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The five Nordic countries (Denmark, Finland, Iceland, Norway and Sweden) have a long tradition of collaboration in communicable disease epidemiology and control. The state epidemiologists and the immunisation programme managers have met regularly to discuss common challenges and exchange experiences in surveillance and control of communicable diseases. After the three Baltic countries (Estonia, Latvia and Lithuania) regained independence in 1991 and the Soviet Union dissolved, contacts were made across the old iron curtain in several areas, such as culture, education, business, military and medicine. Each of the Nordic communicable disease surveillance institutes started projects with partners in Estonia, Latvia, Lithuania or the Russian Federation. The projects were in such diverse areas as HIV surveillance and prevention (1), vaccination programmes and antibiotic resistance. In the mid 1990s the Nordic state epidemiologists noted that there was duplication of efforts and only slow progress towards controlling communicable diseases in the region. Thus, to use the resources more efficiently and to improve the relationships with the Baltic partners, the state epidemiologists set out to co-ordinate their bilateral efforts. They felt that the Nordic network, which had worked so well, could easily be extended eastwards.


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