European centres for disease control

The European Centre for Disease Prevention and Control: hub or hollow core?

The European Centre for Disease Prevention and Control (ECDC) is the small agency established by the European Union (EU) to act as a hub for disease control, drawing on networks across the continent to achieve what other political systems do with large agencies. Despite this important task, the agency is largely unstudied. This article examines the ECDC from different angles, focusing on whether it can become the center of the networks that monitor, control, and prevent contagious diseases in Europe. The essay first retraces the events that led up to the ECDC's creation, focusing on the combination of policy debates about EU actions, political initiatives, and crises such as SARS that led to its creation. It then presents an overview of ECDC activities. The article concludes by examining the ECDC's prospects in light of its ability to secure its future through multiple political connections and a reputation for unique and useful advice. Insofar as it can do that, it will be able to contribute to the development of the EU and European public health.

A hard lesson for Europeans: the ASEAN CDC

Despite the growing threat of major pandemics, the European Union is planning no more than a meager surveillance agency staffed with 70 people on the 2007 horizon: the new European Centre for Disease Control. I argue that an effective structure should be much larger and include a strong research activity. Asian countries, inspired by the US CDC, are now taking this concept in hand and creating an ASEAN Center For Disease Control, with sophisticated laboratory facilities to be included. This is a tough lesson for us Europeans, and our avarice in this domain could have tragic consequences in the future.

Responding to the challenge of communicable disease in Europe

In the 1960s and 1970s, communicable disease seemed a minor threat, but since then the emergence of new infections and the reemergence of old diseases has provoked a renewed focus on European communicable disease surveillance and control. A "network approach" among European countries has been successful in detecting some international outbreaks, but management and funding aspects remain unresolved. Surveillance outside the European Union has faced new challenges as a result of economic and political change following the collapse of communism. Subsequently, innovative international surveillance schemes are currently being implemented in the countries of Central and Eastern Europe and the former Soviet Union. The challenge for surveillance in Europe is to ensure that it has the capacity to meet both the needs of today and the diseases of the future.

Integrated genetic epidemiology of infectious diseases: the Chagas model

Genetic typing of pathogenic agents and of vectors has known impressive developments in the last 10 years, thanks to the progresses of molecular biology, and to the contribution of the concepts of evolutionary genetics. Moreover, we know more and more on the genetic susceptibility of man to infectious diseases. I propose here to settle a new, synthetic field of research, which I call 'integrated genetic epidemiology of infectious diseases' (IGEID). I aim at evaluating, by an evolutionary genetic approach, the respective impact, on the transmission and pathogenicity of infectious diseases, of the host's, the pathogen's and the vector's genetic diversity, and their possible interactions (co-evolution phenomena). Chagas' disease constitutes a fine model to develop the IGEID methodology, by both field and experimental studies.