Via Eurosurveillance, an editorial: From SARS to Ebola —10 years of disease prevention and control at ECDC. As a friend of the ECDC family, I found this brief history fascinating. Excerpt:
A decade ago, the European Centre for Disease Prevention and Control (ECDC) appeared as a new player among international health organisations, with the mandate ‘to identify, assess and communicate current and emerging threats to human health from communicable diseases’ in the European Union (EU) .
As part of the ECDC 10-year anniversary celebrations, Eurosurveillance compiled a print issue with a selection of articles published over this period in the journal. The 10 articles, representing a year each, mark the organisation’s evolution and show its leadership and influence in the areas of its mandate.
The first five years
During 2005 to 2010, the focus was on developing the Centre’s core functions. ECDC officially started its operations on 20 May 2005 and in the autumn of that year, wild birds were found positive for influenza A(H5N1) virus in Croatia, Romania, and Turkey. The then newly established ECDC was asked to answer questions from public health experts and policymakers in EU Member States and the European Commission. Without having the current systems and processes, ECDC experts had to ‘build the plane while flying’.
An editorial by Nicoll in the first year shows that ECDC was, from the very start, able to strategically shape the activities needed to improve the level of preparedness – for influenza and in general – in Europe . Even retrospectively and in the light of the 2009 influenza pandemic, the answers given to the questions posed in the editorial published in 2005 still hold. Some of the issues raised have been addressed in the meantime by the Commission Decision 1082/2013 .
One of ECDC’s key tasks is to identify threats from current or emerging infectious diseases. In its second year of operations, ECDC presented a proposal to complement the traditional indicator-based surveillance, using epidemic intelligence as an early detection and warning system .
Such epidemic intelligence would take into account changes in the information sector, and pick up relevant information from sources such as traditional and social media and others, and analyse it. The proposed framework became the basis for rapid risk assessments, one of the cornerstones of the Centre’s work today and one of its most appreciated outputs.
Another ECDC core function is capacity building. The European Programme for Intervention Epidemiology Training (EPIET) was transferred to ECDC in 2007 and the article by Varela and Coulombier describes the efforts to define and agree on standards for core competencies required for epidemiologists, which still serve as foundation for this important ongoing task .
A short-term vision for surveillance of infectious diseases in the EU was presented in October 2005 to ECDC’s governing bodies and in 2008, the single EU surveillance database, The European Surveillance System (TESSy), was successfully established. EU-wide supranational surveillance is at the core of ECDC’s mandate and the start of TESSy was accompanied by a long-term strategy with challenging goals, with the aim of adding value, on top of national surveillance systems .
Even if not all goals have been achieved today, it is of note that TESSy data are increasingly used, also by non-ECDC scientists as basis for their analyses indicated by the increasing numbers of request to access TESSy data. This demonstrates the added value and that TESSy has become a point of reference for EU data on infectious diseases.
The emergence of a new disease in 2003, severe acute respiratory syndrome (SARS), together with a perceived pandemic threat, sparked the establishment of ECDC. The 2009 influenza pandemic could thus be considered its first ‘real’ test. In June 2009, early in the pandemic, an article was published with contributions from a large group of collaborators from all EU countries, demonstrating the capability of ECDC to rapidly collate and disseminate information necessary for public health action during a public health event . The article specifically pointed out two important features of the pandemic that were confirmed in several publications thereafter: the relatively mild clinical course and children and adolescents as the main groups affected by and involved in indigenous transmission.
In visits to ECDC over the past three years, I've met the remarkably dedicated professionals who work there, some of whom refer to "the pandemic" the way combat veterans refer to "the war." It was a very tough time for them, but clearly equipped ECDC to anticipate and respond to later outbreaks.