Sexually transmitted infections (STIs) in Europe are a major public health concern. Untreated STIs can have serious short- and long-term consequences for the individual. Emerging health threats, in particular antimicrobial resistance; the facilitation of HIV transmission by STI co-infection; the driving of transmission by migration within and across EU borders; and the growing burden on curative services, make harmonisation of approaches to STI control across the EU an urgent priority.

Considerable variations exist in the structure and performance of current EU STI surveillance systems. Many EU countries have poorly developed STI surveillance systems. All countries need to share ideas to raise the quality of local systems and to commit to common case definitions and ways of working. There is therefore an urgent need for capacity building within the EU.

1. To operate and develop the ESSTI network with EU member states; EFTA-EEA; Romania, Bulgaria and Turkey
2. To collate, analyse and report surveillance data on the major acute STIs from participating countries
3. To extend ESSTI_ALERT, the European early warning system for STI outbreaks in Europe
4. To implement a European Gonococcal Antimicrobial Susceptibility Surveillance Project (Euro_GASP), including a quality assurance system, recommended methods, training programmes and molecular typing for outbreaks
5. To deliver training programmes on STI surveillance; lab diagnostics; and STI clinical management to network participants
6. To disseminate information to European policymakers; professionals and the public via the ESSTI website

• The ESSTI network was established in 2001 through funding from the European Commission’s Health and Consumer Protection Directorate-General (DG SANCO)

• ESSTI has instituted a collaborative partnership with the World Health Organization Regional Office for Europe

• ESSTI set up the EU STI outbreak early warning and response system, ESSTI ALERT, in April 2003. Data on STI incidents and outbreaks are immediately disseminated to our collaborators, and also collated into a quarterly feedback report

• ESSTI has completed a comprehensive review of EU STI surveillance systems. Results were presented at International Union against Sexually Transmitted Infections (IUSTI) congress in Uruguay in December 2003

• ESSTI has completed an EU-wide evaluation of laboratory methods for diagnosis of gonorrhoea, chlamydia and syphilis infections

• A panel exchange of N. gonorrhoeae isolates among 14 laboratories across Europe for quality assurance and antimicrobial susceptibility testing was undertaken in 2003.

Professor Catherine Ison is a non-clinical microbiologist. She is Director of the newly formed Sexually Transmitted Bacteria Reference Laboratory (STBRL) at the Specialist and Reference Microbiology Division of the Health Protection Agency (HPA). She is also a Visiting Professor of Investigative Science and Infectious Disease Epidemiology at Imperial College London.

Her main interests are the genetics of antimicrobial resistance and molecular epidemiology of gonorrhoea but she has also worked on bacterial vaginosis and Haemophilus ducreyi. In 1997 she initiated the London Gonococcal Surveillance Programme, which was extended nationally in 2000 (GRASP).

She was the founder of the Bacterial Special Interest Group of the Medical Society for the Study of Venereal Diseases (MSSVD, now the British Association for Sexual Health and HIV: BASHH) and is currently its chair. In her new role she plans to strengthen microbiology of STIs in England and Wales by providing a common focus for gonorrhoea, chlamydia and syphilis and establishing strong collaborations, of which the microbiology part of the ESSTI network is the first example.

Dr Gwenda Hughes is a Consultant Scientist in Epidemiology and is Head of STI Surveillance at the Centre for Infections (CfI) at the Health Protection Agency. She is Programme Manager to the HPA’s Sexual Health Programme Board and is an Honorary Senior Research Fellow at the Department of Primary Care and Population Sciences at University College London. She has recently become an associate editor of the journal, Sexually Transmitted Infections.

As Head of STI Surveillance at CfI, Gwenda takes lead responsibility for all aspects of national STI surveillance in England, directing the development of enhanced surveillance and new surveillance projects. She has particular interest in improving the quality of reporting of STIs across all clinical settings. She is also responsible for identifying and managing research to help direct sexual health policy and provides expert advice and information to Government bodies, public health specialists, clinicians, academic departments, the media and the public. Her research interests include STI diagnosis and management in general practice, gonorrhoea epidemiology and STI reinfection.