“Open borders, changed lifestyles and eating habits make it inevitable that communicable diseases will play an even more important role in the future,” says Richard Coker, professor of public health at the London School of Hygiene & Tropical Medicine. “Since 1973 no less than 50 new communicable diseases have been identified, among them epidemics such as the West Nile Virus and SARS. And there are more to come.”
Martin McKee of the European Observatory on Health Systems & Policies stresses that although potential pandemics like the New Flu (Swine Flu) deserve considerable attention, the biggest threats are at the borders of the European Union. “There are numerous communicable diseases in the area of the former Soviet Union, the Balkans and the Maghreb countries, and it will be an enormous challenge to keep these out of the European Union. This battle is even harder and more important than the action to be taken against pandemic threats such as the current “New Flu.”
Both Coker and McKee agree that the EU has massively improved its preparedness for communicable diseases over the past few years. Nevertheless, the experts demand further improvements:
• Better surveillance at the level of the member states: many of the member states are far from achieving the level of surveillance quality like the Scandinavian countries, the UK or the Netherlands.
• Monitoring outside the EU: while the EU monitors the situation in its territory fairly well, monitoring activity outside the EU, especially at its doorsteps in the East and Southeast, must be intensified in order to identify new threats quickly.
• Linking the monitoring of human and animal disease: as a majority of communicable human diseases have their origins in animal diseases, monitoring and research in both fields must be better linked.
Rifat Atun, professor of international health at Imperial College London and director of strategy at the Global Fund, the largest international institution financing health programmes, demands “more than surveillance. It is action and responsibility that count. The new rise of HIV infections and multi-drug-resistant tuberculosis (MDR TB) in Eastern Europe are an especially big threat for the European Union. “The economic growth of these countries makes them ineligible for funding from the Global Fund, but there are no tools available to replace our expiring programmes. It is imminent that the EU create these tools for some of its new member states as well as for neighbouring countries in order to prevent major setbacks in the prevention of communicable diseases on its own territory.”