Sir

I read with interest the account of the meeting of the international board of advisers for the proposed European Centre for Infectious Diseases (ECID), held in Montpellier, France, in September (Nature 395, 106; 1998). Declan Butler's article raises a relevant point, which is the potential clash between the creation of a Europe-wide public health agency (focused on infectious diseases) and the reluctance of each nation to cede sovereignty over public health policy.

This question was discussed at length at the meeting. Dan Colley, head of the parasitic diseases division of the US Centers for Disease Control (CDC) and a member of the ECID board of advisers, stressed that a parallel with the CDC can be made. In the United States, health policy is the responsibility of each state. The CDC acts only as a coordinator, an adviser and a central data collector. The ECID could play a similar role in Europe, with health policy remaining under the sovereignty of each nation and the ECID providing complementary overall coordination.

The centre would build upon the many structures and initiatives that exist in Europe at national and international levels. However, it would create more efficient coordination at a global scale. This action should be extended to Eastern Europe and the former Soviet Union.

At the Montpellier meeting, a wall structure — where experts involved in research, surveillance and control of infectious diseases, and in training, would be concentrated in the same place — was considered by most to be more attractive, synergistic and effective than a simple network. This view was supported by those representing developing countries, and it was agreed that the central structure should be complemented by outstations, either in Europe or in developing countries. It was also decided to extend the board of advisers to welcome epidemiologists and public health practitioners. A steering committee has been designated, with myself as coordinator. The board and committee will prepare a project plan within six months.