The COVID-19 pandemic revealed weaknesses in healthcare systems globally, above all in the detection, preparedness and response to biological threats such as emerging pathogens. The pandemic was not completely unexpected, considering for example how in 2018 WHO included “Pathogen X” among the list of pathogens which could threaten global health security and have a pandemic potential. In a simulation exercise (SIMEX) there are three principle phases: * A PRE-EXERCISE PHASE dedicated to planning, logistics, implementation of exercise materials and recruitment of participants; * AN EXCERCISE IMPLEMENTATION PHASE, which includes the preparation of the facilitators, the beginning of the exercise, its conduct, the ""hot"" debriefing with the participants and the closure of the exercise itself; and finally * A POST-EXERCISE PHASE dedicated to the collection of results, the debriefing with the facilitators, the preparation of a report and evaluation of the exercise and the administrative reporting. This workshop will present epidemic and pandemic preparedness from an international perspective through the experience of two international experts of the European Centre for Disease Prevention and Control and the example of pandemic simulations carried out currently as part of the National strategic and operational plan for preparedness and response to an influenza pandemic (PanFlu) 2021-2023, in Italy. The Congress takes place in a time of change in the global health security governance context with the revision of the International Health Regulations, the discussions around the Pandemic Treaty and, in the European Union, with the issue of the recent regulation EU 2022/2371 of the European Parliament and of the Council on serious cross-border threats to health. In addition, at the time in which the workshop will take place, the European Centre for Disease Prevention and Control will have a newly expanded mandate and Italy will have performed and analysed one of two national simulation exercises on a single scenario that will take place during 2023 to test the implementation of above-mentioned plan. The changing pandemic preparedness context, with specific reference to simulation exercises and their role in supporting effective and resilient health care systems during epidemics and pandemics, will thus also be discussed. Specific aims/objectives and component parts The workshop aims at promoting discussion among experts about the role and impact of simulation exercises for pandemic preparedness. The specific objectives are to share experiences in SIMEX implementation, discuss how to build national capacity in this field and deepen knowledge on the potential development of SIMEXs taking into account Covid-19 pandemic lessons’ learnt. The workshop will take place at a time in which the results of the first Italian SIMEX will be available, and Ministry of Health and the National Health Institute could be able to contribute to the debate also sharing preliminary results. The key questions that the workshop will address * The role of simulation exercises within the emerging global health governance landscape * Are States aware about the potential of SIMEXs in improving preparedness and readiness to emergencies? * Can SIMEX be effective in helping during an emergency? * How could SIMEX evolve in light of the Covid-19 pandemic legacy?