Combating the free movement of micro-organisms
http://www.100md.com
《英国医生杂志》
Zsuzsanna Jakab, the head of the new European centre for disease control, tells Rory Watson that the centre should enable Europe to mount a more coordinated response to the threat from avian flu than it managed to the SARS epidemic
The Stockholm based European Centre for Disease Prevention and Control (ECDC) is a rarity among the many specialised European Union agencies that give advice to policy makers. Legislation approving its creation was passed in a record eight months and the choice of the Swedish capital as its home was made without the national bickering that usually accompanies such decisions.
With the spread of avian influenza and the extra urgency that this has brought for the development of pandemic preparedness programmes, it now finds itself at the centre of attention within days of moving from temporary offices in a Stockholm suburb to a nearby university campus that also houses the Karolinska Institute and the Swedish Institute for Infectious Disease Control.
Zsuzsanna Jakab: "We have to have a much more coordinated and integrated approach" to threat from avian flu
Credit: PAWEL FLATO
Zsuzsanna Jakab, a Hungarian born health specialist who was appointed the centre's director last December, is coping with the managerial challenge she faces. "We have to build up the centre from scratch, because when I took up my job on 1 March this year, I was totally alone and had to launch a very active recruitment programme. This is going on and will be part of our plans for the next few years." By the end of the year, her team will have 54 members and she hopes that by 2008 the centre will be employing some 300 people.
At the same time, the ECDC—one of its earliest decisions was to adopt the short abbreviation rather than the more ponderous ECDPC—has to develop its policy programme. The centre's remit is to identify, assess, and communicate current and emerging threats to human health from infectious diseases such as influenza, HIV/AIDS, and SARS (severe acute respiratory syndrome), and from possible bioterrorist attacks.
Jakab has already indicated that in the future she sees a potentially wider role for the centre but only once it has fulfilled its present remit. "First, we must be absolutely rock solid on communicable diseases before we go any further. The reason I believe we should do more is that Europe has been very much directed towards the former Soviet Union and has no resources to invest in the European Union. Therefore, there is a gap. We can fill this gap, but we must build up gradually," she explains.
A decision on whether to broaden the ECDC's mandate could be taken in 2007 when EU governments and the European parliament review its current remit.
The centre's director is in no doubt that its work on pandemic preparedness can bring added value to public health policies in Europe. "We have to have a much more coordinated and integrated approach, because it was obvious during the SARS epidemic that every country responded in a different way. We need European guidelines for our response," she says. The ECDC has already shown what can be done by preparing guidelines for chicken workers working with affected animals and giving practical advice to travellers.
Jakab, aged 54, who has three grown-up children, is well qualified for the task ahead. She has a degree in public health and a masters degree in political and social sciences, as well as being fluent in Hungarian, English, Russian, and German. When she worked for WHO Europe, she spent most of her time in Copenhagen, but also travelled widely in central and eastern Europe.
Apart from ensuring that Europe can mount a coordinated response to threats such as bird flu, another consideration lies behind the centre's existence. "Public health issues have become much more global than ever before in the history of mankind. There is now free movement of micro-organisms around the world. You cannot protect European citizens if you operate only in the European Union, so we need an organisation that reaches out."
In the front line are countries on the union's borders—the Ukraine, Belarus, Russia, and Moldova, followed by the central Asian republics and the Caucasus. The centre has already sent teams to Greece, Turkey, Poland, Ukraine, Kazakhstan, and the United Kingdom to discover their degree of pandemic preparedness ( BMJ 2005;331: 922, 22 Oct).
But Jakab has even further horizons. In early October, she visited Asia and would now like to see the European Union have a greater input into public health policy in South East Asia, just as the United States has begun to do.
Within Europe, the ECDC, which has no laboratories or medical facilities of its own, is building up a network of scientists and research institutes that can be associated with its work. It has already agreed a memorandum of understanding with WHO Europe and intends to develop strategic partnerships with other organisations. "We cannot operate in a vacuum. We need links to science, to research, and existing centres of excellence. It is not enough to communicate with politicians. We need to address the media and the general public," explained the centre's director.
Jakab brings extensive national and international experience to the centre. She worked as a director for WHO Europe for 11 years before being invited by the Hungarian government in 2002 to become the top civil servant in her country's health ministry.
At the WHO, she was responsible for preparing all the meetings of the European organisation's governing bodies and ensuring that their decisions were implemented. She collaborated closely with 52 countries and, in 1992, was placed in charge of an intensive health programme for central Europe and the new independent states.
She draws one clear lesson from that experience: "Building a relationship of trust with member states is absolutely vital. Without that, you cannot operate health is a national responsibility. You have to honour countries' mandates. So, if there is a problem you can pick up the phone, if you have trust then the mandate does not matter."
