Good afternoon Chairman and Committee Members.
I am delighted to have this opportunity to:
- Update the Committee on the work of the European Centre for Disease Prevention and Control in 2007.
- Outline our priorities for 2008.
The ultimate aim of our scientific activities is to provide a basis for public health action – at EU level and at national level. That is why I regard my meeting with you today as so crucial.
This Committee is perhaps the single most important barometer to me of whether ECDC’s output is of value to policy makers.
And I must say, Chairman, before we proceed further, that I greatly appreciate the wealth of knowledge and expertise in this Committee and your never ending support.
What kind of agency is ECDC?
As you know, ECDC is a scientific agency of the European Union. We detect the health threats through surveillance and epidemic intelligence, we conduct risk assessments and provide scientific evidence to policy makers for a sound decision making.
But, we also have a more "hands on" side to our mandate. When we talk about "monitoring and assessing" threats to human health we do not just do this sitting in our offices in Stockholm. We regularly have epidemiologists out in the field, assessing the facts on the ground.
We had epidemiologists in Turkey in 2006 to help the authorities there assess the implications of a cluster of human cases of avian influenza in Eastern Anatolia.
Within the past few weeks a team of experts led by ECDC went to Ravenna district in Italy to assess the implications for Europe of an outbreak of chikungunya virus there.
ECDC has also assisted Member States in contact tracing passengers following incidents on international flights and contributed to the co-ordination of measures led by the Commission.
So, while part of our work focuses on population level statistics and scientific debate, we also deal with outbreaks involving EU citizens.
Work of ECDC during 2007 – key milestones
2007 has seen ECDC attaining some important milestones, both in the development of our infrastructure and in the delivery of our scientific programme.
Three developments of strategic importance that I must signal to you are:
- The adoption by our Management Board of a Multi-Annual Strategic Programme covering 2007-2013.
- The delivery in June this year of our first ever Epidemiological Report. This analysed 10 years’ worth of EU-wide data on 49 communicable diseases building on networks developed in the EU Public Health Programmes and now transferred to the ECDC.
- Agreement on the list of Competent Bodies in the Member States with which ECDC should work, and the initiation of a series of meetings with the Directors of these institutions.
The last of these developments gives us a basis for the long term partnerships we need with Member State counterparts. The first two of these developments are very much linked. The analysis we completed of the "state of communicable diseases" in the EU enabled us to identify the key challenges Europe faces. Our strategy seeks to address these.
Put briefly, our Epidemiological Report found that, for most of the diseases analysed, the 10 year trend was either stable or declining. On the whole, Member States’ public health systems are good at controlling communicable diseases.
The report identified four disease specific challenges, and some systemic challenges. The disease specific challenges are:
- The growing problem of healthcare associated infections and antimicrobial resistance.
- Rising rates of HIV.
- The continued threat from tuberculosis.
- Influenza and other acute respiratory infections.
These disease groups are priorities in our Multi-Annual Strategy. The systemic challenges we face are:
- Improving the quality and comparability of disease surveillance data in the EU. Present differences in disease incidence are as often due to differences in reporting as to differences in the "real world" situation. We work closely here with the Commission in improving case definitions, and in proposing new legally binding measures on which diseases should be covered by the Community Surveillance regime.
Addressing these systemic challenges is at the core of ECDC’s mandate. Our Multi-annual Strategy provides a long term framework for doing this.
Important activities in 2007
But I should also tell you that concrete results are already being achieved.
Most notably, in 2007:
- We are already integrating into ECDC this year the surveillance of a number of key diseases, including HIV and TB.
- From this year onward all EU-level surveillance data is being reported into a single database held at ECDC.
This will make this data easier to access and easier to analyse. It will also help to improve the data reliability and comparability.
- ECDC has built a state of the art Emergency Operations Centre from which it can support the coordination of the EU-response to multi-country incidents. Funding for this was provided by the EP, for which we are grateful.
- Dr. Ouzky will be inaugurating this Centre in November, but I can tell you it has already been used to handle some real incidents. Needless to say, our centre works closely with the Commission which coordinates measures to be taken by Member States.
- A number of scientific opinions have been produced for Member States, most recently on pre-pandemic influenza vaccines.
