Strengthening capacity to control communicable diseases

This strategy features in the framework of Agenda 21 as formulated at UNCED (Rio de Janeiro, 1992), now coordinated by the United Nations Commission on Sustainable Development and implemented through national and local authorities.

Agenda 21 suggests that national and regional training institutions should promote broad intersectoral approaches to prevention and control of communicable diseases, including training in epidemiology and community prevention and control, immunology, molecular biology and the application of new vaccines. Health education materials should be developed for use by community workers and for the education of mothers for the prevention and treatment of diarrhoeal diseases in the home.

The European Commission adopted (22 December 1999) two important decisions concerning the setting up of an early warning and response system for communicable diseases. Terms of action are now clearly defined and communicable diseases and special health issues identified. The system will be run by the European network for the epidemiological surveillance and control of communicable diseases which was which was set up in 1998. The network focuses on the permanent surveillance of tuberculosis, travel associated legionnaires' disease, AIDS and HIV, human salmonellosis and the bacteria E.coli O 157. This list has now been extended to include a range of other diseases. The first decision clearly identifies the "terms of action" that will be dealt with by the early warning and response system of the Community network. These are "events", which by themselves or in association with other similar events, are or have the potential to become public health threats. The decision furthermore describes the procedures for information, consultation and co-operation under the early warning and response system. The second decision identifies the communicable diseases and special health issues which have to be covered by epidemiological surveillance in the Community network. The network will progressively cover, amongst others, influenza, hepatitis A, B, C, malaria, other diseases preventable by vaccination – e.g. diphtheria, measles, mumps, sexually transmitted diseases, food and water-borne diseases and diseases of environmental origin, diseases transmitted by non-conventional agents (e.g. Creutzfeldt-Jakob-disease) air-borne diseases, zoonoses, serious imported diseases e.g. cholera, plague. The growing resistance against antibiotic agents will also be observed attentively by means of the European network. This will contribute to ensure timely reaction on this major threat for human health through guidance to health professionals and the public and adaptation of legislation to scientific findings.