Integrating Drug Repurposing into EU Health Crisis Preparedness: The Strategic Role of Health Emergency Preparedness and Response Authority (HERA).

The COVID-19 pandemic exposed significant vulnerabilities in the European Union's health security architecture and highlighted the need for stronger coordination mechanisms for managing cross-border health threats. In response, the European Union established the Health Emergency Preparedness and Response Authority (HERA) as a central body responsible for strengthening preparedness, coordinating procurement, and supporting the development and availability of medical countermeasures. This study examines the potential role of drug repurposing as a strategic tool within the evolving EU health crisis preparedness framework. A narrative literature review and policy analysis were conducted using scientific publications indexed in PubMed and Scopus, as well as institutional and regulatory documents from the European Commission, the European Medicines Agency (EMA), and other relevant organisations. The findings indicate that drug repurposing offers important advantages during health emergencies, including shorter development timelines, lower research costs, and the possibility of leveraging existing manufacturing and regulatory infrastructures. At the same time, several challenges remain, particularly regarding regulatory coordination, intellectual property considerations, and the scalability of pharmaceutical production during periods of increased demand. The analysis suggests that drug repurposing could evolve from an ad hoc response mechanism into a more institutionalised component of EU health crisis preparedness. Integrating repurposing strategies into HERA's threat prioritisation, regulatory coordination, and industrial preparedness mechanisms may significantly enhance the European Union's ability to respond rapidly and effectively to future health emergencies.