The purpose of this study was to provide evidence to the European Centre for Disease Prevention and Control (ECDC) and other key stakeholders in the public health arena on how to help PHLs be better prepared and more resilient to future public health challenges related to respiratory infectious diseases. The guiding research questions for this study were: What were the main challenges PHLs faced during the COVID-19 pandemic? What solutions were implemented by PHLs to address these challenges, and what advances were made during the COVID-19 pandemic? What was the impact and the implications of the solutions implemented by PHLs? What is necessary to sustain the advances made during the COVID-19 pandemic in PHL preparedness? How can the lessons learned during the COVID-19 pandemic be used to enhance PHL preparedness for other respiratory infectious diseases (including influenza, RSV and other emerging threats) and potential new pandemics? What long term strategies should be developed to ensure PHLs remain resilient and adaptable in the face of future public health threats?