Foreword: Networking and Strengthening Health Communication in the European Union

The European Centre for Disease Prevention and Control (ECDC) is a relatively new agency that was created to strengthen the defenses of the European Union (EU) and its member states against infectious diseases. ¹ When the ECDC began in 2004 and 2005, member states already had obligations to alert each other to disease outbreaks that could spread to other EU countries and to share national data on key infectious diseases such as HIV/AIDS, tuberculosis, and influenza. During this period, I was Director-General of the National Institute for Public Health and the Environment (RIVM) in The Netherlands, as well as Chairman of the ECDC's Management Board. It was clear, in those early days, that the ECDC would significantly strengthen EU-level surveillance and assessment of infectious disease risks. It was much less clear to us, in those days, that the ECDC had a role in providing communication expertise. After all, communication is often very culture specific—so how can you provide EU-level expertise?

It quickly became evident, though, that many of the ECDC's national partners wanted it to provide expertise on communication. For example, in its early years, the ECDC did a lot of work on pandemic influenza preparedness. Many countries asked the ECDC for support in developing pandemic communication plans. As the ECDC began to analyze other key public health challenges in the area of infectious diseases, the importance of communication became increasingly clear: influencing people's behavior through communication was often a key element of the public health response.

I will give two examples of this. When we look at the growing resistance of many bacteria to the most widely used antibiotics, two of the main options to respond to this are (a) develop new antibiotics and (b) use the antibiotics we already have in a more effective way. Of course, both of these options need to be pursued. However, a good communication campaign that persuades health professionals and patients to use existing antibiotics more prudently can produce results relatively quickly and cheaply. Developing new antibiotics, in contrast, takes a long time and is costly. It is rather similar when we look at reducing morbidity and mortality from seasonal influenza. Developing new, more effective vaccines against seasonal influenza could make a real difference—and this is something I have urged the vaccine industry to invest in. However, in most EU countries, one could produce even bigger health gains with campaigns to increasing uptake of the existing seasonal influenza vaccines.

In June 2007, the Centre's Management Board endorsed a Strategic Multi-annual Programme for 2007–2013 that identified support to member states' health communication capacities as a priority. ² The articles in this special section in the Journal of Health Communication are, in many ways, the fruit of that decision. As the ECDC began developing its health communication program, two crucial questions came into focus: “What capacity do EU countries have already?” and “Which health communication interventions are likely to be effective in preventing and controlling infectious diseases?” In 2007 and 2008, we did not have enough evidence to give meaningful answers to those questions. Today, with the publication of this special section in the Journal of Health Communication, we have a rich evidence base and a unique analysis of the state of health communication in the EU.

Notes

¹For more information about the ECDC, visit http://www.ecdc.europa.eu.

²To see target 6.3 of the ECDC Strategic Multi-annual Programme 2007–2013, Stockholm, 2007, visit http://ecdc.europa.eu/en/aboutus/Key%20Documents/07-13_KD_Strategic_multi annual_programme.pdf.