Understanding the Systems for Epidemiology and Surveillance of Infectious Diseases in the Baltic Sea Region

 1 Published: 14.05.04 Updated: 29.07.2004 10:59:51
Lars Blad, Project Co-ordinator «Building a Network for Infectious Disease Surveillance in the Baltic Sea Region»

The aim of an international meeting held in Moscow on June 5-6, 2003 was to initiate further discussions on the differences and similarities between the systems for infectious disease surveillance and epidemiology in the Baltic Sea Region.

The meeting was one of the activities of the Task Force on Communicable Diseases in the Baltic Sea Region, Project 211 «Building a Network for Infectious Disease Control in the Baltic Sea Region», financed by the Swedish Foreign Ministry. It was proposed at a meeting in Berlin in October 2002 that Victor Maleyev of Russia and Lars Blad of Sweden proceed with preparations for a meeting addressing surveillance systems. Discussions concerning format and themes were held at the Central Research Institute of Epidemiology (CRIE) in Moscow in February 2003 and, following a meeting of the State Epidemiologists of the Baltic Sea Region in Stockholm, the decision was taken to support and participate in meeting comparing surveillance systems. Lars Blad made further preparations and contacts during a two-week visit to the Russian National Institute of Epidemiology in March-April 2003.

Financial support for the direct costs of the meeting was provided by the Task Force Secretariat. The meeting was held at the CRIE in Moscow, the leading academic institute in the field of infectious disease epidemiology in Russia.

The Russian participants represented the highest level of Russian epidemiology, with participants from the Ministry of Health, the Directors of the two central Russian institutions of infectious disease epidemiology (Federal Centre for Sanitary-Epidemiological Surveillance, FCGSEN, and the CRIE), and the National Centres for AIDS, TB and STD. In addition, representatives from the Russian Federation North-West Regional Sanitary-Epidemiological Centres, the Moscow Centre of SanEpid Services, and Pasteur Institute of St Petersburg also participated. The WHO Director General Special Representative Office in Moscow, the WHO Europe Office of Copenhagen, and the EU Commission were also represented. State Epidemiologists represented the Nordic Countries, and corresponding expertise participated from Latvia and Germany.

The Director of CRIE, Valentin I. Pokrovsky, President of the Russian Medical Academy of Science, and Ambassador Harald Siem, Head of the Task Force Secretariat opened the meeting.

A broad overview of the infectious disease situation in Russia was given by the First Deputy Minister of Health, Gennady G. Onishenko, and a corresponding overview of the situation in all the countries around the Baltic Sea was presented by Preben Aavitsland, State Epidemiologist of Norway.

Presentations and discussions addressing the similarities and differences between surveillance systems in Russia and other countries in and neighbouring the Baltic Sea Region included the following topics:

  • Organisation and systems of infectious disease control
  • Principles of infectious disease control for various important diseases
  • International co-operation in infectious disease control
  • Basic concepts and methods of epidemiology
  • The link between epidemiology and operative health care

The meeting was summarised by Benyamin L. Cherkassky of the CRIE and Ambassador Harald Siem of the Task Force Secretariat. The need for continued and deepened discussions for further mutual understanding was emphasised.

Excerpts from the meeting:

Infections know no borders. Travelling today is faster and pathogens spread more rapidly, as the recent SARS epidemic has demonstrated. Accordingly, there is an increasing worldwide interest in epidemiological surveillance networks and early warning systems. On the global level, WHO leads the way, while in Europe various EU networks have been established. Another small-scale initiative is the project «Building a Network for Infectious Disease Surveillance in the Baltic Sea Region», under the Task Force on Communicable Disease Control of the Council of the Baltic Sea States, with its Early Warning System «What's New in the Baltic Sea Region?». Through this project involving senior epidemiologists from the 11 member countries (Russia, Poland, Germany, Estonia, Latvia, Lithuania, Finland, Sweden, Denmark, Norway and Iceland), it has become clear that there are different ways of collecting, analysing and presenting surveillance data. The methods used in one country are not the same as those used even in a neighbouring country.

There are differences between Russia and the other Baltic Sea States. It has been recognised in the Nordic countries that there is too little knowledge about the background of the Russian figures and about the Russian system of surveillance and epidemiology. It also seems probable that there is a corresponding deficit in knowledge on the Russian side about the different North European systems, especially since they are also among themselves quite diverse.

Lars Blad

The Task Force on Communicable Disease Control was established by the eleven Prime Ministers of the Baltic Sea Region in 2000. They agreed that a concerted effort in this field was needed. While tuberculosis and AIDS are of primary importance, antimicrobial resistance, vaccinations and concerns about how health care could be delivered were the basis for this initiative. Surveillance is a key tool in stopping outbreaks and minimising the spread of infectious disease. Comparable statistics and co-ordinated systems for registration and reporting are of great importance, if not essential, for effective international collaboration. It is our hope that this Task Force will advance common understanding, and accelerate approaches between nations in this field.

Ambassador Harald Siem, Head of Secretariat
Task Force on Communicable Disease Control in the Baltic Sea Region

Epidemics have threatened humanity throughout history. Despite progress in technology and medicine, the world has not become a safer place. Heightened communication between people and expanded international relations increase the risk of spreading infections, infections that do not know borders. Under these conditions, the best measure is to unite and co-ordinate efforts in the struggle against infections and factors that facilitate transmission including drug-use, illegal migration and environmental pollution. The present conference should be the beginning of our common effort against the spread of infections. It is necessary to work out a united strategy of prevention, to avoid duplication, to create a common program for information and complex programmes for surveillance and warning. I hope that the present conference will be a significant step in this direction.

V. I. Pokrovskij
President of the Russian Academy of Medical Science

Through the effort of the 11 Baltic Sea states, a task force for combating infectious diseases, the greatest threat to our countries, was formed in 2000 (Task Force). One of the highest priorities of the group is to work out a system of epidemiological surveillance for the most widespread and dangerous infectious diseases: tuberculosis, HIV-infection, sexually transmitted diseases, hospital infections and antibiotic resistance. However, the incidence-levels, registration systems, surveillance and programmes for prevention and information to the public are different in our countries. There is no doubt that these differences make it difficult to picture the true spread of infections and to define the most effective strategy to combat the challenge. International projects in addition to the organisation of conferences and meetings within the framework of the Council of the Baltic Sea States is the most rational step towards creating a united system of epidemiological surveillance for the whole region.

V.V. Maleev
Russian Representative to the Task Force CBSS