INTRODUCTION: The European Air Transport Command (EATC) is a seven-nation integrated command. One of its core capabilities is strategic aeromedical evacuation (AE). During the global COVID-19 pandemic and Ukrainian crisis, EATC proved that acting in concert is a valuable, effective, and reliable option.

METHODS: By pooling and sharing aircraft and personnel, EATC has privileged access to a diverse fleet and pool of experts. Cooperation is based on a common set of rules and regulations, which ensures that EATC can address any problem with expertise.

RESULTS: During the COVID-19 pandemic, 1060 COVID-19-positive patients were transported in 198 missions, with neither death nor disease transmission reported during those strategic AE flights. EATC transferred 986 military cases, mostly routine priority (91.4%); the other 74 cases were civilians, who were transported in 17 missions, with 81.1% categorized as urgent. During the Ukrainian crisis, 251 patients were transported, 112 military and 139 civilians, including 30 children. Among the recorded injuries were cerebrocranial, abdominal, and chest injuries, as well as fractures (180) and amputations (48) of the extremities.

DISCUSSION: EATC is recognized as a center of expertise within the AE community, where interoperability and harmonization of concepts are key to safety and success. Cross-national missions, where a patient is evacuated by an aircraft and medical crew provided by another nation, offer maximum flexibility. Complex situations, such as the COVID-19 pandemic and the Ukrainian crisis, have shown that multinational cooperation is not only achievable but also provides robust, effective, and reliable solutions for AE in particular.

Fiorini A, Vermeltfoort R, Dulaurent E, Hove MG, Borsch M. Cross-national strategic aeromedical evacuation at the European Air Transport Command. Aerosp Med Hum Perform. 2024; 95(9):709–715.