Public health: European Centre for Disease Prevention and Control ECDC

PURPOSE : to establish the European Centre for Disease Prevention and Control. CONTENT : this Communication discusses the significant threat to the health of EU citizens through outbreaks of communicable diseases. It cites the recent spread of the SARS virus and the anthrax alerts of 2001, as well as multi-resistant tuberculosis and HIV/AIDS. Communicable disease has always been one of the major threats to human health. What has changed in the past few years is the realisation that natural outbreaks of communicable disease can threaten both technologically advanced regions of the world such as the EU as much as developing regions. A communicable disease outbreak could be started deliberately ("bio-terrorism"). In our increasingly interconnected and global world, a disease outbreak in one country can be spread internationally in a matter of hours or days. This proposal aims at creating a European Centre, able to provide a structured and systematic approach to the control of communicable diseases and other serious health threats, which affect EU citizens. The creation of a European Centre for Disease Prevention and Control, an independent European agency, would mobilise and significantly reinforce the synergies between the existing national centres for disease control. The Centre would provide EU policy makers and citizens with authoritative and independent scientific advice on serious health threats and recommend control measures, thus enabling a rapid and effective EU-wide response. The technical work to be conducted between national disease control centres requires shared ownership of objectives, tasks and operations and pooling of resources at EU-level. The European Centre would create this shared ownership and facilitate the joint use of skills and resources to discharge common responsibilities in fighting serious health threats. The Commission would maintain its' overall supervision and existing decision making powers under Decision 2119/98/EC, in close consultation with the Member States through the Network Committee. The Commission's memberships in the Management Board would also ensure the coherence of the Centre's work with other Community policies dealing with health issues (e.g. development aid, research) and with international organisations, such as the WHO. The main tasks of the European Centre will be as follows: - epidemiological surveillance and networking of laboratories at European level : in this work, the Centre could either use its own staff, staff from the dedicated surveillance networks (DSN), or it could subcontract tasks to a national centre of excellence. This gradual integration of epidemiological surveillance will lead to the harmonisation of surveillance methodologies, including better comparability and compatibility of the surveillance data collected in the Member States. The Centre could also identify and maintain networks of reference laboratories, and enhance the quality assurance schemes of microbiological laboratories; - scientific opinions : the Centre will support the Commission and Member States by providing independent scientific evidence. If there is insufficient scientific expertise in the Centre, or in the disease surveillance networks, the Director may, in consultation with the Advisory Forum, set up independent scientific panels for this purpose drawn from recognisedscientific authorities and academia; - early warning and response : to be effective the early warning and response system (EWRS) requires around the clock availability of specialists in communicable diseases. Whilst the responsibility for action will remain with Member States and the Commission, technical operation of the EWRS would be undertaken by the Centre and its networks; - technical assistance : when requested, the Centre would send an EU-team to investigate an outbreak of an unknown human disease in a European country. The Centre should also have the ability to support, if necessary those Commission services that give humanitarian aid or other types of assistance in response to disease outbreaks in third countries; - emergencies and communication : the Centre should have a major role in coordinating the response to serious health threats of EU-wide significance. The need for co-ordinated action is of pivotal importance, taking into account all the actors involved in emergencies. Public health authorities, civil protection, the military and civil society may all need to be involved in responding to an epidemic. Considering the relatively small size of the Centre, however, it will only be able to take on such a coordinating role where the health threat is of direct relevance to its operational goals. With regard to staff and size, the Centre would remain small in terms of human resources, but possessing a far larger influence through its synergy with national institutes. The staff will include relevant specialists, such as epidemiologists, public health experts, microbiologists, logisticians and medical writers, as well as administrators. The Centre will be funded from the Community budget. Total annual costs in the beginning of its operation would be around EUR 12 million and after five years around EUR 48 million. Within this budget, in addition to its normal running costs, the Centre should have an appropriate contingency budget of up to EUR 5 Million to enable it to respond speedily to public health threats. The Centre should also have a consultative role in providing scientific advice in crises, such as in an influenza pandemic, where public health is involved. As with other similar independent Community agencies, the Centre will have a three pillar administrative structure: - a director and his/her staff; - a Management Board will ensure that the Centre carries out its missions and tasks, by adopting its annual work programme and financial regulation. The structure of the Management Board - representatives appointed by the Commission, representatives appointed by the Council, and representatives of stakeholders - is intended to provide supervision of the activities of the Centre and ensure coherence with action under Community policies and national initiatives. - an Advisory Forum, which will be composed of members chosen from senior scientific personnel form the national competent bodies. FINANCIAL STATEMENT : - Budget lines - for the purposes of creating the Centre, two new operational budget lines are needed to cover subsidy of administrative (Titles I and II) and operating (Title III) expenditure. As subdivisions of chapter 17 03, these new budget lines could be designated items 17 03 01 and 17 03 03 02respectively. - Total allocation of action for the start up period until the year n+2: EUR 47.835 million for commitment. - Period of application: Start 2005. - Overall multiannual estimate of expenditure: Subsidy of operational expenditure (Title III budget line 17 03 03 02): Total years EUR 30 658 (CA) EUR 30 658 (PA). - Subsidy of administrative expenditure (Titles I and II): A subsidy of EUR 4.753 million will be required for the first year of operation. Of this EUR 1.215 million will be personnel costs. The number of staff will be 35. For the second year, the subsidy is EUR 14.303 million. For the third year, it is EUR 28.779 million.