Denis Coulombier Unit for Preparedness and Response Protecting health in Europe – the European Centre for Disease Prevention and Control Denis Coulombier Unit for Preparedness and Response

Pre-ECDC capacity EU funded surveillance networks since 1999 (2119/98/EC) Well functioning within their remits, but … … uncoordinated … do not cover all diseases under 2119/98 … funding not sustainable Weak response capacity SARS, anthrax threats, pandemic flu 10 new member states

ECDC milestones July 2003: Commission’s proposal to establish ECDC December 2003: Council decision that Sweden will host the Centre April 2004: Regulation 851 establishing the Centre December 2004: Director Zsuzsanna Jakab nominated March 2005: Director takes office (start-up phase) May 2005: Centre operational October 2005: Move to own facilities at Tomteboda 2007: Evaluation of the possible need to extend the scope of the Centre’s mission

Very broad mandate Founding Regulation 851/2004/EC Close cooperation with MS and EU bodies Surveillance Risk identification and risk assessment Preparedness planning Response to health threats and events Training Communication Scientific opinions and guidelines

Public Health Stakeholders Pre-ECDC situation NSI: National Surveillance Institute MoH: Ministry of Health EC MoH EWRS ESCON DSN NSI HSC Ecdc: European Centre for disease Prevention and Control AF: Advisory Forum NSI: National surveillance institute EC: European Commission HSC: Health Security Committee EWRS: Early Warning and Response System ESCON: European surveillance Committee Network MOH: Ministry of health

Public Health Stakeholders ECDC in place EWRS EC MoH NSI: National Surveillance Institute MoH: Ministry of Health ESCON NSI ecdc DSN AF HSC Ecdc: European Centre for disease Prevention and Control AF: Advisory Forum NSI: National surveillance institute EC: European Commission HSC: Health Security Committee EWRS: Early Warning and Response System ESCON: European surveillance Committee Network MOH: Ministry of health

ECDC Staffing and Budget 2005: 29(+20) staff 5 M € 2006: 50(+30) staff 16 M € Proposal 2007: 70(+?) staff 26.5 M € 2008: 120(+?) staff 40 M € 2009: 170(+?) staff 60+20 M € 2010: 220(+?) staff 60+20 M € 2011: 270(+?) staff 60+20 M € 2012-13: 300(+?) staff 60+20 M €

ECDC Organigramme

Unit for Scientific Advice (I) Provide sound and independent technical and scientific advice Questions, guidelines, toolkits No own research capacity Well acquainted with the front-line of research in all areas of CD control Actively participate in key scientific conferences and meetings

Unit for Scientific Advice (II) Network of experts and scientists in Europe Strong on new and emerging health threats Cooperation with laboratories Support member states in national endeavours Turn policies/guidelines into action if needed Advocacy

Roster of experts Call for interest of experts, still open More than 300 applications from top scientists All will be put on roster to set up ad hoc panels to serve as individual experts Scientific panels 1 on influenza Up to 6 anticipated

Unit for Surveillance and Communication (I) Gradually coordinate/integrate surveillance networks into ECDC Review of case definitions Evaluation of DSN’s Technical assistance to MS on surveillance issues Surveillance  public health action

Unit for Surveillance and Communication (II) Set up data-bases at ECDC Receive data from DSNs Public and privileged web pages for data exchange Surveillance reports Weekly (electronic) epidemiological report Annual epidemiological report Articles in scientific journals

Unit for Preparedness and Response (I) Epidemic intelligence Keep track of emerging health threats inside and outside the EU ProMed, GOARN, GPHIN, GIDEON and other Community alert systems Timely advice on such threats Operating the Early Warning and Response System (EWRS) with a 24h/7d duty system

Epidemic Intelligence Framework Indicator-based surveillance Event-based surveillance “Surveillance” systems Event monitoring Data Events Identified risks Mandatory notification Laboratory surveillance Emerging risks Syndromic surveillance Mortality monitoring Health care activity monitoring Prescription monitoring Non healthcare based Poison centres Behavioural surveillance Environmental surveillance Veterinary surveillance Food safety/Water supply Drug post-licensing monitoring Collect Analyse Interpret Capture Filter Verify Domestic Media review EI focal points International Info scanning tools Distribution lists International agencies Signal Assess Public health Alert Disseminate Early Warning and Response System Rapid inquiries (Enternet) E-Alerts (Eurosurvelilance) Intern. Health Regulations (WHO) Threat bulletin (ECDC) WEB Investigate Control measures

Chikungunya Fever What is the risk for Europe?

This is the internal bulletin…

This is the EIWR from the EC, for which we provide EI information and contribute to produce for the commissioner

Example of Eurosurveillance alert concerning a large outbreak of Salm… posted by Spain, in liaison with ECDC.

Finally, our web site, now producing weekly update on risk assessment for influenza. Refer to Angus presentation tomorrow

Unit for Preparedness and Response (II) Provide technical assistance in outbreak investigation and response Identify outbreak assistance teams Epidemiologists Microbiologists Infection control specialists MoU with international partners (WHO) Inventory and development of response guidelines

Support to investigations of human cases of avian influenza Turkey (3 staff) Iraq (1) Azerbaijan (2)

Training activities Activities in 2005 Planned Activities in 2006-2007 Development of a training strategy document (with EPIET) Consultation of Member States Participation to training on ad-hoc basis Planning an outbreak team leader course Planned Activities in 2006-2007 Transition of EPIET Identify training needs and topics Short courses on national level Develop training materials and manuals (web based)

Matrix organisation Director and Director’s Cabinet Influenza Scientific Advice Surveillance & Communication Preparedness & Response Administrative Services Influenza Antimicrobial Resistance HIV/AIDS and other STI and bloodborne viral infections Other horizontal Working Groups and Task Forces

ECDC actions - Avian Flu Partnership with European Commission and European Food Safety Authority Identified risk groups for acquiring AI infection in Europe Produced educational material on AI Addressed meetings including first ever EU CVO and CMO Meeting Developing guidance for protecting human health around outbreaks

ECDC Actions – Pandemic Flu Monitoring and assessing the threat Providing scientific opinions Strengthening preparedness (assessment tool + country visits) Developing surveillance of seasonal, epizootic and pandemic influenza Ensuring effective communication among MS, European institutions, international partners, and especially to the public

ECDC Actions – Antimicrobial resistance Coordinate and support ongoing activities Add resistance components in all relevant surveillance networks (TB, HIV, enteric infections, etc) Harmonisation and QA of surveillance data Combine data on resistance and consumption Inventory of actions in MS Evaluate the costs of AMR Evaluate the scientific basis for intervention Develop tools and guidelines

ECDC Actions – HIV/AIDS, STI and BBV Coordinate and support ongoing activities Enhance surveillance activities Support links between surveillance and public health actions Ad hoc Scientific Panel on HIV & AIDS, STIs and blood borne viruses Inventory of actions in MS Advocacy

Scope of ECDC from 2010 First rock solid in CDs = priority 1 Review starts in May 2007 Co-decision of Council and EP needed to extend scope Even if this happens not be before 2010 5 years only for CDs If extended: gradual process starting with Health monitoring, analysis and reporting Additional resources needed

Thank you