Protecting health in Europe – the new European Centre for Disease Prevention and Control Denis Coulombier ECDC 2005

Health threats in Europe – 21st century challenges New threats emerge SARS, pandemic flu, WNV, antimicrobial resistance Old diseases reemerge HIV/AIDS, STI, TB, food borne diseases Threat of bioterrorism EU without borders: free movements of goods and people Diseases spread within hours in a globalized and interconnected world ECDC 2005

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 2005

ECDC milestones (I) July 2003: Commission’s proposal to establish the Centre December 2003: Council decision that Sweden will host the Centre April 2004: Regulation 851 establishing the Centre September 2004: 1st meeting of Management Board with international launch December 2004: Director Zsuzsanna Jakab nominated March 2005: Director takes office (start-up phase) May 2005: Centre operational ECDC 2005

ECDC milestones (II) 2005-2006: Building up the centre Staff Networking Operations 2007: Evaluation of the possible need to extend the scope of the Centre’s mission ECDC 2005

What kind of ECDC Small but very well-connected Spider in the web An expert institution that makes a difference A one-stop-shop for CD information and advice An important player on the global arena Moving fast even faster than ambitious Work Programme ECDC 2005

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 ECDC 2005

Organisation Director Advisers, info Chief scientist -- Unit for Scientific Advice Unit for Surveillance & Communication Unit for Preparedness & Response Management & Administration ECDC 2005

Matrix organisation Horizontal, matrix type of projects in priority areas Influenza Antimicrobial resistance HIV/AIDS and STI Zoonoses ECDC 2005

Horizontal projects (I) Pandemic and avian influenza Monitoring and assessing the threat day-by-day Strengthening European and country preparedness (assessment tool + country visits) Developing surveillance of seasonal, epizootic and pandemic influenza Teleconferences with all stakeholders Monitoring scientific development, providing scientific opinion and promoting scientific issues Advocating for pandemic influenza preparedness Developing tools and guidelines Supporting MS for investigation and response Coordinating risk assessment activities in the event of a pandemic influenza or an avian influenza public health crisis Developing partnership ECDC 2005

Horizontal projects (II) Antimicrobial resistance Coordinate and support various 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 2005

Unit for Scientific Advice (I) Provide sound and independent technical and scientific advice Well acquainted with the front-line of research in all areas of CD control Actively participate in all key scientific conferences and meetings Network of experts and scientists in Europe Inventory of resources Build on the scientific competence and experience within the NSI and DSNs ECDC 2005

Unit for Scientific Advice (II) Set up independent advisory panels and initiate studies Cover all categories of CDs listed in Decision 2119/98/EC and develop guidelines and other tools Be strong on new and emerging health threats including antimicrobial resistance Support member states in national endeavours ECDC 2005

Unit for Scientific Advice – Work Plan 2005 (I) Operating procedures and ToRs in place Rules for answering scientific questions ToR for Scientific Panels Scientific Panels operational Six panels with 11 members each agreed on Support staff for panels First meeting of Panels Collaboration with laboratories Clear guidelines for how ECDC will cooperate with EU labs ECDC 2005

Unit for Scientific Advice – Work Plan 2005 (II) Collaboration with learned societies to secure scientific input OP for cooperation with learned societies ECDC guidelines on specific diseases/issues Priority list OP for producing guidelines Sample guideline Internal weekly summaries of new scientific findings ECDC 2005

ECDC with no laboratories Build on what already exists in Member States to avoid duplication Support MS response capacity by always knowing where appropriate lab. capacity is located Ensuring microbiological expertise through secondments and short-term positions Build up a system of reference labs ECDC 2005

Unit for Surveillance and Communication (I) Gradually coordinate/integrate surveillance networks into ECDC Incorporate technical aspects of surveillance components of DSN into the Centre Promote an increase in coverage and effectiveness of the surveillance networks as well as quality control Technical assistance to MS on surveillance issues ECDC 2005

Unit for Surveillance and Communication (II) Avoid all duplicate reporting Data standardisation and comparability Denominators Harmonisation of laboratory methods Further integration of sub-typing data Surveillance  public health action Surveillance  Research Alternative surveillance systems ECDC 2005

