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The Sigtuna Meeting: Combating infectious diseases in the Baltic sea and Barents regions

 Rediger
 1 Published: 30.05.05 Updated: 30.05.2005 10:39:47
Karl Ekdahl, Swedish Institute for Infectious Disease Control

Many regional activities have been initiated to address the growing problem of infectious diseases in the Baltic Sea and Barents regions. One such initiative was the successful meeting "Health in North-West Russia", organised by the University of Tromsø and University Hospital in November 1998. It was decided to hold a follow-up meeting in Stockholm in 2000. 

The Swedish Ministry for Foreign Affairs raised the issue of infectious diseases at the Ministerial Meeting of the Council of the Baltic Sea States (CBSS) in Palanga, Lithuania, in June 1999, and at the EU Ministerial meeting on the Northern Dimension in Helsinki in November 1999. The Swedish Institute for Infectious Disease Control (SMI) was commissioned by the Swedish Ministry for Foreign Affairs and the Ministry of Health and Social Affairs to convene an expert meeting to draw up recommendations on the control of infectious diseases for submission to the Governments of the CBSS member states.

The Expert Meeting held in Sigtuna, Sweden on 31 January - 2 February 2000, was thus the combined result of the two above-mentioned initiatives. The meeting was jointly organised by the Swedish Institute for Infectious Disease Control (SMI), the Swedish East Europe Committee, the Norwegian National Institute of Public Health and the University of Tromsø and University Hospital, and funded by the Swedish and Norwegian Governments.

The meeting

Leading national and regional experts on communicable disease control from Denmark, Estonia, Finland, Germany, Iceland, Latvia, Lithuania, Norway, Poland, Sweden, and the Russian Federation (the Arkhangelsk Region, the Murmansk Region, the Karelian Republic, the Leningrad Region, and St. Petersburg) participated in the meeting, as did observers representing the Swedish, Norwegian and Canadian Governments, the Barents Secretariat, the Finnish National Research and Development Centre for Welfare and Health (STAKES/ HEDEC), the World Health Organization (WHO), and the US Centers for Disease Control and Prevention (CDC).

The first part of the Expert Meeting took the form of a scientific seminar, with 28 short presentations providing an up-to-date background to the problem of communicable diseases as well as examples of successful regional collaborative projects. The second part of the meeting was devoted to the task of drafting the Expert Report. This was done in four workshops - on Tuberculosis, Sexually Transmitted Infections and HIV infection, Antibiotic Resistance and Vaccine-Preventable Diseases.

Recommendations from the different groups, as well as the background material at the meeting, have been compiled in an Expert report [1]. The report has been presented to the chief-of-states of the CBSS member states at a meeting held in Kolding, Denmark, in April.

Further initiatives

As a direct consequence of the discussions at the Sigtuna meeting, the Swedish Government has taken two initiatives. The first is to arrange a multi-sectorial conference later this year on preventing the spread of tuberculosis within and from the prisons in the region. The second initiative is an effort to compile a comprehensive catalogue of the different ongoing international collaborations on communicable disease control in the CBSS region. The issue will also be further addressed on a high political level, since the Kolding meeting resulted in the formation of a governmental CBSS task force against infectious diseases under Norwegian chairmanship.

References

  1. Ekdahl K (ed). The Sigtuna report: Combating infectious diseases in the Baltic Sea and Barents Regions. Report from an international expert meeting. Swedish Institute for Infectious Disease Control, Solna, 2000 (available at http://www.smi.ki.se/archive.asp?theSection=4 )

Recommendations by the Sigtuna Expert Meeting

General recommendations

The Expert Meeting recommends the Governments of the CBSS member states:

  1. to recognise that the sharp increase of infectious diseases is a major threat to public health in the region, with a potential of spread also to presently less affected countries;
  2. to recognise that the increase of communicable diseases is due to a combination of medical, economical and social factors, and that the prevention of further spread is the concern of the entire society and requires co-ordination between health services and other sectors;
  3. to recognise the urgent need to invest adequate resources to counteract further spread of infectious diseases and their impact on society;
  4. to support the national efforts to prevent and control infectious diseases, based on internationally (WHO) recommended strategies;
  5. to support international co-operation both as networks between institutions, and further actions within regional governmental bodies such as the CBSS and the BEAC, including partnerships with intergovernmental agencies and NGOs;
  6. to support comparability of surveillance data for infectious diseases in the region.

Recommendations on Tuberculosis

The Expert Meeting recommends the Governments of the CBSS member states:

  1. to consider the alarming situation of tuberculosis and MDR-TB in the region a major public health problem, and to ensure the implementation of effective tuberculosis control programmes taking into account international recommendations;
  2. to ensure that adequate resources are allocated to control tuberculosis, with special emphasis on preventing the development and spread of MDR-TB, in accordance with the epidemiological situation in the respective countries, especially in regard to high-risk groups such as prisoners, migrants and alcoholics;
  3. to enhance co-operation between responsible health services and the judicial system in order to improve tuberculosis control also in detention facilities and prisons.

Recommendations on Sexually Transmitted Infections (STI) and HIV infection

The Expert Meeting recommends the Governments of the CBSS member states:

  1. to establish special services for young people, aimed at prevention and reproductive health;
  2. to support the implementation of standardised methods for surveillance;
  3. to support the implementation of key elements of the UNAIDS strategy on STI and HIV prevention.

Recommendations on Antibiotic Resistance

The Expert Meeting recommends the Governments of the CBSS member states:

  1. to recognise that every country should develop a national strategy to prevent antibiotic resistance, including national antibiotic resistance surveillance;
  2. to establish guidelines for the prudent use of antibiotics in humans and animals;
  3. to facilitate the introduction of programmes for infection control in health care.

Recommendations on Vaccine-Preventable Diseases

The Expert Meeting recommends the Governments of the CBSS member states:

  1. to underline the importance of a high coverage of the general immunisation programmes;
  2. to ensure that in the absence of a high coverage, appropriate additional measures such as social mobilisation are taken to prevent outbreaks and epidemics;
  3. to further develop surveillance systems for vaccine-preventable diseases, built on reliable diagnostic methods, in order to make necessary corrections of the immunisation programmes in due time.

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