The world faces:

•- the emergence of new or newly recognized pathogens, such as the viruses causing severe acute respiratory syndrome (SARS) and avian influenza;

•- the recurrence of well-characterized outbreak-prone diseases: cholera, dengue, influenza, poliomyelitis, measles, meningitis, shigellosis and yellow fever; and

•- the accidental or deliberate release of biological agents (anthrax, prion diseases such as variant Creutzfeldt-Jakob disease - vCJD)

By the end of 2006, 2.44 million people were estimated to be living with HIV/AIDS in the 53 countries in the WHO European Region, most of them in eastern Europe and central Asia.

Every year, 69 000 people in the European Region die of tuberculosis (TB) and 450 000 people become infected. In eastern Europe, poor TB control practices result in nearly 70 000 cases of multidrug-resistant TB (MDR-TB) every year: the highest rate in the world. About half of these cases are resistant to all first-line anti-TB drugs. Some strains are also resistant to second-line drugs: so-called extensively drug-resistant TB (MDR-TB).

MDR-TB is reported to be increasing in eastern Europe, and causes concern about a future epidemic of virtually untreatable TB.

Poliomyelitis has been eradicated from the Region, and measles is targeted for elimination. This brings obvious benefits, but also exposes countries to risks, including the potential reintroduction of disease from an external source or the intentional release of pathogens. To achieve and maintain disease elimination or eradication, strong public health capacity in surveillance is required at the national and international levels.