FUTURE Infectious Disease Threats to the European Union

Background: It is widely acknowledged that a range of factors associated with globalization and global change will affect communicable disease transmission patterns. Less studied is how these factors might combine to create new threats to public health.

Objective: To systematically identify principle drivers of communicable disease spread and then develop scenarios of how these drivers might interact to generate new threats to public health.

Methods: An expert workshop was used to flesh out disease drivers most important for the EU and to identify outlines of scenarios of disease spread in the year 2020. Subsequent literature reviews were used to substantiate and refine the scenarios.

Results: 12 principle drivers of communicable disease spread were identified, grouped under three headings: globalization and environmental change; social driving forces; and public health related forces (health systems and policies). Based on the potential interactions of these drivers, ten potential health threats facing the EU by the year 2020 were developed. Most prominent were antimicrobial resistance; the emergence of vector-borne diseases currently not in the EU; vaccination ‘fatigue'; an increase in food-borne infections; and the sustained potential for pandemic influenza.

Discussion: Understanding the underlying driving forces of communicable disease spread enables the development of scenarios on how future threats may evolve. Such activities are important for they shed light on current strengths and vulnerabilities within health systems while also drawing attention to the importance of upstream public health action focused on addressing the key drivers of disease, whether social inequalities, trade, environmental change or so on.