A narrative literature review to inform the development of a health threats preparedness framework in Ireland

Louise Marron ^1* James Gilroy ² Michelle Williams ³ Randal Parlour ³ Mairin Boland ^2,4

• ¹ Health Service Executive-Health Protection Surveillance Centre, HSE National Health Protection, Dublin, Ireland
• ² National Health Security/ Threats Preparedness Programme, HSE National Health Protection Office, Dublin, Ireland
• ³ Research guidance and development unit, HSE National Health Protection Office, Dublin, Ireland
• ⁴ Department of Public Health and Primary Care, Institute of Population Health, Trinity College, Dublin, Ireland

Introduction Public health emergency preparedness requires capacities and capabilities to respond to a diverse range of health threats. A key objective of Ireland’s recent Health Protection Strategy is to enable preparedness, prevention, early detection and optimal response to health threats from all-hazards. We aimed to identify priority areas for inclusion in an evidence-based health threats preparedness framework, using lessons from the COVID-19 pandemic, to inform a national health threats strategy and a strengthened emerging health threats function for Ireland. Methods We conducted a narrative literature review to inform health threats preparedness framework development. We carried out literature searches in two phases, from 2017-2022, followed by an updated search covering 2022-2024, to ensure all relevant, recent literature was captured. We used a data extraction tool to collate priority areas reported. Results Overarching priorities for health threats preparedness are rapid decision-making, an outcomes-based, and ethical approach. Health threats preparedness should include a risk-based, all-hazards, One Health approach, aligned with legislation. Multisectoral partnerships, collaboration and communication nationally and internationally are key, alongside clear governance structures and monitoring and evaluation. Adequate resources are required to operationalise effective and sustainable preparedness. Public health leadership must be to the fore. Conclusion Development of an effective health threats preparedness approach is legislatively mandated for European Member States. This evidence review highlights priority areas for the development of a strengthened heath threats preparedness framework. This framework supports the development of a strengthened emerging health threats function in Ireland and may inform other Member States’ preparedness.