A Collaborative Approach to Strengthening Communicable Disease Surveillance

To establish a robust and effective communicable disease surveillance system, it is imperative to have a well-established and nationally standardized data collection system. All actors and jurisdictions involved in epidemiological surveillance must possess a clear understanding of what data to collect, in what format, and how to report it. Achieving standardization and harmonization of datasets, procedures, and protocols necessitates a consultative process involving epidemiologists, microbiologists, IT experts, and clinicians.

One of the initial tasks of the EU Twinning project "Strengthening the capacity of the Serbia's health sector for communicable disease surveillance" was to mobilize national expertise required to update the regulatory framework, guidelines, methodologies, procedures, quality standards, datasets, and case definitions for epidemiological surveillance.

On August 29, 2023, the Minister of Health of the Republic of Serbia, Prof. Dr. Danica Grujicic, signed decisions to establish two expert groups for the project: the Health Policy Working Group (formally titled as a special working group for the implementation of health policies defining  the concept of the framework of the national communicable disease surveillance and response system) and the Epidemiological Surveillance Working Group (formally titled as a special working group for the development and improvement of datasets and procedures in epidemiological surveillance data collection for the purpose of outbreak investigations and reporting in accordance with the requirements of EU/ECDC). These working groups have been formed for the duration of the project, with the overarching goal of extending their relevance and operation beyond the project's time limits and scope.

The expert groups have been tasked with providing guidelines for improving the communicable disease surveillance system in Serbia, analyzing the alignment of national legislation with the EU legal framework on communicable disease surveillance, developing recommendations for revising communicable disease surveillance laws and regulations, and creating methodological and technical documentation for communicable disease surveillance purposes.

The composition of these expert groups is truly interdisciplinary and includes experts from various fields such as microbiology, epidemiology, IT and clinical care. The expert groups encompass representatives from the Serbian Ministry of Health, the Institute of Public Health of Serbia "Dr Milan Jovanovic Batut" various public health institutes, national microbiology reference laboratories and clinics. Additionally, experts from the Finnish Institute of Health and Welfaрe (THL) are active members of these expert groups. The Health Policy Expert Group is chaired by Prof. Dr Verica Jovanovic, acting Director of the Institute of Public Health of Serbia "Dr Milan Jovanovic Batut" and the Epidemiological Surveillance Expert Group is co-chaired by Dr Vladan Saponjic and Assist. Prof. Dr Maja Stosic, both affiliated with the same institute.

The inaugural meeting of the expert groups occurred on September 25, 2023, at the Batut Institute. This introductory meeting aimed to facilitate introductions among participants, present the key objectives of the twinning project, share information about the roles and tasks, discuss priorities and major challenges in the surveillance of communicable diseases in Serbia and reach an agreement on work processes and next steps.

During their respective meetings, the Health Policy Expert Group addressed topics such as the aligning communicable disease surveillance regulations with relevant EU acquis, need for the One Health approach, appropriate prioritization processes, ensuring the involvement of biosafety and biosecurity measures and implementing EQA (External Quality Assurance) system in microbiological laboratories. In the Epidemiological Surveillance Expert Group meetings, subjects included the selection of diseases for surveillance, aligning relevant procedures with EU standards, coordinating and establishing timelines for enhancing the electronic surveillance system, implementing a clinical microbiology laboratory EQA system, methods for creating a network of National Reference Laboratories, and supporting the dissemination of existing guidelines.

The expert groups will convene at least once every three months, with most of their work carried out between these meetings by Serbian experts.