A small European centre may have an important coordinating role

Education and debate p 861

In 1998 a spirited debate over how to organise surveillance for infectious diseases in the European Union culminated in the decision by the European parliament and council to create a scheme for a decentralised network rather than build a large central European surveillance centre.1^–3 According to the scheme, institutions in member states receive funding to organise European surveillance for one or more related infectious pathogens. Using an approach based on hazard analysis and critical control points, MacLehose and colleagues (p 861) studied how these national networks functioned in five international outbreaks.4 They identified seven common critical control points and concluded that the networking approach was successful but needed augmentation under a framework of improving existing organisational, financial, and legal uncertainties.

An important contributor to the networks' success is the high level of participation by the national public health institutes, probably in part because these institutions have had a role in running the networks. The networks' start up costs have been low, because existing …