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Services for sexually transmitted infections in Europe and central Asia.

Without adequate surveillance it will not be possible to monitor the situation

Physicians in the affluent, industrialised countries of western Europe probably pay little attention to directives from the World Health Organization (WHO). They investigate and treat their patients as they see fit and they see little attraction, for instance, in the WHO’s advocacy of syndromic management for sexually transmitted infections (STIs).1 The WHO has a series of policies and principles in relation to STIs which cover prevention, control policies including surveillance and care programmes.2 However, knowledge about the state of affairs in relation to STIs is sketchy for most European countries and those of the central Asia republics, all of which come under the Regional Office for Europe in Copenhagen. There, an STI task force has been established to address the situation in eastern Europe and central Asia.

The paper by Dehne et al 3 in this issue of STI (380) is the first survey of these policies across the region. The authors used an adapted WHO model questionnaire which was sent to officials in ministries of health in all 46 countries of Europe and central Asia; 45 replied. This was part of ongoing efforts by the WHO/UNAIDS to survey the situation in all regions of the world.

Replies from officials in ministries of health, who are not involved usually at the clinical coalface, may not absolutely reflect the reality on the ground. Overall, however, the replies are likely to be reasonably consistent. The study was conducted in 1998 and it is a pity that there has been such a delay before publication. For instance, some countries now have national management guidelines, such as the United Kingdom,4 and the International Union against Sexually Transmitted Infections (IUSTI) and the WHO have produced model European guidelines.5 The …