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Remember these masks? In 2003, they were synonymous with the presence of SARS, Severe Acute Respiratory

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Syndrome, which appeared in China and spread very rapidly to other regions of the world,

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affecting more than 8,000 people, of whom more than 800 died.

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The SARS case a few years ago showed the public health community around the globe, not only

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in Europe, that we should be aware that something happened in China and Vietnam could easily

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spread to Europe, to Canada, to the United States.

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SARS highlighted the need to strengthen international cooperation to fight transmissible diseases.

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Europe drew lessons from that and created the European Centre for Disease Control and

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Prevention, the ECDC. This Stockholm-based centre is charged with monitoring the evolution

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of transmissible diseases in order to help EU countries to react more quickly and more

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efficiently. Today, it's influenza which is the focus of the centre's attention.

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If the famous H5N1 virus originating in birds were ever to mutate and become transmissible

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from human to human, a worldwide pandemic would break out, with potentially catastrophic

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consequences.

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You have to notice and realise that hundreds of thousands of human lives and a huge disturbance

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of the whole society has occurred, even in a mild pandemic. And we don't know whether

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the next one will be a mild or a more severe one, nobody really knows, and nobody really

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knows the timing. But we have to get prepared because through the preparation we can save

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hundreds of thousands of lives.

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This is Utrecht in the Netherlands. It's home to an ECDC partner called the European Influencer

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Surveillance Scheme, EISS. Being prepared to fight a pandemic means above all monitoring

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seasonal flu. This network covering 28 countries does this and, with its statistics, can point

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to any unusual seasonal influenza events.

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The main advantage of the current surveillance system is that it's community-based. That

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means you're sampling from patients, just the general population, patients who go and

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see their general practitioner. So if there is flu out there, a pandemic virus, there's

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a high probability that if it's circulating in the population that we will catch it.

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For 10 years, the backbone of the EISS' network has been general practitioners across Europe.

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More than 12,000 of them monitor their patients and send off data every week, which allows

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the EISS to publish a weekly bulletin on its site.

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Surveillance is all very well, but if it's combined with a rapid response it's even better.

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This is Luxembourg, where a system called EWRS, Early Warning and Response System, connects

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the member states, the European Commission and the ECDC. Its main mission is the rapid

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exchange of information on the outbreak of communicable disease. Its second one is to

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offer an efficient reaction capability. For example...

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If there is a threat, immediately we take action. We contact the member states in question,

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for example, when there was this Lassa patient discovered in Germany who came from Africa

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with a flight via Brussels to Frankfurt. We immediately contact the German and Belgian

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authorities and the ECDC in Stockholm. We agreed on what needed to be done. We contacted

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the airlines to receive the list of passengers and we organized the tracing of all the patients,

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all the passengers in all the member states to care for them appropriately.

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Back to Stockholm and the ECDC. Being prepared to withstand a pandemic is not only a question

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of monitoring the outbreak of the disease, assembling all the data from each member state,

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evaluating the risk of an outbreak and supplying reliable scientific information. It also means

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coordinating action on the ground.

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If a country decides to adopt such a measure, it mustn't contradict a measure taken in another

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country. The preparatory work is really to arrive at a consensus on which approach to

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take.

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This workshop organized by the ECDC brings together health officials working in health

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authorities from EU countries. There are two points on the agenda. The first is the exchange

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of best practices in order to improve the preparedness of each of the member states.

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If some countries are acting differently, you have to try and understand why are they

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acting differently. Is it the best way? Right? So it's better be informed beforehand, try

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to see how you could reach some consensus on ways of operation.

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The second point is interoperability. Because health measures are decided at national level,

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it's important to understand how health decisions taken by one country can affect the others.

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The classical example of that is people saying, oh, well, we should shut borders, which is

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an idea which is intuitive, but we know will not stop influenza. But we've had countries

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who are pointing out that if you shut the border, let's say, for example, around Luxembourg,

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health services will stop, because 45% of the people who work in the hospitals in Luxembourg

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come from other countries.

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The EU countries have pandemic preparation plans for the worst-case scenario, with half

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of the population that could fall ill. But they all tackle the same issues. Preparation

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of hospitals, information of the population on the best measures to protect themselves,

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distribution of antivirals and vaccines. As the crisis may cause major economic disruption,

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the plans are very broad.

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There's a plan and there's a structure and a framework which takes in all aspects of

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society, not just health. In medical terms, I suppose you could use an analogy and say

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that rather than treating the disease, we treat the whole person sitting in front of

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us. So rather than treating this as a health sector problem, we're treating it as a whole

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society problem.

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Very rapid access to medicine will be key to contain the outbreak. This is why stocks

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of antivirals are being made and efforts undertaken to produce more vaccine doses more quickly.

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We've had discussions with our experts so that all of the interested parties are working

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together to take the products forward in a speedy way. But one of the most important

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issues is to make sure that we have safe, efficacious and good quality products on the

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market.

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The European Medicines Agency in London is working on shortening the approval periods

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for the marketing of vaccines and antivirals. Although this procedure takes 70 days at the

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moment, it could be reduced to three days in case of a pandemic. With all these different

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instruments and efficient interaction between them, Europe is combining all its forces.

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Only a global, coordinated response will be efficient enough to fight a pandemic, because

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after all, a virus knows no frontiers.