Delsaux: HERA has taken steps to make pandemic preparedness transparent

As the EU’s Health Emergency Preparedness and Response Authority (HERA) is approaching its second birthday, director-general Pierre Delsaux told Euractiv in an interview that they are taking transparency of their work seriously despite persisting worries.

Emerging from the COVID-19 crisis, HERA was officially launched as a new Directorate-General within the European Commission on 16 September 2021 as part of the European Health Union to prevent and respond to future disease outbreaks.

After two years, HERA is made up of 90 people, expanding to 105 or more at the beginning of 2024 and has a budget of EUR6 billion between 2022-2027, not counting activities supported by a range of other EU programmes which increase the total support to EUR30 billion.

“I can tell you for sure that we are much better prepared now than we were before the COVID-19 crisis,” Delsaux confirms from the HERA offices.

HERA is currently in preparedness mode, as opposed to its other mode of operation, the crisis phase. This means gathering intelligence, prioritising potential health threats, and making deals like the one from June with four vaccine producers to reserve vaccine manufacturing capacity in the event of another disease outbreak.

However, it fuelled transparency concerns early on that HERA became a part of the Commission instead of a full EU agency, separate from the EU institutions and their budgets and subject to regular audits voted on in the European Parliament.

As recently as June, MEPs voted in favour of the final report from the special committee on the COVID-19 pandemic (COVI) in July, in which they emphasised that “in order to fulfil its mandate and reach its objectives, HERA should become an independent EU agency with sufficient funding” because “it would increase the level of transparency and democratic scrutiny.”

Delsaux is sure that “we would not exist now” if HERA was an agency due to the lengthy process of setting up EU agencies. He also believes HERA is transparent about its work because the structure differs from other parts of the Commission.

“We try to involve member states in all our decisions. We also keep the European Parliament fully informed of everything that has been agreed. They know everything about us, they know all the documents. Everything is being shared with them,” Delsaux said, referencing the member states’ involvement in decisions through the HERA board.

There is an evaluation of HERA planned for next year due to the agreement from July 2022 in the regulation on serious cross-border threats to health.

The pandemic’s lessons of transparency

In a crisis, one of HERA’s tasks is to take charge of the EU-wide procurement of medical countermeasures – such as vaccines. The Commission continues to call the COVID-19 vaccine procurement a success, as does Delsaux, however, it could not calm the wave of criticism questioning the transparency of the contracts.

“When we were negotiating those contracts, we were forced to accept conditions, which were not necessarily what we wanted, but which were there. So we had no choice,” he said, adding that the priority was getting vaccines as fast as possible amid the crisis.

“Would those criticising us have accepted that we said: sorry, we don’t want to purchase your vaccines because we want to be transparent. (…) Would that be an acceptable answer? Not at all. The priority was to save lives,” he concluded.

However, he agreed that an evaluation is needed to know how to improve the process in the future.

Other transparency concerns and trust issues arose from the mysterious case of European Commission President Ursula von der Leyen’s text message exchange with Pfizer CEO Albert Bourla while the EU was securing COVID-19 vaccine contracts. Failure to find these texts following a request for access led to widespread criticism and concerns over how the contracts came into place.

Delsaux highlights again that “nothing was decided by the Commission alone” and that they “did not discuss it in secret” because the member states were involved in the entire process of acquiring vaccines.

“People are trying to find something that went wrong with the Commission. Well, actually, nothing went wrong,” he insisted, despite the EU Ombudsman’s harsh criticism of how the Commission dealt with the case, which she deemed maladministration and “a wake-up call to all EU institutions.”

“The best way to avoid such a situation in the future is preparation,” Delsaux said.

Transforming into a global player

This preparation involves looking at a wide range of diseases to evaluate whether they have potential to evolve into a fully-fledged health crisis with the help of member states, the ECDC and EMA.

Delsaux mentions avian influenza, which is not a big risk at the moment, but nevertheless, HERA is using data from the ECDC to investigate medical countermeasures, which could be used in case it evolves and is detected in more humans.

“When we know something is out there, we look at what we can do. That’s very important. That was what was missing before the creation of HERA. Even if some threats were identified, nobody was really doing what was needed because there was not an equivalent of HERA,” Delsaux explains.

A big hurdle is the global aspect of these diseases, which ignores the human-drawn borders between countries. HERA is set to be another major global health actor, as cooperation agreements with organisations and countries are set up so intelligence on health threats can be shared.

Delsaux mentions agreements with the US Biomedical Advanced Research and Development Authority (BARDA) and the World Health Organisation (WHO), as well as an agreement with Japan being signed soon and talks with Singapore, Canada, and the Africa CDC.

“Our international agenda is quite large. For instance, we have also worked with the US to try to help African countries when there was a new Ebola outbreak to try to bring some resources, money and equipment together. So we work with the rest of the world.”

[Edited by Alice Taylor]