1. 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

2. 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

3. 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

4. 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

5. 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

6. 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

7. ECDC Staffing and Budget
2005: (+20) staff 5 M €
2006: (+30) staff 16 M €
Proposal
2007: (+?) staff M €
2008: 120(+?) staff 40 M €
2009: 170(+?) staff M €
2010: 220(+?) staff M €
2011: 270(+?) staff M €
: 300(+?) staff M €

8. ECDC Organigramme

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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

16. Chikungunya Fever What is the risk for Europe?

18. This is the internal bulletin…

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

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

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

22. 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

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

24. 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
Transition of EPIET
Identify training needs and topics
Short courses on national level
Develop training materials and manuals (web based)

25. 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

26. 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

27. 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

28. 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

29. 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

30. 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

31. Thank you