Other important activities in 2007 include:
- Reports on the state of preparedness against pandemic influenza in the EU and an EU/WHO Workshop on this subject held in Luxembourg last month.
- Developing, at the request of the Commission, proposals for an Action Plan against Tuberculosis in Europe. This should be ready in the coming months.
- Organisation of the European Conference of Applied Epidemiology and Infectious Diseases, in Stockholm 18-20 October.
- A lunch debate we are organising in Brussels with John Bowis MEP on 16 October on how to raise awareness of the issue of antimicrobial resistance.
- An expert meeting on how climate change will influence infectious diseases in the EU.
- Development of new Case Definitions on the 49 communicable diseases that are notifiable at EU level.
- Development of a long term Strategy on Disease Surveillance in the EU.
Finally, I am pleased to report that the first stage of the review of ECDC is underway. Terms of reference for an independent evaluation of ECDC were agreed with our Management Board before the summer.
Following a successful call for tender, a contractor has been appointed to conduct the evaluation, and they started work last week.
Emerging threats - Chikungunya
As I said earlier, part of our mandate is to respond to public health incidents and events which also helps us to update risk assessments with information from the ground. These cannot really be programmed in advance.
Chikungunya is a mosquito born disease that causes fever and aching joints. It emerged in Africa and, since 2005 it has spread across the Indian Ocean region into India and South East Asia.
Local transmission of Chikungunya virus is occurring in the EU for the first time, since August 2007. This follows its introduction into the province of Ravenna, Italy by a traveller returning from India.
A team of experts led by ECDC visited the province of Ravenna last month. It concluded that the transmission could spread or be introduced in the coming months in areas of the EU where the tiger mosquito, the vector for Chikungunya virus, is known to be present. These areas include most of the Adriatic coast and some other coastal areas of the Mediterranean.
The emergence of such threats is clearly a challenge needing European and international coordination. ECDC will hold an expert meeting on the possible spread of Chikungunya in the coming weeks and will give advise on how best to proceed to control the disease.
ECDC Work Plan for 2008
Let me end by saying a few words about our work plan for 2008. The Centre will continue to expand its staff and its infrastructure in 2008 – we hope to have recruited nearly 300 people by the end of the year.
Key projects for us in 2008 will include:
- Assisting the Member States and the Commission in implementing the new International Health Regulations.
- Planning the development of enhanced surveillance for several diseases including Hep. B and C.
- Development of a module that will make the detection of outbreaks throughout the region easier.
- A report on migration and infectious diseases.
- Development of a new website with multi-lingual content and offering access to key EU-wide surveillance data, disease facts and scientific advice.
- Initiatives to help Member States raise awareness of the issue of antibiotic resistance, and the need to use antibiotics wisely.
Chairman, ladies and gentlemen, I have set our progress achieved in the past several months and our plans for the future.
There is much good work that we can do together and I look forward to see continued co-operation and collaboration between the ECDC and the ENVI Committee of the Parliament. I am happy to come and report back to you on any item in our mandate when you so require.
Thank you for your attention. I look forward to hearing your questions and comments.
ANNEX – Some key facts from the ECDC Epi Report
Some 700,000 people in the EU are thought to be living with HIV. ECDC estimates that around 30% of these people are unaware that they are infected.
While the incidence of TB in the EU is low by international standards, rates of infection have increased among certain vulnerable groups. These include HIV/AIDS infected persons and people of foreign origin. In addition, some EU countries are reporting a high rate of cases of drug resistant TB. In the Baltic States 18% of TB cases are from drug resistant strains (1).
Every year, around three million people in the European Union catch a healthcare-associated infection, of whom approximately 50,000 die.
EU-wide incidence of Chlamydia has risen from less than 50 per 100,000 in 1995 to nearly 100 cases per 100,000 in 2005.
200,570 cases of Campylobacteriosis were reported in the EU in 2005. Though the incidence has fallen from over 50 cases per 100,000 in 2002 to 45.5 cases per 100,000 in 2005, it is still significantly higher than it was in 1995 (less than 30 per 100,000).
(1) This compares to 0% to 6% in other EU countries