Nobody Left Outside
NLO
The Nobody Left Outside (NLO) initiative is a collective of organisations representing people in some of the most marginalised communities in Europe, including people experiencing homelessness, LGTBI people, people who use drugs, sex workers and undocumented migrants.
ID: 889463795761-47
Lobbying Activity
Response to EU Strategy on medical countermeasures
8 May 2025
The Nobody Left Outside (NLO) initiative welcomes the European Commissions efforts to develop a robust strategy to support Medical Countermeasures (MCMs) against Public Health Threats. We urge that the strategy explicitly addresses the needs of the most marginalised communities in Europe, who are disproportionately affected by public health emergencies and face systemic barriers to accessing care. NLO brings together organisations representing people experiencing homelessness, LGBTI people, people who use drugs, sex workers and undocumented migrants. These communities are often invisible in preparedness planning, but their exclusion undermines the equity, resilience, and effectiveness of emergency responses. For many in these groups, access to basic healthcare is already limited under normal conditions. During public health crises, these barriers are exacerbated, leading to preventable illness, higher transmission risks, and avoidable deaths. We recommend that the Medical Countermeasures Strategy explicitly integrates the following considerations: Equitable Access to Medical Countermeasures: The MCM strategy must guarantee that all individualsregardless of legal status, housing situation, identity, or occupation can access countermeasures (e.g., vaccines, therapeutics, diagnostics, personal protective equipment) without discrimination or fear of legal repercussions. Inclusive Planning and Preparedness: Preparedness frameworks should include specific provisions for people living in unstable conditions (e.g. informal housing, shelters). Emergency stockpiling, distribution plans, and communications strategies must be designed to reach these communities, including through trusted community-led organisations and low-threshold services. Removing Structural Barriers: The strategy should address financial, administrative, and geographic barriers that prevent marginalised groups from accessing MCMs. This includes providing free services at the point of care, removing the requirement for a fixed address, and offering mobile or outreach-based delivery models. Addressing Stigma and Discrimination: Public health responses must actively counter stigma that deters marginalised populations from seeking care. Discrimination within healthcare settings creates mistrust, reduces uptake of countermeasures, and increases vulnerability. Inclusive training for providers and safeguards for patient dignity are essential. Targeted Communication and Health Literacy: Crisis communications must be culturally sensitive, translated into multiple languages, and delivered through channels trusted by marginalised communities. Promoting health literacybefore and during emergenciesis vital to ensure individuals understand and can access countermeasures. Data Collection and Community Participation: Disaggregated data on the impact of public health threats on marginalised groups is essential to identify gaps and monitor equity in countermeasure deployment. Community-led organisations should be actively involved in the planning, delivery, and evaluation of emergency responses and included in structured stakeholder engagement mechanisms. By placing equity at the heart of the MCM strategy, the EU can better protect all peopleand ensure that no one is left outside during future public health emergencies.
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