The European Centre for Disease Prevention and Control: Hub or Hollow Core?

Abstract

The European Centre for Disease Prevention and Control (ECDC) is the small agency established by the European Union (EU) to act as a hub for disease control, drawing on networks across the continent to achieve what other political systems do with large agencies. Despite this important task, the agency is largely unstudied. This article examines the ECDC from different angles, focusing on whether it can become the center of the networks that monitor, control, and prevent contagious diseases in Europe. The essay first retraces the events that led up to the ECDC's creation, focusing on the combination of policy debates about EU actions, political initiatives, and crises such as SARS that led to its creation. It then presents an overview of ECDC activities. The article concludes by examining the ECDC's prospects in light of its ability to secure its future through multiple political connections and a reputation for unique and useful advice. Insofar as it can do that, it will be able to contribute to the development of the EU and European public health.

Global health in the European Union – a review from an agenda-setting perspective

“…SARS not only provided an impetus to further coordinate national efforts in cross-border infectious disease control, it also heightened the understanding of a common vulnerability in the face of global health threats (20). Ultimately, SARS acted as a focussing event which not only led to the creation of the European Centre for Disease Control (21) and the revision and update of the International Health Regulations (22), but also led former Commissioner Byrne to push globalisation and health on the EU's agenda, whose high-level support was essential for the process. His emphasis on strengthening Europe's role in global health was announced not only shortly after the time of SARS, but also in the aftermath of the Iraq war, which had led to substantial global divisions politically.…”

Bricolage or Entrepreneurship? Lessons from the Creation of the European Centre for Disease Prevention and Control

“…In 1999 the Santer/Marin Commission's mandate came to term and Pádraig Flynn was replaced by David Byrne as the European Commissioner for Health and Consumer Protection. The literature on the ECDC underlines the role of the severe acute respiratory syndrome (SARS) crisis in the Commission coming to terms with the idea of an Agency (Greer 2012; Greer and Löblová 2016). However, the dates do not exactly add‐up.…”

“…The proposal did not retain key features of the suggested ECID such as financing and hosting research labs. The ECDC is not a European “CDC” based on the US model but a “hub” (Greer and Matzke 2012), a center that coordinates a network, composed of different authorities in charge of epidemiological surveillance in the EU. It retains all the existing features (including, for instance, the publication of Eurosurveillance) and is still based on the coordination and “synergies between the existing national centres for disease control” (European Commission 2003a).…”

“…The European Union (EU) has a long history of health crises (such as the Bovine spongiform encephalopathy or “mad cow” disease). Most pertinently perhaps, the creation of the European Centre for Disease Prevention and Control (ECDC) is often portrayed as the functional response to the severe acute respiratory syndrome (SARS) crisis that occurred between November 2002 and July 2003 (Greer 2012; Greer and Löblová 2016; McKee, Atun, and Coker 2008). This perspective on the importance of the crisis in the creation of the agency is often used to explain why such a short period was spent between the European Commission drafting a proposal to create the ECDC in July 2003 and the creation in situ of the agency in May 2005.…”

Institutional Resources for Communicable Disease Control in Europe: Diversity across Time and Place

“…The CDC's growth model has long been growth by acquisition -that is, integrating specific tasks (i.e., managing specific illnesses) either already established in the federal bureaucracy or easily justifiable as important new issues to be addressed (and funded). European institution building is facing a different situation: here the growth of EU-level capacities amounts to consolidation -that is, Europeanizing an infrastructure that is already established at the member state and the international levels (see Greer 2012;Krapohl 2008). One can expect "consolidation" to be fraught with more obstacles than "growth by acquisition" because its environment is a developed structure of actors, rules, and resource demands.…”