Pedro Gullón, Spain's director general of Public Health and Health Equity, joined regional officials and medical specialists at a meeting on the future of public health. The roundtable examined leadership by autonomous communities and coordination between administrations, two basic pressure points for the system.
The event was titled 'Dificultades y necesidades de la salud pública en España. Liderazgo autonómico y resiliencia del sistema sanitario'. It brought together officials from the national and regional levels. Specialists in preventive medicine and vaccination also attended, alongside experts in cardiology, pneumology and geriatrics.
No single reform emerged from the meeting. Instead, the discussion focused on preparedness for new health threats and the division of responsibilities between administrations. Spain's national authorities set common strategies, while autonomous communities manage and deliver much of the country's healthcare and public-health activity.
The Interterritorial Council of the National Health System (CISNS) is a central forum where the Ministry of Health and autonomous communities coordinate vaccination and other public-health recommendations before regions put them into practice locally.
That division of responsibility was at the centre of the debate. Elena Andradas, director general of Public Health for the Community of Madrid, took part, as did Ángel Gil, catedrático of Preventive Medicine and Public Health at URJC. Gil also directs the Cátedra de Novedad y Gestión Sanitaria de la URJC. Santiago de Quiroga, president of Fundamed, also attended.
Regional officials showed how the system works beyond the central administration. Antonia Elena Esteban represented the Government of the Balearic Islands. Eva Martínez attended for the Government of La Rioja. Yolanda Márquez represented the Junta de Extremadura, while Cristina Granda took part for the Junta de Castilla y León.
The panel's size was deliberate. The Ministry of Health is responsible for strategic coordination and common policy, while autonomous communities organise services and carry out many public-health measures. The Ministry and the CISNS set the national structure; regional administrations shape the pace and local coverage, as well as the logistics of delivery.
That is where the system gets tested. Autonomous communities are launching their 2026 seasonal vaccination campaigns information from their own schedules. The example shows why national goals for influenza and COVID vaccination depend on regional organisation. They also rely on effective logistics and comparable access across territories.
Vaccination and clinical prevention were discussed alongside institutional management. Jaime Jesús Pérez, president of the Asociación Española de Vacunología (AEV), joined Luis Rodríguez, former president of the Sociedad Española de Cardiología (SEC) and head of the Cardiology Service at the Complejo Hospitalario Universitario de Toledo.
Jorge del Diego, a senior adviser at the Dirección General de Salud Pública y Equidad del Ministerio de Sanidad, also participated. Carlos Almonacid, head of Pneumology at Hospital Universitario Puerta de Hierro Majadahonda, represented SEPAR on the FACME board.
The public-health debate also connects with respiratory concerns covered in earlier coverage. The roundtable took a wider view: how Spain can organise the system before new threats appear, rather than waiting for pressure to build.
Influenza and COVID vaccination show the same split in responsibility. National authorities agree on common recommendations. Regional authorities organise the campaigns and set the pace of delivery, while working to reach people.
Esther Martínez brought experience from geriatric care and vaccination. She is a geriatrician and a member of the vaccine and infections group of the Sociedad Española de Geriatría y Gerontología (SEGG). She also heads studies at the Geriatrics Teaching Unit of Hospital de la Santa Creu de Tortosa. José Javier Castrodeza, catedrático of Preventive Medicine and Public Health at the Universidad de Valladolid, moderated the second session.
Fundamed and the Cátedra de Novedad y Gestión Sanitaria de la Universidad Rey Juan Carlos organised the event, with support from CSL Seqirus. Guillermo Fernández reviewed the event in a video.
The meeting put the structure of public health at the centre of the discussion. Ability to recover depends on more than medical expertise: national and regional authorities must be able to act as one system when a new threat arrives.
At the end of September 2026, the Ministry of Health was also discussing the expansion of pharmacological abortion into primary care with autonomous communities. That issue shows that the practical division of responsibilities remains active. Regional governments are also updating long-term health plans, including measures to integrate mental health.
The challenge is practical. Spain needs coordination and common standards, backed by stable administration, to respond to new threats and maintain comparable access across regions.
