Ministry of Health, Italy – EMERGE Consortium
Highly infectious diseases can spread rapidly across borders through travel or trade, and international coordination through networks like GloPID-R is essential to a prompt and efficient response by public health laboratories. Therefore, identifying resource allocation priorities for research and surveillance has been the focus of a large body of research in recent years.
EMERGE (Efficient response to highly dangerous and emerging pathogens at EU level), the European-wide consortium funded by the European Commission, set out to develop a strategy to prioritize pathogens with the aim of improving diagnostic capabilities for its three-year planning.
EMERGE’s Steering Committee (SC) is made up of representatives of the coordinators such as the Robert Koch Institute in Berlin and the ‘L. Spallanzani’ National Institute for Infectious Diseases in Rome, and other partner institutions in the United Kingdom, Sweden, France, the Netherlands, and Germany. The representatives worked together to develop an assessment method for prioritizing agents of highly infectious diseases. They developed a list of pathogens with the potential to cause cross-border outbreaks in Europe.
The approach used is based on an objective scoring system, a close collaboration with other networks dealing with highly infectious diseases, and a diagnostic gaps analysis. The results were discussed at length by SC members, representatives of the EC and the European Centre for Disease Prevention and Control (ECDC), in teleconferences and face-to-face meetings.
The pathogens chosen for the first year of activities were Crimean-Congo Hemorrhagic fever (CCHF), Lassa Haemorrhagic Fever virus, and Orthopoxviruses. Ebola was not considered an immediate urgency after the gaps analysis (many commercial kits are available or under development today), but will be re-evaluated annually during the course of the project. CCHF was the virus with the highest score and included as a priority for the 2016 activity planning. In a ‘One Health’ approach, Orthopoxviruses (Cowpox and Monkeypox) were also chosen (regardless of their relatively lower score) because of their presence in Europe and cross-border potential, and their relationship to the Smallpox virus, in order to improve the ability of European laboratories to deal with a possible bioterrorism event.
Compared to other more complex prioritization strategies, the EMERGE consortium used a pragmatic approach to produce a tool that is simple, objective and adaptable to changing circumstances. EMERGE is a large EC Health Programme-funded joint action that brings together about 40 nationally appointed BSL-3 and BSL-4 laboratories. The fact that the assessment and selection of pathogens will be repeated at least annually, together with the flexibility of the project (activities can be focused and funds shifted to accommodate changing demands), represents a step forward in the direction of a better response to infectious disease emergencies.