The health and care workforce in Europe's emerging health security architecture: A comparative assessment of seven EU countries.

BACKGROUND

Growing hybrid and military threats are converging with health and care workforce poly-crises, placing increasing pressure on health system resilience.

OBJECTIVES

This study examines how European Union (EU) member states protect and prepare the workforce for health security threats and how these measures impact resilience.

METHODS

A qualitative comparative assessment of EU health security policy and seven country cases was performed, including Czechia, Finland, Germany, Netherlands, Poland, Portugal and Romania. A structured topic guide informed data collection in April 2026, drawing on expert input and secondary sources.

RESULTS

Since COVID-19, health security institutions and defence-related preparedness have expanded substantially across countries. Three broad patterns emerge within a new health security and resilience architecture shaped by health systems, defence strategies and workforce conditions, but also important common trends: workforce stability and resilience remain marginal within these emerging architectures and critical gaps in protection and preparedness, and priority of military-centred approaches threaten health system resilience.

DISCUSSION: Investment in military-centred defence remains inefficient if not aligned with workforce resilience, including preparedness, physical and mental health protection, equity and gender equality. Key challenges for policymakers are to shift from military- and infrastructure-focused preparedness toward integrated strategies with the workforce as foundational pillar of critical security infrastructure and an operational indicator of resilience, and to build capacity for the implementation of new security policies.

CONCLUSIONS

The EU needs a coordinated workforce-centred strategy with a sustainable budget that strengthens preparedness, protection, governance capacity, research and implementation to improve resilience under crisis and defence conditions.