Finland´s Pandemic Preparedness Plan for Healthcare and Social Welfare

Objectives

Finland’s pandemic preparedness plan provides a national framework for prevention, preparedness, management and recovery in healthcare and social welfare, designed to protect health, lives, wellbeing, fundamental rights and essential societal functions while reducing the wider harms of pandemics.[1][2]It complements the Security Strategy for Society and recognises that effective pandemic management requires action across administrative branches as well as healthcare and social welfare.[3][4]

• Promote health security and prevent adverse pandemic effects on people and society, while ensuring adequate healthcare and social welfare services throughout a pandemic.[4]
• Develop strategies based on the pathogen, epidemiological conditions, available resources, medicines and vaccines, population needs and the current situation picture.[2][5]
• Prevent and control infections, reduce morbidity and excess mortality, protect people at high risk, maintain service capacity, support recovery and restore normal societal functioning.[2]
• Apply preparedness across funding, leadership, coordination, situation assessment, communication, diagnostic capacity, material preparedness, non-pharmaceutical interventions, medicines, vaccines, workforce resilience and service continuity.[3]
• Protect equity, gender equality, children’s best interests, accessibility for persons with disabilities and the needs of other vulnerable groups.[6]
• Use a One Health approach connecting human, animal and environmental health, particularly where zoonotic threats or foodborne transmission are relevant.[6][2]
• Plan across inter-pandemic, alert, pandemic and transition phases, using mild, moderate and severe scenarios as preparedness assumptions and updating these as pathogen-specific evidence develops.[6][7]
• Prioritise necessary, proportionate and timely measures that contain transmission with the least possible harm to people, businesses, society and fundamental rights.[8][5]

Implementation

Implementation uses a comprehensive-security model in which national, regional and local authorities work with service providers, businesses, research bodies, civil society and the population.[9][10]The Ministry of Social Affairs and Health guides, supervises and updates the plan, while implementation is adapted to the specific pathogen, legislation, pandemic phase, strategic objectives and available resources.[1][6]

• Coordinate national leadership through the Ministry of Social Affairs and Health for healthcare and social welfare preparedness, supported by the Prime Minister’s Office for cross-government coordination, situation awareness and intensified government communication.[11][10]
• Assign wellbeing services counties, the City of Helsinki and the HUS Group responsibility for regional communicable-disease prevention, preparedness, early detection, outbreak investigation, treatment, rehabilitation and infection prevention.[9]
• Maintain preparedness centres in university hospital counties to coordinate regional preparedness and exchange healthcare and social welfare situation information with other centres and the Ministry of Social Affairs and Health.[12]
• Use the Finnish Institute for Health and Welfare as the national expert institution for communicable disease prevention, vaccination, diagnostics, surveillance, guidance, vaccine logistics and biological-threat coordination.[11]
• Engage Regional State Administrative Agencies in coordinating and monitoring regional prevention, assessing county preparedness, taking administrative decisions and organising preparedness exercises.[13]
• Involve municipalities in preparedness for disruption to local services and critical infrastructure, and in investigating food- and waterborne outbreaks with wellbeing services counties.[13]
• Coordinate specialised functions through the Finnish Medicines Agency, Finnish Institute of Occupational Health, National Supervisory Authority for Welfare and Health, Finnish Food Authority and National Emergency Supply Agency.[14][15]
• Use private providers through preparedness provisions in outsourcing contracts, self-monitoring and oversight by counties and supervisory authorities; procure additional private capacity when needed.[16]
• Engage universities, universities of applied sciences, non-governmental organisations, communities and volunteers in research, training, psychosocial support, complementary services and community resilience.[17]
• Apply statutory powers under communicable-disease and emergency legislation, assessing restrictions case by case for legality, necessity and proportionality.[8][18]
• Maintain a dynamic shared situation picture, drawing on healthcare, laboratory, wastewater, register-based, animal-health and international surveillance to inform coordinated decisions.[19][20][21]
• Specify indicators, monitoring frequency, methods and responsible organisations within pandemic strategies, and use subsequent evaluation to improve implementation and preparedness.[22]
• Strengthen diagnostic and material capacity through distributed laboratory networks, stockpiling, procurement, supply monitoring, domestic production reservations and international cooperation.[23][24][25]
• Deliver clear, multilingual and accessible communication through coordinated national and regional arrangements, multiple channels, media monitoring, surveys and public feedback.[26][27][28]
• Fund preparedness through normal authority operations, universal central government funding for wellbeing services counties, special preparedness compensation, discretionary grants and supplementary support where pandemic demands exceed available resources.[29]

