VIIIth IEA Eastern Mediterranean Regional Scientific Meeting
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1 International Epidemiological Association VIIIth IEA Eastern Mediterranean Regional Scientific Meeting Globalization and Public Health in the EMR November 25-27, 2010 Crowne Plaza Hotel Beirut-Lebanon
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13 Communicable Disease Surveillance and potential for information exchange among Countries of the Mediterranean and Balkans participating to the EpiSouth Network Dr. Nada Ghosn & Dr. Valeria Alfonsi on behalf of the EpiSouth Network VIIIth IEA Eastern Mediterranean Regional Scientific Meeting November 25-27, 27, 2010 Beirut-Lebanon 1
14 The Mediterranean The countries of the Mediterranean region have common sea borders in the remarkable ecosystem of the Mediterranean Sea. As a result, they share common public health problems and threats and need to collaborate and exchange information to strengthen response capacity. 2
15 EpiSouth Network is a group of public health institutions with a shared purpose to tackle the main public health issues and communicable diseases in the Mediterranean and Balkans area. 3
16 Project history In occasion of the Year of the Mediterranean (2005), 6 European Public Health Institutes agreed to elaborate a framework of collaboration on In October 2006 the EpiSouth Project started with 9 European countries with a Grant Agreement with DG-Sanco In March 2007 countries from S.Europe, Balkans, N. Africa and Middle M East, together with WHO and EC met in Rome to elaborate a new partnership, thanks also to EC TAIEX support In June 2007 the Italian MOH made funds available for non-eu countries participation As per 2010, the EpiSouth Network is composed by: 27 Countries with w 71 Focal Points (MOH/PH Institute) and 4 Collaborating Institutions (ECDC, EC-DGSanco, WHO and Italian MOH) 4
17 Balkans and Mediterranean basin WHO Europe region: WHO-EURO (17/26): Albania, Bosnia and Herzegovina, Bulgaria, Croatia, Cyprus, France, Greece, Israel, Italy, Malta, Montenegro, Romania, Serbia, Slovenia, Spain, FYROM, Turkey Eastern Mediterranean region: WHO-EMRO (7/26): Egypt, Jordan, Lebanon, Morocco, Palestine, Syria, Tunisia Africa region: WHO-AFRO (1/26): Algeria European Commission: ECDC(9/26): Southern European Union Countries of Mediterranean: Bulgaria, Cyprus France, Greece, Italy, Malta, Romania, Slovenia, Spain European Neighborhood Policy (18/26): all EU plus Algeria, Egypt, Israel, Jordan, Lebanon, Morocco, Palestine, Syria, Tunisia Euro-Mediterranean Partnership (23/26): all EU plus Albania, Algeria, Bosnia, Croatia, Egypt, Israel, Jordan, Lebanon, Montenegro, Morocco, Palestine, Syria, Tunisia, Turkey 5
18 2010, partecipating Countries 6
19 Areas of activities (WPs) The project is composed by 8 Work Packages (WPs), each led by a PH Institution WP1 WP2 WP3 WP4 WP5 WP6 WP7 WP8 Coordination Dissemination Evaluation Network of PH Institutions Training Cross-border epidemic Intelligence Vaccine preventable diseases and migrant population Epidemiology and preparedness to cross border emerging zoonotic infections 7
20 Learning objectives and Methods Vaccine preventable diseases and migrant populations Pilot assessment of vaccine-preventable diseases and migrant populations in participating countries (with ad hoc structured questionnaire) On-line survey on countries migration status profile and vaccination access of mobile population A descriptive analysis of the communicable diseases surveillance systems of the participating countries 8
21 Results 19 Countries responded to the survey 9
22 50% of countries reported outbreaks occurring among mobile populations in their territory Results 10
23 Results Exchange of information on a citizen s s immunization status, as governed by each Country s s legislation, is allowed in 40% of responders among them one country only for public health reasons through confidential channels, another one if restricted to a confidential area. 11
24 Main findings All the Countries include, in their national surveillance system, the diseases for which vaccination is compulsory (polio, diphtheria, tetanus, pertussis, hepatitis B,TB) Not all countries have set up surveillance for measles and rubella (95%( and 90% respectively) Hepatitis A, invasive bacterial infections and chickenpox seem not to be a priority in many Countries 12
25 The present study is subject to several limitations The study does not explore the types of surveillance in place (if active, passive or sentinel), the components, goals and standards adopted and the different populations targeted It also may miss other aspects in function and organization that could affect surveillance, such as changes in the quality of human resources and adherence to treatment over time 13
26 In conclusion... Our study has shown surprisingly homogeneous communicable disease surveillance priorities in the EpiSouth region and that exchange of information to improve cross-border preparedness seems possible according the existing legislation 14
27 In conclusion... There is therefore space for collaborative mediterranean regional networks such as EpiSouth to conduct further studies in the field of communicable disease surveillance and response as this could provide: o a deeper understanding of the effects of the health system structure on different surveillance systems, o compare types of surveillance and o evaluate financial aspects such as funding and the relationship between public and private providers, and additional structure indicators. 15
28 16
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