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 Catherine Lowndes is a Consultant Scientist in Epidemiology in the Department of HIV and Sexually Transmitted Infections at the Health Protection Agency, and an Honorary Lecturer in the Department of Public Health and Policy at the London School of Hygiene and Tropical Medicine. She has been working with the ESSTI Network Project since its inception in 2002, firstly as Scientific Coordinator, and currently as Surveillance Lead.

In addition to STI surveillance, her main interests are in HIV/STI epidemiology and prevention, particularly among vulnerable populations in developing countries, and she has worked in Brazil, Canada, Russia, West Africa and India. She is currently Scientific Coordinator of the CHARME: CHA-Avahan (Gates Foundation HIV Prevention Programme in India) Research, Monitoring and Evaluation Project.