From Preparedness to Documented Operational Readiness: Mapping Public Evidence Across the EU/EEA Health-Security...

Background/Objectives: Post-pandemic reforms have expanded the EU/EEA health-security architecture across surveillance, crisis coordination, medical countermeasures, workforce mobilisation, civil protection and cybersecurity. Preparedness structures do not themselves establish operational performance. We mapped publicly available documentary evidence of operationalisation across eight health-readiness domains. Methods: We applied structured qualitative documentary analysis and a capability-based Framework Method to 35 primary public sources dated or accessed between 1 January 2024 and 17 September 2026. We extracted 190 source-linked observations. Frequency estimates included 175 observations from 34 sources after excluding 15 potentially overlapping rows from an interim cross-country PHEPA synthesis. Evidence was coded using nonexclusive policy (P), mechanism (M), operational functionality (O), completed exercise (E) and real-world use (R) attributes, without deriving a readiness score. Results: Policy commitments and established mechanisms were documented more often than completed exercise testing or real-world use. Explicitly documented gaps occurred in 62 of 175 observations (35.4%), concerning formalisation and activation, interoperability and situational visibility, scalability and sustainability, exercise and event evidence, learning and corrective-action closure, and cross-sector or cross-border integration. Gap frequencies differed by source type, particularly between PHEPA reports and other documents, and do not indicate comparative readiness. Most observations did not specify hazard interaction; none met the revised strict thresholds for a hybrid campaign, compound crisis or cascading disruption. Conclusions: This study provides a traceable map of public evidence linking preparedness structures to reported operationalisation. Its findings identify documentary patterns and implementation challenges, not direct measures of capability, effectiveness or performance in complex crises.