Diseases thrive on 27 systems

Differing health systems and data collection rules across the EU are making it hard to identify serious health risks, according to Zsuzsanna Jakab, director of the European Centre for Disease Prevention and Control (ECDC).

A first-ever ECDC report on infectious diseases in Europe, published last Thursday (7 June), showed that over the past decade although EU health has generally improved, illnesses including HIV and syphilis are still on the rise.

Jakab said that it was difficult to know which countries faced the highest level of disease, or to offer advice on the best way to reduce risk, because of the differences between 27 national health systems.

"It is absolutely clear that we have to move on to a more standard approach," Jakab said in an interview. "The data is not always comparable across the EU."

She said there was no question of taking away national responsibility for healthcare, but that standardised EU health data guidelines could save lives.

"This is clearly an issue that should be discussed by national ministers," said Jakab. "The ECDC is working with the European Commission to agree what data should be collected and submitted in future."

She said that ideas for a standard data collection procedure would be sent to a Health Council meeting when they had been agreed with the Commission, hopefully within the next year.

If data on key diseases was submitted according to standard rules, she said, it would be easier to compare trends and pinpoint areas where action could be taken.

"Communicable diseases, by their very nature, cannot be solved at country level," Jakab explained. "They have to be tackled at EU level."

The ECDC study has raised particular concern in countries reported to have the highest levels of antibiotic-resistant ‘superbugs’, including those known as MRSA. People sent to hospital in Portugal, Malta, Cyprus, Romania and the UK were found to be up to 20 times more likely to contract an antibiotic-resistant disease than patients in Nordic countries and the Netherlands.

But Jakab said the ‘high risk’ MRSA countries might just be reporting disease incidence more accurately than their neighbours.

"It is absolutely possible that the ‘worst’ countries are actually doing best," she said. "They may just have the most efficient data-collection methods. This is the sort of thing we need to find out."

Jakab said the ECDC hoped to publish its second communicable disease report in five years’ time, when a more co-ordinated system should have been agreed.

Before then the Stockholm-based agency plans to publish several disease-specific analyses and guidelines each year. Jakab said that hospital infections like MRSA would be the subject of one of the first.

She added that a study on HIV, the virus leading to AIDS, was also likely to be published soon. This month’s report estimated that 700,000 people in the EU today have HIV and that 30% of them are not aware that they are infected.

Jakab said a change was needed in European HIV monitoring systems. At the moment, in line with World Health Organization (WHO) recommendations, HIV tests can only be carried out in Europe with the patient’s consent, ruling out the possibility of making them part of any standard blood test.

The US last year introduced new rules allowing doctors to test for HIV unless the patient has specifically asked them not to. Jakab said the ECDC was examining the US and WHO approaches and considering whether new EU recommendations were needed.

Differing health systems and data collection rules across the EU are making it hard to identify serious health risks, according to Zsuzsanna Jakab, director of the European Centre for Disease Prevention and Control (ECDC).