Unit for Surveillance and Communication (III) Public and privileged web pages Surveillance reports Weekly (electronic) epidemiological report Annual epidemiological report Articles in scientific journals Risk communication strategy for target groups ECDC 2005

Road map for future surveillance 2005 Agreements on data access Consultation process Technical systems for storing/accessing data Strategy document (several steps) 2006 Build close links to the BSN Detailed evaluation of networks (SURVEVAL) 2007/2008 (as present network contracts ends) Full coordination of all surveillance activities ECDC 2005

Surveillance and Communication Work Plan 2005 (I) Development of a surveillance strategy Site visits in 10 MS + Commission Web based questionnaires to all MS and learned societies Strategy document presented to MB Integrated operations of networks Inventory of set-ups of networks Re-establishment of the Network Forum Agreements for database access and database transfers ECDC 2005

Surveillance and Communication Work Plan 2005 (II) Surveillance data bases at ECDC Contract with IT company to develop specification for integrated/combined data bases Liaise with IT persons of surveillance networks regarding characteristics of network databases Acquisition of hardware/software for databases ECDC 2005

Surveillance and Communication Work Plan 2005 (III) Preparations for evaluations of networks General protocol for evaluation with disease-specific aspects Zoonoses report Data base of BSN adjusted to fit zoonoses report (human data) Data flow from MS tested in a dummy run in preparation of zoonoses report in 2006 ECDC 2005

Unit for Preparedness and Response (I) Keep track of emerging health threats inside and outside the EU ProMed, GOARN, GPHIN, GIDEON and other Community alert systems Have the organisation and capacity for timely advice on such threats Assist the Commission by operating the Early Warning and Response System (EWRS) with a 24h/7d duty system ECDC 2005

Unit for Preparedness and Response (II) Provide technical assistance in outbreak investigation and response Identify outbreak assistance teams (OAT) Identify and mobilize lab capacity Training activities (follow-up of EPIET) Memorandum of understanding with international partners (WHO) Inventory and development of response guidelines ECDC 2005

Unit for Preparedness and Response – Work Plan 2005 (I) Improved preparedness to tackle PH crises Pandemic preparedness assessment tool Outbreak assistance teams mechanisms in place Training module on Outbreak Assistance Team coordination Intervention kits for outbreak assistance teams ECDC 2005

Unit for Preparedness and Response – Work Plan 2005 (II) Improved detection of emerging threats in Europe Threat tracking tool (3T) Weekly threat monitoring bulletin Annual report on emerging threats EWRS operated by ECDC Meeting with MS on epidemic intelligence ECDC 2005

Unit for Preparedness and Response – Work Plan 2005 (III) Improved coordination of risk assessment and support during PH crisis Crisis room operational Internal public health crisis operation plan External public health crisis operation plan Improved country capacity for CD surveillance and response Capacity strengthening policy developed ECDC 2005

ECDC role in outbreaks Outbreak in 1 MS ECDC may be invited by MS to assist Co-ordinate EU risk assessment and response (if EU threat) Outbreak affecting more than 1 MS Coordinated approach to investigation and response Cooperate closely with other EU agencies Ensure proper communication through the network, with the Commission and the public Offer assistance ECDC 2005

Outbreaks outside the EU Risk assessment Potential to spread to MS Need for co-ordinated preparedness and response Recommendations to MS and Commission Support to response upon request from WHO-HQ, through GOARN, by mobilizing EU expertise WHO-EURO for non-EU European countries Countries if perceived added value for EU ECDC 2005

ECDC Staffing and budget 2005: 29 staff 5 M € 2006: 50 staff 16 M € + 3 M € Proposal 2007: 70 staff 41 M € 2008: 120 staff 80 M € 2009: 170 staff 80 M € 2010: 220 staff 90 M € 2011: 270 staff 90 M € 2012-13: 300 staff 90 M € ECDC 2005

Scope of ECDC ECDC will commission independent external evaluation in May 2007 of its achievements; The evaluation will also assess: The possible need to extend the scope of the Centre’s mission to other areas of public health, such as health monitoring Timing of further reviews ECDC 2005

Key message ECDC could only be strong if built on strong European networks and ideas ECDC will provide needed services and give a clear added value to the European CD control ECDC will channel the best available resources (own and others) to where they will be best needed ECDC 2005