Monitoring & Evaluation

The plan establishes a multi-level monitoring and evaluation approach centred on a shared, dynamic situation picture, risk assessment, surveillance and review of the effectiveness, necessity and proportionality of pandemic measures.[6][30][19]It does not provide a single consolidated national indicator framework, reporting cycle or independent accountability system for the entire plan.[22][18]

• Maintain situation pictures across national, regional and local levels, covering pathogen transmission, healthcare and social welfare pressures, human and material resources, service continuity, wider social and economic effects, and the capacities of relevant actors.[19][31][32]
• Assign authorities responsibility for information within their remits, with the Ministry of Social Affairs and Health, preparedness centres, the Finnish Institute for Health and Welfare, counties, Regional State Administrative Agencies, municipalities and central agencies compiling and sharing relevant data.[32][20]
• Use surveillance systems including laboratory sampling, wastewater monitoring, the Communicable Diseases Register, healthcare registers, animal-disease surveillance and international reporting networks to identify outbreaks, mutations, severity and spread.[20][21]
• Select indicators according to their availability, reliability and usefulness, covering disease transmission, testing, positivity, seroprevalence, hospitalisation, intensive care, mortality, staffing, vaccination, service burden and wider societal effects.[31][33][34]
• Disaggregate information where possible by age, region, testing, chronic illness risk factors and vulnerability to identify unequal impacts and support targeted measures.[31][33]
• Use modelling alongside multiple indicators to estimate current conditions, forecast healthcare demand and assess the likely effects of interventions, updating assumptions as evidence on pathogen characteristics, immunity and behaviour develops.[34][32]
• Evaluate pandemic-management measures for health benefit, wider societal advantages and disadvantages, resource use, effectiveness and cost-effectiveness; use qualitative research where appropriate and recognise that some impacts may only become clear during recovery.[30]
• Specify indicators, monitoring frequency, methods and responsible organisations in pandemic strategies, monitor implementation against strategic objectives and undertake subsequent whole-strategy evaluation.[22]
• Monitor operational performance through defined examples, including contact-tracing response times and coverage, vaccine coverage and effects, medicine availability, diagnostic capacity, stock levels, public attitudes and communication effectiveness.[27][35][36][37]
• Strengthen accountability through statutory responsibilities, supervision of private providers, employer duties, licensing and verification of laboratories, Parliamentary review of emergency-power decrees, and European Union and international notification arrangements.[16][23][18][38]

Costing & Financing

The plan identifies financing, resource availability and cost-effectiveness as integral to pandemic preparedness, but provides no overall budget, quantified funding gap, unit-cost schedule or macroeconomic assumptions for the national framework.[3][30]Resource mobilisation relies on routine public funding, central government transfers, emergency stockpiles, procurement, reserve supplies and capacity arrangements that can be expanded during a pandemic.[29][39]

• Fund preparedness for incidents and emergencies through the normal operations of healthcare and social welfare authorities and agencies, supplemented by universal needs-based central government funding for wellbeing services counties.[29]
• Adjust central government funding when pandemic-related service needs or tasks change, compensate special preparedness duties, and provide discretionary grants when pandemic management exceeds a county’s available resources.[29]
• Use central government transfers, grants and increased agency appropriations to reimburse or support pandemic-related costs, including measures used during COVID-19 for municipalities, hospital districts, Åland, the Finnish Institute for Health and Welfare and the National Emergency Supply Agency.[29]
• Secure adequate funding for prevention measures and pandemic recovery through the legislative framework, although no allocation, source or amount is specified.[7][8]
• Mobilise resources through public and private service providers, businesses, additional procurement, workforce redeployment, overseas diagnostic capacity where feasible, stockpiling and securing domestic production.[16][40][25]
• Use the National Emergency Supply Fund to provide liquidity and capacity for financial measures protecting security of supply during sudden disruptions, alongside state emergency stockpiles that complement routine and preparedness stocks.[15]
• Consider costs, throughput and performance when selecting diagnostic methods; sequencing and laboratory-developed tests require costly or specialised equipment, facilities and expertise, but no quantified diagnostic budget is supplied.[41][42][23]
• Manage material preparedness through joint European Union procurement, stockpiling and compensated domestic production-capacity reservations; stockpiling entails capital, storage, recycling and loss costs, while capacity reservations seek to reduce expiry-related losses and storage costs.[39][25]
• Fund vaccines in the national vaccination programme and other government-decided general vaccinations from state funds, while using public, private and occupational healthcare capacity to scale delivery.[43][44]
• Recognise that medicine and vaccine development, clinical research and production capacity require substantial public, academic and private investment, but no future budget or financing requirement is quantified.[45][36]
• Use social-security benefits and budget procedures, including supplementary budgets, to protect livelihoods and government liquidity during pandemic-related economic disruption.[46]