ECDC assessment of public health workforce capacity in prevention and control of infectious diseases in the EU/EEA

In 2024, ECDC conducted a survey on public health workforce capacity in the field of prevention and control of infectious diseases in the EU/EEA. This was in response to requests from several European Member States to help assess existing workforce capacity and identify gaps and additional investments needed. The survey was designed for this purpose, as well as to support countries in taking the first steps to describe the size and composition of their existing public health workforce capacity, and to better understand issues related to recruiting and retaining that workforce. The survey had a good response rate (70% = 21 countries) and provided some valuable insights that can inform future capacity-building approaches. 

However, due to the diversity of health system structures and governance systems across countries, it was challenging to obtain comparable data. In most respondent countries, a strategic document, mechanism, or legal instrument for workforce planning and development in public health or specifically in infectious disease prevention and control does not exist. The public health workforce is distributed across different organisations, the majority is based within the ministry responsible for health and the national public health institute, and across different administrative levels (national, regional and local).

A lack of harmonised workforce data collection mechanisms at the national level impacted the data collection, so, in general, incomplete data were reported. It was difficult to estimate the number of staff for each job function working in infectious disease prevention and control, as there is often no central registry of staff by profession, and the responsibilities of staff differ in the same country between regions and professionals. As quantifying the infectious disease workforce and the public health workforce in general is challenging, a good first step for all countries that do not currently do this should be setting up a regular census and registry to assess the current workforce capacity situation. 

In all respondent countries, the public health workforce working on infectious diseases increased during the COVID-19 pandemic. However, only some countries retained this additional staff beyond the end of the pandemic. 

Recruitment was not reported as a challenge, even if some difficulties hamper it, such as insufficient numbers of qualified applicants, hiring freezes due to insufficient funding, and inadequate salary scales. In contrast, most of the countries reported that retaining the appropriate number of staff is more difficult, mainly due to the high work burden and/or burnout, aging workforce leading to retirement, and inadequate salary scale compared to staff working in the clinical sector. On the positive side, a career in this area was seen as providing good job security. 

Another positive finding was that many countries have one or more specialist programmes for training the public health infectious disease professionals of the future. Continuous professional development is also provided in several countries. It is important to maintain these in the countries that have them and introduce them in other countries to maintain the supply of well-trained staff in the future. 

The information presented in this report only provides a partial snapshot of the current status of the EU/EEA public health infectious disease workforce, based on a mixture of qualitative and quantitative data. Continuing to collect comparable data over time to monitor trends to identify needs and opportunities will increase the value of this type of survey. ECDC will continue to conduct such public health workforce capacity surveys on a regular basis. Data completeness would be further improved if registries of public health staff, possibly by job type, were developed, where they do not currently exist. Comparability of data would be improved by more harmonised definitions of the job types constituting a public health workforce. 

ECDC encourages EU/EEA countries concerned by potential shortages in their public health workforce to assess their current public health workforce situation, needs and opportunities for progress using the WHO operational roadmap on National Workforce Capacity for Essential Public Health Functions. ECDC can provide methodological support to countries to conduct such exercises through the EU Health Task Force. 

Under Article 8 of the EU Regulation EU:2022/2371 on serious cross border threat to health, ECDC is responsible for assessing all 30 European Union and European Economic Area countries’ prevention, preparedness and response plans every three years. In these public health emergency preparedness assessments, the human resources capacity related to public health emergencies, including surge capacity, is also considered.