European surveillance of infectious diseases: the case of AIDS and tuberculosis

In 1992, the Maastricht treaty gave specific responsibilities to the Europe an Community in the field of research, information and health education. Se veral European surveillance systems for infectious diseases have been organ ised. The surveillance of AIDS was set up in 1984 after the emergence of th is new disease. Seven western European countries participated initially. Th e system currently covers 48 of the 51 countries of the WHO European region . Based on a common case definition, it enables analysis of trends and comp arisons which considerably facilitate the understanding of the epidemic and its determinants, and the evaluation of preventive actions. European count ries have now decided to set up a reporting system for HN infection. The su rveillance of tuberculosis started in 1996 in response to the reversal of t rends in reported cases observed in western Europe and to the threat of mul ti-drug resistant tuberculosis epidemics. Common recommendations on definit ions and data collection procedures facilitated its establishment. Most cou ntries of the WHO European region participated in the first year, revealing a very heterogeneous epidemiological situation. The next objective is to s et up a surveillance system for antituberculosis drug resistance. The Europ ean surveillance of AIDS and tuberculosis are examples of systems adapted t o the specific characteristics of Europe : similarities in diagnostic proce dures, similarities in access to treatments, and common requirements regard ing both the exchange of information and the coordinated response to public health threats. They are not simply looking for a common denominator. They are creating a real momentum among participating countries towards a bette r quality and a higher level of pertinence of the information.