobial drugs. As a result, the medications used to cure the infections become ineffective, may spread to others, and mutate further.
An antibiotic-resistant bacteria that potentially poses a threat to Europe is Meticillin-resistant Staphylococcus aureus (MRSA, European Food Safety Authority) which could present difficulty in treating the infection, and therefore reduces Europe’s ability to manage a MRSA bacterial epidemic.
Europe faces the potential risk of bioterrorism in the future. The malicious exposure of the population of Europe or the world to biological and chemical weapons is a potential threat. Experts estimate that terrorists threats are likely to come from the use of biological and chemical weapons (EP 2018 Report).
Europe has an aging population: in 2021, more than one fifth (20.8 %) of the EU population was aged 65 and over (EUROSTAT). This increases the proportion of people vulnerable to infectious diseases in Europe. The COVID-19 pandemic has had a much greater impact on the health of older people, as the risk of illness and death increases with age.
A majority of EU Member and Participating States consider pandemics and epidemics a key risk. Some EU MS have identified vector-borne diseases, and other health related risks in their national risk assessments. There is an interest in the EU in improving Europe’s capacity to anticipate and prepare for extreme events with transboundary repercussions such as epidemics and pandemics. The 2019 revision of the Union Civil Protection Mechanism legislation requires MS to share information on their key disaster risks, on low-probability risks with a high impact, and on priority prevention and preparedness measures to tackle these risks.
The European Union Civil Protection Mechanism (UCPM) aims to foster collaboration between EU MS so that all European countries can benefit from improved prevention of and response to disasters, including cross-border situations like epidemics and pandemics, which can spread rapidly across countries. rescEU was also created because the European Commission upgraded the UCPM to better protect citizens from disasters and manage emerging risks, including epidemics and pandemics. In response to the shortages, the Commission used rescEU to accelerate the provision of the requested medical equipment.
The European Health Emergency preparedness and Response Authority(HERA) aims to prevent, detect, and rapidly respond to health emergencies. HERA will anticipate threats and potential health crises through intelligence gathering and building responses as a shared resource for MS and EU institutions. HERA will develop, produce, and distribute medicines, vaccines, and medical equipment, which were in short supply during the early stages of the COVID-19 pandemic.
The EU vaccines strategy advocates for the use of safe and effective vaccines as the most effective way to end the COVID-19 pandemic. Through EUR 2.7 billion of funding from the Emergency Support Instrument, the Commission funded part of the cost of procurement of a specified number of vaccines. By mid-July of 2021, the EU had enough vaccine doses to vaccinate 70 % of its adult population.
The EU4Health programme has been created in direct response to the COVID-19 pandemic to fund various healthcare systems in Europe with an investment of EUR 5.3 billion from the EU. The EU4Health programme works to develop the European Health Union and as such its scope is larger than only addressing pandemic risks. The EU4Health programme aims to improve health, medial products and devices and crisis relevant products; strengthen health systems in both their resilience and resource efficiency and address cross-border health threats.
The EU Solidarity Fund assists the COVID-19 pandemic response, however it was not originally designed for use in managing pandemics. The Commission revised the Fund because of COVID-19’s unprecedented effects and resultant financial strain. The Fund supported any EU country or country involved with negotiation with the EU (that applied and was accepted) with financial support to assist the public and contain the disease.
The NextGenerationEU project aims to support the EU to emerge from the pandemic stronger. It is more expansive than a pandemic recovery plan, supporting the EU to become more green, digital, healthy, strong, and equal with investments of EUR 806.9 billion
EU Policy and legislative context | Relevant stakeholders and instruments | Additional information |
European Centre for Disease Prevention and Control: Vector-borne diseases | ||
European Health Emergency preparedness and Response Authority (HERA) | ||
Ageing Europe Looking at the Lives of Older People in the EU (2020) | ||