Digitalisation and COVID-19: The Perfect Storm.

"A ship in the harbour is safe, but that is not what ships are built for," observed that sage 19th century philosopher William Shedd. In other words, technology of high potential is of little value if the potential is not exploited. As the shape of 2020 is increasingly defined by the coronavirus pandemic, digitalisation is like a ship loaded with technology that has a huge capacity for transforming mankind's combat against infectious disease. But it is still moored safely in harbour. Instead of sailing bravely into battle, it remains at the dockside, cowering from the storm beyond the breakwaters. Engineers and fitters constantly fine-tune it, and its officers and deckhands perfect their operating procedures, but that promise is unfulfilled, restrained by the hesitancy and indecision of officialdom. Out there, the seas of the pandemic are turbulent and uncharted, and it is impossible to know in advance everything of the other dangers that may lurk beyond those cloudy horizons. However, the more noble course is for orders to be given to complete the preparations, to cast off and set sail, and to join other vessels crewed by valiant healthcare workers and tireless researchers, already deeply engaged in a rescue mission for the whole of the human race. It is the destiny of digitalisation to navigate those oceans alongside other members of that task force, and the hour of destiny has arrived. This article focuses on the potential enablers and recommendation to maximise learnings during the era of COVID-19.

Policies and actions to tackle rare diseases at European level.

Rare diseases (RDs) are defined by the European Union as life-threatening or chronically debilitating conditions, with a prevalence lower than 5 per 10 000 inhabitants. Around 6000 diseases are described, affecting between 6% and 8% of the European population. Due to their severity, diffusion and multi-faceted aspects, RD are an area where collaboration in public health, health care and research provides a major integrated added value. Main areas for policy actions include: the development and implementation of European Reference Networks, as a main strategy for sharing of knowledge, clinical expertise and foster research; integration of high-quality patient registries, biobanks, and bioinformatics support, as key infrastructure tools addressing research and healthcare needs; the implementation of National Plans on RD in EU Member States by sharing experiences, capacity building and linking national efforts through a common strategy at a European level; actions driven by the recommendations for primary prevention of congenital anomalies (the main RD group with multifactorial aetiology); policy provisions to foster research and development of orphan drugs.

Centres of Expertise and European Reference Networks: key issues in the field of rare diseases. The EUCERD Recommendations.

BACKGROUND: Rare diseases, because of their intrinsic characteristics - large number of disorders and syndromes, low individual prevalence, severity, often limited information, lack of therapies - can benefit from collaboration and sharing of expertise while maximising the limited resources available for these conditions. Therefore, the development of Centres of Expertise (CEs) and European Reference Networks (ERNs) in this field is crucial.The European Union Committee of Experts on Rare Diseases (EUCERD) has been charged to assist the European Commission with the preparation and implementation of activities in the field of rare diseases in Europe. In particular, EUCERD has assisted the EC in drawing up the recommendations issued in the Commission Communication and in the Council Recommendation. In this paper the authors focus on the EUCERD Recommendations on CEs and one on ERNs. MATERIALS AND METHODS: Recommendations on CEs and ERNs are the result of two different processes, developed through iterative reviews and discussions at workshops and EUCERD meetings, and according to the European Union documents. RESULTS: EUCERD has issued two complementary Recommendations, one on CEs (2011) and a second on ERNs (2013). Both address multiple targets (from Member States to Centres, and patient organisations), with the objective of helping them define and organise CEs and ERNs. CONCLUSIONS: The establishment, designation, financial support, and evaluation of CEs throughout Europe allow RD patients and local health care providers to identify high-quality specialised services that can simplify disease management and improve patients' care. The EUCERD Recommendations are useful instruments to help and guide stakeholders in the development of CEs and ERNs and thus ensure equity of access to services and care for rare diseases patients across Europe.