She admits that she was taken by surprise when the Hungarian government asked her to return to Budapest as secretary of state in the health ministry. "It is rare to be asked to go home if you work abroad," she says with a smile. But she accepted the call and had a leading role in ensuring the proper implementation of European Union legislation and administering EU funding. She also managed the country's public health programme, introducing broad population based screening programmes for diseases such as breast cancer.(Rory Watson)
The Stockholm based European Centre for Disease Prevention and Control (ECDC) is a rarity among the many specialised European Union agencies that give advice to policy makers. Legislation approving its creation was passed in a record eight months and the choice of the Swedish capital as its home was made without the national bickering that usually accompanies such decisions.
With the spread of avian influenza and the extra urgency that this has brought for the development of pandemic preparedness programmes, it now finds itself at the centre of attention within days of moving from temporary offices in a Stockholm suburb to a nearby university campus that also houses the Karolinska Institute and the Swedish Institute for Infectious Disease Control.
Zsuzsanna Jakab: "We have to have a much more coordinated and integrated approach" to threat from avian flu
Credit: PAWEL FLATO
Zsuzsanna Jakab, a Hungarian born health specialist who was appointed the centre's director last December, is coping with the managerial challenge she faces. "We have to build up the centre from scratch, because when I took up my job on 1 March this year, I was totally alone and had to launch a very active recruitment programme. This is going on and will be part of our plans for the next few years." By the end of the year, her team will have 54 members and she hopes that by 2008 the centre will be employing some 300 people.
At the same time, the ECDC—one of its earliest decisions was to adopt the short abbreviation rather than the more ponderous ECDPC—has to develop its policy programme. The centre's remit is to identify, assess, and communicate current and emerging threats to human health from infectious diseases such as influenza, HIV/AIDS, and SARS (severe acute respiratory syndrome), and from possible bioterrorist attacks.
Jakab has already indicated that in the future she sees a potentially wider role for the centre but only once it has fulfilled its present remit. "First, we must be absolutely rock solid on communicable diseases before we go any further. The reason I believe we should do more is that Europe has been very much directed towards the former Soviet Union and has no resources to invest in the European Union. Therefore, there is a gap. We can fill this gap, but we must build up gradually," she explains.
A decision on whether to broaden the ECDC's mandate could be taken in 2007 when EU governments and the European parliament review its current remit.
The centre's director is in no doubt that its work on pandemic preparedness can bring added value to public health policies in Europe. "We have to have a much more coordinated and integrated approach, because it was obvious during the SARS epidemic that every country responded in a different way. We need European guidelines for our response," she says. The ECDC has already shown what can be done by preparing guidelines for chicken workers working with affected animals and giving practical advice to travellers.
Jakab, aged 54, who has three grown-up children, is well qualified for the task ahead. She has a degree in public health and a masters degree in political and social sciences, as well as being fluent in Hungarian, English, Russian, and German. When she worked for WHO Europe, she spent most of her time in Copenhagen, but also travelled widely in central and eastern Europe.
Apart from ensuring that Europe can mount a coordinated response to threats such as bird flu, another consideration lies behind the centre's existence. "Public health issues have become much more global than ever before in the history of mankind. There is now free movement of micro-organisms around the world. You cannot protect European citizens if you operate only in the European Union, so we need an organisation that reaches out."
In the front line are countries on the union's borders—the Ukraine, Belarus, Russia, and Moldova, followed by the central Asian republics and the Caucasus. The centre has already sent teams to Greece, Turkey, Poland, Ukraine, Kazakhstan, and the United Kingdom to discover their degree of pandemic preparedness ( BMJ 2005;331: 922, 22 Oct).
But Jakab has even further horizons. In early October, she visited Asia and would now like to see the European Union have a greater input into public health policy in South East Asia, just as the United States has begun to do.
Within Europe, the ECDC, which has no laboratories or medical facilities of its own, is building up a network of scientists and research institutes that can be associated with its work. It has already agreed a memorandum of understanding with WHO Europe and intends to develop strategic partnerships with other organisations. "We cannot operate in a vacuum. We need links to science, to research, and existing centres of excellence. It is not enough to communicate with politicians. We need to address the media and the general public," explained the centre's director.
Jakab brings extensive national and international experience to the centre. She worked as a director for WHO Europe for 11 years before being invited by the Hungarian government in 2002 to become the top civil servant in her country's health ministry.
At the WHO, she was responsible for preparing all the meetings of the European organisation's governing bodies and ensuring that their decisions were implemented. She collaborated closely with 52 countries and, in 1992, was placed in charge of an intensive health programme for central Europe and the new independent states.
She draws one clear lesson from that experience: "Building a relationship of trust with member states is absolutely vital. Without that, you cannot operate health is a national responsibility. You have to honour countries' mandates. So, if there is a problem you can pick up the phone, if you have trust then the mandate does not matter."
She admits that she was taken by surprise when the Hungarian government asked her to return to Budapest as secretary of state in the health ministry. "It is rare to be asked to go home if you work abroad," she says with a smile. But she accepted the call and had a leading role in ensuring the proper implementation of European Union legislation and administering EU funding. She also managed the country's public health programme, introducing broad population based screening programmes for diseases such as breast cancer.(Rory Watson)